New Member and Stressing 16/10/21

[Catmumma]

Hello, earlier this week my precious girl "Stormie" was diagnosed with Diabetes Mellitus. She currently weighs just 2.65kg, having lost 800gms over the last few months. Right now I absolutely hate myself, for not taking her to the vets sooner (long story/not neglect). I'm sorry but this is going to be a long post, in order for me to explain her history. Stormie will be 15 in November and is a black and tan Butterfly Tabby. She has been unwell for 7 years with multiple things. A previous vet misdiagnosed her, they said she had lung cancer and put her on a very high dose of Prednisolone, which severely lowered her immune system and that's really when everything started to go downhill for her. I now know she didn't have cancer. She had a bad lung infection. Long story short: she has suffered from the following for the last 7 years. Asthma/bad lungs, Herpes, which is causing her terrible eye problems and Ringworm which is relentless. She is currently taking the following daily medicines: Prednisolone 2.5mg (lungs), Famciclovir 125mg (Herpes), Sporanox 1/4 capsule (ringworm). Everytime her skin has been clear for a few months, I take her off of the Sporanox, but the ringworm flares back up within a week. My vet has told me to leave her on it indefinately. The Herpes has ravaged her eyes so much, that they are now bulbous, cloudy and fragile. She was having Ocuflox drops, but the vet has told me I should leave her eyes alone now, as they are too fragille for any more medication, and could rupture.
Her Diabetes feels like another cruel blow for her. She has been unwell for so long, and simply doesn't deserve this as well. My vet at ARH has prescribed her Glargine Insulin 1iu every 12 hours. We are going to wean her off of the Prednisolone and start her on a Fluticasone Inhaler (with an Aerokat kit).
She has very bad Neuropathy. Her ankles are bald from te eringworm and very sore from her knocking them all the time. I have ordered her Purina Pro Plan DM (wet), Royal Canin Diabetes (wet), Hills MD Gluco Support (dry). The dry food is purely for a treat. She will only be having approx 10 of the biscuits per day. I have a multi cat household, and they all eat human food, which I cook fresh each day. Chicken breast, BBQ chicken, pink salmon, steak, pork chop, tuna in spring water, sardines in spring water, prawns, kangaroo etc.
I would really appreciate any advice. I have driven myself insane trying to figure out how best to look after Stormie now. What is a good system. I've been injecting her at 9am and 9pm. I take her insulin out of the fridge at 8.30am and load her syringe. I read that it stings if the insulin is injected when cold. I give her a small meal at 8.30am and inject at 9am. Then she has her lunch about 1pm, dinner at 6pm. Then another small meal at 8.30pm before her injection at 9pm. Is the food half an hour before the injection too long to wait? Should she be on Zobaline? She is going to ARH early next week, for her 1st Sugar Curve test. I have to drive for an hour to get there though, and she stresses in the car. I need a routine that is going to work for her and keep her healthy. She is everything to me, and I will do whatever it takes.

 

[Bron and Sheba (GA)]

Hi and welcome to you and Stormie! I see you live in NSW…..so do I. I live in Sydney.
I am so glad you have found us. We can help you.

First thing…..please remove the GA…we use that for kitties that have passed away and means guardian angel or gone ahead,

I am so sorry poor Stormie has so many health problems going on, but it sounds as if you are a wonderful mum to her.
I will try and answer all you questions and also give you some links to read.

My vet at ARH has prescribed her Glargine Insulin 1iu every 12 hours

Glargine is a good insulin. As she only weighs 2.65 kg, I am a bit concerned it might be a bit high a dose.
If you are not home testing the blood glucose levels I would seriously consider doing it. You don’t need your vets permission to home test,….many vets don’t think it is necessary but it is the best way you can keep Stormie safe and to see how the insulin dose is working, without the guesswork.

What is a good system. I've been injecting her at 9am and 9pm. I take her insulin out of the fridge at 8.30am and load her syringe. I read that it stings if the insulin is injected when cold. I give her a small meal at 8.30am and inject at 9am. Then she has her lunch about 1pm, dinner at 6pm. Then another small meal at 8.30pm before her injection at 9pm. Is the food half an hour before the injection too long to wait?

With Glargine you test/feed/ shoot in that order. As long as you know she will eat, you can give the dose as she is eating her meal. It usually takes about 2 hours for the insulin to start working (onset). We suggest giving some snacks during the cycles as well as the main meals. Many of us give snacks at around +2 or 3 ( 2 or 3 hours after the dose of insulin…..and again +4 or +5. If she is underweight, I would let her eat as often as she wants.

have ordered her Purina Pro Plan DM (wet), Royal Canin Diabetes (wet), Hills MD Gluco Support (dry). The dry food is purely for a treat. She will only be having approx 10 of the biscuits per day. I have a multi cat household, and they all eat human food, which I cook fresh each day. Chicken breast, BBQ chicken, pink salmon, steak, pork chop, tuna in spring water, sardines in spring water, prawns, kangaroo etc.

There is absolutely no need for you to be feeding any of the prescription diets the vet likes to sell you.
A low carb canned diet that you can buy at WW, Coles or places like Petbarn are fine. I will give you a link below that has a lot of Australian information in it including food below. The dry MD is around 17%carbs which is too high. You need foods that are 10% or under carbs.
I fed my diabetic cat a home made diet of kangaroo, chicken, egg and heart, plus supplements to make it is complete meal. Are you adding supplements to your human food you feed the cats?

Should she be on Zobaline? She

If she has neuropathy badly, I would give her Zobaline. I gave it to my Sheba. The main thing you need to do though for the neuropathy to get better, it to get Stormie back into better numbers. That will happen with time. The neuropathy can take months to get better….Sheba took well over 6 months but she fully recovered.

She is going to ARH early next week, for her 1st Sugar Curve test. I have to drive for an hour to get there though, and she stresses in the car. I need a routine that is going to work for her and keep her healthy. She is everything to me, and I will do whatever it takes

If you can start home testing, you don’t need to go to the vet for curves. Almost all cats get stressed at the vets and their blood glucose is therefore higher there than at home. So it can be misleading and the dose is raised when it may not need to be.
Don’t you have a vet closer to home you can go to?

I am going to send you some links for you to look through. Make sure you have a hypo kit set up as soon as possible in case you need it.
There are also links to your signature which will tell us about Stormie and will appear below all your posts, how to set up a spreadsheet…..if you can’t do it let me know and I will get someone to help you. Also information about hometesting, food, dosing methods, and lots of other things.


HELP US HELP YOU

AUSSIE INFORMATION

Keep asking lots of questions. We are really happy to help. This is a really supportive and knowledgeable forum
Bron

 

[Sienne and Gabby (GA)]

Bron has done a great job of providing you with the basics in order to get started. Please let us know if you are adding supplements to your kitties homemade food.

I removed the "GA" from your post.

Please let us know what questions you have. The members here are very generous with their time and their knowledge.

 

[Catmumma]

Hi and welcome to you and Stormie! I see you live in NSW…..so do I. I live in Sydney.
I am so glad you have found us. We can help you.

First thing…..please remove the GA…we use that for kitties that have passed away and means guardian angel or gone ahead,

I am so sorry poor Stormie has so many health problems going on, but it sounds as if you are a wonderful mum to her.
I will try and answer all you questions and also give you some links to read.



Glargine is a good insulin. As she only weighs 2.65 kg, I am a bit concerned it might be a bit high a dose.
If you are not home testing the blood glucose levels I would seriously consider doing it. You don’t need your vets permission to home test,….many vets don’t think it is necessary but it is the best way you can keep Stormie safe and to see how the insulin dose is working, without the guesswork.



With Glargine you test/feed/ shoot in that order. As long as you know she will eat, you can give the dose as she is eating her meal. It usually takes about 2 hours for the insulin to start working (onset). We suggest giving some snacks during the cycles as well as the main meals. Many of us give snacks at around +2 or 3 ( 2 or 3 hours after the dose of insulin…..and again +4 or +5. If she is underweight, I would let her eat as often as she wants.



There is absolutely no need for you to be feeding any of the prescription diets the vet likes to sell you.
A low carb canned diet that you can buy at WW, Coles or places like Petbarn are fine. I will give you a link below that has a lot of Australian information in it including food below. The dry MD is around 17%carbs which is too high. You need foods that are 10% or under carbs.
I fed my diabetic cat a home made diet of kangaroo, chicken, egg and heart, plus supplements to make it is complete meal. Are you adding supplements to your human food you feed the cats?


If she has neuropathy badly, I would give her Zobaline. I gave it to my Sheba. The main thing you need to do though for the neuropathy to get better, it to get Stormie back into better numbers. That will happen with time. The neuropathy can take months to get better….Sheba took well over 6 months but she fully recovered.


If you can start home testing, you don’t need to go to the vet for curves. Almost all cats get stressed at the vets and their blood glucose is therefore higher there than at home. So it can be misleading and the dose is raised when it may not need to be.
Don’t you have a vet closer to home you can go to?

I am going to send you some links for you to look through. Make sure you have a hypo kit set up as soon as possible in case you need it.
There are also links to your signature which will tell us about Stormie and will appear below all your posts, how to set up a spreadsheet…..if you can’t do it let me know and I will get someone to help you. Also information about hometesting, food, dosing methods, and lots of other things.


HELP US HELP YOU

AUSSIE INFORMATION

Keep asking lots of questions. We are really happy to help. This is a really supportive and knowledgeable forum
Bron

Hi, thank you for your help.
Sorry, I thought that GA meant General Advice.
Having been a Catmumma for 43 years, sadly, I well and truly qualify for the GA section.
I have 9 cats, 1 budgie and 2 rabbits waiting for the day when we will all be together again.
I lost my ginger ninja "Horatio Caine" (named after Horation Caine in CSI Miami) in March to a brain tumour - he was 16.
I'm still struggling to come to terms with it, he has left such a big hole in my life.
My first fur baby "Bonnie" came with us from England. He was two at the time, and nearly died during his 3 month quarantine.
We sent him ahead, so he would be coming out of quarantine when we arrived in Australia.
He thought we had abandoned him. He refused to eat and was pining himself to death.
Thankfully, one of the nurses there put in the time and effort to bring him around.
When we first came to Australia, we lived on the Northern Beaches for 25 years, but now reside in the Western Suburbs.
I did my first urine test today. Both of the colours looked very similar to the first colours on the bottle.
I could have wept with relief - I was standing there counting the 15/30 seconds and silentily chanting "Please be normal"
I'm slowly coming to terms with this wretched Diabetes diagnosis.
The good thing is Stormie is always ready to eat, she's hungry all the time (partly due to the Prednisolone), so hopefully now she's on treatment, the weight will start to go back on.
A friend told me Stormie looks like a really old homeless cat that's been through the wars.
I suppose she does to an outsider, but to me she is one of the most beautiful girls in the world.
I've looked at various links, written myself notes to ask my vet and will stay positive.
I feel calmer today and hopefully tomorrow's 1st curve test will be good news.
Thanks Again.

 

[Bron and Sheba (GA)]

I am sorry for your loss of Horacio Caine. It is never easy.
I live on the northern beaches.
Please let us know if we can be of any help to you, and how you get on at the vet with the curve.

 

[Sienne and Gabby (GA)]

I'm not entirely sure how your vet is treating your cat's ringworm. My diabetic cat picked up ringworm when hospitalized. It was a miserable experience and given that she was diagnosed with a liver issue, they did not want to prescribe oral medication. I was bathing her weekly for about 2 months is a truly stinky solution and locking her in the bathroom so she could "air dry." In fact, I had to bathe both of my cats and thoroughly decontaminate the house on a weekly basis. I kept both cats locked in my bedroom. Once they had one clear test, I had my rugs and upholstered furniture professionally cleaned. It's not sufficient to treat the one cat. You have to treat all of your animals and you have to decontaminate the environment since the fungal spores can be any and everywhere. It's also recommended that your have the vents in your house cleaned.

This is a good discussion about treating ringworm.

You also can do a curve at home once you start home testing. You will want a glucometer and not test urine for glucose. Urine testing is really not the best way to monitor for glucose levels since it's not an up to the minute reading. In addition, glucose curves at the vet's office are influenced by stress. Usually the numbers are higher leading to the vet recommending a larger than necessary dose increase which puts your cat at risk for hypoglycemia. The tests at home are not influenced by the stress of travel, being in a strange place, etc.

 

[Catmumma]

I am sorry for your loss of Horacio Caine. It is never easy.
I live on the northern beaches.
Please let us know if we can be of any help to you, and how you get on at the vet with the curve.

Hi Bron,
I can't for the life of me remember how I posted my original post.
I've been trying to figure out where to go to post something new ?
It took me a while to figure out how to get back into this thread (I'm a bit thick lol).

There's a few things I'm unsure about.
I read that if you inject cold insulin that it really stings, so I have been loading Stormie's syringe and letting it get to room temperature for 15 minutes, before I inject her.
We still haven't had her 1st Curve test, as my vet called in sick last week. We are booked in for this Tuesday.

I've been researching Glucose monitors.
It seems that Alphatrak2 has a good reputation, so I am going to order one of them.
How would I find somebody on here who uses that brand, to find out whether it's a good choice.
I'd much rather pay more money, to have one that is going to be accurate, and that isn't going to hurt as much for the prick.
I know people are using human ones, but I think I'd rather use one that has been set for cats.

Do people test before each shot ?
If my vet says stick to the 1iu of Glargine, can I stick to that ?
Stormie has to suffer so many things throughout her day, that I'm hesitant to do more things to her.
She has to have an injection at 9am, a tablet at 12pm, more meds at 4pm, injection a 9pm, another tablet at 11.30pm.
I don't want her to have the feeling that every time I go near her that something horrible is going to happen.
I'm going to show my ignorance now.
Do you adjust the amount of insulin depending on what the Glucose monitor reads?
If so, how do you know how much to adjust.
I'm petrified of either under or over dosing her.

Since she was diagnosed, I've been in a constant state of worry and anxiety.
I had a minor freak out last week, as I didn't get the insulin in.
Don't ask me how I managed that.
Stormie is so thin that trying to get a decent amount of skin is a bit difficult (she has no muscle to grab).
I was trying to use a bit further down from her scruff, as I've noticed some bad bruising from previous injections.
Her body is like that of a very old lady, one who bleeds and bruises badly very easily (she is very fragile).
There's practically nothing to grab there though, and that must be where I went wrong.
Usually I can feel the insulin whoosh into the skin I am holding between my fingers, but on that occasion I didn't feel anything.
My fingers were sticky and they stunk, so did her fur, so I must have somehow squirted it on my fingers/her fur.
The needle had definitely gone in, but maybe I was squeezing the little bit of skin too tight, so it had nowhere to go except to come back out.
I didn't try again as I was frightened that some might have gone in and if I gave her more, that I would over does her.
I spent the next 12 hours in an anxious state, but she was ok.

If cat food doesn't have any information on it, is there a way to tell whether it is safe or not.
She loves those Dine Creamy treats (there's 4 in a pack), and I like them because she gently licks one of them, and stays still while I inject her.
If I give her any other kind of food that has solid bits, she tends to move her head around too much while she eats.
Obviously, I don't want to give them to her if they have too many carbs, or sugar.

Last question, but it's an important one to me.
How can I find out if there is anybody from my area (Penrith, Western Suburbs) that has a vet that's knowledgeable about Diabetes.
I currently don't have a local vet, due to the one I was seeing misdiagnosing three of my babies, and one of my boys dying because of it.
The vet I take Stormie to is an hour away at an animal specialist centre (ARH Flemington).
I've been taking her there for nearly two years, because she has been so unwell, and it's just easier to return there as they know her history.
I need to find a local vet though.
For my other babies, and because I need somebody close by for Stormie, incase she needs urgent help.

 

[Bron and Sheba (GA)]

can't for the life of me remember how I posted my original post.

It’s fine to continue with this post. But if you want to start a new post, go to the top right of the main health page and you will see a little box that says “post new thread”. Click on that and you can start a new thread.

It seems that Alphatrak2 has a good reputation, so I am going to order one of them.

Personally I would not use an alphatrak meter. I much prefer the human meters. Our dosing methods are based on the human meters and the test strips are far cheaper than the alphatrak meter strips. Some people here do use them but they often change over to the human meter because of the expense.

Do people test before each shot ?

Yes, always! The routine is test, feed then shoot in that order.

If my vet says stick to the 1iu of Glargine, can I stick to that ?

The dose is always determined by the BG numbers, so no you would not always stick with 1 unit. It may need to be increased, or it may need to be decreased.
The best thing to do is to choose one of our two dosing methods and they will tell you when you need to do anything.
DOSING METHODS here

Do you adjust the amount of insulin depending on what the Glucose monitor reads?

Yes the insulin is adjusted on the nadir (lowest point in the cycle). If you are following one of the dosing methods, it is easy to follow and for the first few months you would need to be posting most days to ask for advice and help until you understand it all…..remember we were all in your position once.

I'm petrified of either under or over dosing her.

If you are testing before every shot and again during the cycle the BG numbers will tell you everything. There is no guesswork.
Whe we adjust the dose we go up or down in 0.25 unit increments.

She loves those Dine Creamy treats (there's 4 in a pack), and I like them because she gently licks one of them, and stays still while I inject her

If you post the ingredients we will be able to tell you if it is OK. Most Dine foods are ok.

Stormie is so thin

Are you giving her plenty to eat during the cycles?
Here is a photo of different places to give the injections

My fingers were sticky and they stunk, so did her fur, so I must have somehow squirted it on my fingers/her fur.
The needle had definitely gone in, but maybe I was squeezing the little bit of skin too tight, so it had nowhere to go except to come back out.
I didn't try again as I was frightened that some might have gone in and if I gave her more, that I would over does her.
I spent the next 12 hours in an anxious state, but she was ok.

Sounds as if you gave a fur shot…..which we have all done at some point. It’s frustrating but never repeat the dose. It is to dangerous as you don’t know how much act got in.

How can I find out if there is anybody from my area (Penrith, Western Suburbs) that has a vet that's knowledgeable about Diabetes.

I don’t know anyone who is living in that area that has a diabetic cat.
I think the best thing to do would be to ring around the vet practices, or go into them, and ask them if they have treated many diabetic cats, are they willing to work with you, you would like to be able to adjust the insulin dose yourself and are they comfortable with that and with you hometesting the blood glucose levels. And also if they are able to treat his other issues.

 

[Sienne and Gabby (GA)]

I want to tweak Bron's statement about adjusting the dose based on the meter readings. With Lantus, you adjust the dose if the numbers drop below a certain cut off based on the dosing method you opt to use. Again, based on the dosing method, you raise the dose if numbers are not in a normal range after 3 - 5 days. You do NOT raise or lower the dose based on the pre-shot numbers at every test. Lantus dosing requires that you allow a dose to stabilize before making a change.

Another reason that the AlphaTrack is less than wonderful is that if you are running low on strips, you can't go to any pharmacy to stock up. They are only available online. I knew that I might be paying more if I had to go to a pharmacy to pick up strips, but I could get what I needed if I wasn't stocked up.

If you do need to look for a vet, this is a post that members contributed to on how to interview/choose a vet. Some of the recommendations are particular to those of us who live in the US so you may need to "translate" the information to your country. University of Queensland has an excellent training program. One thought is to call and ask if they have a graduate they can recommend who's in your area. Do you have a rating system where people can rate services in your area?

 

[Catmumma]

Hi, I still can't figure out how to start a new thread. I went to the Home page where Bron told me to go and I can't see a "Post New Thread" anywhere.
Feeling pretty stupid lol.
I'd like to get an opinion on how Stormie is going with her diabetes.
I asked my vet for her levels/results and they are as follows:

11/10/21 - Visit to vet as she was unwell, and she was diagnosed with Diabetes
Weight was 2.65kg
Blood Glucose 20.9 mmol/L
4+ Glucose in urine
1iu Glargine insulin started, twice a day

26/10/21 - 1st Curve test
Weight 2.78kg
10am 9.7 mmol/L
12pm 5.7 mmol/L
2pm 8.8 mmol/L
4pm 12.2 mmol/L
Vet said she was happy with these results, and told me to continue with 1iu of Glargine, twice a day

1/12/21 - 2nd Curve test
Weight 2.76kg
10am 10.6 mmol/L
12pm 8.8 mmol/L
2pm 4.2 mmol/L
4pm 3.8 mmol/L
1/2 a tin of cat food was given at vets
Vet was unhappy with the results, and told me to decrease the insulin to .5 of Glargine, twice a day

Stormie keeps licking her lips as though she feels sick/nauseous and I have no idea why (been doing it for a few weeks now).
The vet has no idea why she's doing it.
How long does the insulin last, once the seal has been broken on the bottle.
I can't get a straight answer. The internet says 1 month, my vet says 2 months, and my chemist says 3 months ?
My insulin is in a little glass vial, which the chemist says is the insert to a pen.
Stormie seems happy enough, apart from the lip licking. She's eating normally and is definitely better than she was before she started on insulin.

 

[Bron and Sheba (GA)]

It would help a lot if you could set up a spreadsheet and start home testing. What do you think about that? Getting curves done at the vet is not the best way to manage feline diabetes. you can find information about how to set up a spreadsheet in the link I sent you earlier called “help us help you.”

It does sound as if your kitty could have nausea. Ask the vet to give you done cerenia tablets or a script for some zofran wafers which you buy from the chemist.
is your kitty eating well?the insulin will last for 6 months if you keep it in the fridge in a container in the main part of the fridge, not the door.

 

[Sienne and Gabby (GA)]

To start a new thread, you stay on this page -- the Feline Health - (Welcome & Main Forum) page. Just click on the link I provided in dark blue.

On the right side of the page across from the name of the forum, is a button labeled, "Post New Thread." Click on that button and you will be able to start a new thread.

 

[Catmumma]

Hi, I can't for the life of me figure out how to start a new thread. It's doing my head in.
Since I last wrote, Stormie has been plodding along fairly well considering her multiple health issues.
I had a terrible scare 6 weeks ago though, but it turned out to be her lungs and not her diabetes.
She could barely breathe and wouldn't eat, which meant I couldn't give her her insulin injection, so I rushed her to the vets.
She was put on oxygen, and given various injections (prednisolone and some others), and had a glucose test.
She bounced back from that but has been losing weight, and is now only 2.49kg
She is a so skinny and boney.
She had a curve test on Tuesday, and the vet said it looks like she has gone in to remission and to stop insulin injections straight away.
I was told to monitor her, and do a urine test twice a week to check for glucose, and to do a spot blood glucose if there's any glucose in her urine.
I came home from work today, and my mother said Stormie has barely eaten, and she keeps collapsing around the house.
She looks very weak, vague, and she's cold even though I have her wrapped in a blanket.
I have been unable to get her to do a wee.
I recently purchased the Alphatrak II Cat diabetes machine.
I think I have set it up correctly, but not 100% sure.
I've just done a test on Stormie, and the number was 19.3
When Stormie was first diagnosed I was told that if she falls below 3 or goes higher than 20 that it is extremely serious and should take her to the vet immediately.
I have no idea whether the vet was wrong on Tuesday, and Stormie should still be on insulin.
I don't know what to do.
She's just laying in her bed.
My local vet won't see me, as they are fully booked, and I don't want to drive her to the emergency vet (an hour away) unless absolutely necessary.

 

[Bron and Sheba (GA)]

@Catmumma
I am most concerned about Stormie after reading this.
It does sound to me as if Stormie should still be on insulin if the BG was 19.3
With her not eating and collapsing , cold and lethargic….I am very concerned she may have ketones and possibly DKA (diabetic ketoacidosis) which is very serious.
I can’t believe your vet won’t see you ….that is absolutely outrageous! I would get rid of him immediately!

If I were you I would take her to the emergency vet straight away and tell them the vet stopped the insulin on Tuesday and now she is lethargic, won’t eat and is cold and her BGis 19.3 Tell them to test immediately for ketones in the urine.

Try and get her to eat anything at all and take her to the emergency now. And take your insulin and some food with you.
PLEASE DON’T DELAY IN TAKING HER TO EMERGENCY.