New and confused - Duke got diagnosed with diabetes on 8/26

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Tanize

Tanize

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Aloha, I am so glad I found this site. My Cat Duke got diagnosed on 8/26 - last monday.
I took him to the vet as I noticed he lost weight but was eating more than normal for him, always hungry. It was all of sudden , maybe it all happen in 2 months. He's 9 years old, about 11 lbs. Vet did a blood test , Glucose was off the chart at 600 .
Vet started him on vetsulin, twice a day with meals, using the U-40 siringes and dose was 2.5 for the first 3 days ....then increased to 3... Vet put a monitor on the side of his upper chest linked to an app on my phone which I scan to read the glucose level. He said it is actually for people but can be used on animals. Since we started he is always on the HI mode (this monitor highest is 500), after insulin shot the glucose takes 3 -4 hours to lower a bit....stay on mid 300 s maybe for 1 hour ...then goes to 400 's very shortly and back to High (over 500). It has been 5 days ( 10 insulin shots) and the pattern continues....it doesnt seem the insulin is working as glucose level it goes down after 3-4 hours , and then shoots right back up.

For example yesterday I gave his shot at 7:30 am -scan - monitor was HI (above 500). It remained on HI until 9:16 am. Then 9:46 it registered 454mg/dl; 10:24 am registered 341, 11:12 am 336, 12:03 already started to go up 350 and by 2 pm it was HI (above 500) then it remained on HI until 11:40 pm when finally registered 494 (gave insulin at 7:30 pm). it went down to 392 and by 12:58 am it was already back up to 495 and then up to HI all the way to today .
today same thing After his insulin at 7:30 am readings remained HI until 10 am when it registered 290, then 11am 248, and by noon was 386 and by 1 pm was back to HI (500minimum) and then stays HI for the rest of the day.

I was told to feed him twice a day, right before the insulin shot an monitor as much as i could as the monitor would stay on him maybe a week .
He is in good spirits....annoyed as hell as i am keeping him inside as much as I can so I can keep the monitor longer and avoid him to eat geckos. (he is an outdoor cat)
My questions Are:
Is this suppose to be like that? The glucose levels take while to get down, and then go right back up ?
is this how it suppose to be in the beginning of treatment?
How much we should feed now and snack or no snack?
I switched the dry food to canned food- Friskies pate...tuna,chicken as I read online would be the best. And boiled chicken breast. for an 11 lb cat that lost weight is 1.5-2 cans ok? the 5.5 oz size. i am reading and some say to only feed twice a day, others say i could give him a little snack - (boiled chicken) ? what is the right thing to do?
After I give his insulin....for the first couple hours he seems himself....then he kind of lay down for the next 4 hours or so - I think when the levels are going down he gets a little off. I have been monitoring and in 5 days the lowest glucose reading was 260...and not for more than 1 hour..so he is not hipoglicemic ever.


I am writing to get a little advice as this week has been very difficult. I read as much as I could on the forum but looking to see if anyone can answer these few questions and let me know if this is the "normal" or if it suppose to have worked better.
thanks in advance for who reads all the way here and have any advice.
 
Hi and welcome to the forum Tanize and Duke.
With vetsulin you need to feed a meal and then wait 30 minutes for the food to get aboard and then give the dose of insulin.
So the routine is to test first, then feed a meal and wait 30 minutes and then give the dose of insulin.
And it is a good idea to give 2 or 3 snacks of food every cycle. When using vetsulin I would suggest giving a snack at +2 +4 and +6 if you can. A snack is a teaspoon or 2 of a low carb food. Cats need food during the cycles just like humans do. You can feed some chicken breast if you like or just the low carb canned food. He will be happier and more settled with snacks.

In relation to the BGs (blood glucose) starting off high, dropping lower and then going up high again…that is what happens when you use vetsulin. Vetsulin is not a good insulin for cats. It is a dog insulin and as cats have a much faster metabolism than dogs, the insulin hits hard and fast and does not last 12 hours. It drops the BGs too fast and this can cause the cat to bounce. So you get this cycle you are seeing of really high BGs, dropping to the 200s 4 hours later, then back up to high.
Here is an explanation about bouncing
  • Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).
You would be much better if you could get the vet to swap Duke to Lantus insulin or Prozinc insulin which are longer acting insulins and are recommended for cats. Also he was started on quite a high dose of vetsulin and then increased after 3 days to 3 units.
We recommend starting a cat on 1/2 to 1 unit of insulin and then increasing slowly in 1/4 unit increments.

I would suggest a few things
  • Set up our spreadsheet and signature. That will allow us to see more clearly what is going on and also to find out more about Duke. There is also info on setting up a hypo kit in case of low numbers. You don’t want to be racing around looking for something to give if he has a hypo. So get that set up asap. The details are in this link help us help you
  • Ask the vet about swapping to one of the longer acting more gentle insulins.
  • Think about learning to hometest the BGs. It’s not hard and it is the only way to keep Duke safe. The libre is good but expensive to use all the time. Info on HOMETESTING . I would look at buying a human meter not a pet meter as it is far cheaper to run. The libre you are using is a human meter. You will also need a box of test strips, a box of lancets size 26 or 28 and cotton balls to hold behind the ear when testing.
  • Read BEGINNERS GUIDE TO VETSULIN.
  • Keep asking questions, we are happy to help
Bron
 
Bron has provided great information to help you get started. There are a few basics to keep in mind.

Home testing is the best way to keep your cat safe. You want to test before you give a shot so you know that Duke's blood glucose levels are in a safe range for you to give insulin. You also want to get at least one additional test during both the AM and PM cycles. The tests during the cycle tell you how low the dose is taking your cat's numbers.

You want to be sure Duke is on a low carbohydrate diet. We consider low carb as less than 10% although most members feed their cat a food that's in the neighborhood of 5%. This is a chart that contains nutritional information, including the carb amounts, for most canned food available in the US. You have lots of choices!

The only concern I have is that Vetsulin is not an ideal insulin for managing feline diabetes. In fact, the American Animal Hospital Assn stopped recommending it in 2018. This is a link to the AAHA guidelines. The insulins that are recommended are either Lantus (glargine) or Prozinc. Vetsulin is harsh and does not have the duration necessary for a cat's fast metabolism. Both Lantus and Prozinc are gentler and last the entire 12 hours. Lantus, in particular, has a very solid track record of getting cats regulated or into remission. You may want to bring a copy of the AAHA guidelines with you to the vet and discuss the insulin choice.

One observation made by several of our members who use the Libre. It tends to give falsely low readings when your cat is in lower numbers. Many of them also will use a hand held glucometer to test to double check the accuracy of the Libre when numbers are closer to normal range.
 
Tanize said:
Aloha, I am so glad I found this site. My Cat Duke got diagnosed on 8/26 - last monday.
I took him to the vet as I noticed he lost weight but was eating more than normal for him, always hungry. It was all of sudden , maybe it all happen in 2 months. He's 9 years old, about 11 lbs. Vet did a blood test , Glucose was off the chart at 600 .
Vet started him on vetsulin, twice a day with meals, using the U-40 siringes and dose was 2.5 for the first 3 days ....then increased to 3... Vet put a monitor on the side of his upper chest linked to an app on my phone which I scan to read the glucose level. He said it is actually for people but can be used on animals. Since we started he is always on the HI mode (this monitor highest is 500), after insulin shot the glucose takes 3 -4 hours to lower a bit....stay on mid 300 s maybe for 1 hour ...then goes to 400 's very shortly and back to High (over 500). It has been 5 days ( 10 insulin shots) and the pattern continues....it doesnt seem the insulin is working as glucose level it goes down after 3-4 hours , and then shoots right back up.

For example yesterday I gave his shot at 7:30 am -scan - monitor was HI (above 500). It remained on HI until 9:16 am. Then 9:46 it registered 454mg/dl; 10:24 am registered 341, 11:12 am 336, 12:03 already started to go up 350 and by 2 pm it was HI (above 500) then it remained on HI until 11:40 pm when finally registered 494 (gave insulin at 7:30 pm). it went down to 392 and by 12:58 am it was already back up to 495 and then up to HI all the way to today .
today same thing After his insulin at 7:30 am readings remained HI until 10 am when it registered 290, then 11am 248, and by noon was 386 and by 1 pm was back to HI (500minimum) and then stays HI for the rest of the day.

I was told to feed him twice a day, right before the insulin shot an monitor as much as i could as the monitor would stay on him maybe a week .
He is in good spirits....annoyed as hell as i am keeping him inside as much as I can so I can keep the monitor longer and avoid him to eat geckos. (he is an outdoor cat)
My questions Are:
Is this suppose to be like that? The glucose levels take while to get down, and then go right back up ?
is this how it suppose to be in the beginning of treatment?
How much we should feed now and snack or no snack?
I switched the dry food to canned food- Friskies pate...tuna,chicken as I read online would be the best. And boiled chicken breast. for an 11 lb cat that lost weight is 1.5-2 cans ok? the 5.5 oz size. i am reading and some say to only feed twice a day, others say i could give him a little snack - (boiled chicken) ? what is the right thing to do?
After I give his insulin....for the first couple hours he seems himself....then he kind of lay down for the next 4 hours or so - I think when the levels are going down he gets a little off. I have been monitoring and in 5 days the lowest glucose reading was 260...and not for more than 1 hour..so he is not hipoglicemic ever.


I am writing to get a little advice as this week has been very difficult. I read as much as I could on the forum but looking to see if anyone can answer these few questions and let me know if this is the "normal" or if it suppose to have worked better.
thanks in advance for who reads all the way here and have any advice.
Click to expand...
Aloha!Welcome to the Forum:bighug::cat::cat:
 
Last edited:
Sienne and Gabby (GA) said:
Bron has provided great information to help you get started. There are a few basics to keep in mind.

Home testing is the best way to keep your cat safe. You want to test before you give a shot so you know that Duke's blood glucose levels are in a safe range for you to give insulin. You also want to get at least one additional test during both the AM and PM cycles. The tests during the cycle tell you how low the dose is taking your cat's numbers.

You want to be sure Duke is on a low carbohydrate diet. We consider low carb as less than 10% although most members feed their cat a food that's in the neighborhood of 5%. This is a chart that contains nutritional information, including the carb amounts, for most canned food available in the US. You have lots of choices!

The only concern I have is that Vetsulin is not an ideal insulin for managing feline diabetes. In fact, the American Animal Hospital Assn stopped recommending it in 2018. This is a link to the AAHA guidelines. The insulins that are recommended are either Lantus (glargine) or Prozinc. Vetsulin is harsh and does not have the duration necessary for a cat's fast metabolism. Both Lantus and Prozinc are gentler and last the entire 12 hours. Lantus, in particular, has a very solid track record of getting cats regulated or into remission. You may want to bring a copy of the AAHA guidelines with you to the vet and discuss the insulin choice.

One observation made by several of our members who use the Libre. It tends to give falsely low readings when your cat is in lower numbers. Many of them also will use a hand held glucometer to test to double check the accuracy of the Libre when numbers are closer to normal range.
Click to expand...

thank you so much
The libre just stopped working a couple hours ago . Vet said I had it for 14 days …. It only lasted 5
I will keep reading it all better and will order the home test. I won’t be able to reach vet until Tuesday as tomorrow is a holiday. Will for sure ask more questions as it’s definitely stressful trying to do the right care .
 
Tanize said:
Aloha, I am so glad I found this site. My Cat Duke got diagnosed on 8/26 - last monday.
I took him to the vet as I noticed he lost weight but was eating more than normal for him, always hungry. It was all of sudden , maybe it all happen in 2 months. He's 9 years old, about 11 lbs. Vet did a blood test , Glucose was off the chart at 600 .
Vet started him on vetsulin, twice a day with meals, using the U-40 siringes and dose was 2.5 for the first 3 days ....then increased to 3... Vet put a monitor on the side of his upper chest linked to an app on my phone which I scan to read the glucose level. He said it is actually for people but can be used on animals. Since we started he is always on the HI mode (this monitor highest is 500), after insulin shot the glucose takes 3 -4 hours to lower a bit....stay on mid 300 s maybe for 1 hour ...then goes to 400 's very shortly and back to High (over 500). It has been 5 days ( 10 insulin shots) and the pattern continues....it doesnt seem the insulin is working as glucose level it goes down after 3-4 hours , and then shoots right back up.

For example yesterday I gave his shot at 7:30 am -scan - monitor was HI (above 500). It remained on HI until 9:16 am. Then 9:46 it registered 454mg/dl; 10:24 am registered 341, 11:12 am 336, 12:03 already started to go up 350 and by 2 pm it was HI (above 500) then it remained on HI until 11:40 pm when finally registered 494 (gave insulin at 7:30 pm). it went down to 392 and by 12:58 am it was already back up to 495 and then up to HI all the way to today .
today same thing After his insulin at 7:30 am readings remained HI until 10 am when it registered 290, then 11am 248, and by noon was 386 and by 1 pm was back to HI (500minimum) and then stays HI for the rest of the day.

I was told to feed him twice a day, right before the insulin shot an monitor as much as i could as the monitor would stay on him maybe a week .
He is in good spirits....annoyed as hell as i am keeping him inside as much as I can so I can keep the monitor longer and avoid him to eat geckos. (he is an outdoor cat)
My questions Are:
Is this suppose to be like that? The glucose levels take while to get down, and then go right back up ?
is this how it suppose to be in the beginning of treatment?
How much we should feed now and snack or no snack?
I switched the dry food to canned food- Friskies pate...tuna,chicken as I read online would be the best. And boiled chicken breast. for an 11 lb cat that lost weight is 1.5-2 cans ok? the 5.5 oz size. i am reading and some say to only feed twice a day, others say i could give him a little snack - (boiled chicken) ? what is the right thing to do?
After I give his insulin....for the first couple hours he seems himself....then he kind of lay down for the next 4 hours or so - I think when the levels are going down he gets a little off. I have been monitoring and in 5 days the lowest glucose reading was 260...and not for more than 1 hour..so he is not hipoglicemic ever.


I am writing to get a little advice as this week has been very difficult. I read as much as I could on the forum but looking to see if anyone can answer these few questions and let me know if this is the "normal" or if it suppose to have worked better.
thanks in advance for who reads all the way here and have any advice.
Click to expand...
Thank you very much for all that information . I hope I am replying it right , was confused on how to post . Will read it all and will talk to my vet on Tuesday to switch insulin . Tomorrow is a holiday . Only emergencies . Will look on Amazon to order the home tests and watch the videos etc.
Will probably ask more questions . ❤️
 
The Libre has that problem they either fall off, or stops working before the 14 days, and they are not so reliable in reading low BG or Glucose numbers, most of us here use a human monitor and strips like the ReliOn Premier and strips, inexpensive and very reliable, or any human simple monitor, ( you do not need a Pet monitor) if you do decide on that we can send you a link on how to home test:bighug::cat::cat: and you are doing great!
https://www.felinediabetes.com/FDMB/threads/how-to-shoot-your-cat.290439/
 
Thank you. I only now was able to get the ReliOn. All I could find was the ReliON Premier - complete kit. And got extra lancets. But Have not been successful yet as tried twice and Duke was not happy. Escaped and come back hours later for food. Going to watch the video few more times before attempt again. When I had the monitor his BG was always off the chart (above 500). So I have been making sure he eats then I do insulin. Been able to give insulin fine twice day but can not control if he eats a lizard or two or 3 as he is an outdoor cat. But kept him at 2.5 dose for now.
Just today (a week later ) my vet responded if I want to switch Vetsulin for Prozinc he would do it but he wants to put another libre monitor . So just to do the insulin switch will cost $100 monitor, $150 vet visit , $180 for Prozinc. I just spent $700 12 days ago for the first round of visits, blood test, monitor etc.. I do not have infinite cash. I remember reading here somewhere that a few folks order insulin online ? Anyone knows price online? and if it's safe to ship ? Thought insulin had to be refrigerated. And anyone here works with a online vet? That might be a little more affordable ? I am not sure if I agree on another monitor ...it supposed to work for 2 weeks and worked for barely 5 days. thanks you in advance for any more insights.
 
I can’t help with online vets as I live in Australia but you don’t have to get another libre put on. Tell the vet you are hometesting and can do the testing yourself. And $150 for a visit to swap insulin is outrageous.
You need a script to order insulin online though.
He’s allowed to eat several snacks a day. We recommend that.
See what others suggest about getting the Prozinc. It’s a much better insulin for cats.
 
For the testing- When I first started, I found this link on Ear Testing Psychology helpful (it’s also listed on the Hometesting link Bron gave you above, for reference). It helped me to think of a testing position that fit my cat’s preferences. Different routines work for different cats. For my cat, that meant letting him sit between my legs on the floor facing out, like he was the captain of a little lap boat. ;) He loves sitting in things like that, but not on people and doesn’t like being held. You may find something else that works for Duke.

Beyond that, creating the routine does take time! There will be plenty of failed attempts in the beginning. My advice is to be extra liberal with the treats in the first few days (regardless of if the test is successful) to help create that positive association. Sitting with your cat and rubbing their ears with something warm and then releasing them with treats is another way to help build the routine between attempts. My cat reached the point where he’d come running to his testing spot, just because he heard the rice sock get popped into the microwave. :)
 
Bron and Sheba (GA) said:
I can’t help with online vets as I live in Australia but you don’t have to get another libre put on. Tell the vet you are hometesting and can do the testing yourself. And $150 for a visit to swap insulin is outrageous.
You need a script to order insulin online though.
He’s allowed to eat several snacks a day. We recommend that.
See what others suggest about getting the Prozinc. It’s a much better insulin for cats.
Click to expand...

Insist that you will be home testing, the Vet wants you to use the Libre to charge the visit and sensor, if you do decide on the Libre Sensor which is an outrageous amount of money and unreliable, you can see how the Vet places the sensor, or the box instructions are very very simple, also you should ask for a PRN prescription for the sensors, it is a year prescription, you save Vets visit charges etc, I still believe in the human monitor, it just takes practice, try a trat before testing and after testing, this way he will associate treat with shot, and place him next to you, hand on his back, caress his head between the ears palm holds the head I use a small flashlight that I place in my mouth I have a small sock with rice in it make a little ball, place inside the ear, while you pinch, have everything in front of you so he does not lose your hold, after a few tests, he'll start relaxing, you, breath in breath out relax, he will sense your anxiety, You'll be a pro in no time:bighug::bighug::cat:
 
Hang in there, it gets easier! As others mentioned I found it best to warm the ear with a heated rice sock, then poke and use my fingernail to collect the blood droplet (that way kitty can move along and not feel pinned down for so long or move as you are trying to collect). Start with bigger lancets and don’t use the device, just directly poke the outer edge.

I remember feeling defeated after so many failed attempts but incorporate a snuggle time and treat and it becomes a new routine. We also tested at the same spot, my bed worked best for us. We used freeze dried chicken as a treat and every time we’d test Zyler would get a treat so he’d go running to the bed when I said let’s check your sugar. After a couple weeks sugar testing took less than 30sec and could easily be done multiple times a day.

You got this!
 
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