4/30 - New Member - Mac Diagnosed Diabetic 4/20

[Nat & Mac]

Hey everyone,

My sweet Mac was diagnosed diabetic last Monday. He spent most of the week in the vet to regulate his high sugar levels and severe dehydration. On Thursday 4/23, they said he was hydrated and his sugar levels were looking much better and so was able to bring him home with instructions to give him 7 units of insulin twice a day after feeding. By early, early Monday morning, he had suffered an episode of vomiting, incontinence and loss of use of his back legs. I took him back to the vet that morning and they said his sugar was low. Tuesday when I called to check on him they said his sugar was high. Yesterday the vet said his sugar levels were looking good, but he was fine to stay another night just to be sure. So today they confirmed he was still doing good and ready to come home. I went and picked him up, brought him home to my house (Mac had been staying with my dad) and got him situated with everything he would need. So far this evening he has drank a bunch of water, peed outside and inside the litter box, and won't eat. I am very new to having a diabetic pet, and right now I'm feeling discouraged. I worry about him not eating tonight. The vet said they had been giving him half a can of food during his feedings and he had been eating half of that (1/4 basically). I'm just not sure if he's not hungry, not happy because he's back at my house (I have other cats and they are not fond of each other), or if he's not feeling good. I am reading through this site which was recommended to me from other diabetic cat owners, but any help or information is very much appreciated.

Thank you!
Nat & Mac

 

[Bron and Sheba (GA)]

Hi Nat and Mac and welcome to the forum.
It is a bit scary and overwhelming in the beginning but you have come to the right place
I was astonished to read that the vet is giving him. 7 units of insulin twice a day. That is a HUGE amount for a newly diagnosed cat. It sounds as if Mac had a hypo when he was incontinent and lost the use of his back legs.
Most cats start at 1 unit twice a day.
What dose of insulin is he on now and what type of insulin?
Did the vet mention ketones to you at diagnosis?

Do you think that Mac might be nauseated?
Is he sniffing at the food and walking away or is it that he doesn’t like the food?

What food are you feeding him?

To keep Mac safe I would highly recommend you go out and buy a human test meter from a pharmacy or Walmart if you live in the US and start testing the blood sugars yourself. That is the only way you will be able to keep him safe. Cats usually get stressed at the vets and their BG is higher there. The vets dose the insulin on the BGs at the clinic and then when the cat comes home the BG drops some and the dose is too high.
Keep asking questions
Here is a link to how to home testing. It is easier than it looks.. we can help you.
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

 

[Nat & Mac]

Hi Nat and Mac and welcome to the forum.
It is a bit scary and overwhelming in the beginning but you have come to the right place
I was astonished to read that the vet is giving him. 7 units of insulin twice a day. That is a HUGE amount for a newly diagnosed cat. It sounds as if Mac had a hypo when he was incontinent and lost the use of his back legs.
Most cats start at 1 unit twice a day.
What dose of insulin is he on now and what type of insulin?
Did the vet mention ketones to you at diagnosis?

Do you think that Mac might be nauseated?
Is he sniffing at the food and walking away or is it that he doesn’t like the food?

What food are you feeding him?

To keep Mac safe I would highly recommend you go out and buy a human test meter from a pharmacy or Walmart if you live in the US and start testing the blood sugars yourself. That is the only way you will be able to keep him safe. Cats usually get stressed at the vets and their BG is higher there. The vets dose the insulin on the BGs at the clinic and then when the cat comes home the BG drops some and the dose is too high.
Keep asking questions
Here is a link to how to home testing. It is easier than it looks.. we can help you.
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

What dose of insulin is he on now and what type of insulin?
- They lowered his dose to 5 units twice a day and his type of insulin is N.

Did the vet mention ketones to you at diagnosis?
- Yes, the vet did say there were ketones in his urine when he was initially diagnosed.

Do you think that Mac might be nauseated?
Is he sniffing at the food and walking away or is it that he doesn’t like the food?
- It's a possibility he could be nauseous. Hes sniffing the food and walking away. I feel frustrated since the vet acted as if he did great eating and everything at the vet.

What food are you feeding him?
- The vet told me that they had just been feeding him friskies wet food to get him to eat right at meal times instead of grazing on dry food all day.

 

[Bron and Sheba (GA)]

I have to go out but I will answer you in about an hour.
Can you tell me where you live. Is it morning there or night? I was going to suggest I think you should go to a pharmacy (or Walmart if you are in the US) and buy a bottle of Ketostix to test the urine for ketones. It’s not hard and it’s really important that ketones are managed.
Also can you go to the vet today and ask for some cerenia tablets to help with the nausea?
I’ll be back in around an hour. Bron

 

[Bron and Sheba (GA)]

If a cat has ketones in the urine (or the blood) it is really important that they are eating well and getting enough insulin.
Ketones form when there is not enough food, not enough insulin and an infection or inflammation. If not treated, this can Quickly escalate into DKA which is a very serious illness for cats.
The treatment for ketones and DKA is enough food, enough insulin and any infection treated.
What does Mac weigh?

so what you need to do is:

• Make sure Mac is eating plenty of food. He needs to be eating more than he normally does...up to 1 1/2 times the number of calories. At this point it doesn’t matter if he will only eat the dry food. Food is more important than the number of carbs in the food when there are ketone present. When the body doesn’t have enough carbohydrates to use they start to break down the fat and protein in the cats body and that is when ketones form. Humans can deal with ketones but cats can’t......they are deadly for cats. So offer him food frequently during the cycle....just leave the 2 hours before the shots without food so that the BG is not influenced by the food.

• The other really important thing is insulin. Mac needs enough insulin to combat the ketones. But we don’t want him to have so much that he has another hypo! 5 units is still a huge dose to give a newly diagnosed cat.
  
• 
  
• Make sure he is getting plenty of fluids.....is he drinking well? It is really important he drinks enough to help flush out the ketones. Add warm water to his Canned food if he will allow it
  
• 
  
• Test the urine twice a day while he has ketones.......it is really important that they don’t increase again and start to cause a problem. If you are testing for them you are in control of the situation.
  
• 
  
• Look into home testing the blood glucose levels. It is again really important that Mac gets the right dose of insulin to combat the ketones but we don’t want him to have another hypo. If you are testing, you are in control and can intervene to stop any hypos from happening. Testing before every shot is needed to see that it is safe to give the shot and then again during the cycle to see how low the insulin is taking Mac.

Novolin is a harsh fast acting insulin and you need to make sure that Mac has eaten really well AN HOUR BEFORE YOU GIVE THE INSULIN so that he has food aboard when the insulin onset starts.
Here is a guide to using Novolin. Once Mac has get over the ketones properly, I would go back to the vet and ask to have Mac swapped over to Lantus insulin. It is a much better insulin for cats.......longer lasting and more gentle.
http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-novolin-humulin-nph.186097/

 

[Nat & Mac]

Hey Bron,

It is about 7:30am where I am now. When I replied earlier it was about 3:00am (I did not sleep very well worried about Mac). When I got out of the bed at 6:00am, he did eat a bit of wet food and after reading your last reply I gave him some of the dry food he normally ate and he was a bit happier to eat that. I gave him about a cup of dry food and he's probably ate 1/4 of it and he ate maybe a tablespoon of the wet. Mac has been drinking a lot of water. I think Mac weighs about 10 lbs. He is an older cat, he has lost a fair bit of weight over the last few months.
I will look into getting a glucometer and testing his urine for ketones. I'm also looking into taking him to a feline vet for a second opinion on his treatment. Thank you so much for all the help and information. Everything is a bit overwhelming right now, but trying to keep calm especially for Mac's sake.

 

[jt and trouble (GA)]

Hi Nat My name is Jeanne. I am SO glad you found us! You and Mac will get on the right track now. The folks here have just about seen it all. (your case may be the exception) as I dont know WHAT that vet was thinking.
Seriously we have a team of veterans here, ready, willing, and able, to get you AND Mac feeling better about diabetes. YOU CAN DO THIS!
WELCOME TO FDMB!

 

[Nat & Mac]

Hi Nat My name is Jeanne. I am SO glad you found us! You and Mac will get on the right track now. The folks here have just about seen it all. (your case may be the exception) as I dont know WHAT that vet was thinking.
Seriously we have a team of veterans here, ready, willing, and able, to get you AND Mac feeling better about diabetes. YOU CAN DO THIS!
WELCOME TO FDMB!

Thank you Jeanne! Mac is such a sweet cat and I just want him to be happy and healthy living his best life again.

 

[jt and trouble (GA)]

Thank you Jeanne! Mac is such a sweet cat and I just want him to be happy and healthy living his best life again.

So do we! Its our goal. I was in your shoes so long ago, I barely remember it all. And LOOK I'm still here! If I can pay any part of it back, I will. I'm no expert but I AM still grateful for the advice I got in what seemed the darkest days of Troubles life. I may just be a cheerleader / greeter but if I can calm just one person, I WILL be here!.
Your on the right track now KEEP UP THE GOOD WORK.

 

[Nat & Mac]

If a cat has ketones in the urine (or the blood) it is really important that they are eating well and getting enough insulin.
Ketones form when there is not enough food, not enough insulin and an infection or inflammation. If not treated, this can Quickly escalate into DKA which is a very serious illness for cats.
The treatment for ketones and DKA is enough food, enough insulin and any infection treated.
What does Mac weigh?

so what you need to do is:

• Make sure Mac is eating plenty of food. He needs to be eating more than he normally does...up to 1 1/2 times the number of calories. At this point it doesn’t matter if he will only eat the dry food. Food is more important than the number of carbs in the food when there are ketone present. When the body doesn’t have enough carbohydrates to use they start to break down the fat and protein in the cats body and that is when ketones form. Humans can deal with ketones but cats can’t......they are deadly for cats. So offer him food frequently during the cycle....just leave the 2 hours before the shots without food so that the BG is not influenced by the food.

• The other really important thing is insulin. Mac needs enough insulin to combat the ketones. But we don’t want him to have so much that he has another hypo! 5 units is still a huge dose to give a newly diagnosed cat.
  
• 
  
• Make sure he is getting plenty of fluids.....is he drinking well? It is really important he drinks enough to help flush out the ketones. Add warm water to his Canned food if he will allow it
  
• 
  
• Test the urine twice a day while he has ketones.......it is really important that they don’t increase again and start to cause a problem. If you are testing for them you are in control of the situation.
  
• 
  
• Look into home testing the blood glucose levels. It is again really important that Mac gets the right dose of insulin to combat the ketones but we don’t want him to have another hypo. If you are testing, you are in control and can intervene to stop any hypos from happening. Testing before every shot is needed to see that it is safe to give the shot and then again during the cycle to see how low the insulin is taking Mac.

Novolin is a harsh fast acting insulin and you need to make sure that Mac has eaten really well AN HOUR BEFORE YOU GIVE THE INSULIN so that he has food aboard when the insulin onset starts.
Here is a guide to using Novolin. Once Mac has get over the ketones properly, I would go back to the vet and ask to have Mac swapped over to Lantus insulin. It is a much better insulin for cats.......longer lasting and more gentle.
http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-novolin-humulin-nph.186097/

I'm sorry, I'm trying to understand what this means "So offer him food frequently during the cycle". I'm looking on the forum, but what is a cycle? How do I know Mac is in a cycle? It's around 2pm now and he's wanting to eat his dry food. Is he ok to eat now as long as I don't feed him again 2 hours prior to him eating this evening? ... I'm a visual person I think I need to make a timeline to help me understand .

I have also made an appointment for Mac at a feline clinic to get a second opinion on his treatment.

 

[jt and trouble (GA)]

A cycle is the time in between shots. Usually 12 hrs. I think it depends on the insulin being used.

GOOD on the second opinion!

 

[Nan & Amber (GA)]

I'm a visual person I think I need to make a timeline to help me understand .

Have you looked at any of our spreadsheets of blood glucose data? You can see the one for my FD kitty, Amber, in my signature. We rely heavily on these because a lot of us are pretty visual too, and they let you see the whole picture (with color coding!) of a cat's BG patterns and history.

The template and instructions can be accessed here: FDMB SPREADSHEET INSTRUCTIONS

 

[Bron and Sheba (GA)]

Show are things today? Is Mac eating well?
Have you been able to test for ketones.?

 

[Nat & Mac]

Mac is doing pretty good right now I believe except he's wanting more food right now. I found some little soup cups at the store today and gave one to him as part of his evening meal and he seemed to enjoy it. I was out running errands most of the day and when I returned he seemed a bit more lively and acting like himself. I was able to get test strips from Walmart today to test for ketones but I have not done a test yet. I was also going to purchase a glucometer but the Walmart by my house (which is not my favorite Walmart) had poor stock and poor selection. I looked at getting the ReliOn however the only one they had was the Prime and I read on here somewhere not to get that one but to get the Micro.
I spoke with the vet this morning regarding concerns I had with his behavior and a few other questions. They said they could give me something to give Mac to increase his appetite, and if he doesn't eat at all or eats very little that I could cut his insulin dose in half. They said his BG levels usually ran high while he was there the past couple of weeks. However I have read on here too where that could happen due to the animal being stressed at the vet.
I am getting a second opinion this week. I have made an appointment for him at a feline clinic to review his condition and treatment plan. I'm still taking everything moment by moment and hoping we can get all this figured out soon.

 

[Chloe007]

Mac is doing pretty good right now I believe except he's wanting more food right now. I found some little soup cups at the store today and gave one to him as part of his evening meal and he seemed to enjoy it. I was out running errands most of the day and when I returned he seemed a bit more lively and acting like himself. I was able to get test strips from Walmart today to test for ketones but I have not done a test yet. I was also going to purchase a glucometer but the Walmart by my house (which is not my favorite Walmart) had poor stock and poor selection. I looked at getting the ReliOn however the only one they had was the Prime and I read on here somewhere not to get that one but to get the Micro.
I spoke with the vet this morning regarding concerns I had with his behavior and a few other questions. They said they could give me something to give Mac to increase his appetite, and if he doesn't eat at all or eats very little that I could cut his insulin dose in half. They said his BG levels usually ran high while he was there the past couple of weeks. However I have read on here too where that could happen due to the animal being stressed at the vet.
I am getting a second opinion this week. I have made an appointment for him at a feline clinic to review his condition and treatment plan. I'm still taking everything moment by moment and hoping we can get all this figured out soon.

The ReliOn Prime meter is absolutely fine and is what most of us use. I don't think the micro meter is even sold anymore, some people like it because it takes a smaller blood sample but in the grand scheme of things it's just more important that you test. ReliOn Prime strips are affordable, and in my opinion the slightly larger sample it requires is negligible. I highly suggest you grab it along with some strips!

 

[Diane Tyler's Mom GA]

@Nat & Mac
The micro is discontinued, as Chloe said the Relion Prime is fine, I use it also
Most of us use it
You will probably be doing a lot of testing in the beginning, the meter is 9 bucks and for 100 test strips I think its 17.88
They go pretty fast when you are just starting out, I would go buy it
Also get 28 gauge lancets to start out with

 

[Diane Tyler's Mom GA]

Aim for the sweet spot , You might want to purchase 28 gauge lancets and do it free hand on an angle, eventually more capillaries will grow and it becomes easier or you can buy the lancing device which I have never used, just did it free hand.If you choose to go with the device I would ask the members which one they would recommend

Diabetic Cat Care Home Testing Your Cat’s BG

 

[jt and trouble (GA)]

Just wanted to say GOOD LUCK! We are cheering you and Mac on! Sending positive thoughts and good wishes.

 

[Nat & Mac]

The ReliOn Prime meter is absolutely fine and is what most of us use. I don't think the micro meter is even sold anymore, some people like it because it takes a smaller blood sample but in the grand scheme of things it's just more important that you test. ReliOn Prime strips are affordable, and in my opinion the slightly larger sample it requires is negligible. I highly suggest you grab it along with some strips!

Thank you so much! This helps so much! Thank you ♡

 

[Sienne and Gabby (GA)]

When you meet with the new vet, please discuss the choice of insulin. Humulin N/Novolin is not recommended for the treatment of diabetes in cats. The American Animal Hospital Association's 2018 guidelines for diabetes treatment recommend either Prozinc or Lantus for kitties. N is an ok insulin for dogs. A cat's metabolism is faster than a dogs so you do not get the kind of duration you need with N since it lasts about 8 - 10 hours. In addition, it is a harsh insulin: you have to have feed your cat about an hour before you give an injection or you risk the numbers dropping fast and hard. Between an initial dose that was exceptionally high and an insulin known to cause a fast drop in blood glucose levels, I'm not surprised that Mac most likely was hypoglycemic.

I hope you like the "cats only" vet. I've used feline specialists in 2 cities and have liked them a lot. It's a huge difference even in bringing your cat to the waiting room. (No barking dogs!)

 

[Nat & Mac]

I most definitely will. They were supposed to be getting his records from the other vet Friday to look over. I'm looking forward to seeing Dr. Holmes. She has a lot of great reviews and testimonies.

 

[Nat & Mac]

Today I have tested Mac's ketones and blood glucose. I need a urine test this morning that showed negative for ketones. A moment ago I was able to test his blood sugar (after a couple failed attempt earlier today) and the meter just read HI.

 

[Bron and Sheba (GA)]

Today I have tested Mac's ketones and blood glucose. I need a urine test this morning that showed negative for ketones. A moment ago I was able to test his blood sugar (after a couple failed attempt earlier today) and the meter just read HI.

Great you got negative ketones.
What is probably happening with the BG is that the Novolin is probably dropping Macs BG quickly and it is shooting back up at the end of the cycle.. Where abouts in the cycle was the Hi?
He would do much better on Lantus which is a long lasting more gentle insulin.

 

[Nat & Mac]

Great you got negative ketones.
What is probably happening with the BG is that the Novolin is probably dropping Macs BG quickly and it is shooting back up at the end of the cycle.. Where abouts in the cycle was the Hi?
He would do much better on Lantus which is a long lasting more gentle insulin.

I tested him around 2 hours before his feeding time.

 

[Diane Tyler's Mom GA]

Can you set up the spreadsheet so that we can see how the insulin is working for Mac, if you have trouble setting it up there is a member that will set it up for you so you can record Mac's numbers, Mac is sure a handsome boy, I love his color, it looks like a chocolate brown
The template and instructions can be accessed here: FDMB SPREADSHEET INSTRUCTIONS

 

[Diane Tyler's Mom GA]

I tested him around 2 hours before his feeding time.

What are his feeding times, do you live in the US?
Take a look at anyone's spreadsheet, also if you would please hit the like word so we know that you have seen this
Also if you can set up your signature that would be helpful
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[Nat & Mac]

Thank you! I will work on getting everything setup for Mac. His appointment is today so hopefully I will have updated information for him later this afternoon.