New to Boards, Ailish, her brother and her brand new human nephew

[Ailish’s Brother]

Hi,

My name is Eamon and I am here with my 16 year old cat Ailish. Ailish came to live with my wife and I after my mom passed away. She has transitioned from being an indoor/ outdoor cat to being a loving apartment cat, who sometimes sits on the stoop with her humans.

Background:
Ailish has steroid-induced diabetes.

At the start of the summer of 2024 my wife was hospitalized for a week, due to pregnancy complications. When she got out, we noticed Ailish having urinary and constipation issues. Following many a diet switch and much stress, the doctor prescribed Prednisolone, starting at 10mg a day, tapering to 5mg, then 5mg every other day, for suspected IBD. Ailish was urinating and drinking more, but when I asked vet they said this was expected and not to worry.

On 10/10 Ailish went to the ER urinating blood, was diagnosed with a UTI and we were told to follow up with our primary vet about glucose in urine. On the same day we followed up, 10/13, my wife was admitted to the hospital again, and on the same day Ailish was diagnosed as diabetic, our first child was born.

Diabetes situation/ Keytones/ Food/ Testing
I am now working with an internal medicine specialist to treat Ailish, my wife and I both love her and really want her to be able to be around our newborn son when he gets home from the hospital.

Ailish tested negative for keytones at our primary vet on 10/20, and then positive for traces on 10/22 when we saw the internist. The internist said she should immediately start on insulin and be tested daily using Keto-Diastix Strips.

Right now Ailish is on 1u of Glargine twice a day, at 6:00am and 6:00pm. She has historically been a free grazer on dry food, but with the diabetes diagnosis I have transitioned her to Tiki Cat Ahi Tuna Recipe, 12 oz a day, spread over 4 meals (12am, 6am, 12pm, 6pm).

I test her daily using the test strips, starting on 10/25. All of the results have come back negative for keystones but with results between 500-2000 on the glucose reading. We also have a Freestyle Libre 3 put on, but Ailish usually reads (HI, over 400, on it, with only a few dips into the 380's)

Her main symptoms of the diabetes are PU and PD. She is still drinking and urinating a lot.

I have a record I am keeping on the notes app of my phones, and will transfer it to a spreadsheet once I have a blood tester for BG.

Other Medical Issues:
Ailish is still tapering off the steroids which were prescribed for GI and allergic upsets. I am very frustrated that the vets prescribed them the way they did and am working to get her off ASAP, if possible. Right now she is on 1mg Budesonide every other day. She has shown no GI symptoms on this dose, and if she is still doing ok at our next check-up, 11/7, her internist has agreed to take her off altogether.

Ailish's UTI from early October returned on 10/25 and she is now on Pradofloxacin to clear that. Her symptoms have improved, and she is no longer straining in the litter box.

Questions:

1. I would like to start blood testing. Does anybody have a recommendation for a BG tester? Is there one that also does keytone testing? It would be great to not have to stalk her to the litter box every day!
   
   
2. Is the Tiki Cat Ahi Tuna Recipe a good wet food? I see on the food chart that Tiki Cat is generally good but am having trouble finding that exact formulation. Also, does anyone have advice/ experience on transitioning grazing cat to timed feeding? Right now I kinda follow her with the food, but Im not sure I can keep that up once our son is home.
   
   
3. Any advice on vets in the NYC area that are experienced in handling feline diabetes?
   
   
4. Any advice/ experience on dealing with steroid-induced diabetes and/ or a diabetic cat with a newborn baby would be greatly appreciated!

Thank you all for your help, I really want to help my little old lady Ailish get through this!

 

[Sienne and Gabby (GA)]

Welcome to FDMB! Either you have been doing a lot of reading or you have incredible instincts when it comes to managing Ailish's diabetes. You are doing everything right.

First off, the Libre is a way of testing for blood glucose levels. It's not 100% reliable since the sensor can stop working before the advertised 2 week period, Ailish may remove the sensor, and the readings are typically not wholly accurate in the lower range. However, it is convenient. Many people here use the Walmart Relion meter because the strips are the least expensive around. We generally encourage people to use a human meter since inevitably, when you most need to be testing, you are close to running out of strips and you can't get strips for a pet-specific meter in a brick and mortar store. Your vet may tell you that human meters are inaccurate for cats and you should get a pet specific meter (e.g, an AlphaTrack). The strips are expensive. (I'd also ask what kind of meter the vet used 20 years ago. It was a human meter!!) There are a few meters that test for both glucose and ketones. The Precision Xtra, Keto-Mojo, and Nova Max Plus are among those people use. They require different strips for testing either glucose or ketones and the ketone test strips are expensive (around $1.00 each).

You will need to get lancets in order to test. It will take a few weeks for the capillary bed along the edge of your cat's ear to more fully develop so his ear bleeds more easily when you test. Using a thicker gauge (e.g., 28 gauge or lower number) lancet will help. One testing is a bit easier, you can move up to a thinner lancet (e.g., 30 gauge) which may be more comfortable for Ailish. This is a link to our information on home testing.

It looks like the Tiki Cat Ahi Tuna is under 2% carb. There's a question in the Chewy's information that suggests it's 0%. The calculation I looked at was based on the guaranteed analysis so it's an approximation. No matter what numbers you're using, it's low carb! There is no real need to change the way your cat is used to eating. Grazing is fine or having your cat on a schedule of several small meals is also fine. You do not want to provide food the 2 hours prior to shot time so food isn't influencing your pre-shot test. One other thing to keep in mind is that you may want to avoid feeding Ailish after nadir. You'll need to have test data in order to see what your cat's pattern is and where the lowest point in the cycle most typically falls in order to determine when nadir is. As numbers start to rise after nadir and some cats are sensitive to the effects of food, you may want to refrain from feeding after nadir.

If IBD is an issue, have you tried putting Ailish on a diet of novel proteins? This is a site that I use for my IBD kitty (non-diabetic) that focuses on a raw diet. If a raw diet isn't a route you want to go, it's still a great site for general information about IBD in cats. Budesonide is a better choice than pred for many cats especially kitties that may have a more systemic response to a steroid. It's unpredictable what may happen if you taper Ailish off of a steroid. The diabetes may disappear or blood glucose may stay elevated.

I'd also suggest that you take a look at the sticky notes at the top of the Lantus board if you've not already seen the posts. There's a great deal of information in the sticky notes. In particular, I'd suggest you look at the post on dosing methods. We increase doses at either 3 days or a week depending on which method you're using. If your cat's test numbers are as high as you noted, you may want to consider a dose increase but I'm not fully comfortable making that recommendation without seeing your spreadsheet. Also, are you using syringes for dosing or are you injecting using the pen? If the latter, we strongly recommend using a syringe. The pens dispense in 1.0u only and we change doses in much smaller amounts -- 0.25u.

I'll check around to see if anyone is from NYC and can recommend a vet. You may want to start a new thread with a subject line asking for a vet in NYC.

 

[Diane Tyler's Mom GA]

Here is the link for the meter and test strips so you don't have to search for them
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197
At least if you need more test strips you can run into Walmart and pick them up or if you're running low you can just order them from Walmart

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

Try putting a thin layer of Vaseline on the ear so the blood will bead up
Here's a video one of our members did ignore where she had to code her meter because she is using a pet meter. With a human meter you don't have to
VIDEO: How to test your cat's blood sugar

Here is the link to set up our spreadsheet, where you can track your cats BG numbers, it also explains how to use it. You can look at anyone's spreadsheet to see what it looks like
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Take a look at this Members spreadsheet to see what it looks like

https://docs.google.com/spreadsheet...l4ZtCY55EYA1oVyLSxuAPNO7jLuIdE6zkiyM9/pubhtml


You can get it on Amazon
here are links for the Nova Max Plus supplies on Amazon.

Nova Max Plus (meter)
https://www.amazon.com/Nova-Max-Glucose-Monitoring-System/dp/B01G5OE0QY

Nova Max Plus (ketone test strips)
https://www.amazon.com/Nova-Ketone-Strips-Count-Total/dp/B008P0WMI0

Congrats on the baby

 

[Ailish’s Brother]

@Sienne and Gabby (GA)

Thank you for your response! I have ordered the Relion Meter and some lancets. They should arrive by Tuesday. For right now I will keep using the Keytone urine strips, and if the meter works well for BG I will look into using one for Keytones as well.

I am glad to know the Tiki Cat is a good fit! We have tried a novel protein diet, and its been a struggle to get her to eat them. With the diabetes diagnosis, the internist said her eating is the most important thing. I chose to go with the Tiki Cat as it only had the tuna in it, so even if its not a novel protein, it is limited to one she has historically tolerated. I will keep the feeding info in mind, and Ailish will be happy to not have as strict a schedule on her food!

I am using syringes with markers every .5 units. I asked the internist about upping the dose, and she wanted to wait until our scheduled follow up this Friday, November 7th. She said she normally holds cats steady on the initial dose, as it can take a while to be effective.

I'm making a post mentioning NYC vet in the subject, and am looking forwards to using the new meter to set up her spreadsheet. Hopefully between the spreadsheet and the follow up with the vet I'll have the information to keep improving her treatment.

Thank you again for your kind and thorough response!

Welcome to FDMB! Either you have been doing a lot of reading or you have incredible instincts when it comes to managing Ailish's diabetes. You are doing everything right.

First off, the Libre is a way of testing for blood glucose levels. It's not 100% reliable since the sensor can stop working before the advertised 2 week period, Ailish may remove the sensor, and the readings are typically not wholly accurate in the lower range. However, it is convenient. Many people here use the Walmart Relion meter because the strips are the least expensive around. We generally encourage people to use a human meter since inevitably, when you most need to be testing, you are close to running out of strips and you can't get strips for a pet-specific meter in a brick and mortar store. Your vet may tell you that human meters are inaccurate for cats and you should get a pet specific meter (e.g, an AlphaTrack). The strips are expensive. (I'd also ask what kind of meter the vet used 20 years ago. It was a human meter!!) There are a few meters that test for both glucose and ketones. The Precision Xtra, Keto-Mojo, and Nova Max Plus are among those people use. They require different strips for testing either glucose or ketones and the ketone test strips are expensive (around $1.00 each).

You will need to get lancets in order to test. It will take a few weeks for the capillary bed along the edge of your cat's ear to more fully develop so his ear bleeds more easily when you test. Using a thicker gauge (e.g., 28 gauge or lower number) lancet will help. One testing is a bit easier, you can move up to a thinner lancet (e.g., 30 gauge) which may be more comfortable for Ailish. This is a link to our information on home testing.

It looks like the Tiki Cat Ahi Tuna is under 2% carb. There's a question in the Chewy's information that suggests it's 0%. The calculation I looked at was based on the guaranteed analysis so it's an approximation. No matter what numbers you're using, it's low carb! There is no real need to change the way your cat is used to eating. Grazing is fine or having your cat on a schedule of several small meals is also fine. You do not want to provide food the 2 hours prior to shot time so food isn't influencing your pre-shot test. One other thing to keep in mind is that you may want to avoid feeding Ailish after nadir. You'll need to have test data in order to see what your cat's pattern is and where the lowest point in the cycle most typically falls in order to determine when nadir is. As numbers start to rise after nadir and some cats are sensitive to the effects of food, you may want to refrain from feeding after nadir.

If IBD is an issue, have you tried putting Ailish on a diet of novel proteins? This is a site that I use for my IBD kitty (non-diabetic) that focuses on a raw diet. If a raw diet isn't a route you want to go, it's still a great site for general information about IBD in cats. Budesonide is a better choice than pred for many cats especially kitties that may have a more systemic response to a steroid. It's unpredictable what may happen if you taper Ailish off of a steroid. The diabetes may disappear or blood glucose may stay elevated.

I'd also suggest that you take a look at the sticky notes at the top of the Lantus board if you've not already seen the posts. There's a great deal of information in the sticky notes. In particular, I'd suggest you look at the post on dosing methods. We increase doses at either 3 days or a week depending on which method you're using. If your cat's test numbers are as high as you noted, you may want to consider a dose increase but I'm not fully comfortable making that recommendation without seeing your spreadsheet. Also, are you using syringes for dosing or are you injecting using the pen? If the latter, we strongly recommend using a syringe. The pens dispense in 1.0u only and we change doses in much smaller amounts -- 0.25u.

I'll check around to see if anyone is from NYC and can recommend a vet. You may want to start a new thread with a subject line asking for a vet in NYC.

 

[Ailish’s Brother]

@Diane Tyler's Mom GA

Thank you for this info, it is really helpful on showing the best way for me to start testing!

Here is the link for the meter and test strips so you don't have to search for them
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197
At least if you need more test strips you can run into Walmart and pick them up or if you're running low you can just order them from Walmart

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

Try putting a thin layer of Vaseline on the ear so the blood will bead up
Here's a video one of our members did ignore where she had to code her meter because she is using a pet meter. With a human meter you don't have to
VIDEO: How to test your cat's blood sugar

Here is the link to set up our spreadsheet, where you can track your cats BG numbers, it also explains how to use it. You can look at anyone's spreadsheet to see what it looks like
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Take a look at this Members spreadsheet to see what it looks like

https://docs.google.com/spreadsheet...l4ZtCY55EYA1oVyLSxuAPNO7jLuIdE6zkiyM9/pubhtml


You can get it on Amazon
here are links for the Nova Max Plus supplies on Amazon.

Nova Max Plus (meter)
https://www.amazon.com/Nova-Max-Glucose-Monitoring-System/dp/B01G5OE0QY

Nova Max Plus (ketone test strips)
https://www.amazon.com/Nova-Ketone-Strips-Count-Total/dp/B008P0WMI0

Congrats on the baby

 

[Diane Tyler's Mom GA]

Thank you for this info, it is really helpful on showing the best way for me to start testing!

You're very welcome
@Ailish’s Brother