06/07/2024 New Member Kuro 9y female newly diagnosed

Hello everyone, our beloved cat Kuro was diagnosed with diabetes this week. We're her caretakers Matt & Nia.

Kuro was diagnosed after some concerning PU and PD in addition to hind leg neuropathy and significant weight loss in the past month. She's always been a powerful jumper, and at first we thought she might have injured herself an surprise fall from the counter, but we now suspect it was overall weakness was due to the diabetes showing up in full force.

After a UTI years ago she was immediately prescribed the Royal Canin Urinary S/O wet + dry foods, along with the Hills T/D dental food as treats, and unfortunately they're all likely the reason we're here now. She's always loved to eat and until very recently was a delightful chonk. When we suspected diabetes, we immediately switched her over to LC wet food (Fancy Feast classic) and are trying to taper off the Hill's dental. As of today at 7:15pm she is officially on 1u glargine/Lantus BID.

We're still overwhelmed with learning all the new info and getting up to speed with our new lifestyle, so we haven't started filling out her spreadsheet. We're off to shop for our hypo emergency kit tomorrow (but have Karo in the house along with some med/high carb wet food.) Once we get a more reliable monitor we'll only be too happy to get some consistent data going and hopefully dive deeper into learning her cycles.

Kuro is the absolute light of our lives and we would do anything for her. We're so grateful to have found such a wealth of knowledge in this forum, and are so glad there's a place like this for support and encouragement.

Thank you for all you do!

 

Hi and welcome Matt, Nia and Kuro to the forum
It can be overwhelming in the beginning but it will soon become routine.
Well done setting up the spreadsheet, signature and information list.That is a great help to us. It looks like you are super organised!
Kuro is a beautiful girl.
Fancy Feast classic food is a good choice for diabetic cats. Yes, many of us fell into the trap of feeding unsuitable dry food, often recommended by the vet, and ended up with a diabetic cat. That’s what happened to me.
Lantus is a great insulin for cats so you have a good insulin. With a long acting insulin like Lantus, the onset of the insulin is around +2 (2 hours after the dose is given). The routine is to test/feed/ give insulin. If you know Kuro will eat well for you, you can give the dose as she is eating. As well as testing before every dose, if you could get a test in somewhere +4 to +7….vary it…we can see how well the dose is working for Kuro. Don’t forget to test in the pm cycle as well as the am cycle.
Here is a link to Hometesting tips and links
And a link to the 2 dosing methods for Lantus. Ask questions about the methods if they are confusing to you. You can swap so don’t feel you are locked into one or the other. DOSING METHODS
Whatever method you choose, you will need to stay with the 1 unit twice a day for 5 to 7 days in the beginning to let the depot fill, unless the BG falls under 90… In which case you reduce the dose to 0.75 units.

So you have the U100, 3/10, 30 or 31 gauge, 6 or 8 mm insulin syringes with the 1/2 unit markings?
And we recommend you use the 26 or 28 gauge lancets in the beginning until the ears learn to bleed and you and Kuro get used to the routine.

I would recommend you post daily here for a few days and then when we think you are all sorted out….you are more than 1/2 way there already!. ..We will get you to start posting over on the Lantus page where you can get daily help with dosing. We just like to get you fully setup here first. So glad to found us. You will find this a very friendly, helpful and supportive group.
Bron.

 

Welcome to FDMB! I'm sorry you're joining our ranks but this is a great place to be for help and support.

Being overwhelmed is pretty much where everyone is for the first couple of weeks. That's the bad news. The good news is that much of this will become routine both for you and for Kuro. You're really done a great job getting yourselves set up and Bron has provided a good deal of information to fill in any blank spots.

Please let us know if you have questions. The members here are very generous with their time and their knowledge. We're here to help.

 

Thank you for the warm welcome @Bron and Sheba (GA) and @Sienne and Gabby (GA)! We're still getting up and running - our glucometer finally arrived today and we were able to start taking some tests. After a dose of 1u this morning Kuro was slow and lethargic for most of the day, but we weren't able to get a reading in the AM. When we tested before her PM shot, she had a reading of 113 mg/dL. We were worried about hypo and unsure what to do, so we opted not to shoot. We fed her and tested again at PMPS +1 and got a reading of 150. We're planning on continuing to test through the evening to get a sense of what might be happening. Compared to her reading at the vet's of 350, this felt low but we're very much beginners at this. Hopefully tomorrow we'll be able to get into a more consistent pattern and get a better range of data.

Currently we only have the 0.3 mL syringes with 31 guage and 1/2 unit markings.

An initial suggestions for what to do tonight and tomorrow?
-Nia

 

They sound like the correct syringes

You did the correct thing in not giving any insulin with the preshot at 113.
Until you get more data I would not give any insulin if the Preshot BG is under 210 (as you are using alphatrak). We say don’t give if under 200 if using a human meter.
I would get a few tests in during the cycles, even if you are not giving any insulin as that will give us information about what her BGs are doing.
I can see you have chosen SLGS dosing method.
I would recommend you reduce the dose to 0.5 unit instead of the 1 unit, as you are doing SLGS and are feeding a low carb wet diet, and stay at that for the 7 days unless the BG drops under 90.
Cats often test higher at the vet office due to stress…that is why it is so much better to hometest.
Also do you know if they tested for ketones in the urine at diagnosis? As a safely precaution, while you are having to skip doses and getting sorted, I would recommend you buy a bottle of Ketostix from Walmart or a pharmacy and test Kuro’s urine for ketones. There should be no ketones, so let us know if any appear. I would test daily just now.

Are you giving snacks during the day as well as the 2 main meals? We find that is better for diabetic cats….well better for all cats really. I feed my 2 non diabetic cats 4 times a day and they are very happy and content.
Also I meant to mention a couple of another things. Kuro should start to put weight back on once the BGs come back to normal.
And with the neuropathy, you can buy some Zobaline from lifelink.com which helps. Also getting the BGs back to normal helps with the neuropathy. My Sheba had neuropathy badly but with the help of zobaline and getting the BGs back to normal, she returned to normal after about 6 months.

 

Thank you Bron! That's such a relief to hear, and very useful guide info about AlphaTrak.

We'll test in the morning and go with this dose if warranted - I wasn't sure if this was the direction we should go, so thank you for making it so clear! We're starting with SLGS as we learn and may switch once we have a better handle on the data.

The vet did test for ketones the two times she was in over the past week and she was negative both times. One silver living! We got some testers this afternoon, and will get a setup for urine testing this week.

Yes, I ended up giving her two snacks (quarter can of Fancy Feast, came out to a few teaspoons) in addition to meals. We previously fed her 4 times a day, so it's good to know we can modify back to that diet. She's also learning to like freeze dried chicken for treats as of this evening.

Thank you! We just started looking into getting this. Kuro is notoriously finicky about things in her wet food, though, so we may have to get creative about pilling.

Also apologies if this should go in the Lantus forum, but I was curious about using the pens. How are they modified, and how are they used instead of the vials?

-Nia

 

That is very good she was tested and was negative. Always a good result.

I don’t think they taste at all. I used to sprinkle it over the first part of Shebas food and she never seemed to notice it.. when she’d eaten that part I gave her the rest of the meal. That way I know she always got it.

This is the place to ask this so that is fine. The pens are actually cartridges (they come in a pkt of 5 pens) and there is one end that you draw the insulin from. They only have 3 mls in each one. The vials have 10 mls in each one and unless your kitty is on a lot of insulin, you will most likely not use it all before it needs throwing out. So the pens are more economical. Both last about 6 months after opening as long as they are kept in the fridge in a container (not the door). Both contain the same strength of Lantus…it only comes in one strength, so no modification needed. The pens usually have a long use by date so as long as they are kept in the fridge, and unopened, they are good this the use by date…does that make sense?
You don’t need to buy the actual pen itself…just the pkt of 5 cartridges (pens)
Bron

 

That does, thanks - do the needles need to be changed at all?

Managed to get one last test in before bed at PMPS +4.5. Result is 244; we may have stressed her out trying to get the prick right too many times at +4 or this may just be the result of no PM dose. We'll test again in the AM. Thank you for all your guidance so far Bron!
-Nia

 

You use the syringes when you use the pens. Not the pen itself. So as you use a new syringe each time, the needle will be new. Don’t ever use a syringe twice because of contamination and the needle will be blunt.

Well done getting those tests in. I can see Kuro is in good hands!
The 244 is most likely from skipping the dose but that’s ok. With no ketones in the picture it’s less of a worry to miss a dose. With the new dose of 0.5 unit hopefully she will not drop too low. I would say with her being slow and lethargic after the 1 unit dose, she was most likely dealing with a low blood glucose level. Let’s see how she goes with the smaller dose. Bron.

 

Just a small correction to information that Bron posted. Bron is in Australia. In the US, the cartridges for Lantus pens are no longer available. Actually, they haven't been available for quite some time. However, there is really no difference. I actually liked the pen better. If you drop the pen, because of the plastic housing, there's very little chance you will break the glass cartridge. If you drop the cartridge, much like dropping a vial, your insulin is now all over the floor.

 

@Sienne and Gabby (GA) I was unaware the cartridges for Lantus were no longer available in the US. What is available in their place now? Does that mean that the actual pens are no longer being used as well?

 

@Bron and Sheba (GA) - the pens are widely available and are likely easier to find than vials. It's just the cartridges that haven't been available for years. What's confusing is that the cartridges are still available in Canada. It's just a US thing.

 

Hi all, Matt's first post and I want to echo how reassuring this community and your fast and thorough feedback have been as we've been trying to learn the ropes this weekend!

We're suspecting Kuro is quite insulin sensitive. After a startling 589 mg/dL AMPS, we gave 0.5U with breakfast. After a long midmorning nap, she's been very much her active, curious, talkative self all afternoon. Descended to a respectable 288 AM+4, and was down at 187 PMPS so opted to skip the evening shot per Bron's 210 threshold advice.

I think the hardest thing for us to learn has been how to quickly and reliably get BGs. We do okay when we work together but it's been hard to restrain, poke, and collect a sample without either losing the cat or having the glucometer time out when either of us tries to read solo. Any tips?

- Matt

 

Hi Matt and Nia
You are doing very well for newbies! It takes time to get the testing so it’s just routine but you are more than 1/2 way there.
Try pushing the test strip part way in before you start, then when you are ready to test, push it all the way in. Are you giving Kuro a treat every time you test…successful or not?
Try not to restrain Kuro too much when you are testing. Do you think she would sit still if you gave her a little low carb food or a treat as you start to test? I used to get everything ready first, including a treat, and then kneel down and sit on my heels. Then I would put Sheba in between my knees facing the same way as me, so that if she backed away, she just backed into me. I put one hand gently on her chest under her chin, put the food down and then tested. Talk quietly to Kuro or even hum or sing.
Are you still giving snacks during the cycles?
See how you go over then next few cycles. If you are finding you are having to skip doses, we might have to reduce the dose further. The aim is to find a dose that you can shoot both cycles.
It is possible Kuro could bounce after dropping lower and also dropping quite fast from 589 to 288 so don’t be surprised if you see high numbers. Here is an explanation for bouncing, which is very common in newly diagnosed kitties. That 589 could have been a bounce.

• Bouncing - 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).

 

Thanks for the encouragement, Bron! Most of that we're already doing, and another day into this process we're feeling that much more comfortable with both testing and treatment. Our latest big breakthrough was realizing that a tiny spoonful of wet food in a bowl is a more effective distraction than loose treats. Two 0.5U doses today with three readings between 280 and 400. Behaviorally she's more or less herself. The cool mornings here in Seattle have kept her quite cuddly; if she's upset about the pokes and prods she's not holding a grudge for long.
- Matt

 

Well done. Great to hear things are going well.
Have you done any ketone tests yet?

 

We got our first green! No ketone testing yet, but also Kuro's LB habits were lower than expected today (but she did finally use it in the evening.) Fingers crossed she's not headed for a UTI.

It seems like Kuro is adjusting to the new cycle - or we're finally catching a full day. She is a little low in the middle of the day and seems a bit quiet and slow, but is still very excited to have her midday meal and afternoon snack and goes back to being her BAR self.
-Nia

 

With the BG of 83 and doing SLGS you need to reduce the dose to 0.25U at the next dose. I know it might seem odd to do that with some of the BGs still quite high but those BGs are from bouncing and the nadir or lowest point is where we decide on dosing.

 

Thanks, Bron. We did reduce to 0.25 (or something near .25, I'm really eyeballing even with the half-unit graduation) last night and this morning. If I'm reading the SLGS protocol correctly we'll stay here until / unless a weekend curve's high nadirs tell us to come back up. Is there a resource for converting the human glucometer values cited there to our feline meter's values?
-Matt

 

There is no conversion available. The pet meter reading run a bit higher. Both are Suitable for cats. Our dosing methods are based on the human meter values. The BG number you need to be aware of is 68. If Kuro drops under this number you need to give high carb food or honey and keep testing until it comes up higher. The number for the human meter is 50 so you can see there is a slight difference. Does that make sense.?

He is doing well on a very small amount of insulin. Is he eating ok and getting those extra snacks?

I think you are ready to start posting over on the Lantus page now. You post over there daily and you will find a lot of support. I am going to tag @Bandit's Mom and @tiffmaxee to watch out for you over there.
I will link you to the page and also how you write the subject line each day. It’s simple but different to this page.
LANTUS PAGE

POSTING GUIDELINES

THE BASICS, NEW TO THE GROUP, START HERE

 

Thanks Bron! We so appreciate your guidance and help over the past week. We just got a PMPS of 194 and opted not to shoot, so I expect we'll see another high number in the AM. We gave her dinner and will test again this evening to keep an eye on what's happening, but please let us know if you think we should adjust. She's still eating great and very happy about the extra snacks.

Off to investigate the Lantus page. Thank you @Bandit's Mom and @tiffmaxee for keeping an eye out for us!
-Nia

 

Next time you get a number under the shooting range…stall, dont feed, and test again in 20 minutes to see if the BG is rising. And post and ask for guidance.
Over on the Lantus page the no shoot number is 150, until you get more data. Because there are so many more people over there who use Lantus the no shoot number is dropped (until you get more data), and then you will be encouraged to lower the no shoot number over time.

 

Welcome to the FDMB. I will see you on the lantus forum.