03/28/2024 - New Member to the Club

Hello All,
I feel so lost right now. My cat, Lord Fuzzy Bottom, was diagnosed with diabetes this past Monday. He had gone in to ketoacidosis (I believe that is what the vet said) and he has been hospitalized as they are trying to get his blood sugar levels normal.
Everything seems like a haze right now because a few days before he started losing weight rapidly, my other cat just had bladder stone surgery and had to be put on a special diet. So I was picking up the 'grazing bowl' and only feeding the 'normal cats' 2x a day so the surgery cat couldn't access their food.

Anyhow, yea. Chaos. I seriously feel so overwhelmed right now. I am massively grateful for this site and I have been learning a lot. Like the vet told me that I won't need to monitor Fuzzy's glucose levels. But I am seeing on here that it is wise to keep an eye on them. So I've been researching monitors- it seems the ReliOn micro and the other one that only needs .3ml sample are no longer made. I can get my hands on a monitor, but I don't know if they still make the testing strips. The Freestyle Lite looks good, but strips are expensive. And then I am supposed to have an emergency kit set up for if the numbers drop too low and it is so much to take in. I intend on doing it because I want to do whatever I can to help him, it is just a lot. I think he may be coming home today, not sure. I figure in the mean time until I can get a good monitor, I may just go with whatever Walmart has in stock and try to pick up some good canned petfood that is on those lists.
I am sorry for rambling- I'm waiting on the vet to call and am nervous. I just wanted to pop on here and get my introduction out of the way because I'm sure I will be posting on here more often as I start on this journey.
Take care and I hope you all have a good day.

 

Just got home with Fuzzy. He is on something called Glargine Insulin Pen. I am supposed to give him 3ml, 2 times a day. The lady who was explaining everything told me that if he doesn't eat, don't give him insulin. And don't test before insulin- test 4-6 hours after insulin. But this site says test before insulin and it is super confusing.
I also got him a Relion Compact monitor. It says it only needs .5ml sample. And in that same area was some ketone test strips so I grabbed those too. I asked the vet what glucose levels would be ideal when testing with the monitor I bought and she told me between 70-170. Currently his bs will be high though but slowly we will get it back down to a good range. And he will apparently be "flooding" the litterbox and drinking lots of water for a little bit longer as he is still recovering and getting his bs under control.

If anyone has any tips/tricks/advice, I would be more than happy to hear it. Tonight I give my first dose of insulin at 10pm. Super nervous.

 

You mean (hopefully) 3 units (can also be written as 0.03 ml but units is more common) of Lantus. 3 mls is three full 1 ml / 100 unit insulin syringes, a massive overdose for a cat or person. Please update your signature to correct this

3 units is an awfully big dose for a new diabetic, especially if you're not testing. Lantus users here on FDMB recommend 0.5 units to start. Some cats may need a large dose, though. @Wendy&Neko @Sienne and Gabby (GA) OP plans to give 3 units tonight. Would a smaller dose be safer?

The Lantus forum is here: https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/ The info stickies has tons of good info.

See this thread for info on meters that have small blood drop size requirements: https://www.felinediabetes.com/FDMB/threads/relion-micro-meter-equivalent.288124

Ideally you want a diabetic cat to have blood glucose levels in the normal healthy range which is approximately 70 to 150 mg / dl with insulin and diet. This may take time to achieve but don't feel bad if your cat never gets there. You can do everything right but the cat's body just doesn't want to respond the way you want it to That my was first diabetic. He never got well regulated but he was happy and spoiled and that was all that really mattered.

Respectfully ignore the vet's office on their recommendation of when to test. Always test before giving insulin. You need to know what the blood glucose level is and if it's at a level safe enough for any insulin to be given. FDMB generally recommends newbies to not give insulin if the cat tests below 150 mg / dl to prevent a hypo. A few blood glucose checks during the day (or night if that works better for you) gives you an idea of how the insulin is working.

You'll want to keep track of the blood glucose levels in some way. Paper and pencil is fine for now but to really help FDMB members help you, a Google spreadsheet is best. The instructions are here: https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Yes, do get all the supplies you need to have on hand in case a hypo does happen. The list is here: https://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

What are you feeding your diabetic? The right diet is very important to diabetics. FDMB members highly recommend feeding any affordable commercially available low carb canned food. Prescription food the vet may push contains no magic ingredient that makes it any better than a brand you can find at the supermarket. Dry food is one reason why many cats become diabetic in the first place. A canned food only diet would benefit the cat who had bladder stone surgery, too.

 

Some of the normal guidelines are thrown out the window if a cat is coming home from DKA. The last thing you want to do is skip insulin. Some reading for you: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters. By the way, Novamax also makes a meter needing a 0.3 blood drop, but strips may be more expensive. They also make a blood ketone meter. Depending on how shy kitty is about testing when they are in the litter box, or how easy it is to pinpoint which cat peed.

As per the link above: The basic recipe for developing DKA = an insufficient supply of insulin + inappetance + infection OR other systemic stresses.
Was he diagnosed with any infection or inflammation at the vet hospital? If so, he'll be on antibiotics. It'll be very important for him to eat, maybe even 1.5 times his normal amount of food. You might want to get some anti nausea meds from the vet, such as Cerenia and ondansetron, to make sure he eats. An appetite stimulant like Mirataz may also help. And no skipping of insulin. You'll need to test regularly (daily at least for a while) for ketones. Some people get sent home with fluids, which can help flush the ketones out of him.

If at all possible, it would be good to get a description from the vet of the insulin doses they have been giving, and the resulting blood glucose (BG) values he's been seeing. I wouldn't want to start him on too low a dose if the vet testing has shown he needs 3 units.

 

Hi and welcome to you and Fuzzy. I am sorry he has DKA but sounds as if he is in the best place at the moment.
I agree with everything Wendy has said. When DKA is in the picture, some things are done differently.
Here is a list of things you will need to do for Fuzzy over the next few weeks while he recovers from DKA. Wendy has mentioned them as well.

• you need to give one and a half times as many calories as he normally eats. Offer snacks every couple of hours during the day and evening as well as the 2 main meals. Food is like a medicine and helps keep ketones away. If your kitty won’t eat the low carb food, feed him whatever he will eat as eating any food is better than not eating,
• Don’t skip any doses of insulin as insulin helps keep ketones away. If the BG is not high enough to give the dose…stall, dont feed and test again in 20 minutes and post and ask for help.
• Test daily for ketones. Put the results of the tests into the remarks column of the SS so we can see. Please report any trace ketones at all.
• Give antinausea medication if needed such as cerenia and ondansetron. I would ask the vet for some to have at home, even if he doesn’t need them at the moment. DKA kitties are often nauseated for a week or two once they come home.
• Give appetite stimulant if needed after the antinausea medication. Ask the vet for some Mirataz.
• Give extra fluids. If kitty will tolerate warm water in the food, put a teaspoon into each snack..
• Ask the vet about subQ fluids
• Set up a spreadsheet and test the BG frequently. If you are having trouble setting it up I can ask @Bandit's Mom to help you.its important that we can see the BG data to help with dosing which is so important at the moment.
• Post daily with updates and ask for help as often as needed.

The lady is not correct. It is very very important that you don’t skip any doses of insulin with DKA in the picture. If you are having any trouble with him eating, make sure you are giving an antinausea medication and try any food at all, even if it is not suitable for a diabetic cat. Any food at all is more important than not eating. And post and ask for help.
Always test before every dose of insulin to make sure it is safe to give the dose. And then you can test during the cycle to see how well the dose is working.
And testing the urine for ketones or the blood if you have a blood ketones meter every day is also very very important as this will tell us if he is getting enough food and enough insulin..

 

Wow, lots of new info.
Ok, I did double check his insulin, it is 3 UNITS and I made the adjustment on my signature. As far as food goes, I did purchase a pack of the Fancy Feast Classic as suggested by the Beginners page. He is also eating Beyond grain free kibble, turkey lunch meat (trying to make sure he is eating which is what the vet said to do.). I also gave him some churu licky treat which he didn't want, and I tried giving him some normal dry treats.
I gave him his first dose of insulin tonight as per the the vet's orders. Tomorrow I will start testing blood sugar with the meter I bought today. I will make a spread sheet that I can share with the forum as well as the vet. Right now I'm still shaky from giving him the injection. It did go really well- I gave him some deli turkey in a bowl and he was nomming on that while I did it. I did need to shave a small patch on his shoulder so I could see his skin and not stab myself. I just hope I did well. I want to thank yall for giving me all of the advice- tonight unfortunately it isn't sinking in, there has been so much chaos and I think giving him his first injection just pushed me over and I'm so worried that I could have done it wrong or something.
Also, he wasn't diagnosed with anything else, just diabetes and the dka. He has always been a grazer when it comes to feeding. I would just leave a bowl down with their foods and they would eat when hungry. When my other cat had the bladder stone surgery very recently, I had to pick up their food and was attempting to feed them every 12 hours. Shortly after I started that, his weight started falling off- so I think that is what caused the DKA. The vet said he believes Fuzzy has been diabetic for awhile and just kept it hidden.
Anyhow, I'm going to go watch my Fuzzles. Please take care and have a wonderful night.

 

Please keep feeding lots of times during the days and evening.
Let us know if you need help with the spreadsheet.
Did you get some Ketostix to test the urine for ketones? This is really important!
Sounds like you are doing well. keep posting with the progress and for help and guidance

 

I am giving him as much food as he wants to eat. The vet said to leave food out for him that right now we are working on getting his bg down to a normal level. They told me that for awhile it will be reading up around 600-700 using my meter.
I do have some Ketone Test Strips, I need to read up on how to use them, which I plan on doing today.
Also, I tried to do the spreadsheet. I am not sure if I did it properly. Could someone look at it and let me know if I did?
I did not check his bg pre-shot. I checked it 5 and a half hours after his shot and the meter read HI, which according to the meter it will read HI if the reading is over 600. Which sounded about right with what the vet told me. I made notation that he may not have gotten all his insulin (or any if I pierced the skin) this morning. I do see what I did wrong and will not make that mistake again.

 

Yes, your spreadsheet is viewable just fine

The urine test strips are easy to use. Ideally you want to hold a strip right under the stream of urine. That means stalking the cat until he goes to the litter box. You can also try holding a small cup of long handled spoon or ladle to catch the urine and then pour the urine over a test strip. Another alternative is to get a brand new clean litter box and put some non-absorbent cat litter such as Kit4Cat in or very clean fish tank gravel (the glass-like kind won't need to be rinsed of dust). If using fish tank gravel, tip the box to pool the urine into a corner and dip the test strip into it.

 

Please test the BG before every dose to see it is safe to give the dose. If the reading is hi at +5… that could mean he has dropped low and is bouncing or he needs more insulin. More testing will give us more information to work out what is happening. You definitely don’t want to be having the BGs up high

 

Tonight's insulin shot went really well. I also checked Fuzzy for ketones earlier in the eve. I am including those readings in his spreadsheet. It was super easy, I just took a small deli condiment cup and held it in his urine, he didn't move and we didn't make a mess. I have to say, Fuzzy is being a real trooper with me on this. Also, on his spreadsheet, since I am using that for my own notes as well, I am including the location of his injection each time. That way I can know which place to shoot next. So if anyone sees my little notes, that is why I am doing it. I have a poor memory so I leave notes everywhere for myself and I have my Alexa set up to announce at 10am and 10pm to give him insulin as well as when to check his bg 5 and a half hours after AM shot. After he is more accustomed to me pricking his ear and we get through this DKA and his levels more acceptable will start preshot testing.

 

I was going by what the vet told me to do. They actually didn't even tell me to test. I am doing that on my own because I want to monitor and they said if I do test, do it between 4-6 hours after AM shot. But they also said while he is flushing the ketones out (i think that is what they said) that his bg will be high. When he was hospitalized, they were giving him 2 different types of insulin at the same time. A fast acting and a normal type to get his levels lower. He really was bad off. So far he is seeming to do better. I'm watching him put weight back on. He is eating throughout the day and not using the litterbox constantly nor drinking water constantly like he was when I took him in to the vet.
I do fully intend to start pre-shot testing, I just want to get the dka under control/gone first. He is supposed to go in for a curve or something like that on the 4th where they are supposed to check his levels throughout the day so I am hoping I will know more then.

 

I can’t stress enough that you need to start testing before the dose now. It is all part of trying to get the DKkA under control as you say. Waiting until it is under control is counterproductive and you may not get it under control
We need to know how well the dose is working and we won’t know that unless we know what the BG was before the dose. Does that make sense?
We have set things we do with DkA kitties and we have great success in getting them better as long as the caregiver follows the directions.

that is not necessarily true. It is really important that we start to get the BGs down. And that may mean giving more insulin especially if he has a trace of ketones in the urine. The things that get rid of ketones are insulin and food. They won’t magically go away on their own unless the cat is getting enough of both.
Please test the urine again today so we can see what is happening with the ketones. Any ketones at all is a worry with a post DKA cat.

can you tell me are you using the pen to give the insulin or are you drawing it up in a syringe?

 

I just tested at +3 and the meter read HI
I will pre-test before tomorrow morning's shot.
I will try to catch him going potty and grab some more urine to see what it is doing and let you know.
I am using the pen. The vet told me to rotate it to 3 and press the button and it resets back to 0.
Again, this morning I think I accidently pierced his skin all the way and just shot the insulin on his fur and he got barely any - I could be wrong, I don't know, but I wasn't going to re-dose. I am starting to learn more about his insulin that it is a long acting type.

 

I know you all mean well, I truly do believe this. But I am also scared. I have the vet telling me one thing, and you all telling me another and it really is so very confusing. I have learned so much more over here on this group. But I don't fully know who to listen to and I don't what anything to happen to Fuzzy. I know there is talk about adjusting doses, but his pen doesn't have smaller doses than 1 unit segments. Which he is supposed to be taking 3 units. If I increased it, it would go straight to 4, decreasing would take him down to 2. I don't know if that would be too much or too little. It scares me his numbers are reading high- but the vet told me they would though for the beginning days. Like, I don't understand why the vet would tell me the wrong thing to do. But then again, they told me I don't need to test really that a lot of owners don't. Actually, it wasn't the vet who told me that, it was a vet tech that he sent to give me the 'diabetes talk'. I am not going to give up and I am going to keep trying, like I am most likely oging to make him a condo over on the lantus board. I just learned that that is the name brand of the meds he is on.
Does anyone else go through these same feelings of fear and not knowing who to listen to or am I jsut bonkers and overthinking everything?

 

The last thing I want to do is confuse you. We get many post DKA kitties here and most of them are told very little by the vets about how to look after the kitty once they get home. And the post DKA care at home is so important to ensure that the cat does not relapse.
Many caregivers are torn between who to listen to with post DKA kitties. You need to ask your vet how many cats he has treated and how many have lived.
I’ll tag @Hendrick Cuddleclaw. He’s been through DKA and was given conflicting advice

Regarding the dose and the Lantus pen.i would e-commerce you think about getting some insulin syringes and using them instead of the pen. You can the. Give much smaller increases which is what is needed. You are right in thinking an increase or decrease of 1 unit is too much
These are the insulin syringes you need to buy… U100 3/10ml, 30 or 31 gauge, 6 or 8 mm, insulin syringes with 1/2 unit markings.

Here is a picture of how you withdraw the insulin from the pen.

 

That is great you are looking all over the board for information. Before you can start to post over on the Lantus forum, we need you to have set up a spreadsheet and a signature.

 

I have a spreadsheet set up as well as signature don't I?

 

I see the spreadsheet, Bron. It’s in blue where you see his name.

 

Sorry, yes you do. Not sure what happened there. Apologies.

 

Weird. Did not open for me earlier. I’ll try now.

 

I see it.