New Member :)

[Lynn.Oyinloye]

Hello! My cat Lucifer got diagnosed with diabetes like 3 days ago, in a few days we are going to see the vet to start him on caninsulin which they say we should give him every 12 hours. I know about the spreadsheet and I'm waiting for us to get his doses before filling it all out. My mom says that she doesn't want to give him insulin, and rather just change his diet. But I'm really worried that it will worsen if we don't. I want to try, but ultimately she has the power whether to treat him or not
Right now we have him on Whiskas dry food (1/2 cup) and 1 full can of Friskies gravy food every day. Thanks!!

 

[Ale & Bobo & Minnie (GA)]

I’ll write more soon but first off welcome and good on you for finding us within 3 days of diagnosis!!!

If you want to change the diet before starting insulin, you need to remove the dry food completely as it’s too high carb for a diabetic cat. As for the insulin, caninsulin is not a good insulin for cats. As the name indicates it was created for canines who have a much slower metabolism than cats. It hits hard and fast and it wears off before the 12 hour mark so your cat is not protected the entire day.

You may want to share the guidelines from the American Animal Hospital Assn for the treatment of diabetes in both dogs and cats with your vet. the AAHA no longer recommends Caninsulin/Vetsulin for treating feline diabetes.

 

[Lynn.Oyinloye]

I’ll write more soon but first off welcome and good on you for finding us within 3 days of diagnosis!!!

If you want to change the diet before starting insulin, you need to remove the dry food completely as it’s too high carb for a diabetic cat. As for the insulin, caninsulin is not a good insulin for cats. As the name indicates it was created for canines who have a much slower metabolism than cats. It hits hard and fast and it wears off before the 12 hour mark so your cat is not protected the entire day.

You may want to share the guidelines from the American Animal Hospital Assn for the treatment of diabetes in both dogs and cats with your vet. the AAHA no longer recommends Caninsulin/Vetsulin for treating feline diabetes.

Tysm for the reply! I heard about the dry food while doing research, so we are starting to phase him off it slowly. I'm going to try and ask the vet about latnus or Pz instead of caninsulin. The guidelines you shared is very helpful to back it up so thanks again!

 

[Sienne and Gabby (GA)]

Welcome to FDMB.

The first question I have is how was Lucifer diagnosed? Undoubtedly, his blood glucose was high in the vet's office. However, did the vet have a fructosamine test done? (This test is the equivalent of a hemoglobin A1c that is done for humans. It gives an average of blood glucose over the course of several weeks so you know if the result in the vet's office was accurate.)

Rather than get into a debate with your mom, either way, you're going to need to change Lucifer's diet. Change his diet now. Even with only a few days, you would see some change in your cat's blood glucose numbers. If the vet tests your cat, you'll know if the food change has gotten Lucifer out of a diabetic range (i.e., are his numbers outside of normal range -- over 120). You could also start testing him at home. You want to be feeding Lucifer a low carbohydrate diet. We regard low carb as under 10% although most members feed their cats in the neighborhood of 5%. This chart lists most of the canned foods available in the US. Canned food is far lower in carbs than dry food. Many of the members here feed their cats either Friskies or Fancy Feast pate style food. Do check the list since not all of Friskies or Fancy Feast are low in carbs.

As Ale noted, Caninsulin is not a great insulin for cats. Many vets persist in using it because they can sell it to you. It's not sold in a pharmacy because it's an animal insulin. The AAHA recommends either Lantus (glargine) or Prozinc. The latter is formulated for animals. Lantus, which is now available in a generic/biosimilar version that is much less expensive, is a human insulin and available at any pharmacy. Not all pharmacies carry the biosimilar so you may need to call around. The biosimilar is about a third of the cost of Lantus.

If your mom opts to not treat Lucifer's diabetes, if she cares about your cat, she will truly regret that decision. Untreated diabetes is a death sentence. Cats can experience diabetic ketoacidosis, kidney failure, seizures, heart problems, and ultimately sufficient weight loss to experience multi-organ failure. The parallel I would draw is if she would make the same decision if this were an infant. If she wants to try diet control, that's fine but I would not go beyond a couple of weeks to see if a change in diet lowers blood glucose levels sufficiently and permanently. What you and your mom likely do not know is that unlike with humans, cats who are treated early and effectively, can go into remission. This article on feline diabetes from Cornell Vet School will give you an overview of treatment and prognosis.

 

[Lynn.Oyinloye]

Welcome to FDMB.

The first question I have is how was Lucifer diagnosed? Undoubtedly, his blood glucose was high in the vet's office. However, did the vet have a fructosamine test done? (This test is the equivalent of a hemoglobin A1c that is done for humans. It gives an average of blood glucose over the course of several weeks so you know if the result in the vet's office was accurate.)

Rather than get into a debate with your mom, either way, you're going to need to change Lucifer's diet. Change his diet now. Even with only a few days, you would see some change in your cat's blood glucose numbers. If the vet tests your cat, you'll know if the food change has gotten Lucifer out of a diabetic range (i.e., are his numbers outside of normal range -- over 120). You could also start testing him at home. You want to be feeding Lucifer a low carbohydrate diet. We regard low carb as under 10% although most members feed their cats in the neighborhood of 5%. This chart lists most of the canned foods available in the US. Canned food is far lower in carbs than dry food. Many of the members here feed their cats either Friskies or Fancy Feast pate style food. Do check the list since not all of Friskies or Fancy Feast are low in carbs.

As Ale noted, Caninsulin is not a great insulin for cats. Many vets persist in using it because they can sell it to you. It's not sold in a pharmacy because it's an animal insulin. The AAHA recommends either Lantus (glargine) or Prozinc. The latter is formulated for animals. Lantus, which is now available in a generic/biosimilar version that is much less expensive, is a human insulin and available at any pharmacy. Not all pharmacies carry the biosimilar so you may need to call around. The biosimilar is about a third of the cost of Lantus.

If your mom opts to not treat Lucifer's diabetes, if she cares about your cat, she will truly regret that decision. Untreated diabetes is a death sentence. Cats can experience diabetic ketoacidosis, kidney failure, seizures, heart problems, and ultimately sufficient weight loss to experience multi-organ failure. The parallel I would draw is if she would make the same decision if this were an infant. If she wants to try diet control, that's fine but I would not go beyond a couple of weeks to see if a change in diet lowers blood glucose levels sufficiently and permanently. What you and your mom likely do not know is that unlike with humans, cats who are treated early and effectively, can go into remission. This article on feline diabetes from Cornell Vet School will give you an overview of treatment and prognosis.

I am not exactly sure what test was done on him, but they took blood from his vein and the results showed his albumin, glucose, cholestrol and triglycerides were increased. They also did a urine test to confirm the results. I'll ask and make sure when I go to the vet!! Thank you for the chart and especially the article. I'll show it and this forum to her so hopefully she'll change her mind.

 

[Ale & Bobo & Minnie (GA)]

That’s a very good point Sienne made about remission. Bobo went into remission in a month because I got him on insulin quickly.

Unfortunately most vets do not know a lot about feline diabetes…. they have many animals to look after and they all have different diseases and treatments. Dry food is really not good for any cat, especially a diabetic cat. That’s like feeding your diabetic child a diet of chips, ice cream and sweets.

With a diabetic cat you need:

• A low carb wet diet that is 10% carbs or under as Sienne said. Most of us use around 4-7% carbs and Friskies or fancy feast pages are totally fine. You don’t need expensive prescription foods which are mostly too carby too.
• A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
• We recommend hometesting the blood glucose daily with a human meter…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.
• HELP US HELP YOU has information about the spreadsheet, signature and hypo box which you will need to be able to look after your beloved kitty properly

You want to change the food now because once you start insulin, if you do any food changes it can affect the cat’s blood glucose making the insulin dose no longer safe. I’d follow Sienne’s suggestion and change the food now to see the difference at the next bet’s appointment. Remove all the dry and give only the Friskies pate. You can increase the amount of wet food so Lucifer is still getting enough calories. If you wait to do the food transition till after you start the insulin, you’ll need to be home testing because a change over then can drop the BGs by up to 100 points and we don’t want you to have a hypo on your hands.

We are happy to help you with setting up the spreadsheet, sorting out what food to buy, how to transition safely to a low carb diet, how to learn to home test and much more.

This is an excellent site for diabetic cats…it has been around for more than 25 years and has very experienced people to help you.

Keep asking lots of questions!

 

[Diane Tyler's Mom GA]

@Lynn.Oyinloye
Welcome Lynn and Lucifer
I see you live in Canada ,saw it in your profile
I would definitely tell your vet you want Lantus/glargine
As far as I know you don't need a script for it in Canada depending on where you live in Canada .
You would want to purchase the cartridges , the 5 pack.
The syringes you would need for lantus are these, they have the half unit markings because we adjust the doses by 0.25 units at a time . With the cartridges you can only adjust by whole units
Call the pharmacy's to see if they have them

Just take the cap off the pen and use a U100 syringes and pull the insulin out of the pen! You will see a small gray rubber stopper, insert the syringe there

Copied from another member about the insulin
Glargine insulin is a human insulin that is OTC in Canada. You just find the best price at the pharmacies near you and go in and ask for it. You're not asking for them to run it through your national health insurance. A 5 pack of Lantus pens is about $125 last time I heard (and you want the pens instead of the vial for several reasons. 1 is that if you drop a pen, you don't end up with an expensive puddle on the floor. 2. each pen only holds 300 units---a vial holds 1000, so unless your cat is on a very high dose, you can't use 1000 units before the insulin starts to lose efficacy. With the pens (or cartridges) only holding 300 units, you can pretty much use every drop. A 5 pack will last most cats at least 1 year and some up to 2 years! That makes it very affordable. If they tell you it has to be thrown away after 28 days, just smile, nod your head and go home. Stick it in the fridge (not the door) and it will be good until the expiration date on the box (usually at least 2 years).

Do NOT buy the special pen needles! We use regular insulin syringes with half unit marks and pull the insulin out of the pen. The pen needles not only allow you to only make changes in whole units, but you're supposed to "prime" it before each shot. That means shooting 2 units into the trash or down the drain before each shot. You also are supposed to hold the needle in for at least 10 seconds. For people that's fine, but our cats are not humans! It doesn't take much movement to have that needle come out. As far as the 28 day thing, in humans, who carry it with them which allows it to get warm may need to dispose at 28 days (IF they haven't used it all which would be unusual). As long as it's kept in the fridge, it's good until at least the expiration date unless for some reason it becomes cloudy or has "floaties" in it. It should be absolutely clear.

 

[Diane Tyler's Mom GA]

For lantus

 

[Diane Tyler's Mom GA]

About the meters I copied this information from other members

I used the FreeStyle Lite. I think they are only marginally cheaper than the Verio strips $80/100.
I used my PC points to cut the cost. (Also, if you have a senior human handy, take advantage of Seniors Days at Shoppers.)

There is also the Bravo meter. It takes a larger drop of blood than the FreeStyle.
The upside is the cost of the strips.
The downside is - and it's a big downside - the strips are not in stores and have to be ordered. This means you should have 200 to 300 strips (100 in your hypo kit) at any given time. During a low numbers event you'll be surprised just how quickly you will go through strips.
https://diabetesexpress.ca/products/bravo-meter
https://diabetesexpress.ca/collections/test-strips/products/bravo-test-strips

Another member suggested about the Bravo strips
I usually suggest buying 400 on your first purchase. Then, when you open the last 100, it's time to order again so you have a little time before you totally run out. You also need to spend at least $200 to get free shipping.

Unfortunately, Diabetes Express no longer offers the free meter with the purchase of 100 strips. The meter itself is $31.49

Just so you have a visual, this chart shows how big a blood drop needs to be.

 

[Diane Tyler's Mom GA]

Most of us feed Fancy Feast or Friskies
Fancy Feast and Friskies are available in Canada are called pates . It is the pates that are low carb.
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

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 to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with
Here is a video one of our members made testing her kitty
She's using a pet meter that has to be coded ,with a human meter you don't have to code it.
So ignore that
I have always used a human meter
VIDEO: How to test your cat's blood sugar


Learn how YOUR kitty is responding to insulin:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose
• How to do a Curve - a simple explanation

I suggest you set up your hypo kit in case you need to bring Licifer's BG up
For your Hypo kit
Med and High Carb food and some honey/karo



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods


https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.

Also here is the
Canadian food chart.


Just keep asking questions

 

[Lynn.Oyinloye]

Most of us feed Fancy Feast or Friskies
Fancy Feast and Friskies are available in Canada are called pates . It is the pates that are low carb.
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

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 to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with
Here is a video one of our members made testing her kitty
She's using a pet meter that has to be coded ,with a human meter you don't have to code it.
So ignore that
I have always used a human meter
VIDEO: How to test your cat's blood sugar


Learn how YOUR kitty is responding to insulin:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose
• How to do a Curve - a simple explanation

I suggest you set up your hypo kit in case you need to bring Licifer's BG up
For your Hypo kit
Med and High Carb food and some honey/karo



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods


https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.

Also here is the
Canadian food chart.


Just keep asking questions

omg thank you so much for your replies!! I'm still new so I'm confused when you said you adjust the doses. Do you adjust the dose based on the Bg? or is it like a week by week thing. I saw something about tight regulation, is it related to that?

 

[Sienne and Gabby (GA)]

Lynn -
Since you haven't started giving your cat insulin yet, dosing is a bit further down the line. For the purpose of background, very few members here get their dosing instructions from their vet. We have posts on dosing methods that are specific to each insulin. The major reason we don't rely on vets is that they want to use blood glucose date from when they test your cat at their office. Cats are stressed by travel and by being at the vet's office. As a result, their test numbers are artificially high. Basing the dose on those numbers is likely to result in an overdose. We strongly encourage members to learn how to home test and make dose adjustments based on what the data tells you. Frankly, this is no different than what diabetic humans do.

Tight regulation is a dosing strategy that was developed for use with glargine quite a few years ago.

 

[Diane Tyler's Mom GA]

omg thank you so much for your replies!! I'm confused when you said you adjust the doses. Do you adjust the dose based on the Bg? or is it like a week by week thing. I saw something about tight regulation, is it related to that?

As Sienne said dosing is a bit further down the line
But to answer your question ,you dont adjust the dose based on the BG, the test you would do first thing in the morning which is called the AMPS ( AM PRE SHOT)
Same goes for the PMPS the first test you do at night (PM PRE SHOT)
We adjust the dose by what's called the NADIR , the lowest point during each 12 hour cycle.
Learn how YOUR kitty is responding to insulin:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose

If you can get your vet to prescribe Lantus and want to read about it here is the link, be sure to read all the yellow stickys on it
https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
There are 2 dosing methods when using Lantus/Glargine either TR or SLGS
You will read about them when you read the link I gave you
Members will then chose one to follow


You can also read about Vetsulin/Caninsulin here, there is no dosing method to follow when it comes to Vetsulin/Caninsulin , when you read about
https://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/

I told you about the syringes to use if you get Lantus/Glargine in my post

Caninsulin the syringes will be different syringes to use but still with half unit markings
I found a thread on our site and found a member from Canada got the U-40 syringes here with the half unit markings
https://www.petsdrugmart.ca/en/Product/CarePoint-Vet-Insulin-Syringes-119693/5676

But I hope you can get the Lantus
When you find out what insulin you will be using and then we can go from there
@Lynn.Oyinloye

 

[Ale & Bobo & Minnie (GA)]

As Sienne said dosing is a bit further down the line
But to answer your question ,you dont adjust the dose based on the BG, the test you would do first thing in the morning which is called the AMPS ( AM PRE SHOT)
Same goes for the PMPS the first test you do at night (PM PRE SHOT)
We adjust the dose by what's called the NADIR , the lowest point during each 12 hour cycle.
Learn how YOUR kitty is responding to insulin:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose

If you can get your vet to prescribe Lantus and want to read about it here is the link, be sure to read all the yellow stickys on it
https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
There are 2 dosing methods when using Lantus/Glargine either TR or SLGS
You will read about them when you read the link I gave you
Members will then chose one to follow


You can also read about Vetsulin/Caninsulin here, there is no dosing method to follow when it comes to Vetsulin/Caninsulin , when you read about
https://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/

I told you about the syringes to use if you get Lantus/Glargine in my post

Caninsulin the syringes will be different syringes to you , but still with half unit markings

When you know what insulin you will be using just post and let us know and we can go from there
@Lynn.Oyinloye

I believe you can follow SLGS for Vetsulin

 

[Lynn.Oyinloye]

As Sienne said dosing is a bit further down the line
But to answer your question ,you dont adjust the dose based on the BG, the test you would do first thing in the morning which is called the AMPS ( AM PRE SHOT)
Same goes for the PMPS the first test you do at night (PM PRE SHOT)
We adjust the dose by what's called the NADIR , the lowest point during each 12 hour cycle.
Learn how YOUR kitty is responding to insulin:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose

If you can get your vet to prescribe Lantus and want to read about it here is the link, be sure to read all the yellow stickys on it
https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
There are 2 dosing methods when using Lantus/Glargine either TR or SLGS
You will read about them when you read the link I gave you
Members will then chose one to follow


You can also read about Vetsulin/Caninsulin here, there is no dosing method to follow when it comes to Vetsulin/Caninsulin , when you read about
https://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/

I told you about the syringes to use if you get Lantus/Glargine in my post

Caninsulin the syringes will be different syringes to use but still with half unit markings
I found a thread on our site and found a member from Canada got the U-40 syringes here with the half unit markings
https://www.petsdrugmart.ca/en/Product/CarePoint-Vet-Insulin-Syringes-119693/5676

But I hope you can get the Lantus
When you find out what insulin you will be using and then we can go from there
@Lynn.Oyinloye

Thank you for all the help! We went to the vet today and we told him about PzI/Lantus and my family has decided to go ahead with Lantus for him (PZI is completely out of our budget). I found/got the same monitor you used (the freestyle lite). What should i do now? Do I go to the specific Lantus group or should I just post on the main for help with the dosing (we're still gonna try and get our vets opinion though). I'm afraid we're still kinda in the dark about all this so I'm still really confused about what the measurements on the glucose monitor mean as well haha.

 

[Ale & Bobo & Minnie (GA)]

@Diane Tyler's Mom has some great tips on how to get cheaper Lantus. You can also get the generic glargine that is just as great.

your vet probably gave you a starting dose right? It’s a good idea to start with a low dose of .5 or 1 units. Did you get the 1/2 unit marked syringes?

You can continue to post here until you've got the hang of it, but I think it would be good for you to go over to the Lantus forum and read all the yellow sticky notes, especially the one on dosing. Most folks start with the SLGS method: https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

we also have testing tips to make it easier on you and your cat. Who is going to be testing, you or your mom?

 

[Lynn.Oyinloye]

@Ale & Bobo & Minnie (GA) We are getting the syringes today, my vet recommended .2 units as a starting dose (for Caninsulin though). Me and my mom are gonna be testing, but mostly me because he's more comfy with me. I think I'll head over to the Lantus forum, thanks a lot!!

 

[Ale & Bobo & Minnie (GA)]

I wouldn’t start higher than 1 unit. 2 is too high a starting dose. These are the ones I used from Walmart