08.03 New cat Richard AMPS 374, +5 337, +8 360, PMPS 389

[Alex&Richard]

Hi! First time here.
Richard got diagnosed with diabetes and DKA a month ago and we are still struggling to get him regulated. He is 10.5, 5.5kg, Burma, male, neutered.

Intro
Apparently, made a lot of mistakes and our vets seems to not know much about diabetes treatment other than standard protocol. Our vet recommendation was to give 1U if 360+ and 0.5U if 180+. We've tried so, but as there are no 0.3 syringes sold in pharmacies here (Lithuania), we had to use 0.5 and they are terribly inaccurate. After I've obtained calipers, I've found out that the gap above zero mark is up to 0.6U! So we were constantly overdosing the poor Richard back in Feb, which led to lows all the time.Had to leave him in hospital for the second time.
Meanwhile discovered the FDMB and it is such a great source of information! Took Richard back home on March 3. Now trying to start with SLGS properly. We are on Lantus. I've created a spreadsheet, hope it is done right. Food is mostly wet Royal Canine (instinctive jelly, sterilized jelly, & trying to switch to diabetic slowly), dry is only Royal Canine diabetic, so not sure if it is considered LC or not yet.
So we've started with 1U again (0.3 syringe + calipers from now on) and got a low right away. Dropped to 0.7U and got another low after 2 shots. Panicked, dropped to 0.3-0.4U. Got Ketones rising and potentially some UT issue (at some point of the day for an hour or so he cycles to and from litter box, trying to pee tiny-tiny amounts, but the remaing day pees normally and is calm. Checked him a day ago at vet - no signs of urinary issues found on ultrasound and normal blood test). Sitting at 0.5U at the moment. No lows so far, but no drops below 360 either. Appetite is normal, as well as activity for now.

TL/DR
Considering all the previous lows and bounces and ketone levels, what could be the best way to proceed? Keep 0.5U for a few more days, hopping BG will go down? Try raising to 0.7U again in hope to deal with ketones? I'm at loss & don't have enough statistics for ECID/KYC. No hypoglycemia symptoms on lows so far, but I'm terribly worried seeing low each time. Any other advises for beginner are also appreciated!


Side question
Is this a good place to make injections? Vet said it is ok, just want to double check. I'm using the "tent" method and the spot was shaved for the glucose monitor.

Sorry for a long text.

Best regards,
Alex

 

[Wendy&Neko]

Hello and welcome. Sounds like you had a rough start with the DKA. How long was he in hospital?

I'm glad to see you are home testing regularly for ketones and recording them in the spreadsheet. You should be doing that daily for a while yet.

This post has some links to information that may help you: How to "Shoot" Your Cat including a diagram of where to give insulin.

Which brand syringes are you using? I found the ones I used for Neko to be quite inaccurate. The calipers really help.

Regarding food, there isn't much in the way of low carb dry food. You want 10% and under in carbs. You don't need special vet food. There are many commercially available options. Check out this food list. It's for the UK but a lot are available in Europe: UK Cat Food List
UTI's are diagnosed with urinalysis first and then a urine culture to see what bacteria are present and what antibiotic is needed to treat it. Another explanation for many tiny pees is idiopathic cystitis.

Regarding dose, stick with the 0.5 units for a while yet. You are likely seeing high numbers from a bounce from that 49.

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).

Lots more information in the yellow starred Sticky Notes. I recommend reading them all. Maybe not all at once, it's a lot to learn!

A couple housekeeping items to get out of the way. We ask new members to post first on the Feline Health forum, to get basic questions out of the way and signature/spreadsheet set up properly. The Lantus forum is the busiest one, so we ask that people have everything in place before posting here. You have most of it done, but have a lot of common questions the new members do. One change I would request on the signature is that you put the date of his DKA diagnosis in there. We like to know how much in the past it is.

 

[Alex&Richard]

Hello and welcome. Sounds like you had a rough start with the DKA. How long was he in hospital?

I'm glad to see you are home testing regularly for ketones and recording them in the spreadsheet. You should be doing that daily for a while yet.

This post has some links to information that may help you: How to "Shoot" Your Cat including a diagram of where to give insulin.

Which brand syringes are you using? I found the ones I used for Neko to be quite inaccurate. The calipers really help.

Regarding food, there isn't much in the way of low carb dry food. You want 10% and under in carbs. You don't need special vet food. There are many commercially available options. Check out this food list. It's for the UK but a lot are available in Europe: UK Cat Food List
UTI's are diagnosed with urinalysis first and then a urine culture to see what bacteria are present and what antibiotic is needed to treat it. Another explanation for many tiny pees is idiopathic cystitis.

Regarding dose, stick with the 0.5 units for a while yet. You are likely seeing high numbers from a bounce from that 49.


Lots more information in the yellow starred Sticky Notes. I recommend reading them all. Maybe not all at once, it's a lot to learn!

A couple housekeeping items to get out of the way. We ask new members to post first on the Feline Health forum, to get basic questions out of the way and signature/spreadsheet set up properly. The Lantus forum is the busiest one, so we ask that people have everything in place before posting here. You have most of it done, but have a lot of common questions the new members do. One change I would request on the signature is that you put the date of his DKA diagnosis in there. We like to know how much in the past it is.

Thank you very much for reply! Syringes are BD microfine plus demi 0.3 (with 1/2 marks). I went through all the stickies and most of begginer sections already. Regarding DKA - 10 days in hospital. From Feb 4. Added the date to the signature.
Should I copy the starting post to the Feline Health forum or what would be the proper procedure in this case?

 

[Wendy&Neko]

You can continue posting here now. Feline Health would have been the right place to start. But you are here now.

I used the BD Ultrafine syringes, also had large gaps under the zero line, but it varied from box to box.