Thoughts on Purina DM

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SaraMV

SaraMV

Member Since 2022
We just left our regular vet with Taz. We were given a RX for Purina DM and I'm just curious what you guys think about it? The vet said that if we don't feed it, then we need to pick one flavor of something that he'll eat for now on, so that the food is consistent.

I fed Taz at 7:30 this morning and it took him an hour to eat 1/2 of a can of food. He has pancreatitis and the ER vet didn't send home pain meds. I gave him .5 unit of lantus at 8:45 when I was sure he was finished. Was that wrong?

The vet tested his blood sugar and their meter just said "high". They couldn't tell us the number reading because apparently Taz's went above what the monitor reads. His next meal and insulin is due at 8:30. The vet agreed with Taz's ER discharge instructions, for us to give him 2.5 units twice a day. I'm really scared to start out on a high dosage. :(

We were given a week's worth of .3 Bupe. After that we're supposed to use compounded Gabapentin. He also has cerenia, Omeprazole, and clavamox. This vet also wouldn't give us any sub fluids because it's usually for cats with kidney distress. :(

P.S. how do I edit a title on here?
 
There should be a drop down to the right of the title to let you edit

The DM isn't necessary, in fact the dry is fairly high carb. If you browse some signatures of experienced folks (like on the Lantus forum) you'll see nearly all of us feed Friskies, Fancy Feast, or something like Weruva/Tiki Cat.

The flavors don't really matter, just try to keep it roughly within the same carb range (like 3-7%). The majority of cats are not carb sensitive enough for that to affect things much. Would YOU want to eat the same thing every day for the rest of your life? I personally rotate about 3-5 different flavors of Friskies, different ones AM and PM. I tracked it for awhile to see if it impacted BG and it did not.

Going to tag @Bandit's Mom @Wendy&Neko @tiffmaxee. Since you already has a post on Lantus forum going I don't want anything to get mixed up. The food question is ok here, but the dose question is better for the Lantus forum.

Glad you got the meds.

Did your monitor come? Ketone strips?

If I had to guess he's high because everything the vet did the last few days really messed him up, so his liver released stored glycogen as a sort of emergency response - we call it bouncing. Normally high numbers at first aren't too concerning, but with ketones in the picture have to be cautious. Tagging @Bron and Sheba (GA) for ketone advice. High numbers can also cause neuropathy if it goes on too long, but that's usually treatable with B12.
 
Fluids are really for any cat that's dehydrated or needs to keep things flushed out, that's a shame. Just really going to have to stay on top of his water intake to keep ketones at bay
 
FrostD said:
Fluids are really for any cat that's dehydrated or needs to keep things flushed out, that's a shame. Just really going to have to stay on top of his water intake to keep ketones at bay
Click to expand...

I have a question. Should I use vaseline when I test his ear? My husband is going to pick up the monitor now from my brother's house and I plan to use it for the first time tonight. Top part of the ear, right? Do I go for the little vein towards the top or just anywhere on the ear? I've watched videos but some of them are hard to tell.
 
Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up
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6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear tostop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
You can also use a little Vaseline on the ear if you want to so the droplet of blood will bead up
 
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You need to withhold food 2 hours before doing you first test in the AM and PM so the reading is not food influenced. After that you can feed him several times during each 12 hour cycle while testing.
 
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I find Vaseline helps a lot. Just a bit where you're going to test, helps the blood bead up better. Aim for a drop the size of a ball on a ball point pen - it's more than you need, but until you get the hang of it will save you wasted strips and error codes from not enough blood.

I free hand the lancet, I find the clicking noise of the device scares him more than anything. So I fold a cotton round in half and put that on the inside of the ear, then use the lancet to poke the other side. You will pierce his ears many times before you get the hang of it, don't feel bad. Sometimes they even pull away and fling blood. Again don't worry! It will get better
 
We took his reading. It was 546. He's currently eating dinner. So I guess 2 units is correct to give him?
 
I am very uncomfortable advising in this situation, but to at least give you a reply - if it were me, and assuming I had a hypo kit, I would give 1.5 units and then test at +2
 
FrostD said:
I free hand the lancet, I find the clicking noise of the device scares him more than anything.
Click to expand...

I also free handed it. I trusted my own hand better than a pen. Thankfully I got him the first poke, but my husband was helping and he was warming up his ear beforehand.
 
FrostD said:
Fluids are really for any cat that's dehydrated or needs to keep things flushed out, that's a shame. Just really going to have to stay on top of his water intake to keep ketones at bay
Click to expand...
SaraMV said:
We just left our regular vet with Taz. We were given a RX for Purina DM and I'm just curious what you guys think about it? The vet said that if we don't feed it, then we need to pick one flavor of something that he'll eat for now on, so that the food is consistent.

I fed Taz at 7:30 this morning and it took him an hour to eat 1/2 of a can of food. He has pancreatitis and the ER vet didn't send home pain meds. I gave him .5 unit of lantus at 8:45 when I was sure he was finished. Was that wrong?

The vet tested his blood sugar and their meter just said "high". They couldn't tell us the number reading because apparently Taz's went above what the monitor reads. His next meal and insulin is due at 8:30. The vet agreed with Taz's ER discharge instructions, for us to give him 2.5 units twice a day. I'm really scared to start out on a high dosage. :(

We were given a week's worth of .3 Bupe. After that we're supposed to use compounded Gabapentin. He also has cerenia, Omeprazole, and clavamox. This vet also wouldn't give us any sub fluids because it's usually for cats with kidney distress. :(

P.S. how do I edit a title on here?
Click to expand...
SaraMV said:
We just left our regular vet with Taz. We were given a RX for Purina DM and I'm just curious what you guys think about it? The vet said that if we don't feed it, then we need to pick one flavor of something that he'll eat for now on, so that the food is consistent.

I fed Taz at 7:30 this morning and it took him an hour to eat 1/2 of a can of food. He has pancreatitis and the ER vet didn't send home pain meds. I gave him .5 unit of lantus at 8:45 when I was sure he was finished. Was that wrong?

The vet tested his blood sugar and their meter just said "high". They couldn't tell us the number reading because apparently Taz's went above what the monitor reads. His next meal and insulin is due at 8:30. The vet agreed with Taz's ER discharge instructions, for us to give him 2.5 units twice a day. I'm really scared to start out on a high dosage. :(

We were given a week's worth of .3 Bupe. After that we're supposed to use compounded Gabapentin. He also has cerenia, Omeprazole, and clavamox. This vet also wouldn't give us any sub fluids because it's usually for cats with kidney distress. :(

P.S. how do I edit a title on here?
Click to expand...


Hiya, sorry Taz has been unwell. Our Pilch has been in twice with pancreatitis, comes on suddenly for him. He has been on Purina DM wet since diagnosis. Not sure it is right for him along with pancreatitis tendencies. He has been on fluids for several days when admitted and it was essential as he had DKA, ketones in his urine. He was initially sent home whilst ketones still present and was back in within 4 hours. We have found BG spikes when pancreatitis occurs. I test for ketones regularly now, using the ketostix.
 
You don't need to feed DM (dietetic management, no longer allowed to call it diabetic management), and many cats grow tired of the taste. I rotated 4 different proteins of raw food. A lot of cats like variety.

Great job getting those tests in tonight and nice to see he's coming down some.
 
Regarding the depot, when you inject Lantus, it forms microcrystals that deposit in fat tissue. Most of those crystals dissolve over the course of the 12-hour cycle. However, not all of those crystals dissolve completely. So, the next time you give a shot, the same process is in place resulting in what amounts to "storage" of some amount of insulin. This process is what gives Lantus its long duration as well as overlap between cycles. With shorter acting insulin, whatever insulin you inject is completely used up often in much less time than the 12-hour cycle and there are big fluctuations in blood glucose numbers between shots.
 

Thank you. That makes sense. Is there a certain time frame after starting insulin that I can expect for something to happen due to the depot if it's going to? (Days, weeks?)
 
We tell people you should hold the initial dose 5-7 days, depending on which dosing method they are following. Unless of course that dose is too high and they go below a certain blood sugar number indicating they need a lower dose. We call that number the "reduction point".
 
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