Hello from me and Poopy!

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Raiye

Raiye

Member Since 2022
Hello everyone!

My obese 12 year old, Poopy (his 'legal' name is Budley, but we call him by his nickname more than his real name now honestly) was diagnosed with diabetes 8/4. At that time he was also diagnosed with a UTI (treating with Clavamox 2x a day), arthritis in his back end (treating with .2 mL of buprenorphine 2x a day), and asthma (no treatment yet, but I will be asking the doc for some soon).

His prescription was for Vetsulin u40, 3 units twice a day. After finding this resource and searching for the most cost effective treatment I decided to go with Lantus. Luckily, a friend recently changed insulins and donated (!!!!!) her leftover pens, a couple glucometers (an AccuChek Guide Me and an Ascensia Contour), syringes, lancets and lance devices, and some testing strips. I've decided to use the AccuChek as we have many more testing strips for that.

I decided to go with the TR method and that I would be giving Poopy his insulin at 11 (as that works best with my schedule). We started last night at 11 PM.

I have a few concerns-
One of the biggest things we need to focus on is losing weight. Weight loss will help with the majority of his ailments. Poopy was 24.8 lbs when weighed 8/4. Vet believes his ideal weight is 11-13 lbs max, but I am unsure. He is a LARGE cat outside of the obesity (his paws are half the size of my palm!). The vet recommended that we cut his food back to 3/4 cup dry food a day and gradually cut down to 1/2 cup a day in two weeks. She also states that he should only be fed the same time as his insulin. Due to his arthritis (or a combination arthritis/neuropathy) he does not get around well, and therefore does not get much exercise, so cutting back on his food is going to be the only way to get him to shed some pounds.

I want to switch him over to wet food ASAP (and so does he!) and picked up some Friskies poultry pate but I am unsure how much to feed him. I'm also nervous that restricting his food will mess up his sugars? Can anyone help me figure out the conversion between 3/4 cup dry food to the equivalent amount of wet food? Should I feed his daily amount in small amounts throughout the day or follow the vets advice and only feed him at insulin time? I also have some Pure Balance lickable treats I am using to get him accustomed to his ear pokes, will that little bit of treat (maybe 1/8 of a .5 oz tube) mess up his diet at all?

The second thing is that his sugars haven't had much of a change, and are still consistently high. It has only been one day and I did read that it can take time for the insulin to work, but I am just an anxious mess. I tested his urine this afternoon and there were no ketones. I know being stressed out with the ear pokes, other meds 2x a day, and the UTI can cause higher blood sugar too. Should I not expect to see much of a difference with his levels until his UTI has cleared?

The last thing is that we were prescribed a U40 insulin and I have not really seen anything (other than the conversion chart for using U100 needles with U40 insulin) comparing the two types as Vantus is a U100 insulin. I did find the dosage calculator for the TR method (.25 units/ideal weight in kg) and with that he should be getting 1.5u of Vantus. We currently do not have syringes small enough for that so I've just been giving him 1u. With his numbers so consistently high would it be safe to do 2u? (I did 2u on the first night. I asked for help in the facebook group and mistakenly said I only gave one :( )

I have had my boy since he was 8 weeks old (in 2010!), with his twin brother Dudley. We lost Dudley very abruptly to cancer in 2018. Dudley was my heart cat and losing him hit me very hard. I have ADHD and a very hard time with numbers and I am so scared and anxious that I am going to mess this up, and be the reason we lose Poopy. This cat has been there for me through all my major life events. He was there for my high school graduation, my first apartment, emotional support through failed relationships and family members deaths. We faced possible homelessness or having to admit defeat and move back in with my parents. We were there for each other after the loss of his brother. Poopy was even in the room during my wedding. I do not have children, nor will I ever. Poopy and his brother ARE my kids, and the reason I am where I am today. I absolutely cannot imagine my life without him and will do anything to make sure he is healthy, happy, and pain free. I've attached a baby photo of Budley(Poopy) and Dudley (Budley is the bigger one, Dudley was really really sick when I adopted them) and a recent photo of Budley enjoying some fresh primo quality dirt on an adventure. He has a stroller and LOVES to come with us anywhere. He loves exploring the woods and chilling by the campfire.
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Hi Chelsey and Poopy, welcome to the club. Love the pics! Adorable kitties.

If I am reading your post correctly, you are giving Poopy Lantus but only have u40 syringes? That's tricky. I hope you are getting u100 syringes ASAP! Make sure you get the ones with half-unit markings like these:

https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct

Also, maybe I miss-read so please clarify, did you only give 1 unit of Lantus?

As far as the food conversion, losing weight, etc -- when my boy Hendrick was diagnosed we switched our entire six-cat household to canned/raw only. No more dry food. Donated all the kibble and all the temptations and greenies, got that crap out of the house. We had two of the six that were definitely overweight, we used to just put dry food in gravity feeders and let them free-feed and graze.

Simply the switch to canned/raw, and doing scheduled feeding instead of free feeding caused every single cat to slim down, some more than others. Our heaviest kitty at nearly 15 pounds, has trimmed down to 11.5 over the past six months after the food change.

Regarding his blood glucose numbers still being high, you will need to be patient. This is a marathon, not a sprint, and it takes time for insulin therapy to do it's thing. Usually at least a week after starting insulin, to get an understanding of how well the dose is working. And then getting to regulation can take weeks or even months.


You are doing a great job already with the home testing and spreadsheet, well done! When i was new like you I could not even figure out how to get a blood drop from Hendrick's ear. We struggled and struggled.

I am sure other members will chime in here soon enough, I am not one of the experts just someone who has been through the process recently.
 
Regarding feeding, I would feed about 1-15? fewer calories and tnd weight weekly at the same time and then change the calories as determined by how the weight is changing. Do not have him lose weight too fast.
Dr. Arguelles also emphasizes that owners should not push for a quick drop in weight. “We only want cats to lose half a pound to one pound per month. Any faster than that and they can become ill with fatty liver disease.”
https://www.petmd.com/cat/care/how-help-your-cat-lose-weight-and-keep-it
When I adopted DeeDee in November of last year she was obee@17 libs. Now she is a little less that 10 lbs and looks like she can lose more weight.
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Welcome to FDMB!

Everyone (pretty much) is anxious when they arrive here and have similar concerns much like you noted. Both on this part of the message board and the Lantus forum, there are usually people who are around 24/7. You can always find help.

First, Larry is usually a great resource for information but I think he didn't proofread his note. I was confused! In addition to the link on weight loss that he posted, I like the information provided by Lisa Pierson, DVM. She has a wonderful website on feline nutrition. There's a section on feline obesity, as well, and how do manage getting your cat to lose weight safely. Kyle's point is also well taken -- a switch from carbohydrate laden dry food to a higher protein, canned food diet will help your cat to lose weight. (You're essentially putting your cat on a keto/paleo diet.) Cats are obligate carnivores and can't process the carbs that are in dry food.

As far as converting from dry to canned, see how many calories you're feeding your cat on dry food. Feed the same calories of canned. The calorie count should be on the label or check the manufacturer's website. The information on canned food is on the food chart on Dr. Lisa's website. From the information on obesity in cats, Required calories per day = [13.6 X optimal lean body weight in pounds] + 70. She discusses why this is a starting point. Also, if Poopy is a big breed cat, the vet may be underestimating his ideal weight. I have big breed cats and males are around 13 - 15 lbs.

Most of the folks here do not feed their cats 2 meals a day. Once you have figured out the amount of food your cat needs, you can spread that out over a few hours. You do not want to give your cat food during the 2 hours prior to shot time (unless you test and numbers are low). For many cats, feeding during the latter part of the cycle means your giving your cat food after the effects of insulin are waning.

The dose of Vetsulin is a very large starting dose. Given that it is a harsh, fast acting insulin (i.e., it can drop numbers fast and hard), starting on 3.0u is a lot especially if you're still getting used to home testing. If you are switching to Lantus and planning on using Tight Regulation as your dosing strategy, you can used a weight based formula to calculate the starting dose. (Initial dose = 0.25 x cat's ideal weight in kilograms) However, you may need to use your cat's current weight since he's a bit, ummmm....., "fluffy." Since it looks like you have switched to a 1.0u dose of Lantus, you can stick with that. I would, however, see if you can get a prescription for U100 syringes. It will make life much easier.

It will take roughly 5 - 7 days for the Lantus depot to stabilize. It's unlikely that you will see a great deal of change prior to that time. Also, if your cat is dealing with a UTI, until the infection clears, you might not see much change. Any infection or inflammation can cause a rise in blood glucose levels. Just keep an eye on Poopy's numbers since they can drop quickly once the infection clears. Also, did the vet get a sterile urine sample to diagnose the UTI (i.e., use a needle into the bladder to get the sample)?

Your cat's spreadsheet lists the insulin as "Vantus." I'm assuming from your signature, you've already switched to Lantus?
 
Welcome and Poppy is one good looking fella!!

I think everyone already said everything I’d say and more. The only thing I’ll add is that you can get the u-100 ReliOn syringes from Walmart and here in California you don’t need a prescription for it. I’m not sure where you’re located, but I’d call the Walmarts around you and ask if they have them in stock and if you need a prescription. This is what they look like

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We have U100 syringes, I was just worried about the Vetsulin and Lantus having different U numbers. The syringes we currently have are 100 unit ones, so thank you all for the recommendations for the smaller size. He has only been getting 1u of Lantus every 12 hours. His sugars have finally dropped below 300 today! I finally felt that he was stable and I was comfortable enough to get some sleep. I've been very sleepless since Wednesday night when he initially got sick.

I do not know what breed of cat he is, his parents were just regular ole house cats, so I don't have any idea where his size came from. He was around the 10 lb mark when he got neutered at sevenish months old. He has never been a very active cat either, other than when he was a kitten.

We switched to wet food exclusively for him Friday. He loves and has been on wet food before so we were able to cut the kibble out without any complaining from him or upset tummy. Our other cats think we're starving them to death now, even though they still have a bowl full of kibble that's just been moved onto their cat tree where Poopy can't get to it. *eye roll*

They did a cystocentesis (needle into the bladder) to get the urine sample, and x-rays to confirm asthma and arthritis. .

I finally think that my initial sticker shock has worn off. Believe it or not I have a couple semesters of veterinary tech school under my belt, but it's been YEARS and I wasn't able to finish the course so didn't quite make it to any sort of diabetes/insulin classes. Though I have broken out my text and workbook to try and get a better understanding of it all!

You guys have really been such an invaluable resource and the spreadsheet has been so much help. I am also keeping a "diary" with the time, sugar levels, activity levels, food given/eaten....etc

For sharps disposal, I've heard that you can use a hard plastic container (like for laundry soap), and once its full, tape it shut and pharmacies will dispose of it for you? Is that something that I will need to just ask around in my area?

Any recommendations on asthma treatment? I'm nervous about pred as I don't want to make his diabetes worse. He typically only has a cough (sounds like throwing up a hairball) every few days, but since he got really sick Wednesday (below I'll include what was going on Wednesday) he's been out of breath much more often and isn't even able to walk halfway across our apartment right now without open mouth panting. Would an inhaler be enough for now until the UTI is completely cleared, diabetes controlled, and is under good pain management with his arthritis (since i know all that can make asthma worse?)

I am going to start him on the B12 for neuropathy next week (already have it saved in my amazon account!) and I'd like to also start him on Glucosamine Chondroitin - Is that safe for sugarcats or is there a better alternative for joint support?

We have a small zoo at home (3 cats, 2 rabbits, 3 ferrets, 5 cockatiels, a conure, a pigeon, an aquarium and a praying mantis) and the rest of the zoo will be happy that Poopy is feeling better and isn't getting 150% of my attention anymore.
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Poopys ears look a hot mess, and I only stabbed myself on accident once!, but I think we're going to make it through this. He's definitely not going to complain about wet food or the little bit of chicken lickable treat he gets while I fumble around trying to get a good sample. Hes finally deep sleeping again too, his favorite past time.

Wednesday night: Came home from bowling league and noticed some vomit on the floor and Poopy in the litter box, straining to pee and he screamed in pain. Noticed when he got out there was nothing new in the litterbox. Started freaking out that he was blocked and that we couldn't afford an emergency vet (shame on me and my husband for thinking we could actually pay some other bills this month!). Husband came home from work to calm me down, Poopy threw up a couple more times but stopped panting and ate a little and drank some. We set up Poopy in our bedroom for the night. I finally fell asleep, in the AM noticed he threw up a couple more times and called our vet ASAP and they were able to get us in that morning. Vet said that the most pressing concerns are his weight and the UTI, and while he could wait on insulin, its something i needed to start in a couple days. Thats when I started shopping around for affordable prices and found you guys!
 
I just checked and the food we were feeding him was 420 k/cal per cup!
The friskies pates we have are all about 180 k/cal per can so we're gonna do 2 cans a day for a week and see how he goes and cut down from there!

Any recommendations on scales?
 
Baby scales work well for getting a cat’s weight. I got mine off of Amazon.

I have an asthmatic cat as well. You are correct that pred has a systemic effect and can increase BG. My guy uses an inhaled med called Flovent with an Aerokat chamber for administration. That’s pretty commonly recommended these days.

Aerokat is available online from various sellers.
https://www.chewy.com/trudell-medical-international-aerokat/dp/175949

Flovent is very effective but pricey is the U.S.
Some people get their Flovent from Mark’s Marine Pharmacy in Canada, which is much cheaper. Mark’s sells Lantus as well. We use 110 mcg cartridges of Flovent, but it will show 125mcg on Mark’s (or any Canadian Pharmacy) website. It’s the same strength, apparently, but Canada and the US choose a different point (push mechanism vs canister exit) to measure the strength. Or so I’ve been told.

Sounds like you have 1ml u-100 insulin syringes.
U-100 is the strength of the insulin (100 units of insulin per ml for Lantus). The 1ml is how much liquid the syringe holds. Each “tick” mark on your current syringes should be 2 units, so I assume you’re only drawing half way to the first mark.

It will be easier to draw the correct dose when you get the 3/10cc syringes as they only hold 1/3 as much liquid. Cats use such tiny doses compared to humans that it really does make a difference.

If you have any U-40 syringes (which is what you’d have used with the Vetsulin, a U-40 strength insulin), I’d label them as such and put them high up in the back of some cupboard. If you accidentally use one of those U-40 syringes with Lantus, you will overdose your cat significantly.
 
Raiye said:
For sharps disposal, I've heard that you can use a hard plastic container (like for laundry soap), and once its full, tape it shut and pharmacies will dispose of it for you? Is that something that I will need to just ask around in my area?
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Yes, you should check your county's/city's website usually under trash disposal for how to dispose of sharps. It varies by locality. Where I like the website say put in shatterproof (not glass or shatterable plastic container, a plastic laundry detergent bottle is fine) and tape the lid on and make container with "Sharps".
 
JL and Chip said:
\ Each “tick” mark on your current syringes should be 2 units, so I assume you’re only drawing half way to the first mark.
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AH! You're right! I've been giving him two units of insulin! I was in such a panicked state when we started I feel so bad for not noticing that! I'm assuming I should continue with the 2 units until his blood sugars are close to a normal range before starting to decrease by .25u? It will be very hard to only draw up to half the line on the syringes I currently have. I have updated my SS to reflect the correct dosages

I haven't picked up any U40 syringes so no worries about mixing them up! I'm gonna call my pharmacy and see if they have any of the 3/10 mL's recommended by either in stock, or if they have a couple I could get until payday.
 
it is actually tough to tell what the 2U is doing just yet. Takes about a week for a new dose to settle in.

I am not sure if you should stick with the 2U or drop it back down to 1. I am not one of the experts who can advise you there.

I have a couple boxes of u100 1/2 unit syringes I would gladly give you but no idea how far away you might be. I am in the WNY area
 
Raiye said:
Any recommendations on asthma treatment? I'm nervous about pred as I don't want to make his diabetes worse. He typically only has a cough (sounds like throwing up a hairball) every few days, but since he got really sick Wednesday (below I'll include what was going on Wednesday) he's been out of breath much more often and isn't even able to walk halfway across our apartment right now without open mouth panting. Would an inhaler be enough for now until the UTI is completely cleared, diabetes controlled, and is under good pain management with his arthritis (since i know all that can make asthma worse?)
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For arthritis I see many members use adequan go top where it says search type in adequan and you can read all the posts

@tiffmaxee

@Wendy&Neko

@Suzanne & Darcy
 
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My Walgreens was able to sell me a box of 3/10ml syringes! I emailed my vet today and she agreed with all the choices I've made so far regarding his care.
She was very impressed with the spreadsheet! Good job on that guys!

I asked about an inhaler for his asthma, and she didn't recommend it because it's a steroid and could make his asthma worse? I read somewhere that since it's applied directly to the lungs it doesn't effect diabetes?
 
My vet showed the ss to his third year veterinary students and was impressed as well. I can’t answer your asthma question but know others have used inhalers. If needed it seems like it should be used and if necessary adjust the dose if lantus accordingly. I hope someone else replies.
 
Poopy normally gets his insulin and dinner at 11 pm. How much of a difference does the time I check his blood sugar make? If I test his sugar at 10:50, make his dinner, and then give his insulin at 11 is that okay? Or should you be testing right before giving the shot?
 
Raiye said:
Poopy normally gets his insulin and dinner at 11 pm. How much of a difference does the time I check his blood sugar make? If I test his sugar at 10:50, make his dinner, and then give his insulin at 11 is that okay? Or should you be testing right before giving the shot?
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That’s fine.
 
Raiye said:
Poopy normally gets his insulin and dinner at 11 pm. How much of a difference does the time I check his blood sugar make? If I test his sugar at 10:50, make his dinner, and then give his insulin at 11 is that okay? Or should you be testing right before giving the shot?
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as Elise said, that's fine. With Lantus or generics the general rule of thumb is

  • Test to make sure it is safe to shoot
  • Feed
  • Shoot the insulin
Ideally, all within about a 10-15 minute window give or take. So you're doing it just right!
 
Good morning! This AM I checked his sugar before giving his antibiotics and pain meds and got an E3 error on my glucometer. That means that there was an error with the test strips or his sugar was too high.
I tried with three or four test strips, with both ears, and got the same error each time. Once I got a reading of 160-something but then the screen turned off really quickly (it normally stays on for a while). I grabbed a strip from a new container, and got a reading of 147, and then tried with the other ear and got 153 (or whatever is on my sheet for the most recent +9.

Is my glucometer going bad? Batteries low (no indication of that on the screen)? Any ideas what happened?
 
It sounds like there is something wrong with your meter. How about calling the manufacturer customer service number and explain what is happening.That will likely let you know if a faulty meter or battery. Just don’t say it’s being used for a cat. Do you have a backup meter? It’s good to have one for instances like this. I also would double check an odd reading with my backup.
 
tiffmaxee said:
Do you have a backup meter? It’s good to have one for instances like this. I also would double check an odd reading with my backup.
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I got another of the same meter at Walmart today. It was only $14 and came with a better lancet than we currently have. The old glucometer tested fine for his afternoon test, and then after I got the new one home tested with both and they were close to each other (124 and 127).
Not sure what was going on with the old one this AM. Glad it happened though so I have an extra now!
 
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