New Member-Trying to get up to speed fast!

My 14yo DSH boy (MyGuy!) was into the vet on the 12th for sudden increase in water intake and urination. BS came back on the 13th @414. Fructosamine came back a day later (same specimen) at 575.

I'm familiar with DM in humans, and my father's cat, some 12 years ago, had DM, but managed to turn it around and live another 8ish years without further treatment.

My vet has not offered any treatment other than insulin, and MyGuy was started on the 16th on Lantus - just 1unit a day, with the intent to repeat the fructosamine today (27th).

I'm measuring water consumed from water bowl (weigh when I put out the bowl, weigh again before I dump and refill). His water intake was increasing! After I had a sleepless Sunday night, I started a second dose on Monday morning, then called the vet when they opened: I told them what I had done, and said I didn't see any point in repeating Fructosamine since it clearly would have remained elevated. Current plan: continue Lantus 1Unit twice a day, return to office in one week for FreeStyle Libre (FSL) if continued poor response, otherwise return for repeat Fructosamine in 3 weeks.

Thoughts? Fructosamine is expensive ($141, but that was from an existing specimen), and I know FSL isn't cheap, but I think I'd rather do that and skip F'amines althogether.

Also, MyGuy was on a Purina+BlueBuffalo dry foods + FF Gravy Lovers (mostly consuming the gravy, of course). He is now on Purina One Grain Free Chicken Recipe Chicken (ingredient list is sooo interesting) and continued access to the kibble, but trying to simply de-emphasize the kibble and increase the canned.

AND - he's been hyperthyroid for about a year and a half. Was somewhat out of control on the 12th, increased dosing, and probably back in control now.

AND, and - treats...Greenies + Delectables + Tasteful Purees with Chicken. One can hide pills in the delectables, distract during injections with puree - and Greenies for teeth and happiness....

I understand there's some sort of spread sheet - will attempt that soon. No BS testing going here, so no need for a daily spreadsheet update.

Welcome to FDMB.

We have several recommendations for new members. Since you mentioned a spreadsheet, the information for setting up both your signature and spreadsheet are in this post on helping us to help you. The link also contains useful general information.

I would strongly encourage you to start home testing. We are big advocates of testing your cat either with a glucometer or a Libre (continuous glucose monitor -- CGM). It is the only way to ensure your cat is in safe numbers before you give a shot. It's also the only way to know if your cat is dropping into low numbers and you have to intervene as well as give you data on how well your cat is doing. It also means that you don't need your vet to run fructosamine levels. You should not get a fructosamine level in less than 3 - 4 weeks. A fructosamine test gives you a value that reflects blood glucose level for up to 3 weeks. If you're home testing, you have to the minute results making a fructosamine test superfluous.

Once you get started with a Libre, you can replace the sensor yourself. This is information on using a Libre.

I'm not sure why your vet initially suggested giving insulin only once a day. Cats have a fast metabolism and require insulin twice a day. I'm glad you're shooting twice a day. Also, Lantus does best with consistency. In other words, do your best to give a shot every 12 hours.

As far as food, a diabetic cat needs a low carbohydrate diet -- preferably canned or raw food. We consider low carb as under 10% carb. There are very few dry foods that are low in carbs -- Dr. Elsey's Clean Protein and Young Again Zero Carb. On the other hand, there are lots of options when it comes to low carb canned foods. This is a chart that has most of the canned foods available in the US listed along with nutritional information including carbs. While Fancy Feast is popular, you want to consider the Classics variety. The Gravy Lovers is high in carbs. It's good to have a few cans in the cupboard in case MyGuy's numbers are low but it's too high in carbs for a diabetic's regular diet.

Treats -- the treats you're using are high in carbs. (Sorry!) Most of the members here use a freeze dried protein (e.g., chicken) treat. Pet food stores, Chewy's, and Amazon also are sources. There are also jerky style treats. You want something that is protein only. If MyGuy likes something like chicken breast that you cook for him, that's also fine. We've had caregivers who spoiled their kitty with shrimp!!

If you haven't already, please get your cat's thyroid rechecked. Hyperthyroid can have an effect on diabetes.

Please let us know if you have questions. We're here to help.

Thanks, @CORKY - I too was puzzled by the once-a-day dosing. The only reason I can think of is that she was concerned about bottoming out his sugars too fast.

Curious: the vet + tech have told me that the BS will slowly come down after starting Lantus (or changing doses) - as in, a few days or a week - is that your experience?

re: BS and testing - I'll contact them to get him started on Libre - I'm guessing, but I think it will be early next week before it gets placed. I'm actually more concerned that he's still running too high. His fluid intake remains elevated (but probably not increasing like it had) and ditto for urination.
* how close to normal range should I aim for?
* how do members handle out of range BS - adding fast-acting insulin??

re: Food - I gave away the last can of Gravy Lovers, but so long as I have Delectables (or Churus) around, I'll have an emergency treatment.
* So, it's the tapioca starch (starch!) in the Tastefuls/Delectables/Churus that's the problem? Unfortunately, it's tough to hide a pill in other things, so some of that will continue.
* I need distraction while I shoot him. I could switch to a mashed anchovy? Yuck to me, but he loves it.
* Is there another alternative to Greenies crunchiness for teeth cleaning?
* I don't like Delectables because they are primarily tuna-based. Since he came to my house, he's primarily had poultry flavors (whether dry or canned), and definitely not tuna.

re: thyroid - yes, it will get rechecked, but it too has a period of stabilizing after dose changes. But I had wondered if the two affected each other. Trips to the vet are always traumatic (just being in the cage, too), so will combine it with a future visit (soon).

Thanks for sharing your insight and experience, and sorry for asking questions that are probably answered elsewhere!

Please keep posting any concern of your is ours, tge pill you might want to crush it to a powder and sprinkle it in the food if possible, Fancy Feast Pates between 0-10% carbs are great they have many flavors to choose from and they are US made so they are regulated so no waste goes into the food, You might want to check CHEWY.COM
When you get the Libre placed, is good to also have a manual glucometor, like the ReliOn human monitor and strips. Or any other brand The Libre tends to read low numbers lower (two digits) so it is good to alway double check

Lantus is a depot insulin. What that means in practical terms is that it takes about a week for the insulin depot to be established and stabilize. Any time you make a dose change, it takes a few days for the depot to restabilize. The vet tech gave you good information.

Using a fast acting insulin is an advanced technique. Unless you have an experienced member guiding you through the process, I'd not recommend it. Further, I wouldn't just add a second insulin until you know that all you need to do is to increase the Lantus dose. Insulin doses change. Don't get stuck thinking that the same dose that worked last week should be producing exactly the same results this week. Also, most members here make dose changes based on what the numbers tell them and don't go to the vet to get "permission." Not all vets appreciate not being able to direct the show, though. However, if you have any friends or family who are diabetic, I'd be pretty certain that they adjust their insulin dose without calling or paying for an office visit all the time. The other thing to factor in is that if MyGuy's numbers drop into a lower range, there's a really good chance that his numbers will then spike upward. We refer to this as a "bounce." You do not want to automatically try to "shoot down" the high number with either a larger dose of insulin or a fast acting insulin. The bounce will clear. Managing a cat's diabetes will teach you patience.

We like to see cats return to being in normal numbers (50 - 120). If a cat stabilizes in this range, the cat is a food controlled diabetic but is in remission. A cat's pancreas can heal. Not all cats are able to achieve remission. There are some cats who will be well regulated. Their blood glucose numbers will be good but not remission worthy. Rather, their numbers range a bit higher but are below a level that would cause kidney problems which are associated with diabetes (and aging).

Greenies being good for dental hygiene is a myth. If that were the case, no human would need to brush their teeth. We'd just need to eat crunchy stuff and could avoid the dentist. You'd be better off brushing your cat's teeth or using something like chicken gizzards or necks to address any dental issues. Using an anchovy will work fine as a distraction. There may also be freeze dried treats -- freeze dried chicken is popular. At one point I found freeze dried mussels which my cats loved but they seem to have disappeared off of the shelves.

Also, keep in mind that if your cat is stressed by going to the vet, the blood glucose numbers you get at the vet's office will be inflated due to stress. The readings at home will be more reliable.

No worries about the questions. We like questions!! You may want to take a look at the sticky notes at the top of the Lantus forum. There's lots of good information in those notes.

@Sienne and Gabby (GA) My previous "thank you" should have been given to you - and this one is!

He will be disappointed if there are no greenies but we'll give it a whirl.

To keep him distracted while I shoot him, something that I can smear (and he has to work to lick off the plate) would work best, so we'll be trying smashed anchovies. A bit of salt is the worst ingredient. The EVOO liquid that they come in is working on making his canned food more appealing.

I'll post again as things progress - thanks again.

Vet office attempted to place Libre today - after the hour wait, the sensor reported that it wasn't working, need to remove and place new. Now if only I could get it off, but the surgical glue used is slow to respond to the Aquaphor...
The Libre company might replace it?

ABBOTT will replace it but you cannot tell them is for your cat or they will not, and glue tends to give inaccurate readings and irritates the skin

MyGuy said:

Vet office attempted to place Libre today - after the hour wait, the sensor reported that it wasn't working, need to remove and place new. Now if only I could get it off, but the surgical glue used is slow to respond to the Aquaphor...
The Libre company might replace it?

Click to expand...

Hello, if they used glue to place the Libre, it most likely flooded the sensor and shut it down.
Please read the link that was put on this thread earlier about using Libre. It gives much good information about using one.

If you have another Libre put on please use no glue. You don’t need it.
Most cats wear a little tee shirt to protect the sensor so they can’t try to pull it off.

This is all covered in that Libre link.
You can try some coconut oil or Brava spray to gently loosen the sensor if glued on.
Be very careful, their skin is very fragile.
If you have questions, please ask.

CORKY said:

@Staci & Ivy

Click to expand...

I hope my answers helped. I wasn’t sure what you are asking me Maria.

your exact answer was the key thank you