10/7 NEW MEMBER- kitty Isy - Latest Info from Vet re Insulin and Diet

Sherri & Isy

Sherri & Isy

Member Since 2020
Hi All:
I’m a new member and have been posting on the FDMB since my cat Isy was Dx 9/23.
My vet re-checked Isy’s BG (meter reading) on Wed 9/29 and BG was 354. She lent me a iPet pro meter to do my readings at home for a BG curve etc which I’m supposed to do after 7-10days on insulin. I got the Lantus pen on Wed (But I planned to start insulin today /Saturday since I would be home all day and would also have received the ReliOn prime meter and test strips that I ordered to use for daily testing)

My vet told me to start at 1/2 unit BID and also told me not necessary to pretest BG or no need to monitor Isy over the first week, just give the 1/2unit dose after food and watch for any physical changes and just test if seems Isy might be too low.
(My vet felt testing her daily would stress her and that dose was low enough to not cause issues as long as I fed her first, and just watch physical signs and text her if I thought she could be too low).

But I DID test her today before I was going to start the insulin (before food) and it was 155 on ReliOn and 196 on the pet meter. I didn’t do the insulin yet!
It’s now noon here my time - should I just keep feeding Isy thru the day and test tonight and maybe start the insulin tonight to get onto a 12hrcycle for tomorrow?!

I don’t know what I’m doing!! Uggh!!!

And other members suggest I test Isy’s ketones, (Last week urine analysis at vet was negative for ketones.) I tried testing last night (using ketone test strip and putting into urine on the pee pad where Isy peed - it showed small amount of ketones (15)

Ugh!! I’m starting to panic!!
My vet didn’t tell me to test ketones.
I’m treading carefully with my vet - I need her support and follow what she says, so have to be careful of sounding like I’m questioning her based on information I’m getting from an online group (my vet is really awesome but I know vets can be sensitive when owners start contradicting based on info from online etc ;))

Also I tried setting up my SS but looks like I can’t do it using my iPhone so I need to borrow my daughter’s laptop to try to get it setup. Help with my SS would be appreciated since I know I need that done ASAP!

I am becoming a wreck!! I feel I’m losing time but am juggling a lot right now between Isy and family stuff!
Thanks for listening!!
Sherri
 
tiffmaxee said:
Welcome. Now you see why your vet is wrong about not testing. This is very common. Deep breaths. We will help you with Isy and give your ways to work with your vet. I will tag a few people to help you with your spreadsheet. @Chris & China (GA) @Bandit's Mom

When were you planning to give insulin? Shots are 12 hours apart so I’m guessing not until tonight?
Click to expand...

Hi!
Thanks for responding!
So I just got thru to my vet by text (she is away this weekend). Yes I was planning to possibly start insulin tonight since it’s a 12hr cycle and then get onto 2x/day starting tomorrow.
My vet told me it was the right thing to hold off on insulin and she will call me later to advise for later today etc. Also she told me to go ahead and give Isy subq fluids today to help with the ketones.

She said Isy is a complicated case with many other health issues to consider, so may have factors that other diabetic cats don’t have, so she wants me to stay in close communication with her and she’ll advise what to do and support me. She’s really a very caring vet, and she’s very responsive as much as she can at any day or time (and I know she has to have a life too).
 
That’s good. Would want to give the first shot during the day as some cats gave a strong first response. If you start tonight you might want to test every few hours up until Isy stops going down and stays up without food for 2 hours.
 
Chris & China (GA) said:
@Sherri & Isy I'd be happy to set up a spreadsheet for you. Just click on my name and choose "start a conversation" to send me a private message.

If you want to use your IPhone, make sure you have Google Sheets and Google Drive downloaded on it
Click to expand...
Thanks Chris!
Yes I already have Google Sheets and Google Drive on my iPhone and use those frequently!
But when I open the SS template with my iPhone it doesn’t let me have access to save it with another name etc
I was going to follow the instructions provided here on FDMB to setup my SS but couldn’t using my phone.

So I’ll message you about it.

Thanks!
Sherri
 
Sherri & Isy said:
Thanks Chris!
Yes I already have Google Sheets and Google Drive on my iPhone and use those frequently!
But when I open the SS template with my iPhone it doesn’t let me have access to save it with another name etc
I was going to follow the instructions provided here on FDMB to setup my SS but couldn’t using my phone.

So I’ll message you about it.

Thanks!
Sherri
Click to expand...
Hi Chris
FYI - I just did a “start conversation” with you re setting up my SS. I think I did it right.
Let me know if you don’t see it.

Thanks!
Sherri
 
Sheri, how many test strips do you have? When you start Lantus I sure hope you will test before each shot and get some mid cycle tests to try and see how low it is taking Isy. You will need enough test strips and I am concerned your vet did not give you close to enough. What you can do is use the Relion meter for the testing and use the pet meter for the curve. Did you buy a box or two of test strips for the Relion? If not they are at least easy to get from Walmart.
 
Sherri & Isy said:
Hi Chris
FYI - I just did a “start conversation” with you re setting up my SS. I think I did it right.
Let me know if you don’t see it.
Click to expand...

I see your "Signature" but not a spreadsheet link.

We may have to shorten your Signature information once we get the spreadsheet link. It only allows so many characters.
 
I read through some of your condo on health. The pancreatitis test is not that high. Max had chronic pancreatitis and sometimes registered 50. The number did not always transfer over into how he felt. He seemed more sick at times with lower than higher scores. He sissy’s was inappetent when it reared its ugly head. I always had ondansetron for nausea on hand and started it at the first sign he wasn’t acting right. Max never had hepatic lipidosis because of ondansetron for nausea and cyproheptadine as an appetite stimulant once the nausea medication kicked in. That’s the likely cause if the high liver enzymes for Isy and the cure fir that is food. I’m glad you didn’t give up on him and have decided to treat the diabetes. Max didn’t have IBD either but it sounds like that is being controlled by diet. Budesonide might be something to consider for that. I really think you will be able to get him back to a good quality of life. :bighug:
 
tiffmaxee said:
Sheri, how many test strips do you have? When you start Lantus I sure hope you will test before each shot and get some mid cycle tests to try and see how low it is taking Isy. You will need enough test strips and I am concerned your vet did not give you close to enough. What you can do is use the Relion meter for the testing and use the pet meter for the curve. Did you buy a box or two of test strips for the Relion? If not they are at least easy to get from Walmart.
Click to expand...

Hi Tiff,
Yes I plan to test Isy before I give insulin and mid cycle - my plan is to get readings using the ReliOn prime meter (I have a box of 100 test strips) and IF the reading is low then also test on the iPet pro so I can report that reading to my vet.

For the BG curve I will just use the iPet pro meter to report values to my vet. (Right now I have 48 test strips left for the pet meter).

My vet has told me to start insulin tonight (1/2unit at 9pm PST - gosh that’s in 10mins!) So I’ll go do another BG reading shortly with the ReliOn meter.
Hopefully the number is up higher so I have less worry about giving the insulin tonight.

(FYI - Isy’s reading today late morning was only 155 with ReliOn/196 with pet meter. My vet said the past test at the vet in am was about 200 , and the 2 late afternoon readings were about 350 - that’s while not on insulin yet. )

Ok guess I better go get ready to test Isy and then hopefully be successful to give the 1/2unit insulin! I’m nervous!!! Ugh!!
 
Sherri & Isy said:
Hi Tiff,
Yes I plan to test Isy before I give insulin and mid cycle - my plan is to get readings using the ReliOn prime meter (I have a box of 100 test strips) and IF the reading is low then also test on the iPet pro so I can report that reading to my vet.

For the BG curve I will just use the iPet pro meter to report values to my vet. (Right now I have 48 test strips left for the pet meter).

My vet has told me to start insulin tonight (1/2unit at 9pm PST - gosh that’s in 10mins!) So I’ll go do another BG reading shortly with the ReliOn meter.
Hopefully the number is up higher so I have less worry about giving the insulin tonight.

(FYI - Isy’s reading today late morning was only 155 with ReliOn/196 with pet meter. My vet said the past test at the vet in am was about 200 , and the 2 late afternoon readings were about 350 - that’s while not on insulin yet. )

Ok guess I better go get ready to test Isy and then hopefully be successful to give the 1/2unit insulin! I’m nervous!!! Ugh!!
Click to expand...

I just tested Isy’s BG - got 145 on ReliOn meter so I did another prick and measured with the iPet pro meter and got 196.
So basically both numbers are too low to give insulin!

I just texted my vet and told her I decided to test Isy before giving insulin, for my piece of mind so I wouldn’t be worrying about her all night since this is her first dose of insulin.
I told her the iPet pro result (196) and that I didn’t give insulin and what does she advise, since that’s even lower than her result this am.

Also I explained to my vet that my ketone test results maybe aren’t accurate since I waited longer than 15secs to read the strips (waited for darkest color, and initially the strips didn’t change color).

So I’m waiting to hear if my vet answers me back.
But I’m thinking maybe I just shouldn’t start insulin tonight and wait til tomorrow 9am to re-test and maybe start tomorrow??
 
Sherri & Isy said:
I just tested Isy’s BG - got 145 on ReliOn meter so I did another prick and measured with the iPet pro meter and got 196.
So basically both numbers are too low to give insulin!

I just texted my vet and told her I decided to test Isy before giving insulin, for my piece of mind so I wouldn’t be worrying about her all night since this is her first dose of insulin.
I told her the iPet pro result (196) and that I didn’t give insulin and what does she advise, since that’s even lower than her result this am.

Also I explained to my vet that my ketone test results maybe aren’t accurate since I waited longer than 15secs to read the strips (waited for darkest color, and initially the strips didn’t change color).

So I’m waiting to hear if my vet answers me back.
But I’m thinking maybe I just shouldn’t start insulin tonight and wait til tomorrow 9am to re-test and maybe start tomorrow??
Click to expand...
You can stall, don't feed and test again in 20 minutes to see if the BG is going up, or you can skip the dose.
I would only test with the human meter or you will drive yourself mad with the two different meters.
If you decide to skip, I would make sure Isy eats well and get another ketone test when you can get a urine sample. If there are ketones present, the test strip will change colour straight away.

Its a pity a fructosamine test wasn't done to make sure she definitely has diabetes and it wasn't just a high BG from the pancreatitis. BGs at the vet are typically higher at the vet due to stress.
You are doing great by the way. Try not to get stressed out about it...…Isy's BG is only 145 which is only just a bit above normal.
 
tiffmaxee said:
Exactly. I hope she reads this.
Click to expand...

Hi Tiff and Bron:
Thanks for your input.
Just to clarify - my vet was recommending I start with 1/2 unit (half unit) not 2 units.
Also just to summarize history re Isy’s BG numbers over the past 10 days or so (No insulin started):

9/21 - 201 (about 9:45am veinous draw at vet)
9/23 - 358 (5:15pm Meter reading at vet)
9/30 - 354 (4:45pm meter reading at vet)
10/1 - 269 (12:00pm iPet pro reading at home)
10/3 - 195 (12pm iPet pro reading at home/155 ReliOn reading)
10/3 - 165 (9pm iPet pro reading at home/145 ReliOn reading)

So in general day to day doesn’t it seem like basically Isy’s BG numbers are dropping?

I think I will hold off on giving insulin tonight, do subq fluids and keep feeding Isy, then re-check her BG around 8am (PST) and figure out if I should give her insulin.

FYI - While I was writing this Isy just peed on the pee pad so I did a ketone test - this time right away the test strips did change color. I’d say it’s reading somewhere between “trace” (5mg/dl) and maybe as much as “small” (15mg/dl)amounts.
But I’m still not sure if the fact that Isy’s urine itself has a lot of blood in it for her cystitis could also color the test strip??

I’ll attach photos of her latest ketone results and also of her urine so you can see what I mean.
(FYI - don’t be surprised by the color of her urine/amount of blood - this happens frequently with her cystitis which my vet has seen. Although I’m wondering if this is what is contributing to her recent anemia results since it’s been going on for about 9months?)

*Note: In the photo with the ketone test strips, the strip on far left is an untested strip for comparison to the other 2 test strips done from the same urine sample tonight on the pee pad.
 

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I don’t think that blood in the urine effects the ketone result.
That amount of blood if it has gone on for 9 months probably is causing the anaemia.
I am concerned if she has ketones in her urine though. Having glucose spilling over into the urine has nothing to do with the ketone result that your vet said was the reason for the ketones in the urine.

have you given the SubQ fluids yet?
 
Bron and Sheba (GA) said:
I don’t think that blood in the urine effects the ketone result.
That amount of blood if it has gone on for 9 months probably is causing the anaemia.
I am concerned if she has ketones in her urine though. Having glucose spilling over into the urine has nothing to do with the ketone result that your vet said was the reason for the ketones in the urine.

have you given the SubQ fluids yet?
Click to expand...
Just giving the subq fluids now - so that ketone result was before fluids.
Isy was being pretty feisty and temperamental tonight after I did the BG testing etc.
So I was letting her calm down before doing fluids - then I had to kids my kids to bed, then she was eating, then peeing and I was doing the ketone trst etc! So finally I’m about to do her fluids (my husband is not very supportive of anything related to my animals, so he won’t help out with the kids if it’s to give me time to care for Isy.)
 
Sherri & Isy said:
Just giving the subq fluids now - so that ketone result was before fluids.
Isy was being pretty feisty and temperamental tonight after I did the BG testing etc.
So I was letting her calm down before doing fluids - then I had to kids my kids to bed, then she was eating, then peeing and I was doing the ketone trst etc! So finally I’m about to do her fluids (my husband is not very supportive of anything related to my animals, so he won’t help out with the kids if it’s to give me time to care for Isy.)
Click to expand...
It’s hard if you don’t get support.
Hopefully the ketones will reduce with the subQ fluids.
What time were you going to test in the
morning to see if you can give the insulin.? I don’t like leaving cats who are showing any ketones without insulin. Try and test every urine sample you can. If there are still ketones there in the morning and the BG is not higher it might be worth even giving 1/4 unit. But we will need to wait and see

Is Isy her usual self? Not lethargic and eating ok?
 
Bron and Sheba (GA) said:
It’s hard if you don’t get support.
Hopefully the ketones will reduce with the subQ fluids.
What time were you going to test in the
morning to see if you can give the insulin.? I don’t like leaving cats who are showing any ketones without insulin. Try and test every urine sample you can. If there are still ketones there in the morning and the BG is not higher it might be worth even giving 1/4 unit. But we will need to wait and see

Is Isy her usual self? Not lethargic and eating ok?
Click to expand...
I was planning to test Isy in the morning probably between 8-8:30am PST (I’ll have to decide fairly quickly if I’m going to give insulin at that time or not because I need to leave the house by 8:45am to take my daughter to her running practice at 9am and then I won’t be home until 10:30am).

I think Isy seems herself - she’s been eating, was alert earlier, a bit fiesty when I was doing her fluids.
Now she’s sleeping beside me on the couch. I’ll sleep on the couch tonight and put her in her bed so I can easily check on her.
I gave her extra subq fluids tonight (close to 100ml, usually I only give 50mls EOD per her vet cause she has a heart murmur and with the anemia/not dilute her blood too much.)

I’ll test for ketones each time she pees - maybe with the extra fluids tonight she’ll pee again in the morning so I could test ketones again before deciding about insulin in the am, as long as she pees again.
 
Test in the morning a bit earlier, say 15 mins , so you have time to get help and to decide If you are going to shoot. I will probably be asleep by that time. Try and get a ketone test in if possible before that so we can see if there are ketones. That is really important.
Make sure you say in your subject line you need help
Hope you can sleep.
 
Bron and Sheba (GA) said:
Test in the morning a bit earlier, say 15 mins , so you have time to get help and to decide If you are going to shoot. I will probably be asleep by that time. Try and get a ketone test in if possible before that so we can see if there are ketones. That is really important.
Make sure you say in your subject line you need help
Hope you can sleep.
Click to expand...
Ok thanks! I’ll definitely test for ketones as long as she pees again by the morning.
I’ll plan to test her BG by 8am so I have time to post here with the results and figure out what I should do.
 
Good Morning Sherri!

Looks like you've had the 'intro by trial and fire'! I've read through this thread and there's a lot that's been coming at you.

So first, WELCOME to the LB&L forum! Best place you never wanted to be.

And secondly, you'll never find a better place on the web to get good solid information and advice about feline diabetes! The collective wisdom and experience of all these members is far beyond what any other group or even a vet may understand.

Many many kitties have gotten to remission or at least to good health (like my Luci) who are not in remission, but who while on insulin are healthy and happy and continue to live good lives.

So, with that said, I'll keep it brief here and ask if you could please start a new Condo aka/thread aka/post on the LB&L forum this morning.

Click on the top of the forum, then on 'Create a New Post' - and set up your title like this: 10/4 Isy AMPS ### - or AMBG (am = morning, blood glucose) in case you're still not sure about the shooting thing... (PS = pre-shot)...if all that makes sense.

We'll be looking for your new post there so we can continue with the conversations.

Thanks! And again, welcome to the group!!
 
Hi!
I just tested Isy’s BG at 8;15am PST - got 212 (and 225 with iPet Pro cause my vet asked me trst and text her result).
My vet advised I should go ahead and START the first dose insulin this am now - 1/2 unit
given the number is over 200 and looks like ketones in urine last night.

So I’m going ahead with the first dose NOW.
(Unfortunately then I need to leave home in about 15min at 8:45am PST and won’t be home til about 10:30am). I have honey on hand and can chrck Isy once home again.

WHEN should I recheck BG? How long after shot to make sure she’s not going too low?
 
Two hours is ok. Will you leave out food and if eaten will your husband feed him I hope? Onset is generally two hours but if he doesn’t eat after insulin and his pancreas is working at all he could drop by then.
 
tiffmaxee said:
Two hours is ok. Will you leave out food and if eaten will your husband feed him I hope? Onset is generally two hours but if he doesn’t eat after insulin and his pancreas is working at all he could drop by then.
Click to expand...

Gave the insulin at 8:40am after she ate a bit of Fancy Feast
I Left dry food and FF out by her.
Will be home by 10:30am to check her
 
tiffmaxee said:
That’s good.
Click to expand...
I’m home now (10:45am PST) so it’s been 2hrs since Isy’s insulin.
She was sleeping comfortably when I got home. I offered her more Fancy Feast and she ate it. Now she’s walking around a little bit. (Seems like she needs to pee but she’s not going to her pee pad).

Since she seems herself, I’m thinking I can wait for now to check her BG. She’s getting cranky when I touch near her head (my vet said she maybe anticipating me going to prick her ear) and I need her to be Ok with me touching her head since I have to give her various other daily meds and eye drops and eye ointment for her other health issues.
So I’m thinking I should be selective on When I check her BG and try to do it just when it’s most important/critical (like maybe mid-cycle and then tonight PFE-shot)

Thoughts??
 
tiffmaxee said:
Please start a new thread when you get home and link this one. Post the bg test result too.
Click to expand...
Hi!
Sorry just saw your post/comments above right after I just wrote my latest update.
FYI - Chris and Bron told me to only start ONE thread per day. So should I not keep posting on this 10/4 thread??
OR - should I change the Subject/title of this 10/4 thread??
 
Sorry. I thought it was the old thread. Yes one a day. My bad. A +2 is very important because if lower than the amps she could drop a lot. Give a treat after each test. I picked one place for meds snd tests so Max knew he was safe from icky stuff everywhere else.
 
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tiffmaxee said:
Also some cats have a big response to the first shot.
Click to expand...

Ok I’ll test Isy now - it’s +3 from her AM shot
(She did go pee again a few minutes ago - didn’t want to go on her usual pee pad area, was about to pee on the living room floor so I quickly stuck a pee pad under her. I repeated the ketone test - I think it basically looks the same as past tests (no darker).
I checked her weight this am and she’s holding stable at 9.4lbs (she was down to 9.2 about 2wks ago and gained a bit back last week).

Btw - I’ve never found any “treats” Isy likes. She’s always been a picky eater, eats small amounts just when she’s hungry. She has never been one to like some of the typical things (Won’t eat things like baby food, cat treats, tuna, cooked chicken etc.)
So I’m not sure how I can “treat her” after doing BG test to make it a positive experience??
 
Sherri & Isy said:
Ok I’ll test Isy now - it’s +3 from her AM shot
(She did go pee again a few minutes ago - didn’t want to go on her usual pee pad area, was about to pee on the living room floor so I quickly stuck a pee pad under her. I repeated the ketone test - I think it basically looks the same as past tests (no darker).
I checked her weight this am and she’s holding stable at 9.4lbs (she was down to 9.2 about 2wks ago and gained a bit back last week).

Btw - I’ve never found any “treats” Isy likes. She’s always been a picky eater, eats small amounts just when she’s hungry. She has never been one to like some of the typical things (Won’t eat things like baby food, cat treats, tuna, cooked chicken etc.)
So I’m not sure how I can “treat her” after doing BG test to make it a positive experience??
Click to expand...

I just tested Isy’s BG at +3 - she fought me!! I had to prick her ear twice (she was too feisty and trying to bite me so I couldn’t hold the meter to her ear and I lost that first blood drop, then second time was a bigger drop and it covered more than just the tip of the test strip).

Should I give her honey?
52 is low right?!
 

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I just looked at the picture. Under 50 she was be in danger of a symptomatic hypo. You are early in the cycle. Her nadir, lowest point in the cycle could be several hours away. If you gave only honey you need to test in 20 minutes. It acts faster but the results dint last as long as food. Food will take about 30 minutes to kick in which is why I say both were needed if possible.
 
Don’t see any results on your spreadsheet. Please write the +3 in your title and all subsequent tests. You might need lots of tests for the next few hours to avoid needing to go to the ER. Nadir might not be until +6-7.
 
tiffmaxee said:
Sherry, have you fed her?
Click to expand...

Hi! Sorry was texting with my vet.
She had me test her BG again with the pet meter (before I had fed yet) - it was 89.
So she had me syringe in some baby food (10ml so far) and some Fancy Feast. Also I have a packet of Fancy Feast Classic Broths (not sure carb amount cause don’t see it on Dr Lisa’s list)- Isy just ate some of that on her own.
 
Sherri & Isy said:
Hi! Sorry was texting with my vet.
She had me test her BG again with the pet meter (before I had fed yet) - it was 89.
So she had me syringe in some baby food (10ml so far) and some Fancy Feast. Also I have a packet of Fancy Feast Classic Broths (not sure carb amount cause don’t see it on Dr Lisa’s list)- Isy just ate some of that on her own.
Click to expand...

FYI - I just updated Isy’s SS with today’s numbers.

Also I just gave Isy her transdermal Mirataz (it gets rubbed in her ear - usually easy but now she is not liking me touch her ears so that was harder to apply! Ugh!!). Hopefully that will pick up her appetite so she’ll also eat more on her own through the day in addition to any food I can syringe in her.

I am getting concerned that Isy is not going to tolerate this!! She is getting very angry at me handling her! Ugh!!

I’m going to go to the store after and get some higher carb Fancy Feast/gravy type also to have on hand.
 
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Sherri & Isy said:
Hi! Sorry was texting with my vet.
She had me test her BG again with the pet meter (before I had fed yet) - it was 89.
So she had me syringe in some baby food (10ml so far) and some Fancy Feast. Also I have a packet of Fancy Feast Classic Broths (not sure carb amount cause don’t see it on Dr Lisa’s list)- Isy just ate some of that on her own.
Click to expand...
Here’s the Fancy Feast broth packet -Isy ate a bit of this in addition to the 10ml baby food I syringed in.
SEE PHOTO
Any idea if it’s higher carb?

(My vet said stick with giving food thru the day and syringe feed if needed. I didn’t give honey just the food). It’s about 20-30min since I started syringing one some baby food. Isy got stressed and fighting me so I had to take a break,
She’s on her pillow resting now.
 

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The pet meter runs higher. The take charge number one it is 68. Im glad she wrote back. Gravy lovers is higher carb. I don’t think broths are but never used them. I feed raw to my current girls. Most foods in gravy are higher carb and the carbs are in the gravy.
 
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