New, waiting to meet vet and overwhelmed

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StarburstMom

StarburstMom

Member Since 2021
Hi all, I am so glad I have found you! I have done so much researching but still have so much to learn. I took my Starburst (female 11 year old spayed tortie) to the ER vet on July 6th due to suspected diabetes (all the typical symptoms). ER vet did glucose, thyroid, CBC and liver and kidney tests. Long story short Starburst has diabetes (474 mg/dl). She also is anemic, has high TP and GLOB, SDMA and BUN. The ER vet said the results indicated early kidney disease. I was given insulin (prozinc) with direction to start treatment at 1 IU 2xday and Purina DM wet cat food prior to insulin shots. My normal vet was on vacation last week and the soonest appt I could get is a week from today. I did request that he look over the test results on Monday and hopefully try and work me in if he feels we should go in ASAP. The more I look at the results the more worried I am. Her neutrophils and monophils are barely on the high end but I'm fearful that something more than FD and early stage kidney disease is going on, like a UTI. No urinalysis was done at the ER since I told them I was taking her to normal vet in 2 weeks (I regret that decision now).
Fast forward to yesterday and she started acting a bit more like normal, a bit more social...more "bright". Then tonight I gave her wet DM dinner and her 1 IU and she is more tired acting. I did receive my new cat glucose meter this afternoon (I didn't realize human ones work fine) and tested her 2 hours after dinner/insulin and it was "hi" which means over 600 according to the pamphlet. I also was initially shaking the vial like other liquid medications until I read that you have to be gentle with insulin. I have since done the hand roll and it looks like the insulin is still well mixed when I do that but now I'm wondering if I inactivated the whole vial (the ER vet didn't mention being gentle with the vial). So basically I am a ball of anxiety and the soonest I can get any further direction is Monday IF they can squeeze me in. I'm overwhelmed.
I am thinking of doing a curve tomorrow morning, but she's only been on insulin since Tuesday night so is it too soon? I am waiting on the ketone urine test strips and glucose urine test strips (will get here Monday). Is there anything else I can do? Oh and she's not as interested in water tonight and hasn't urinated since the afternoon (she's been going more frequently). Her weight has been steady for several days, so that's good I guess.. Thanks
 
StarburstMom said:
Rechecked her sugars and 5 hours post shot it was 565
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I am not an advisor, my kitty went otj in a month but from what I (and again I'm not an advisor) went through with tuna he bounced like crazy when I first started him on insulin. I'll tag in @Bandit's Mom who can help you with your spreadsheet and is an amazing advisor! Everyone here will recommend taking his blood glucose before every shot to make sure it's safe, but it sounds like you've been doing the research!
 
Hi and welcome to you and Starburst.
I am going to give you a link to setting up your signature and spreadsheet. If you can add any BG data to the SS we will be able to help you.
HERE is the link for the SS and signature and other useful information.
Once you have the SS set up you will be able to add the pathology results which we can also have a look at for you.

If you are getting a reading of hi, it is possible she has already dropped low and is bouncing up high again.
Please make sure you test before every dose of insulin to see if it is safe to give the dose. And again around 3 to 7 hours later (+3 to +7) to see how low the dose is taking her. It is possible she may need a reduction in dose. Testing will tell us if she does.
Please also read the information about hypos that is in a the link above and print off the information sheet. Also make sure you have a hypo kit set up ASAP.
HERE is a link to using Prozinc
HERE is a link to Prozinc dosing methods

It will be fine to do a curve tomorrow. The more tests you can get in the better and we will be able to see how the insulin is affecting her.,,,,,,,it’s normal to feel overwhelmed. We will support you.
Ask as many questions as you need to . We are happy to help you.
Bron
 
StarburstMom said:
She was on Prescription Diet c/d dry along with all my other cat (one has bladder stone history) but I had already switched her over to fancy feast for a day or two before we went to the ER.

I will put together the ss today
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I’m not sure about her other conditions, but the Fancy Feast pate (no gravy) is a totally acceptable food to feed diabetic cats. It’s cheaper and cats also usually like it better!
 
StarburstMom said:
She was on Prescription Diet c/d dry along with all my other cat (one has bladder stone history) but I had already switched her over to fancy feast for a day or two before we went to the ER.

I will put together the ss today
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If it's the Hill's® Prescription Diet® c/d® Multicare Dry food - the Hill's website says it's 43% carbs. That's a huge difference from what you're feeding now and could already be making a big difference and dropping her overall BG significantly - all the more reason to get those tests in, curve included!
 
Welcome to FDMB!

First -- take a few breaths. Managing Starburst's FD will be overwhelming at first. I promise -- it gets easier. This board has been helping diabetic cats and their caregivers for 25 years. We're here to help.

If the numbers dropped from HI to the 500s, there's a reasonable chance your insulin is OK. I'm tagging a veteran Prozinc user to comment on whether the shaking the vial might have been a problem. @JanetNJ

The switch to Fancy Feast is a good choice. Just make sure you're using a low carbohydrate variety. We consider low carb (LC) to be under 10% carb. There is a wonderful website on feline nutrition that's authored by a vet -- Lisa Pierson, DVM. She also has a chart of most canned foods available in the US along with their carb count and other nutritional information. You may want to take a look at her information on urinary track issues in light of your other kitty. (Dr. Lisa isn't a big fan of dry food. Cats have a limited thirst drive so canned is better and especially so for diabetic kitties and cats with urinary track issues.) Given the labs you mentioned, adding water to Starbursts canned food will help. You may also want to find foods that are lower in phosphorus. I'd also suggest getting the labs redone in a couple of months once your cat's system is less stressed. Once you have your spreadsheet set up, there's a tab for your cat's lab values. If you can include that information, we can take a look.

It's fine to do a curve.. It's less of an issue with Prozinc than with the depot insulins (i.e., Lantus and Levemir) which need to build up in a cat's system. You can get Ketostix at any pharmacy. I'd suggest stopping by a pharmacy and getting some.

Is there any chance Starburst is munching on your other cat's food? You may want to consider feeing them the same thing. It will make your life considerably easer and guarantee that Starburst isn't sneaking anything that's high in carbs.
 
Sienne and Gabby (GA) said:
Welcome to FDMB!

First -- take a few breaths. Managing Starburst's FD will be overwhelming at first. I promise -- it gets easier. This board has been helping diabetic cats and their caregivers for 25 years. We're here to help.

If the numbers dropped from HI to the 500s, there's a reasonable chance your insulin is OK. I'm tagging a veteran Prozinc user to comment on whether the shaking the vial might have been a problem. @JanetNJ

The switch to Fancy Feast is a good choice. Just make sure you're using a low carbohydrate variety. We consider low carb (LC) to be under 10% carb. There is a wonderful website on feline nutrition that's authored by a vet -- Lisa Pierson, DVM. She also has a chart of most canned foods available in the US along with their carb count and other nutritional information. You may want to take a look at her information on urinary track issues in light of your other kitty. (Dr. Lisa isn't a big fan of dry food. Cats have a limited thirst drive so canned is better and especially so for diabetic kitties and cats with urinary track issues.) Given the labs you mentioned, adding water to Starbursts canned food will help. You may also want to find foods that are lower in phosphorus. I'd also suggest getting the labs redone in a couple of months once your cat's system is less stressed. Once you have your spreadsheet set up, there's a tab for your cat's lab values. If you can include that information, we can take a look.

It's fine to do a curve.. It's less of an issue with Prozinc than with the depot insulins (i.e., Lantus and Levemir) which need to build up in a cat's system. You can get Ketostix at any pharmacy. I'd suggest stopping by a pharmacy and getting some.

Is there any chance Starburst is munching on your other cat's food? You may want to consider feeing them the same thing. It will make your life considerably easer and guarantee that Starburst isn't sneaking anything that's high in carbs.
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Thank you! I did put together her spreadsheet this morning. I had read that the fancy feast classic pate was the kind to feed and that's what I gave her this morning, I will read the website (you guys have all the info I have been looking for for the past week and finally I found it). I am starting a glucose curve this morning (AMPS was 577) with a pet-specific meter (I have a cheaper human one on order as I will run out of test strips in a few days at this rate). I will add water to Starbursts next food, she is drinking water on her own as well. I will also get some Ketostix this morning. Thank you again
 
2 hours post morning shot is 562 (AMPS was 577), fed fancy feast classic pate ocean whitefish and tuna. Will pick up a "human" meter today when getting ketone strips. She is drinking a lot of water this morning. I think I deactivated her insulin by overshaking....or she has an infection going on....or her CKD is worse than "early stage". Ugg, patience is not my strong suit.
 
StarburstMom said:
I think I deactivated her insulin by overshaking
Click to expand...
Are we talking a gentle figure 8 type shake or a vigorous martini shake? Interested to hear what @JanetNJ thoughts are.
StarburstMom said:
2 hours post morning shot is 562 (AMPS was 577), fed fancy feast classic pate ocean whitefish and tuna.
Click to expand...
For most cats Prozinc onset is around +2. Fingers crossed the insulin is good and just hasn't started working yet.
StarburstMom said:
or she has an infection going on....or her CKD is worse than "early stage". Ugg, patience is not my strong suit.
Click to expand...
And hoping your vet can squeeze you in Monday :bighug:
 
Shelley & Jess said:
Are we talking a gentle figure 8 type shake or a vigorous martini shake? Interested to hear what @JanetNJ thoughts are.

For most cats Prozinc onset is around +2. Fingers crossed the insulin is good and just hasn't started working yet.

And hoping your vet can squeeze you in Monday :bighug:
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Vigorous martini shake.....yes, crossing fingers for getting in tomorrow
 
Just got back from the drug store and Starburst started peeing on cue! However I hate subjective tests because it's so uncertain. The test strips should be read a 15 seconds, this photo was taken at 20-25 due to me getting the phone out and snapping pic because I couldn't tell. How do you read this? Is this OK for now?
https://linksharing.samsungcloud.com/oiwCaKzK5uu4
 
StarburstMom said:
Vigorous martini shake.....yes, crossing fingers for getting in tomorrow
Click to expand...
Hi! Sorry about the diagnosis but I'm glad your found us. You mentioned some kidney issues. Do you have a copy of his lab reports?

With ckd and diabetes (my cat had this as well) you will want a food that is both low in carb and low in phosphorus. For my cat I feed her weruva foods because they have a lot of good choices. You want carbs under 10 percent and phosphorus under 1 percent. The dm food is 1.27 phosphorus.

These are some choices that my cat liked... There are a few more than this. Weruva is very transparent with the nutrition information on the weruva website.

Weruva slide and serve pate foods Family Food (.97 phosphorus and 0 carb).

Jeopurrdy Chicken (0.97 P 6.1 carb)

What a Crock 0.71 phosphorus and 8 carb lots of gravy so she loved it.

Goody stew shoes 0.71 phosphorus, 8.5 carb. This one was a big hit

Weruva Steak Frites (0.57 phosphorus 5.5 carb although I take out any big pieces of potatoes to try to limit the carbs just a bit)

Weruva LA isla Bonita - phosphorus 0.77 carb 4.5 (used to like, not a favorite anymore)

Glam and punk 1% carb, 0.93 phosphorous.

Weruva paw lickin chicken 3.3 carb 0.82 p

Press your lunch 5.9 carb. 0.82 phosphorous

Bff play Laugh Out Loud chicken and lamb 7.7 carb, 0.82 phosphorous

BFF play destiny (chicken and duck) 0.87 phosphorus 7.7 carb

Bff play chicken cherish 0.71 phosphorus 7.6 carb

Bff play best buds chicken and beef 7.9 carb 0.9 phosphorus

Bff play chicken Checkmate. 7.7 carb 0.7 phos

On the Cat Wok 3.8 carb 0.74 phos
 
StarburstMom said:
Just got back from the drug store and Starburst started peeing on cue! However I hate subjective tests because it's so uncertain. The test strips should be read a 15 seconds, this photo was taken at 20-25 due to me getting the phone out and snapping pic because I couldn't tell. How do you read this? Is this OK for now?
https://linksharing.samsungcloud.com/oiwCaKzK5uu4
Click to expand...
Looks negative to me. :). I always used a ketone blood meter because my cat was hard to catch in a box.
 
JanetNJ said:
Hi! Sorry about the diagnosis but I'm glad your found us. You mentioned some kidney issues. Do you have a copy of his lab reports?

With ckd and diabetes (my cat had this as well) you will want a food that is both low in carb and low in phosphorus. For my cat I feed her weruva foods because they have a lot of good choices. You want carbs under 10 percent and phosphorus under 1 percent. The dm food is 1.27 phosphorus.

These are some choices that my cat liked... There are a few more than this. Weruva is very transparent with the nutrition information on the weruva website.

Weruva slide and serve pate foods Family Food (.97 phosphorus and 0 carb).

Jeopurrdy Chicken (0.97 P 6.1 carb)

What a Crock 0.71 phosphorus and 8 carb lots of gravy so she loved it.

Goody stew shoes 0.71 phosphorus, 8.5 carb. This one was a big hit

Weruva Steak Frites (0.57 phosphorus 5.5 carb although I take out any big pieces of potatoes to try to limit the carbs just a bit)

Weruva LA isla Bonita - phosphorus 0.77 carb 4.5 (used to like, not a favorite anymore)

Glam and punk 1% carb, 0.93 phosphorous.

Weruva paw lickin chicken 3.3 carb 0.82 p

Press your lunch 5.9 carb. 0.82 phosphorous

Bff play Laugh Out Loud chicken and lamb 7.7 carb, 0.82 phosphorous

BFF play destiny (chicken and duck) 0.87 phosphorus 7.7 carb

Bff play chicken cherish 0.71 phosphorus 7.6 carb

Bff play best buds chicken and beef 7.9 carb 0.9 phosphorus

Bff play chicken Checkmate. 7.7 carb 0.7 phos

On the Cat Wok 3.8 carb 0.74 phos
Click to expand...
Thanks! I did add her blood test results on her spreadsheet...hope they are showing up. Hope you could make more sense of some of them than I can (these results were last Tuesday after waiting @4 hours with no water source at the ER vet so that may be a factor)
 
JanetNJ said:
Looks negative to me. :). I always used a ketone blood meter because my cat was hard to catch in a box.
Click to expand...
Oh thank goodness!:) Currently we have litter pans that are top entry and Starburst is putting the front of her body in the box with her butt high in the air so it sounds and is like a sprinkler (thank goodness for pee pads)....it does make it easy to collect a sample when I hear her tinkle
 
StarburstMom said:
Thanks! I did add her blood test results on her spreadsheet...hope they are showing up. Hope you could make more sense of some of them than I can (these results were last Tuesday after waiting @4 hours with no water source at the ER vet so that may be a factor)
Click to expand...
On great! That's super helpful! Just looked. So it's stage 2 kidney disease.... Not terrible but you'll want to prevent it from getting worse as long as possible. Add extra water to the food and maybe put an extra bowl of water where she hangs out. My cat Allie is about the same level as your girl. The phosphorus level is pretty high, and high phosphorus will make the kidney disease worse, so definitly check out those lower phosphorus foods I posted.

The biggest concern I see on the labs is the anemia. The hct level is quite low at 24.... It's concidered moderate. It should be over 30. This can make them weak and lose their appetite. Talk to your vet about b vitamin shots. You can also give b vitamin supplements. When my cat was boarderline anemic I started giving Jarrows b-right with additional b12 methylcobalamin supplements. Here's Tanya's website for ckd http://www.felinecrf.org/anaemia.htm

There's a good ckd group on Facebook called Cats with Chronic Renal Failure.

Get a few more days of readings of the bg and then we'll see if you need am increase to 1.5. I'm thinking you will.
 
StarburstMom said:
Thank you! I did put together her spreadsheet this morning. I had read that the fancy feast classic pate was the kind to feed and that's what I gave her this morning, I will read the website (you guys have all the info I have been looking for for the past week and finally I found it). I am starting a glucose curve this morning (AMPS was 577) with a pet-specific meter (I have a cheaper human one on order as I will run out of test strips in a few days at this rate). I will add water to Starbursts next food, she is drinking water on her own as well. I will also get some Ketostix this morning. Thank you again
Click to expand...
GREAT start, Starburst Mom. :bighug:
 
JanetNJ said:
Hi! Sorry about the diagnosis but I'm glad your found us. You mentioned some kidney issues. Do you have a copy of his lab reports?

With ckd and diabetes (my cat had this as well) you will want a food that is both low in carb and low in phosphorus. For my cat I feed her weruva foods because they have a lot of good choices. You want carbs under 10 percent and phosphorus under 1 percent. The dm food is 1.27 phosphorus.

These are some choices that my cat liked... There are a few more than this. Weruva is very transparent with the nutrition information on the weruva website.

Weruva slide and serve pate foods Family Food (.97 phosphorus and 0 carb).

Jeopurrdy Chicken (0.97 P 6.1 carb)

What a Crock 0.71 phosphorus and 8 carb lots of gravy so she loved it.

Goody stew shoes 0.71 phosphorus, 8.5 carb. This one was a big hit

Weruva Steak Frites (0.57 phosphorus 5.5 carb although I take out any big pieces of potatoes to try to limit the carbs just a bit)

Weruva LA isla Bonita - phosphorus 0.77 carb 4.5 (used to like, not a favorite anymore)

Glam and punk 1% carb, 0.93 phosphorous.

Weruva paw lickin chicken 3.3 carb 0.82 p

Press your lunch 5.9 carb. 0.82 phosphorous

Bff play Laugh Out Loud chicken and lamb 7.7 carb, 0.82 phosphorous

BFF play destiny (chicken and duck) 0.87 phosphorus 7.7 carb

Bff play chicken cherish 0.71 phosphorus 7.6 carb

Bff play best buds chicken and beef 7.9 carb 0.9 phosphorus

Bff play chicken Checkmate. 7.7 carb 0.7 phos

On the Cat Wok 3.8 carb 0.74 phos
Click to expand...
Thank you so much for this list. I don't understand how to get the phosphorus value how you have them, I'm just finding mg/100 calories. The chart I found somewhere on here looked like Tiki Cat ( especially Puka Puka, Koolina, Napili and Manana Grill) had pretty low phosphorus (@ 150 mg/100 calories). Is that information old or am I missing a concern in the Tiki Cat? I'm trying to find the cheapest yet good-quality option (I have 6 cats total, so costs add up quickly). I was liking the whole earth Farms Duck but saw some reviews that they changed their formulation and now have triple the phosphorus so there goes that idea. In the interim I am using the DM or Fancy Feast Salmon Feast (267....lowest of the fancy feasts). Thank you again for this.
 
I suspect you want Janet to answer. You need to tag her. To tag someone, type the "@" sign and start to type out their user name. The board will supply the options and click on the person you want. @JanetNJ

When you have a chance, can you flesh out your signature. The information is in this post on helping us to help you. Without the information, we're going to end up nagging you by asking the same questions again and again (and again and again).
 
StarburstMom said:
Thank you so much for this list. I don't understand how to get the phosphorus value how you have them, I'm just finding mg/100 calories. The chart I found somewhere on here looked like Tiki Cat ( especially Puka Puka, Koolina, Napili and Manana Grill) had pretty low phosphorus (@ 150 mg/100 calories). Is that information old or am I missing a concern in the Tiki Cat? I'm trying to find the cheapest yet good-quality option (I have 6 cats total, so costs add up quickly). I was liking the whole earth Farms Duck but saw some reviews that they changed their formulation and now have triple the phosphorus so there goes that idea. In the interim I am using the DM or Fancy Feast Salmon Feast (267....lowest of the fancy feasts). Thank you again for this.
Click to expand...
Yes many of the Tiki cat cans are low phosphorus too. I got these values from weruva.com. They are very transparent with the nutrition information.
 
I did up her insulin to 1.5 this morning. She's acting fine, definitely better than when she diagnosed (even though she read HI this morning). She did feel warm to me this morning and I'm still so worried about a possible infection . Luckily I was able to do a drop off appointment at my vet hospital (not with my normal vet but it's better than nothing). Hoping they do the urinalysis soon and let me know what's going on or if I'm being paranoid.
 
Urine looked good per vet. No bacteria, ketones or crystals. No fever, even though I thought she was warm.Vet said her numbers looked very good for a cat of her age and diagnosis. Glucose value in urine of 100 mg/dL. I did ask they redo her blood panel while she is there just to confirm the original values.
 
StarburstMom said:
Urine looked good per vet. No bacteria, ketones or crystals. No fever, even though I thought she was warm.Vet said her numbers looked very good for a cat of her age and diagnosis. Glucose value in urine of 100 mg/dL. I did ask they redo her blood panel while she is there just to confirm the original values.
Click to expand...
Good! Ask for a copy of all the labs.
 
JanetNJ said:
Hi! Sorry about the diagnosis but I'm glad your found us. You mentioned some kidney issues. Do you have a copy of his lab reports?

With ckd and diabetes (my cat had this as well) you will want a food that is both low in carb and low in phosphorus. For my cat I feed her weruva foods because they have a lot of good choices. You want carbs under 10 percent and phosphorus under 1 percent. The dm food is 1.27 phosphorus.

These are some choices that my cat liked... There are a few more than this. Weruva is very transparent with the nutrition information on the weruva website.

Weruva slide and serve pate foods Family Food (.97 phosphorus and 0 carb).

Jeopurrdy Chicken (0.97 P 6.1 carb)

What a Crock 0.71 phosphorus and 8 carb lots of gravy so she loved it.

Goody stew shoes 0.71 phosphorus, 8.5 carb. This one was a big hit

Weruva Steak Frites (0.57 phosphorus 5.5 carb although I take out any big pieces of potatoes to try to limit the carbs just a bit)

Weruva LA isla Bonita - phosphorus 0.77 carb 4.5 (used to like, not a favorite anymore)

Glam and punk 1% carb, 0.93 phosphorous.

Weruva paw lickin chicken 3.3 carb 0.82 p

Press your lunch 5.9 carb. 0.82 phosphorous

Bff play Laugh Out Loud chicken and lamb 7.7 carb, 0.82 phosphorous

BFF play destiny (chicken and duck) 0.87 phosphorus 7.7 carb

Bff play chicken cherish 0.71 phosphorus 7.6 carb

Bff play best buds chicken and beef 7.9 carb 0.9 phosphorus

Bff play chicken Checkmate. 7.7 carb 0.7 phos

On the Cat Wok 3.8 carb 0.74 phos
Click to expand...
Finally got the Chewy delivery with the case of truluxe Steak Frites.....she devoured it!! And looks to be the best option for her. Thank you so much @JanetNJ for this recommendation and all the others you have been giving!!
 
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