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cab

cab

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Hi,
I have a 10 1/2 yr kitty (Maggie) who was diagnosed yesterday with diabetes. I am scared. I like my vet but I don't feel I am getting much guidance. By way of background, back around Dec. 12-16, my kitty stopped eating, I took her to the vet, and all blood work was fine, x-rays fine, etc. He gave her a steroid appetite stimulant, but that didn't help, so I was referred to an internal medicine specialist. Did an ultrasound- found nothing, so she was put on antibiotics (metronidazole) on assumption she had bacterial overgrowth. (before this started, i gave her some new foods, which i didn't slowly introduce and wonder if this set that off). The antibiotics worked in that she started to eat. But her eating really didn't return to normal; that is, she ate about 1/2 c dry a day (she was 15.4 lbs in Dec 16, and 13.9 on Wed., Dec. 27). I also noticed she was drlnking and peeing a lot. I took her back to the specialist on Wed, Dec 27, and they re-ran blood work, coming back with diabetes diagnosis- glucose was 510. (also just saw the specialist's notes and he was recommending cont. metronidazole @100mg for possible intestinal dysbiosis-which no one mentioned to me when discussing... urg) (And the vets did think it's weird her blood work was fine in Dec., but now this.)

Vet recommeneded Lantus, 2u, 2x/day. At the vet, we gave her the 1st shot at 3:00 yesterday, and I gave her the second shot this morning and plan to do 7am and 7pm schedule.

Food: She has been on Purina one dry and pretty much grazes all day. I put out about 1/4 c dry overnight, which she eats usually, but has been inconsistent when she eats for the remaining of the day, usually some in morning, then late afternoon, and again around 8-9pm, for a total of 1/2c-5/8c. I bought the Purina DM dry, and got some canned, but haven't really tried any of it yet.

After reading various things here, I feel even more overwhelmed, and worry about doing the right thing. Thus I would welcome any guidance and advice about:
1. Feeding & Diet: Is it ok to do the small amounts through the day? (she's always tends to eat little nibbles throughout the day, but as discussed above is, generally speaking, when she eats)
2. Do I switch to low carb now or wait, especially as they have her on 2u? I did try some of Purina DM dry and she ate it. I think the Purina One dry is pretty high carb. My regular vet didn't provide much guidance on diet: when to feed or how it might effect dosage if I change to low carb vet. (The specialist instructions did say to switch to a diabetic diet therapy).
3 Dosage: Should I ask my vet if I could start at 1u instead? I'm afraid to change anything without my vet's advice.
4. Basically, any advice about how to start all this with dosage and diet is most welcome.
5. Testing- I ordered the Alpha Trak, and should get it today. I think the vet tech said she would help me set it up.
5. Also, when administering the insulin, the vet showed me how, but in drawing out the insulin, he left the needle in the vial when adjusting, with excess insulin going back into vial. I saw a video (after I gave shot) this morning that says don't do that, as the silicon can contaminate the insulin. Have I just ruined a very expensive vial of insulin, or do you think it's ok to still use? I just wont do that going forward.

The specialist vet seems to think there is a good chance she will revert/ go into remission; so that just makes me more nervous to do everything I can to make that happen. I ap0logize for such a long post, but I am just really overwhelmed and scared.
Thanks so much, and I am so glad to have found you.
Cecily
 
cab said:
Vet recommeneded Lantus, 2u, 2x/day. At the vet, we gave her the 1st shot at 3:00 yesterday, and I gave her the second shot this morning and plan to do 7am and 7pm schedule.
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HI! Sorry about the diagnosis. I totally understand how overwhelming and scary it is. I want to assure you that it is NOT a death sentence, and they can live long healthy lives with it. I'm sorry you aren't getting much help from your vet... but I'm glad you found us. WE CAN HELP! Lantus is a very good insulin, so your vet did that right. I'm a little concerned that she started you on 2 units because the recommended starting dose is 1 unit... so until you get the hang of testing the blood at home yourself, and especially since you will be moving from high carb dry food to a low carb food, I would lower the dose to 1 unit. The food change alone could drop the numbers significantly.

1. YES... you can feed through the day. I feed four times a day and she grazes whenever she wants. THe only exception is once you start home testing, no food for at least two hours prior to the preshot test so that the number is not food influenced. Many here feed fancy feast classic or friskies pate. I feed Weruva foods.

2. I would switch to the low carb diet, but when you do would also lower the dose to 1 unit. No need for the prescription DM food. that dry food is about 14% carb... it's best to keep the carb count under 10%. If you can't get the cat to eat the wet, try doing half and half and see if that works.

3. Tell your vet you are switching to low carb food and would like to only give 1 unit to make sure she doesn't go to low. it's safer. It could very well be that you will need to raise the dose back up to 2, but we really don't know until you start testing at home.

4. ask away. hahaah Here's a food chart. Choose foods under 10 carb. https://catinfo.org/chart/index.php

5. Excellent. I have a video in my signature showing how I test my cat CC at home, and I also use an alphatrak. It's very easy to set up and use. If you have any questions on it once you get it, I will help you.

6.It's ok if you did that... One time isn't going to ruin the whole vial... but best practice is not to shoot the insulin back into it. :) Just pull it back slowly. Remember to keep your insulin in the fridge... it will last a long time. When it's time to reorder, a lot of people buy it from Marks Marine Pharmacy in canada for MUCH less. Like half the price.

If you are testing at home and feeding the correct food there is a good chance he may go into remission. Some cats go into remission fast, some never do. mine went into remission after 4 months and stayed in remission for a year. THen came out of remission and has needed shots again for the last three years. It is what it is. Just have to take it as it comes. There are very experienced people on here to help you, and we will be with you every step of the way.
 
I have some different thoughts than Janet.

First and foremost, have you started home testing? It sounds like you haven't. One thing to consider with the AlphaTrack -- the strips run about $1.00 each. That's expensive. Many people here use a human meter rather than a pet meter for home testing. The cost for the strips for a Walmart brand meter is $18 for 100 strips. I used a Bayer Contour and strips, at the time, were about $25 for 100. The AT meter is good and vets often recommend it because its calibrated to be close to the lab equipment in their office. They are also likely to be unaware of how expensive it is for most of us to use a pet-specific meter.

That said, until you start home testing, do not change your cat's food. You are currently feeding Maggie a high carbohydrate food. Ultimately, you will want to switch to a low carb, preferably canned food diet. (Canned is preferred since cats have a limited thirst drive. Water is good for their kidneys which is an organ that diabetes can have an effect on.) The link that Janet provided has many canned foods that are below 10% carbohydrate. We consider under 10% to be low carb. However, lots of the people here feed their cats in the 5% range. If you switch Maggie to low carb and are still giving 2.0u, you will need to do a lot of testing to make sure she's not dropping too low on that dose. Hence my concern about getting started with home testing.

Depending on the dosing method you opt for, the starting dose of Lantus can be based on weight. If you chose to use the Tight Regulation Protocol, you cat MUST be on a low carb, canned food diet. The initial dose = 0.25 x ideal weight in kilograms. Generally, this calculates out to around 1.0u. If Maggie was at a good weight at 15.4lbs, her starting dose would be 1.75u. Alternatively, since she has dry food in her diet, with the Start Low Go Slow method, her starting dose would be 1.0u. Wth this method, if you change her diet, you would start at 0.5u

Are you using a vial or a Lantus pen for your insulin? You do not want to shoot air or excess insulin back into an insulin pen. The insulin in the pen is under pressure. It's OK to to shoot back into a vial. However, you are correct about the silicon lining in the syringe. As long as you're not drawing off a huge amount from either the vial, you can then adjust the dose without trying to hold onto the vial while adjusting the dose. You'll get the hang of drawing off just enough to make sure you can squeeze out bubbles and still have enough insulin for your dose.
 
Thank you both so much for the advice. I kinda cried knowing you are out there for support!

I haven't started home testing, but my vet tech is going to show me how tomorrow. I spoke to the vet again today, and mentioned going down to 1.0u, but they feel the 2.0u isn't too high, but said it is up to me. So I'm a bit stressed about it. To be honest, I am overwhelmed about the two protocols. I'll need to clarify with my vet, but I think they just want me to stick with a dose for 2 weeks then do a fructosomine (sp)? test.

A complicating factor is that a month ago she stopped eating, and was treated as if it was bacterial overgrowth. So, she got back to eating 1/2c of the dry, but I am scared about changing her food. She got that first dose yesterday, and ate pretty well. Today, she isn't eating well, and not sure if it's because she is mad at me (think she is upset with me for the shot I gave her this morn) or what. My vet says we just want to be consistent- and I just want her to eat. I mention the bacterial overgrowth condition as I think it might have been set off when I tried to give her a low carb wet food -purina true nature (before diabetes diagnosis); I gave her a can or two right off (so probably didn't introduce it properly) - and, though not sure- fear it is what set her off. (but she liked it) I also use to give her purina pro plan focus 11+, which is low carb, but I think it was giving her digestive issues as she had an odor when eating it.
So I am just struggling as to how to ensure she eats, but give her a diabetic appropriate diet, and treat her with insulin.
So maybe I just stick with the dry food (maybe 75 purina one and 25% purina dm) and at 1.0 (or 1.5- though I need syringes with 1/2 markers)and test to see how she does? I'm guessing you both still think 2.0 is too high? And I am using the vial.
She is currently 13.9 and the vet thinks she still has some "fat" to lose. So she hasn't been eating enough to maintain weight. On top of that vet suggested possible metronidazole for possible intestinal dysbiosis (gut biome issues), but I think I am going to wait on that.

I realize I may not make sense, but thank you so much for your help! Just feeling scared.
Cecily
 
cab said:
Thank you both so much for the advice. I kinda cried knowing you are out there for support!

I haven't started home testing, but my vet tech is going to show me how tomorrow. I spoke to the vet again today, and mentioned going down to 1.0u, but they feel the 2.0u isn't too high, but said it is up to me. So I'm a bit stressed about it. To be honest, I am overwhelmed about the two protocols. I'll need to clarify with my vet, but I think they just want me to stick with a dose for 2 weeks then do a fructosomine (sp)? test.

A complicating factor is that a month ago she stopped eating, and was treated as if it was bacterial overgrowth. So, she got back to eating 1/2c of the dry, but I am scared about changing her food. She got that first dose yesterday, and ate pretty well. Today, she isn't eating well, and not sure if it's because she is mad at me (think she is upset with me for the shot I gave her this morn) or what. My vet says we just want to be consistent- and I just want her to eat. I mention the bacterial overgrowth condition as I think it might have been set off when I tried to give her a low carb wet food -purina true nature (before diabetes diagnosis); I gave her a can or two right off (so probably didn't introduce it properly) - and, though not sure- fear it is what set her off. (but she liked it) I also use to give her purina pro plan focus 11+, which is low carb, but I think it was giving her digestive issues as she had an odor when eating it.
So I am just struggling as to how to ensure she eats, but give her a diabetic appropriate diet, and treat her with insulin.
So maybe I just stick with the dry food (maybe 75 purina one and 25% purina dm) and at 1.0 (or 1.5- though I need syringes with 1/2 markers)and test to see how she does? I'm guessing you both still think 2.0 is too high? And I am using the vial.
She is currently 13.9 and the vet thinks she still has some "fat" to lose. So she hasn't been eating enough to maintain weight. On top of that vet suggested possible metronidazole for possible intestinal dysbiosis (gut biome issues), but I think I am going to wait on that.

I realize I may not make sense, but thank you so much for your help! Just feeling scared.
Cecily
Click to expand...
Could you post a copy of the bloodwork?


And you're not alone. Lots of people here to help. :)
 
Hi, Any advice how to do that? I see an option to "upload a file" but it says I don't have permission. It's a pdf file.
:)
 
cab said:
Hi, Any advice how to do that? I see an option to "upload a file" but it says I don't have permission. It's a pdf file.
:)
Click to expand...
There's a bit of a problem with the Upload a File button at the moment, but FDMB's webmaster is working on a solution.

In the meantime you can drag and drop files from File Explorer into the thread reply box and that will enable you to attach the labs to your post. See this post for an example:

https://www.felinediabetes.com/FDMB/threads/uploading-files.241806/


Mogs
.
 
Nice labs other than the glucose. Kidneys look good. are you giving her any probiotics for her digestive issues? it could help.
 
Hi, I just started giving her VertriScience Everyday Probiotic - chew form. She loves it- I think she looks on it like a treat. She rejected forti flora..turned her nose up on any food it was put in. My gut tells me she probably would reject any powdered probiotic. But if you have other suggestions, I would most welcome it.
I lowered the dose to 1.0u, and I will discuss this with the vet today. She isn't as lethargic as she was when I gave her the 2u. I now appreciate the importance of getting her on a low carb diet. I will need to be careful because of what happened in December, when she had the bacterial overgrowth (we think), in addition to worrying/monitoring glucose levels and trying to figure out the dosing. If the food switch causes the overgrowth again, I guess I can go back to the antibiotics, which helped last time. So again, I am feeling a bit scared, but not as bad as the last two days. :)
I noticed on the food chart, that Purina Pro Plan focus 11+ was on it and was low carb. I used to feed that to her, in addition to the dry food until early December. I noticed she had an odor when I fed that to her, then we had the bacterial overgrowth incident, so I stopped feeding it (and she lost interest) and the odor went away. So again, that's why I worry about finding the right cat food. I will look into Weruva, and maybe the fancy feasts- just something I hope she can like.

Also, thank you for the link to you video on home testing; It was great and makes me feel much better and informed as I visit the vet today to learn how to do this!
Thanks so much!
Cecily
 
cab said:
Hi, I just started giving her VertriScience Everyday Probiotic - chew form. She loves it- I think she looks on it like a treat. She rejected forti flora..turned her nose up on any food it was put in. My gut tells me she probably would reject any powdered probiotic. But if you have other suggestions, I would most welcome it.
I lowered the dose to 1.0u, and I will discuss this with the vet today. She isn't as lethargic as she was when I gave her the 2u. I now appreciate the importance of getting her on a low carb diet. I will need to be careful because of what happened in December, when she had the bacterial overgrowth (we think), in addition to worrying/monitoring glucose levels and trying to figure out the dosing. If the food switch causes the overgrowth again, I guess I can go back to the antibiotics, which helped last time. So again, I am feeling a bit scared, but not as bad as the last two days. :)
I noticed on the food chart, that Purina Pro Plan focus 11+ was on it and was low carb. I used to feed that to her, in addition to the dry food until early December. I noticed she had an odor when I fed that to her, then we had the bacterial overgrowth incident, so I stopped feeding it (and she lost interest) and the odor went away. So again, that's why I worry about finding the right cat food. I will look into Weruva, and maybe the fancy feasts- just something I hope she can like.

Also, thank you for the link to you video on home testing; It was great and makes me feel much better and informed as I visit the vet today to learn how to do this!
Thanks so much!
Cecily
Click to expand...
Weruva is a great food and is what I feed my diabetic. They have a lot of low carb choices that aren't on the list because they are new. Luckily the weruva website is very transparent with nutrition information. Look at the ME profile for the carb count. https://weruva.com/nutrition-landing/
 
Hi,
First, thank you for sharing the food chart- I went through it today to look at the options. I'm so glad you also shared this Weruva list, and that they are pates- which is really all she eats if it's wet. I will definitely try them (I just posted a new question about how to make this transition as I do worry about her getting digestive issues when I try new wet food).
Again, thank you SO much for replying and helping me through this; you don't know how much it helps me. :)
 
cab said:
Hi,
First, thank you for sharing the food chart- I went through it today to look at the options. I'm so glad you also shared this Weruva list, and that they are pates- which is really all she eats if it's wet. I will definitely try them (I just posted a new question about how to make this transition as I do worry about her getting digestive issues when I try new wet food).
Again, thank you SO much for replying and helping me through this; you don't know how much it helps me. :)
Click to expand...
Happy to help
 
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