Help New Dibetic Cat

[Ricky Jones]

Hello all My Cat Snow is 12 years old and has been diagnosed with diabetes. When I first took him in his BG level was 400 I changed his diet from dry food to 2 3oz cans of wet fancy feast food per day which brought his BG down to 300. The vet put him on 2 shots of insulan per day 3 units per shot. I took him back today 1 week from starting the insulin and his BG was low at 44 maybe even lower because I know cats get stressed going to vet. could anyone please give me advice on what I should do next ? I work 10 hour days and it scares me to give snow a shot before work and think his BG level may drop to low and me not be home.

 

[Julie and Honey]

Hi Ricky,

Welcome to you and Snow! Good you are on low carb food, that is a great start. It is overwhelming and a lot to take in, but you will find a great support system here.

44 is very low and normally cats sugar goes up at vet, so that is concerning. Did vet give any glucose when seeing this number, recommend a reduction, etc?

Are you testing Snow’s blood sugar at home? What type of insulin are you giving?

Also good to have a “hypo” kit at home in case of emergencies. High carb food, Karo syrup, etc.

3 units 2 x a day sounds like a very high starting dose, especially if you were starting with a BG at 300 (which may have been higher than actual if this number was taken at vets, due to stress) and on low carb, but not knowing all the other factors, it is hard to say.

If you are gone 10 hour days, it is important to be testing before giving a shot so you can have better control over Snow’s levels when you are gone. You may have seen automatic feeders for wet food, which can be set to feed the cat during the day when you are gone, it is important to help with their blood sugar swings during the time you are away. Once we know more about which insulin we can help more with that, some insulins are slower to start than others and would affect when the cat needs food to help keep blood sugar at a safer level.

A good start for us to offer some help would be if you can create a signature with your cats details that would help and it will show up with each of your posts and we won't have to keep asking the same questions.

Here's how:
click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what (s)he eats/any other meds or health issues (s)he has. You can add your name, and a geographic location (sometimes the time zone matters) Be sure to SAVE when you are finished.

Also for testing we use a spreadsheet here to record the insulin and testing data to see how the insulin is affecting our kitties. Then we can take a look at it before offering any suggestions or advice. See link below.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

 

[Ricky Jones]

Hi Ricky,

Welcome to you and Snow! Good you are on low carb food, that is a great start. It is overwhelming and a lot to take in, but you will find a great support system here.

44 is very low and normally cats sugar goes up at vet, so that is concerning. Did vet give any glucose when seeing this number, recommend a reduction, etc?

Are you testing Snow’s blood sugar at home? What type of insulin are you giving?

Also good to have a “hypo” kit at home in case of emergencies. High carb food, Karo syrup, etc.

3 units 2 x a day sounds like a very high starting dose, especially if you were starting with a BG at 300 (which may have been higher than actual if this number was taken at vets, due to stress) and on low carb, but not knowing all the other factors, it is hard to say.

If you are gone 10 hour days, it is important to be testing before giving a shot so you can have better control over Snow’s levels when you are gone. You may have seen automatic feeders for wet food, which can be set to feed the cat during the day when you are gone, it is important to help with their blood sugar swings during the time you are away. Once we know more about which insulin we can help more with that, some insulins are slower to start than others and would affect when the cat needs food to help keep blood sugar at a safer level.

A good start for us to offer some help would be if you can create a signature with your cats details that would help and it will show up with each of your posts and we won't have to keep asking the same questions.

Here's how:
click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what (s)he eats/any other meds or health issues (s)he has. You can add your name, and a geographic location (sometimes the time zone matters) Be sure to SAVE when you are finished.

Also for testing we use a spreadsheet here to record the insulin and testing data to see how the insulin is affecting our kitties. Then we can take a look at it before offering any suggestions or advice. See link below.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Oh thank you for your reply he is on the Novlan N 3 units twice a day. Hes only been on for 1 week and yes I thought the same thing it was probley lower than 40 with stress at vet. I dont have a BG tester at home and vet told me not to change anything just bring home and feed him. I'm very concerned about keeping giving him the same amount.

 

[Julie and Honey]

@MrWorfMen's Mom
@Squeaky and KT (GA)
@Elizabeth and Bertie


I have copied some members that I believe are more knowledgable about Novalin to get you headed in the right direction. Everyone here are volunteers and they may not respond immediately. I am trying to find someone to help ASAP with advice.

Did Snow get insulin this morning? What has been done since 44 reading today at vet, just fed regular low carb? Do you have any high carb wet food like Fancy Feast or Friskies with gravy? Gravy has high carbs. Any honey or Karo syrup at home just in case?

 

[Idjit's mom]

Hi and welcome Ricky and Snow. Julie gave you some good pointers and I am going to add my personal opinion that your vet's advice is not complete. "I dont have a BG tester at home and vet told me not to change anything just bring home and feed him."
Not all vets are knowledgeable or experienced with feline diabetes.
From the Beginner's Guide to Novolin:
A number of different insulins can be used in cats. They work in slightly different ways. They are almost always injected twice a day (every 12 hours).
In cats, N/NPH tends to be a faster-acting insulin, often with a rapid ‘onset’ and a short ‘duration’. It may not last in the system a full 12 hours. Some cats only get around 8 hours duration. How long it lasts depends on the individual cat: as we often say around here, Every Cat Is Different (ECID).
N/NPH can start acting quite soon after it’s injected, and it can drop the blood glucose very steeply in the first hours of the insulin cycle. It is therefore very important that the caregiver learns to test the cat's BG at home (‘home test’) as soon as possible, and becomes familiar with the effects of N/NPH in their cat’s system.

You may want to explore using a longer lasting more mild insulin for Snow in future.

The best way to keep Snow safe and see how low that blood sugar level is going is for you to test at home before every shot and then the best you can during the cycle between shots.

• Buy a human glucose meter ASAP. Choose one that gives a reading with only a tiny blood drop and has (relatively) cheap test strips because that's where the home testing cost is. The ReliOn Prime at Walmart does require a larger blood drop, but it's very affordable, the strips are affordable and very accessible.
• Learn to home test right away. This is useful: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/ Buy some larger gauge lancets (26 - 28 gauge) to make it easier to get blood.
• Set up the spreadsheet we use here so we can see the test results and give you the best advice.
  http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
• Please consider dropping the dose to 1 unit twice a day so Snow isn't experiencing a drastic drop in blood sugar then a going to a very high number because his body is releasing stored sugars to compensate. Then when you test you can see if that dose is enough or not. (I understand the concern with Snow going too low when you are not there to help him)
• Read this great guide to using Novolin. It was put together by people knowledgeable in its use. http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-novolin-humulin-nph.186097/

• Follow this basic home testing routine as closely as you can:

1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
3. do extra tests on days off to fill in the response picture
4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
5. post here for advice whenever you're confused or unsure of what to do.

Snow is unregulated at this point, and you want to be sure he has enough food. His body isn't able to process food as it should right now, and he is probably feeling very hungry with only 2 3oz. cans of food a day. Sugar cats do better with more frequent smaller meals. If you don't have a timed feeder, freeze some wet food in ice cube trays and leave some out to thaw that he can nibble on while you are at work or during the night.

 

[Ricky Jones]

@MrWorfMen's Mom
@Squeaky and KT (GA)
@Elizabeth and Bertie


I have copied some members that I believe are more knowledgable about Novalin to get you headed in the right direction. Everyone here are volunteers and they may not respond immediately. I am trying to find someone to help ASAP with advice.

Did Snow get insulin this morning? What has been done since 44 reading today at vet, just fed regular low carb? Do you have any high carb wet food like Fancy Feast or Friskies with gravy? Gravy has high carbs. Any honey or Karo syrup at home just in case?

Yes he had his insulin shot this morning before vet. Then I came straight home fed him another can of low carb food and gave him some treats I do have Karo syrup on hand and I have his purina hard food but hes not had it in over a week. His walking and jumping and water intake has improved. But that was also improving once he went on diet without insulin. Is it possiable the vet has prescribed to much of a dosage for snow?

 

[Ricky Jones]

are you saying I should not feed him 2 hours before his injection ?

 

[MrWorfMen's Mom]

Hi and welcome to you and Snow.

I was hoping the vet took some action (glucose drip) when Snow had a BG of 40 at the vet's office today it sounds like that might not be the case. How long after this morning's shot was that 40 reading? What did the vet do/advice?

The 3u dose of Novolin is definitely too high and frankly that is a very high dose for any newly diagnosed cat. That said, after that low reading today, Snow may be even more sensitive to insulin following that extremely low BG so I suggest you skip giving any insulin tonight. Novolin hits hard and fast and can drop BG significantly and quickly within the first couple of hours post shot.

I assume you are not home testing Snow. Home testing is the only way you are going to be able to monitor Snow and keep him safe. I notice you switched Snow's diet from dry to Fancy Feast after getting the FD diagnosis. The diet change alone reduces BG in the majority of cats and in some cases actually puts the cat into remission. While his BG may have been 400 when diagnosed, that reading as you know may have been elevated due to stress alone and that elevation could have been as much as 100 or more points so Snow's BG may not have been nearly as high as the vet assumed. Now with the diet change, you have no idea what Snow's BG is under normal circumstances on the new diet. Only by home testing can you deal with giving insulin shots safely to avoid low readings such as was the case today at the vet.

We can help you learn how to test Snow and if you are interested, then a quick trip to Walmart ASAP for a Relion meter and some lancets would be a really good idea as mentioned by Idjit's Mom. You might want to make sure you have some higher carb wet food available. Fancy Feast Gravy Lovers is a good option.

Going forward, I would strongly recommend you start home testing and do so before giving Snow any more insulin. Without knowing what Snow's BG is at shot time, you are shooting blindly and the diet change may have lowered his BG enough that giving insulin could be dangerous even at a lower dose.

 

[Julie and Honey]

are you saying I should not feed him 2 hours before his injection ?

2 hours is before blood test to get accurate reading, then shot and feed right after shot..

 

[Idjit's mom]

It is very possible that the dose is too high. That's why Julie tagged more experienced members to take a look and advise.
It is recommended not to feed 2 hours before the pre-shot tests, so the result is not food influenced.

 

[Ricky Jones]

are you saying I should not feed him 2 hours before his injection ?

Hi and welcome to you and Snow.

I was hoping the vet took some action (glucose drip) when Snow had a BG of 40 at the vet's office today it sounds like that might not be the case. How long after this morning's shot was that 40 reading? What did the vet do/advice?

The 3u dose of Novolin is definitely too high and frankly that is a very high dose for any newly diagnosed cat. That said, after that low reading today, Snow may be even more sensitive to insulin following that extremely low BG so I suggest you skip giving any insulin tonight. Novolin hits hard and fast and can drop BG significantly and quickly within the first couple of hours post shot.

I assume you are not home testing Snow. Home testing is the only way you are going to be able to monitor Snow and keep him safe. I notice you switched Snow's diet from dry to Fancy Feast after getting the FD diagnosis. The diet change alone reduces BG in the majority of cats and in some cases actually puts the cat into remission. While his BG may have been 400 when diagnosed, that reading as you know may have been elevated due to stress alone and that elevation could have been as much as 100 or more points so Snow's BG may not have been nearly as high as the vet assumed. Now with the diet change, you have no idea what Snow's BG is under normal circumstances on the new diet. Only by home testing can you deal with giving insulin shots safely to avoid low readings such as was the case today at the vet.

We can help you learn how to test Snow and if you are interested, then a quick trip to Walmart ASAP for a Relion meter and some lancets would be a really good idea as mentioned by Idjit's Mom. You might want to make sure you have some higher carb wet food available. Fancy Feast Gravy Lovers is a good option.

Going forward, I would strongly recommend you start home testing and do so before giving Snow any more insulin. Without knowing what Snow's BG is at shot time, you are shooting blindly and the diet change may have lowered his BG enough that giving insulin could be dangerous even at a lower dose.

It was 3 hours after snow ate and the injection. His advice was for to continue to do the same thing I'm doing and feed him a can of food when I got home. I knew that was non sence because if I do the same thing I'm doing now I could kill snow if his BG keeps dropping. Yes I had planned on skipping shot tonight and I'll be on my way to Walmart first thing in the morning to get the test kit. Will need your guys help to teach me. where is this located in Walmart pet section or medical supplies?

 

[MrWorfMen's Mom]

Go to the pharmacy. They may have the kits on the shelf or behind the counter....not sure how they do it in the US.

You are right to be concerned about your vet. It's absolutely ridiculous to suggest continuing the same dose with a BG that low. Did the vet check Snow's BG with a hand held glucometer or did they draw blood? If it was a handheld glucometer what colour was it? (Dusty pink colour by any chance) Just wondering if that 44 was taken on a human or pet meter or is a lab value. Pet meters and lab values are higher than human meter readings and some vets do use human meters.

 

[Idjit's mom]

The ReliOn Prime meters, strips and the lancets are in the human diabetic section of the Pharmacy. Get a bag of cotton balls to back the ear when you "poke", and protect your finger, then use it to press gently on the poke site after you get the reading on the meter. It helps prevent bruising. A tube of Equate or Neosporin pain relieving ointment (not cream) can be applied before the poke to help the blood bead up and/or after to relieve any discomfort.
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

 

[Julie and Honey]

Also pick up some

The ReliOn Prime meters, strips and the lancets are in the human diabetic section of the Pharmacy. Get a bag of cotton balls to back the ear when you "poke", and protect your finger, then use it to press gently on the poke site after you get the reading on the meter. It helps prevent bruising. A tube of Equate or Neosporin pain relieving ointment (not cream) can be applied before the poke to help the blood bead up and/or after to relieve any discomfort.
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Don’t forget the lancets which will be right there. You can get a lancet pen or free hand poke, a kit may include a lancet device and starting supply of lancets.

Also some low carb treats are good to teach testing, freeze dried chicken or salmon are good.

This will take some patience on your part until cat gets used to it, look over some tips provided above before starting. If you are holding off on insulin, which seems prudent until able to test, give the cat time to get used to testing.

 

[MrWorfMen's Mom]

Idjit's Mom has given you a good shopping list but I'll add one more to that list .....get lancets that are 26 or 28 gauge. The meter may come with a few but they may be higher gauge (thinner needle) and therefore will make getting a blood sample a bit more difficult in some cats.

Another question before your shopping trip.......do the syringes you have been using have half unit markings? If not, I would strongly suggest you pick up a supply of syringes that have half unit markings. We usually adjust insulin dose in 0.25u increments and those half unit markings make it so much easier to do so.

 

[Idjit's mom]

Also pick up some


Don’t forget the lancets which will be right there. You can get a lancet pen or free hand poke, a kit may include a lancet device and starting supply of lancets.

Also some low carb treats are good to teach testing, freeze dried chicken or salmon are good.

This will take some patience on your part until cat gets used to it, look over some tips provided above before starting. If you are holding off on insulin, which seems prudent until able to test, give the cat time to get used to testing.

Good reminder about the treats/rewards. I forgot
Ricky, if you don't find commercial low carb treats right away, you can use small pieces of boiled chicken before and after testing. Idjit loves chicken breast, so I pressure cook a couple of breasts, cool, slice and freeze in freezer bags. That way we always have a supply and it's inexpensive and readily available.

 

[Kris & Teasel]

!! I'm so glad these members were here to help you.

 

[MrWorfMen's Mom]

commercial low carb treats

Add these onto your Walmart shopping list. They should have some freeze dried chicken treats in the dog aisle. It's cheaper to buy the dog sized treats and break them into kitty size pieces.

Your homework for today/tonight.....play with Snow's ears every time you pet him to get him used to you fussing with them.

 

[Ricky Jones]

Go to the pharmacy. They may have the kits on the shelf or behind the counter....not sure how they do it in the US.

You are right to be concerned about your vet. It's absolutely ridiculous to suggest continuing the same dose with a BG that low. Did the vet check Snow's BG with a hand held glucometer or did they draw blood? If it was a handheld glucometer what colour was it? (Dusty pink colour by any chance) Just wondering if that 44 was taken on a human or pet meter or is a lab value. Pet meters and lab values are higher than human meter readings and some vets do use human meters.

I really don't know what he used this is the first time they dident take me back with snow. The tech came and got snow and said they would be right back and snow was gone for about 5 mins and that's when she came out and told me about the 44 BG and to take snow home and feed him. The Vet just called back and said only give snow 3 units of insulin at his biggest meal once a day so he dropped 2 doses to 1 dose but I'm still concerned and will skip injection tonight until I get meter and then i think I'll start at 1 unit and go from there. because snow showed a great deal of improvement on diet change alone. I wish I had known cats could get diabetes. but I was younger when I got him and had no clue.

 

[Richard P]

Hang in there. My boy Big is new to this as well. He’s had all sorts of problems but is a fighter. Lucky the Novolin is working. Mine didn’t react to it at all. Is now on Lantus. I hope to see a change. Like you I’m away at work for long hours. I travel far just to get to work. Difficult to test the way many do on this forum. I was terrified of testing and he hides on me all the time. Finally getting readings. The people who are helping you helped me and are still, Big still doesn’t have good numbers yet.

This is the thing. I’ve been trying to do the impossible because Big means so much to me. I get upset, stressed, angry and depressed. Sometimes within minutes of each other. Do the best you can. Try to be kind to yourself. Be forgiving because you will need that. Give the shots on a time table that you can. Mine are close to 12 hours apart but not exact. It’s physically impossible for me to test 2 hours before I give him a shot or feed him. Just do the best you can. That’s all you can do.

 

[MrWorfMen's Mom]

None of us can foresee the future. You took Snow to the vet and are now treating him which is far more than a lot of kitties get. This can be a bit of steep learning curve but we will do whatever we can to assist you to keep Snow safe and get better regulated.

I am shocked at the vet's lack of concern with a BG that low. Taking Snow into the back suggests they likely drew blood and ran it through a lab machine. There would be no need to take him out of the exam room to do a quick glucometer test. I hate to beat up vets but yours is not knowledgeable about feline diabetes and seemingly doesn't recognize or know how to treat seriously low BG unless they gave him some oral glucose in the back room before sending him home with you to be fed. I have to wonder though why they wouldn't have told you if that's what they did. The idea that they want you to continue to give the same dose is terrifying. It doesn't even seem they understand how insulin works because insulin once a day does not work in cats. Novolin is an "in and out" type of insulin and often doesn't last a full 12 hours in cats. cats have a fast metabolism and require twice daily shots even when long acting insulin is used.

How is Snow acting now? He may be a bit lethargic from the ups and downs in his BG. If he is hungry, feed him. A little more caution is going to be required with the insulin at this point in time.

I would NOT give insulin again until you can get the testing supplies and get a BG reading tomorrow. I am seriously concerned that the diet has lowered his BG and you need to check his BG to make sure it is safe to give ANY insulin. It is important to note that you will want to get a BG test that is not food influenced before any insulin shots. That means you withhold food for at least 2 hours before testing prior to administering insulin. Let's see if we can get you testing tomorrow, determine a baseline and then we can revisit the question of insulin dose.

 

[Idjit's mom]

Hang in there. My boy Big is new to this as well. He’s had all sorts of problems but is a fighter. Lucky the Novolin is working. Mine didn’t react to it at all. Is now on Lantus. I hope to see a change. Like you I’m away at work for long hours. I travel far just to get to work. Difficult to test the way many do on this forum. I was terrified of testing and he hides on me all the time. Finally getting readings. The people who are helping you helped me and are still, Big still doesn’t have good numbers yet.

This is the thing. I’ve been trying to do the impossible because Big means so much to me. I get upset, stressed, angry and depressed. Sometimes within minutes of each other. Do the best you can. Try to be kind to yourself. Be forgiving because you will need that. Give the shots on a time table that you can. Mine are close to 12 hours apart but not exact. It’s physically impossible for me to test 2 hours before I give him a shot or feed him. Just do the best you can. That’s all you can do.

@Richard P you just need to withhold food for 2 hours before testing, shooting, feeding. Not test 2 hours before shooting, feeding..

 

[AmandaE]

The Vet just called back and said only give snow 3 units of insulin at his biggest meal once a day so he dropped 2 doses to 1 dose but I'm still concerned and will skip injection tonight until I get meter and then i think I'll start at 1 unit and go from there. because snow showed a great deal of improvement on diet change alone. I wish I had known cats could get diabetes. but I was younger when I got him and had no clue.

I'm in a similar boat to you. My first vet prescribed a large dosage for Mowgli (5u Caninsulin 2x/day), and I work 10 hrs away from home. Once I did some research online and through this forum, I backed off the Caninsulin dosage to 1u 2x/day. I set my dosage schedule up to be 6am/6pm because I basically live that schedule Mon-Fri, I am often slow getting up in the mornings and as I adjust to my new schedule I am tired at work, my weekends will suffer, but it's definitely worth it for Mowgli to get better. I think that having a long work day is the toughest part about trying to manage a diabetic cat, especially with a hard hitting insulin like Caninsulin or Novolin, when you can't be there to ensure that your cat will eat enough in the morning to manage the insulin you administer.

I ended up switching vets and my new vet recommended switching Mowgli to Lantus, (as did a few members on this forum) this is because Lantus has a slower onset so you don't have to worry as much about being there to monitor the cat after his shot, and you can leave food out since with proper dosage there is less of a risk that your cat will go Hypo. This may be an option that you might like to discuss with your vet, since you're away for 10 hour days. Right now Mowgli has been on 1u 2x/day but as his BG has not really decreased by much I will be trying a 0.25u increase this weekend. I am currently also considering a timed feeder since Mowgli is basically ravenous right now since he cant control his BG and it's a one cat stampede any time I feed him now.

I can't offer too much advice since I'm also new to the cat diabetes world but, I can let you know that I am in a similar situation to you and that I believe that in the end we will be able to turn our cat's health around! In the mean time, there are SOOOO many super experience people on this forum that will arm you with the tools you need to gain confidence and turn Snow's life around!

 

[Squeaky and KT (GA)]

I apologize, I just now got this tag - my little ISP is awful.

A vet that gets a 44 at his office and just tells you to take him home and feed him doesn't understand even NPH enough to be using it to dose anything! Heck, that advice is awful even if using vetsulin, an even faster driving insulin. They should have done something right then to at least raise that number a bit instead of waiting for you to go home. You've got lots of good advice already, nothing I can really add that hasn't been brought up. I started on NPH many years ago, moved to Lantus and have used Levemir for the last 4 years and MUCH prefer it to any other.

Testing at home is SO important - I'm thankful to see you're getting a meter!