New member - May(human) & Mingau (Urgent)

[May & Mingau]

Hi everyone,
My name is May and I’m from Brazil (Rio de Janeiro). I’m looking for guidance on managing my diabetic cat, Mingau.

Mingau is a 12-year-old male orange cat, currently on Lantus (glargine).
I’m still working on dose adjustments, usually around 1–2 units twice daily, but his glucose levels have been quite inconsistent.

I home test using a human glucose meter (Accu Chek). On weekdays I can only test AM and PM, but I try to get nadirs on weekends.

By the time that he was first diagnosed, he had DKA and pancreatitis, letargy, drinking and urinating a lot.

Recent situation (urgent context):
Yesterday night and this morning Mingau refused to eat and appeared uncomfortable, possibly in pain. I took him to the vet, and he was hospitalized today.

He received:

• Cerenia
• Fluid therapy
• Apevitin BC Syrup (Cyproheptadine with B Vitamins and Vitamin C)

By the end of the day he started eating again and looked a bit better. The vet recommended keeping him hospitalized until tomorrow for continued treatment and to perform a glucose curve.

He also has a history of pancreatitis, and others issues, but vets always says to just monitoring. Today’s ultrasound showed:

• pancreatic changes consistent with active disease
• chronic kidney changes with nephroliths
• intestinal thickening (possible chronic enteropathy)

So I understand multiple conditions may be impacting his glucose control.


Diet question (important):
My vet mentioned that wet food could worsen pancreatitis due to higher fat content, but I’ve read conflicting information suggesting this may not apply to cats.
I’m currently trying to transition him to a low-carb wet diet for better diabetes control, but I’m unsure how to balance this with his pancreatic condition.

I would really appreciate guidance on:

• How to safely adjust insulin with limited weekday data
• How pancreatitis may be affecting his glucose patterns
• Whether wet food (low carb) is appropriate in this case
• What to prioritize right now
• What I should discuss or request from my veterinarians to ensure he is receiving the best care

He has an endocrinology appointment tomorrow as well.

Results of the ultrasound exam he had today here

Results of previous ultrasound exam

Thank you! I’m trying to do the best I can for him and would really appreciate your help.

 

[CORKY]

Welcome to FDMB
It is overwhelming not only when you hear the words Feline diabetes, but the good thing is that it is manageable, with the right diet, home testing and the right insulin, and you are on the right track, diabetic cats need to have a diet of wet can or raw foods between 0-10% carbs, also a diabetic cat needs to eat between 3-4 small meals or snacks during the day to keep the insulin in check, beside the two main meals before shots, also home testing is important, before shots and testing throughout the day is also important, to develop a pattern on how the insulin reacts during the day, the best insulins for cats are Lantus and ProZinc they are a 12-hour insulin and gentle on the cats' system, and you have all that under control. however, the dose prescribed must be the same at each 12 hours, it takes approximately 3 cycles (3days) to for the insulin dose take effect, so changing doses is not a good idea, we like to increase or decrease dose in increment of .025units at a time, a non-diabetic cats' glucose level is between 50-120 If you are feeding any dry food or dry treats, that can be a reason for the high glucose levels, the dry foods or even "prescribed" foods contain between 20-30% carbs, and cats cannot digest carbs. regarding home testing the AlphaTrak is ok, but the strips are very expensive, most members here use a human monitor, you might want to consider CGM The Libre, I will tag a member that can give you insight on the CGM @Staci & Ivy if you are not home during the day, as well as a wet food feeder, some have chips and cameras. I will tag a member that has amazing knowledge on feline medical issues
that Mingau is going thru and can give better insight on these as well as dosing advice, in regards to a curve, this you can do yourself and save your money, besides that at the vet, the glucose level will not be realistic, which can cause an unnecessary increase in dose, cats are very sensitive to stress, a curve is simply testing every 2-3 hours for a cycle (12 hours), I think I have answered most of your concerns,
We are very numbers oriented, so we would like you to create your signature, so we know more about Mingau and we can all be on the same page as well as creating a spreadsheet for Mingau, links below, we are here for you please keep posting we are here for you

On our Maim menu there are sticky notes with much valuable information

Sticky - New? How You Can Help Us Help You!
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
@Wendy&Neko
@Sienne and Gabby (GA)

 

[CORKY]

This is the link to the Glucose Continuous Monitoring device information, know that the sensors only last 14 days, and a bit pricy , is good to have a few at hand, in case the placed sensor stop working, also testing on low two-digit numbers manually will be important, since the Libre reads them much lower than reality, so is good to compare manually, and take the manual reading as value
Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats

 

[Staci & Ivy]

This is the link to the Glucose Continuous Monitoring device information, know that the sensors only last 14 days, and a bit pricy , is good to have a few at hand, in case the placed sensor stop working, also testing on low two-digit numbers manually will be important, since the Libre reads them much lower than reality, so is good to compare manually, and take the manual reading as value
Getting Started With Continuous Glucose Monitors (CGMs) for Diabetic Cats

Hello and welcome, May!
Just one caveat on the comment above that the "Libre reads them (BG) much lower than reality".

Some members here have found the BG on both a handheld and Libre to be very close, or up to 20 points difference.

Others (like myself) find that if our Libre reads 40 or LO, the BG values are between 60 and 120 on a handheld meter.
So we can't make a flat out statement that the Libre ALWAYS reads much lower.

You will have to see what you find with your own cat and your meters by using them both.

It's absolutely advised to check BG under 100 when the Libre shows those green numbers to be sure Mingau is safe.

Maria is correct that a CGM like a Libre can be very helpful when you are not at home to monitor, especially in the beginning.

Please let us know if you have any questions.

 

[KristinMMorneau]

Hello and welcome, May!
Just one caveat on the comment above that the "Libre reads them (BG) much lower than reality".

Some members here have found the BG on both a handheld and Libre to be very close, or up to 20 points difference.

Others (like myself war the knights ) find that if our Libre reads 40 or LO, the BG values are between 60 and 120 on a handheld meter.
So we can't make a flat out statement that the Libre ALWAYS reads much lower.

You will have to see what you find with your own cat and your meters by using them both.

It's absolutely advised to check BG under 100 when the Libre shows those green numbers to be sure Mingau is safe.

Maria is correct that a CGM like a Libre can be very helpful when you are not at home to monitor, especially in the beginning.

Please let us know if you have any questions.

Thank for suggesstion! I agree in your answer!

 

[May & Mingau]

Hi everyone,

Thank you for the suggestions about using a Libre! I appreciate it and I’m considering it for better monitoring once Mingau is back home.

Right now I wanted to give an update on his current situation and get some guidance.

Mingau has been hospitalized since Monday due to pancreatitis and IBD.
He stopped eating, appeared uncomfortable, and became very lethargic.

At the clinic he is currently receiving:

• Assisted feeding
• Fluid therapy
• Cerenia
• Corticosteroids
• Pain management (initially dipyrone, but yesterday I insisted on stronger analgesia and they started Methadone)

One thing that concerns me is that the vets mentioned that on palpation he “does not appear to be in pain”, but I’ve noticed clear behavioral changes! He has been in a different posture since he stopped eating and seems really uncomfortable to me, and his third eyelid has become visible, which was not present before. From what I understand, pancreatitis can be painful in cats even if it’s not always obvious on examm that's why I had to insist on stronger analgesia.

He is still quite withdrawn and not eating well on his own, no improvements since monday.

They performed a glucose curve during hospitalization, and my plan is to also run curves at home once he is discharged, since I will have a few days available to monitor him more closely.
At the moment, my main concern is stabilizing him through this pancreatitis episode.


I would really appreciate input on whether there is anything else I should be asking or ensuring is being done during hospitalization and anything I should prepare for once he comes back home.

Thank you again. I’m trying to make sure I’m doing everything I can for him.

 

[CORKY]

I am sorry you and Mingau are going thru all this, I am sure he misses you very much let me tag a member that can give you advice on all your questions, it may be a little bit before she answers, she's a very very busy person, but she will get back to you most likely before Mingau gets home I will tag another member that may also give you input.
@Sienne and Gabby (GA)
@squeem3