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

[Sherri & Isy]

I just tested Isy’s BG again (so it’s a bit past +4) = 96 (ReliOn meter)
So BG went up
I’ll keep feeding her thru the afternoon.

(I have been having a harder time getting a blood drop when pricking her ear cause she’s not liking it. I’m probably not hitting the sweet spot outside the marginal vein as well but at this point I’m not sure what I can do. I am just trying to at least get a drop of blood. She is NOT happy with me doing this. And on top of it my husband is not supportive and feels I’m spending too much time on “a 17yr old cat” instead of focusing on my family! He’s not speaking to me! Ugh!!
But Isy is my furchild and totally dependant on me! I feel he doesn’t really care!)

 

[tiffmaxee]

She’s out of potential danger. You will need a PMPS test. Post it please. She might need .25 but see where she is. Don’t feed within two hours of PMPS test as you don’t want it food influenced.

 

[Sherri & Isy]

She’s out of potential danger. You will need a PMPS test. Post it please. She might need .25 but see where she is. Don’t feed within two hours of PMPS test as you dint want it food influenced.

So do you think as long as I keep feeding her small amounts thru the rest of the day (up until 2hrs befofe PMPS), that her BG shouldn’t drop too low? Can I wait to test her BG again tonight as long as there are no concerning clinical signs/changes?

Or do I need to test again maybe at + 6 or +7?
(Of course if it’s not really critical to do it I’d rather not so it gives her more time to relax and calm down before I have to get the PMPS reading )

 

[tiffmaxee]

If you can get one two hours after your last test. She could drop again but as long as she’s eating and theb Bg came up with what you are feeding it should be okay. We always say if they can stay up for two hours without food it should be okay. I’m trying o juggle your home situation with caring for Isy. When you test if you get the blood on your finger you can get it onto the strip from there if that’s easier. If it’s not a problem with your husband to test then please test.

 

[tiffmaxee]

FF broths are only 1% carbs. Mostly water. Gerber's baby food is low carb. Try finger feeding. Might accept better than syringe.

 

[Sherri & Isy]

If you can get one two hours after your last test. She could drop again but as long as she’s eating and she Bg come up with what you are feeding it should be okay. We always say if they can stay up for two hours without food it should be okay. I’m trying o juggle your home situation with caring for Isy. When you test if you get the blood on your finger you can get it onto the strip from there if that’s easier. If it’s not a problem with your husband to test then please test.

Ok thanks that’s helpful advice!!
And I didn’t know I can get the blood drop on my finger and then put it on the meter test strip! That would definitely help because once I prick Isy’s ear she is getting feisty and I can’t keep her head still and steady to touch the end of the test strip into the little blood drop without really having to do additional restraining of her! That adds to her stress and negative attitude!!

So I’ll plan to check her BG again at about +7
(I’m going to run out to the store quickly now and get some wet food with gravy - my husband is actually at the grocery store now but he won’t get it for me! Ugh! Probably he doesn’t want to be involved with anything related to Isy right now plus maybe he thinks he’ll buy the wrong thing? So I’m heading to the store now so I can get back in time to test again by +7)

Thanks for all your help, advice and understanding!

 

[tiffmaxee]

Let the meter draw up the blood from your finger it it ends up there. You can’t put it on the strip. Make sense?

 

[Sue and Luci]

he won’t get it for me

It would be great if you could show him what you buy - so maybe next time he's at the store he'll know what to buy.

It take a little while but often DH's can be purrsuaded to help out...

 

[Sherri & Isy]

Let the meter draw up the blood from your finger it it ends up there. You can’t put it on the strip. Make sense?

Yep - so you mean stick the end of the test strip down into the blood on my finger and let the strip draw it up (don’t cover that test area with blood)

Btw when blood is drawn up into the strip when I do it by touching the drop on Isy’s ear, if some blood gets on the surface of the strip/test area what will that do to the result? Can I tell if it affects the reading? Is there an error reading or anything?
(Cause I think one of Isy’s previous readings likely got some blood onto the test strip surface when I stuck the tip into the blood cause it was a bigger drop - but the meter still gave a reading, so would it have still been accurate?)

 

[Sue and Luci]

The drop size doesn't matter all that much - as long as you don't 'flood' the test strip with it.

There's a tiny little bit of paper in there - that draws the fluid up to where it can 'read' what the BG is...you'll see it if you watch the end of the strip. Have you ever used litmus paper or anything like that? It sucks the fluid up to itself...you don't have to immerse it or anything like that...

 

[Sherri & Isy]

It would be great if you could show him what you buy - so maybe next time he's at the store he'll know what to buy.

It take a little while but often DH's can be purrsuaded to help out...

Well unfortunately I don’t think my husband will even do that. I have been buying the Fancy Feast Classic pate type (various flavors) for over a year and he knows what I buy, where it is in the store etc but he will no longer buy it for me when he goes to the store to get groceries! (He feels the animals are my responsibly and he won’t do much to help - except sometimes feed our dog. To him our animals mostly just represent high vet costs! Ugh! )

 

[Sherri & Isy]

The drop size doesn't matter all that much - as long as you don't 'flood' the test strip with it.

There's a tiny little bit of paper in there - that draws the fluid up to where it can 'read' what the BG is...you'll see it if you watch the end of the strip. Have you ever used litmus paper or anything like that? It sucks the fluid up to itself...you don't have to immerse it or anything like that...

Yep I know it draws up the blood by capillary action. Just wondering how sensitive the strips are and if excess blood gets on the surface if it affects the accuracy of the Value read.

 

[Sue and Luci]

I best not say anything else about the man you married...you probably wouldn't like my comments.

I'm sorry.

 

[Sherri & Isy]

I best not say anything else about the man you married...you probably wouldn't like my comments.

I'm sorry.

Sue - you are just thinking what I already know and I’m sure your comments wouldn’t bother me!
There are many “home life challenges” I’m dealing with and I have 2 human kids as well as my 3 furry kids. (When I got married many years ago I was working in high tech, had my own source of income and could independently take care of my furkids and their medical care. I became a stay-at-home mom 15yrs ago and since that time my various furkids have had different medical issues that have cost many thousands of dollars - I no longer had income, went thru most of my savings. So my husband now has to pay for all the vet expenses - pet insurance helps some, but he’s developed a general negative attitude about the kitties (not too much toward our dog yet - maybe cause he’s healthy/not too high expenses and for some reason he likes my husband (altho he’s a “Momma’s boy“ dog for sure!) Ha!!

 

[tiffmaxee]

Have you bought from chewy.com? You can look there and usually get all your questions answered and prices are competitive. That’s where I looked up the carb content of the broths.

 

[Sue and Luci]

but he’s developed a general negative attitude about the kitties

I hope he can get over the 'expenses issue' and open his heart toward the furbabies in your life...so sad when someone builds resentment over financial things. Been there done that...

However, on a brighter note, we are here to help and support you in any way we can...all kinds of folks, from all walks of life...with one purpose, one love...of our FD cats and all their ups and downs...take solace in that.

There's also help financially if you ever run into trouble...just let us know.

 

[Sherri & Isy]

I hope he can get over the 'expenses issue' and open his heart toward the furbabies in your life...so sad when someone builds resentment over financial things. Been there done that...

However, on a brighter note, we are here to help and support you in any way we can...all kinds of folks, from all walks of life...with one purpose, one love...of our FD cats and all their ups and downs...take solace in that.

There's also help financially if you ever run into trouble...just let us know.

Thanks Sue!! I really do appreciate all the support from the wonderful members of FDMB!!

I just got back from buying lots of higher carb wet food for Isy (based on Dr. Lisa’s list)
I just fed her some of the Fancy Feast Gravy Lovers Beef Feast - she has never had it before and seemed to really like it! She ate about half the can! That’s a lot for her! So hopefully eating today will help keep her BG numbers up enough until I check her BG again tonight for the PMPS reading.

I’ll take a reading at 3:45pm PST (+7) to make sure her number is good.

 

[Bron and Sheba (GA)]

Hi Sherri,
I see you got lots of support for your first shot!

Have you been able to test for ketones again? Can you put any ketone results in the remarks column of the SS please. It’s over on the right hand side of the SS. You can also put what you fed to bring up the BG there as well and any other relevant information.

I would not change meters mid cycle, especially when you are getting a low number. I know the vet asked you to take it with the pet meter but it is not really a safe way of monitoring the cycle and it will mess with your mind and you won’t know where you are with the numbers.
If you get a drop like you did down to 52 so early in the cycle, you need to take action as @tiffmaxee said. And it is important to take another test 20 minutes later to see that you were able to holt the drop.
By the time cats start showing sign and symptoms of a hypo, they are usually dangerously low, so by testing you can avoid that.

I am also concerned about the dose of 0.5 units. Lantus is a depot insulin which means it forms a depot in the tissues by leaving some of each dose there which it continues to release. It takes up to 5 days initially for that depot to form and the true effect of the 0.5 units will not be felt until the depot is full. Because of this I think you should reduce the dose to 0.25 units.
I know you like your vet to be aboard for all of this so will you please talk to her about reducing the dose.?....we need to keep Isy safe.

 

[tiffmaxee]

I see you are of the same feeling as I am. @Bron and Sheba (GA)

 

[Sherri & Isy]

I just tested Isy’s BG at 4pm (so about +7) = 145 (ReliOn meter)
It took 3 tries (2 ear pricks) to get a reading - Isy is now not letting me touch her! Hissing, biting!
I tried twice just getting a drop of her blood on my finger and then using the meter to get a reading but it gave some kind of error message (need to look it up - maybe sample too small?)
I finally got a reading on the 3rd try and 2nd prick but she was flipping out - and my family is there saying “she hates you now! You’re just torturing her!”

I just want to cry!! I don’t know what to do -only first day and Isy now won’t let me touch her! And I need to be able to get her regular meds in her too!
(Sadly this what my vet was worried about, knowing Isy for so many years and her temperament etc!)

I honestly don’t know what to do?!
I won’t give up on Isy but I can’t care for her and treat her if she won’t let me touch her! And I know I can’t blindly give insulin not knowing her numbers?
Is this just not doable?! My heart is hurting for her!!

 

[tiffmaxee]

Until it’s easier to test I think you need to lower the dose. We would suggest that anyway but at least on a lower dose you won’t need to test as much. Almost all cats get used to testing once we get good at it. If you continue with this dose she needs higher carbs so she won’t drop anywhere close to hypo territory.

 

[Sherri & Isy]

Hi Sherri,
I see you got lots of support for your first shot!

Have you been able to test for ketones again? Can you put any ketone results in the remarks column of the SS please. It’s over on the right hand side of the SS. You can also put what you fed to bring up the BG there as well and any other relevant information.

I would not change meters mid cycle, especially when you are getting a low number. I know the vet asked you to take it with the pet meter but it is not really a safe way of monitoring the cycle and it will mess with your mind and you won’t know where you are with the numbers.
If you get a drop like you did down to 52 so early in the cycle, you need to take action as @tiffmaxee said. And it is important to take another test 20 minutes later to see that you were able to holt the drop.
By the time cats start showing sign and symptoms of a hypo, they are usually dangerously low, so by testing you can avoid that.

I am also concerned about the dose of 0.5 units. Lantus is a depot insulin which means it forms a depot in the tissues by leaving some of each dose there which it continues to release. It takes up to 5 days initially for that depot to form and the true effect of the 0.5 units will not be felt until the depot is full. Because of this I think you should reduce the dose to 0.25 units.
I know you like your vet to be aboard for all of this so will you please talk to her about reducing the dose.?....we need to keep Isy safe.

FYI - whenever my vet asked for a reading I took readings with BOTH monitors so I could have the reading to post here (ReliOn) and one to give my vet from the pet meter.

I tested ketones every time Isy has peed - so last night 11pm and today 11am (I just added the info in Notes on SS)

I have the 1/2unit syringes but the markings are very tiny and I can barely tell where 1/2 is so I don’t know how you all can figure out giving 1/4?
I will text my vet tonight before giving more insulin.

I know it’s just the first day but I’m very discouraged! Isy is not tolerating the testing and handling well at all! She is unhappy and won’t let me touch her - so how can I treat any of her health issues with her responding this way?!
My family is saying it’s a sign that I’m trying to do more than she’ll tolerate in the time she has left with me!! I’m so upset!!

 

[Bron and Sheba (GA)]

Sherri, have you tried giving her something nice to eat as you test? I know she isn’t all that food motivated.
Remember this is all new to both you and to her and she will pick up on your stress.
Things will settle down I promise.
I think you have done amazingly well. Some people cant get a successful first test for a week and here you are almost an old pro by day one.
Isy is just confused at the moment as to what is happening.
Just think if you hadn’t tested her and continued with the 0.5 units......knowledge is power.

FYI - whenever my vet asked for a reading I took readings with BOTH monitors so I could have the reading to post here (ReliOn) and one to give my vet from the pet meter.

I tested ketones every time Isy has peed - so last night 11pm and today 11am (I just added the info in Notes on SS)

I have the 1/2unit syringes but the markings are very tiny and I can barely tell where 1/2 is so I don’t know how you all can figure out giving 1/4?
I will text my vet tonight before giving more insulin.

I know it’s just the first day but I’m very discouraged! Isy is not tolerating the testing and handling well at all! She is unhappy and won’t let me touch her - so how can I treat any of her health issues with her responding this way?!
My family is saying it’s a sign that I’m trying to do more than she’ll tolerate in the time she has left with me!! I’m so upset!!

don’t be discouraged! You are doing great!
I used a magnifying glass so I could see the markings more easily. I always used the magnifying glass each time I draw up insulin.
This is just day 1 for Isy too....give her a chance to get used to it.
Try and find something she really likes and give it too her as you test every time.
Try humming as you test ....that will release stress.
I think testing with bothers meters every time will cause major stress. And cost a lot of money.
I think you need to choose one or the other.
I know you are doing it for the vet but you don’t need to tell the vet every test. We can help you with any drops in the BG ......I know we are an online group but we are all people who have had diabetic cats and looked after them 24/7 for years. Only the very experienced people give dosing advice and we will stay with you if there are any issues.

I want you to take some deep breaths and try and relax a bit. Just spend time cuddling Isy and talking to her gently.
Know you are doing really well and IT WILL GET MUCH EASIER,!

 

[Sherri & Isy]

QUESTION RE 1/4 DOSE:
- how do you see or even physically give 1/4 unit dose? My syringes (U-100 0.3ml, 31g, 8mm) have 1/2 unit markings. But even the 1/2 unit (first tiny line) is barely any amount drawn from the Lantus pen. So how do you withdraw only 1/4 unit because it feels like if I pull the syringe plunger any less than to the first 1/2 unit line it basically doesn’t move at all to withdraw any insulin.
Or If I withdraw the plunger more when in the pen, and then try to push it back up above the 1/2 unit line it ends up being basically no insulin in the syringe.
What am I doing wrong?

SEE PHOTOS -you can see the markings on my syringe and the first photo is showing the syringe CLOSED/nothing drawn and the second photo is with the syringe plunger at the 1/2 unit mark .
There’s hardly any difference so how can I get it to only 1/4 unit which would be getting the syringe plunger in between the 2 positions shown in the photos (and these are enlarged photos, harder to see on the syringe with my bare eye)

 

[Bron and Sheba (GA)]

Will answer shortly. Just caught up for a few minutes.

 

[Bron and Sheba (GA)]

Sherri, have you tried giving her something nice to eat as you test? I know she isn’t all that food motivated.
Remember this is all new to both you and to her and she will pick up on your stress.
Things will settle down I promise.
I think you have done amazingly well. Some people can get a successful first test for a week and here you are almost an old pro by day two.
Isy is just confused at the moment as to what is happening.
Just think if you hadn’t tested her and continued with the 0.5 units......knowledge is power.

FYI - whenever my vet asked for a reading I took readings with BOTH monitors so I could have the reading to post here (ReliOn) and one to give my vet from the pet meter.

I tested ketones every time Isy has peed - so last night 11pm and today 11am (I just added the info in Notes on SS)

I have the 1/2unit syringes but the markings are very tiny and I can barely tell where 1/2 is so I don’t know how you all can figure out giving 1/4?
I will text my vet tonight before giving more insulin.

I know it’s just the first day but I’m very discouraged! Isy is not tolerating the testing and handling well at all! She is unhappy and won’t let me touch her - so how can I treat any of her health issues with her responding this way?!
My family is saying it’s a sign that I’m trying to do more than she’ll tolerate in the time she has left with me!! I’m so upset!!

don’t be discouraged! You are doing great!
I used a magnifying glass so I could see the markings more easily. I always used the magnifying glass each time I draw up insulin.
This is just day 1 for Isy too....give her a chance to get used to it.
Try and find something she really likes and give it too her as you test every time.
Try humming as you test ....that will release stress.
I think testing with bothers meters every time will cause major stress. And cost a lot of money.
I think you need to choose one or the other.
I know you are doing it for the vet but you don’t need to tell the vet every test. We can help you with any drops in the BG ......I know we are an online group but we are all people who have had diabetic cats and looked after them 24/7 for years. Only the very experienced people give dosing advice and we will stay with you if there are any issues.

I want you to take some deep breaths and try and relax a bit. Just spend time cuddling Isy and talking to her gently.
Know you are doing really well and IT WILL GET MUCH EASIER,!

ETA..I wrote this a bit earlier and forgot to press post

 

[Bron and Sheba (GA)]

QUESTION RE 1/4 DOSE:
- how do you see or even physically give 1/4 unit dose? My syringes (U-100 0.3ml, 31g, 8mm) have 1/2 unit markings. But even the 1/2 unit (first tiny line) is barely any amount drawn from the Lantus pen. So how do you withdraw only 1/4 unit because it feels like if I pull the syringe plunger any less than to the first 1/2 unit line it basically doesn’t move at all to withdraw any insulin.
Or If I withdraw the plunger more when in the pen, and then try to push it back up above the 1/2 unit line it ends up being basically no insulin in the syringe.
What am I doing wrong?

SEE PHOTOS -you can see the markings on my syringe and the first photo is showing the syringe CLOSED/nothing drawn and the second photo is with the syringe plunger at the 1/2 unit mark .
There’s hardly any difference so how can I get it to only 1/4 unit which would be getting the syringe plunger in between the 2 positions shown in the photos (and these are enlarged photos, harder to see on the syringe with my bare eye)

If you look at the link I am sending you, scroll down to the video of how to draw up insulin. Just below that you will see some syringes that have tiny doses. The 1/4 unit (0.25unit) dose is shown.
We give smaller doses than that as well...0.1 and a drop
See how you go. The other option is to buy some caliber and use those. I haven’t used them at all so can’t help you with them but if you are interested I will try and find someone who uses them.
Keep asking questions.

https://www.felinediabetes.com/FDMB...info-proper-handling-drawing-fine-dosing.151/

 

[Sherri & Isy]

Sherri, have you tried giving her something nice to eat as you test? I know she isn’t all that food motivated.
Remember this is all new to both you and to her and she will pick up on your stress.
Things will settle down I promise.
I think you have done amazingly well. Some people can get a successful first test for a week and here you are almost an old pro by day two.
Isy is just confused at the moment as to what is happening.
Just think if you hadn’t tested her and continued with the 0.5 units......knowledge is power.




don’t be discouraged! You are doing great!
I used a magnifying glass so I could see the markings more easily. I always used the magnifying glass each time I draw up insulin.
This is just day 1 for Isy too....give her a chance to get used to it.
Try and find something she really likes and give it too her as you test every time.
Try humming as you test ....that will release stress.
I think testing with bothers meters every time will cause major stress. And cost a lot of money.
I think you need to choose one or the other.
I know you are doing it for the vet but you don’t need to tell the vet every test. We can help you with any drops in the BG ......I know we are an online group but we are all people who have had diabetic cats and looked after them 24/7 for years. Only the very experienced people give dosing advice and we will stay with you if there are any issues.

I want you to take some deep breaths and try and relax a bit. Just spend time cuddling Isy and talking to her gently.
Know you are doing really well and IT WILL GET MUCH EASIER,!

Ok I’ll try to relax and not be so stressed about Isy being difficult.
I haven’t given her any food DURING trying to do the testing, only AFTER I tested her- cause I thought it was better to take readings and then feed (but I guess if she’s just starting to eat more food when I do the test, that isnt digested food so shouldn’t affect the BG number right at that test.)
Since she’s a picky eater and it’s challenging to get her to eat enough (and I even restarted Mirataz today to pick up her appetite),I just don’t want her to associate me pricking and testing her with food and make her have negative feelings/not want to eat. She’s already a nervous eater, looking over her shoulder for our other cat and dog to make sure they aren’t coming to eat her food or surprise her while she’s eating (this got much worse when she lost one eye and near blindness in the other eye over the past 10 months).

But I could try some of the new Gravy Lovers Fancy Feast while I test and just see if it helps her tolerate everything better.

 

[Bron and Sheba (GA)]

If you give the gravy lovers food that is high carb so you would have to only give a tiny amount....probably better not to give that when you are testing the preshot number. I used to give Sheba chicken stock I had made without any salt while I tested her and she loved that.

Can you feed her where she feels safe away from the others. I feed one of mine on the bathroom with the door shut otherwise she keeps looking around and is a bit concerned Harry might come and eat it.

 

[Sherri & Isy]

If you give the gravy lovers food that is high carb so you would have to only give a tiny amount....probably better not to give that when you are testing the preshot number. I used to give Sheba chicken stock I had made without any salt while I tested her and she loved that.

Can you feed her where she feels safe away from the others. I feed one of mine on the bathroom with the door shut otherwise she keeps looking around and is a bit concerned Harry might come and eat it.

Yep she already now only gets fed/eats in her bed so the other animals can’t get to her but I think it’s just habit for her especially due to her very poor vision.

 

[Sherri & Isy]

UPDATE from MY VET:
My vet just called me. She has requested that I just not give any insulin tonight because she’s worried Isy will drop too low while I’m sleeping. She has asked me to continue the Mirataz and measure out all food Isy eats over the next 24hrs so we get a better idea of her calories and carb intake (on her usual diet).
My vet is traveling out of town and back to work on Tuesday but said I can continue to text her any updates ongoing tonight or tomorrow.
I think this is the best plan for tonight.
(My vet sounds like now she isn’t sure if we can juggle Isy’s various health issues and treat the diabetes unless she becomes less sensitive to only 1/2 unit dose to start. I think she’s concerned if she drops low on 1/2unit and the fact she’s already a picky eater, it will be hard to get her stabilized and I’d need to be basically home all the time to monitor her. Plus no support from my husband and 2 kids to care for and their daily schedules which require me to have to be out if the house various times each day, and no local family etc )
I’m worried that she’s not hopeful I can treat Isy in a realistic way.)

 

[tiffmaxee]

You can take a used syringe. Get some colored water. Count how many drops in your .50 and then practice getting half that number of drops. Once you get a good count that can be your measurement for future doses. Digital calipers make it easy as well. I got the ones in the video from Harbor Freight. Skipping is fine tonight. It could be that the pancreatitis caused her glucose to be higher and she might not need insulin long with just that going away and the diet change. Get some rest and do something to take your mind off this for tonight.

 

[Bron and Sheba (GA)]

I’m concerned about not giving any insulin with ketones in the Picture. Ketones are caused by not enough insulin and not enough food. please keep testing every urine sample and Feed her as much as she will eat.

I can’t agree with your vets assessment about the 1/2 unit of insulin. It’s not about Isy being too sensitive of the 1/2 unit. It is simply not the correct dose.
The dose needs to be reduced to 1/4 unit insulin. We know this because she dropped to 52 at +3 on the first dose. It’s that simple.
If she is only needing that tiny amount she has a good chance of going into remission.

Insulin is a hormone and doesn’t act like an antibiotic that is a set dose and fixes the problem. ALL cats need their doses of insulin to be adjusted to find the most suitable dose and that is why we test the BG to give us that information.
How many diabetic cats has your vet treated successfully and got into remission I wonder? Remission means no more insulin and only diet controlled.
In all my years here I can’t think of one cat we couldn’t treat with insulin for whatever reason and we have plenty of cats here with multiple health issues.
Please don’t let her talk you into thinking you can’t threat Isys diabetes. You can and can get a good outcome.

 

[Chris & China (GA)]

I know it’s just the first day but I’m very discouraged! Isy is not tolerating the testing and handling well at all! She is unhappy and won’t let me touch her - so how can I treat any of her health issues with her responding this way?!
My family is saying it’s a sign that I’m trying to do more than she’ll tolerate in the time she has left with me!! I’m so upset!!

Has anybody suggested you trying to test on her pawpad? It's not the most common, but a lot of people do it! It may help instead of possibly making her head-shy

 

[Sherri & Isy]

Thanks Tiff, Bron and Chris for all your advice.
Sorry for being slow to respond. ( I’ve been doing dinner, kids homework help, then bedtime routines etc plus preparing for a mtg I have tomorrow am with my son’s teacher - which I’m still not completed prep yet! Ugh!).

So I’ve continued to feed Isy more FF tonight and she’s been eating fine, in small amounts at a time as she usually fits. I’m going to do subq fluids again tonight and go back to daily (had switched to EOD last week).

QUESTION RE KETONES:
Here’s a general question- Do you know if potentially my vet clinic might be able to do a basic urine analysis (by Cystocentesis) and just check ketones and kidney values in house, rather than having to do a full UA panel and send to outside lab, to get a recheck on ketones (ie. given they have an in-house lab to test things like basic kidney values, glucose in the urine etc).
Or is it more likely for ketones they would also just be able to do a test strip which might not be more accurate than what I do?
I just prefer to get accurate updated ketone results but have to limit cost if possible and not do another full UA again since it was only 2wks since the last one( last UA on 9/21 showed Negative for ketones).
Given Isy’s urine is dark pink brown from blood, even if it gets on white paper it turns it pinkish brown - so I’m wondering if that could distort the color results I see on the ketone strips and not give accurate results?

Also once I can get my head together better (just too overwhelmed tonight plus last night I stayed up all night with Isy so going with only 1hr sleep in the past 48hrs), then I will re-think about the idea of how to try treating Isy’s diabetes, if starting on only 1/4 unit how I might do it since my vet said tonight that she thinks that’s too difficult for me to do that small dose.
(I’m not sure if she thinks in general it’s too hard to give any diabetic cat a 1/4 unit, or if she just feels that it’s too challenging for me to try for Isy given her many other health issues and advanced age, the amount of monitoring needed re BG/food intake etc, and my other family commitments with my kids and non supportive husband etc)

RE FDMB:
I haven’t mentioned the FDMB to her. I just mentioned I have “friends with diabetic cats and many years experience treating them ” and I’ve been reading online, checking some helpful videos etc.
She has asked me to rely on asking her everything first because she knows Isy’s full history, her unique health issues, my own limitations and family issues etc which all factor into what is realistically possible for me to do to possibly give Isy some more quality time with me. So I haven’t mentioned FDMB to her.

RE 1/4 Unit:
So tomorrow I’ll try to figure out how I could work out figuring out what is a 1/4 unit dose etc (somehow with my tired brain I’m not sure if I understand Tiff’s explanation in the post above Re if I figure out how many drops in a 1/2 unit and then cut that number in have to get the drops in a 1/4 unit, then I just give that amount of drops for 1/4 unit insulin.
- Do I draw up 1/2unit in the syringe of colored water, and then push it back out by drops and count the total number of drops of insulin, and then cut that number in half to get number of drops equal to 1/4 unit. Then when actually giving the insulin I would first draw up a 1/2unit and then push back out (As waste) the number of drops equal to 1/4 unit, thus leaving 1/4 unit left in the syringe for the shot to give Isy? Am I following??

Thanks!

 

[Sherri & Isy]

Re: UPDATE ON KETONES
FYI - Isy just peed and she went over to her usual pee pad off the kitchen! Yeah!!
She had less blood in her urine than this am and yesterday. (See photo - Note the pee pad has a blue backing so the pee looks much darker than it actually is).

I measured her ketones by pushing test strips onto the pee pad - the readings after 15seconds looked not as dark as previous tests (more like “trace amounts” instead of small amounts). You can see a photo with the 2 test strips compared to the non-tested strip on far left.
The color difference was less after 15 seconds than previous strips , and looked a bit lighter than in the photo (Got darker by the time I took the photo).

I’m going to go give Isy 50ml subq fluids now.

 

[Chris & China (GA)]

Do you know if potentially my vet clinic might be able to do a basic urine analysis (by Cystocentesis) and just check ketones and kidney values in house, rather than having to do a full UA panel and send to outside lab, to get a recheck on ketones

The best way to check for ketones is in a blood test. They show up in the blood before they show up in urine. You'd have to ask if their equipment is able to test for ketones in house. Bloodwork is also the best way to check on kidney values like BUN and Creatinine.

Am I following??

Purrfect!

 

[Bron and Sheba (GA)]

Do you know if potentially my vet clinic might be able to do a basic urine analysis (by Cystocentesis) and just check ketones and kidney values in house, rather than having to do a full UA panel and send to outside lab, to get a recheck on ketones (ie. given they have an in-house lab to test things like basic kidney values, glucose in the urine etc).
Or is it more likely for ketones they would also just be able to do a test strip which might not be more accurate than what I do?

IM not sure if they would just use a strip or put it into a machine. You would need to ask.

I’m not sure if she thinks in general it’s too hard to give any diabetic cat a 1/4 unit, or if she just feels that it’s too challenging for me to try for Isy given her many other health issues and advanced age, the amount of monitoring needed re BG/food intake etc, and my other family commitments with my kids and non supportive husband etc)

It is not too hard to give a cat 1/4 unit. In Australia we don't have 1/2 unit syringes so I had to use 1 unit syringes and I gave 1/4 unit doses whenever I needed to. It is the thought that it is hard....once you do it the first time, I'm sure you will be fine. Monitoring a cat on 1/4 unit is no different to monitoring a cat on any other dose. It will all become routine to you soon.

Re if I figure out how many drops in a 1/2 unit and then cut that number in have to get the drops in a 1/4 unit, then I just give that amount of drops for 1/4 unit insulin.

Yes you can do it that way or just eyeball halfway between the 0 and 1/2 unit marks.

I haven’t mentioned the FDMB to her. I just mentioned I have “friends with diabetic cats and many years experience treating them ” and I’ve been reading online, checking some helpful videos etc.

I haven’t mentioned the FDMB to her. I just mentioned I have “friends with diabetic cats and many years experience treating them ” and I’ve been reading online, checking some helpful videos etc.

That is fine to say that....we are friends who have had cats for many years

Do I draw up 1/2unit in the syringe of colored water, and then push it back out by drops and count the total number of drops of insulin, and then cut that number in half to get number of drops equal to 1/4 unit. Then when actually giving the insulin I would first draw up a 1/2unit and then push back out (As waste) the number of drops equal to 1/4 unit, thus leaving 1/4 unit left in the syringe for the shot to give Isy? Am I following??

Yes.

Sherri, you must try and get to bed and get some sleep. You can't possibly function on so little sleep.
It is impossible to think straight and make decisions when you are so sleep deprived!
Please go to bed now and don't worry about anything....it will all sort itself out.

 

[Bron and Sheba (GA)]

Re: UPDATE ON KETONES
FYI - Isy just peed and she went over to her usual pee pad off the kitchen! Yeah!!
She had less blood in her urine than this am and yesterday. (See photo - Note the pee pad has a blue backing so the pee looks much darker than it actually is).

I measured her ketones by pushing test strips onto the pee pad - the readings after 15seconds looked not as dark as previous tests (more like “trace amounts” instead of small amounts). You can see a photo with the 2 test strips compared to the non-tested strip on far left.
The color difference was less after 15 seconds than previous strips , and looked a bit lighter than in the photo (Got darker by the time I took the photo).

I’m going to go give Isy 50ml subq fluids now.

Great on the ketone test!
Please go to bed after the sub Q fluids.
You are an amazing cat Mom!

 

[Sherri & Isy]

Great on the ketone test!
Please go to bed after the sub Q fluids.
You are an amazing cat Mom!

Thanks Bron

 

[tiffmaxee]

Hi Sherry? It looks like you haven’t tested or given any insulin today. How’s she acting?

 

[Sherri & Isy]

Hi!
I just wanted to give a quick update on Isy as far as where things stand right now, and the latest discussion with my vet today.

So I ended up not doing insulin last night, which is what my vet advised. I did 50ml fluids and then right after I took Isy on the couch with me to give her some cuddle time- and I literally crashed, fell asleep all night on the couch (before I could even get a shower in for myself! Ha!)
When I woke up this am I found Isy had gotten herself down off the couch (with her mobility issues that’s not easy for her) and she was in her bed in the living room. Also she had peed on her pee pads back in the usual spot again by the kitchen. Woohoo!!

I fed her this am and am keeping a log/measuring how much she eats. I also am continuing her on Mirataz to keep up her appetite (along with daily cerenia and prednisolone). Isy has eaten well
through today and peed again around mid day on the pee pads - her urine had much less visible blood so likely the added fluids helped that, I tried doing another ketone test - used 3 test strips to test different areas of her urine on the pad and some some variation from “trace amounts” to “small amounts” based on the strip color change.

Btw - I asked my vet whether it would be worth considering to switch from Prednisolone to budesonide in case it would have less affect on the diabetes , and I’m waiting for her response
(Altho Isy has been on the pred for over 8yrs and the IBD seems fairly stable/no vomiting or diarrhea etc so not sure if it’s worth changing to budesonide at this point given the long term steroids likely already caused the diabetes??)

Also today my vet consulted the Internal Med specialist vet who used to help treat Isy for her IBD etc (she has just recently retired) , to get her input re overall treatment approach for Isy based on all the recent new issues in her 9/21 test results .
My vet is going to call me tonight to discuss what came out of the consult call.

For now I’m still holding off and not doing insulin and making sure Isy gets enough food and fluids.

I’ll update here again once I talk to my vet tonight to find out what she’s suggesting for next steps based on her call with the Internal Med Vet etc.

 

[tiffmaxee]

Thanks for the update. We are here if you need us.

 

[OlivesMom]

Hi Sherri. I just stumbled upon your post and first off I want to say WELCOME and YOU ARE NOT ALONE! I came to this place in August overwhelmed beyond words and scared beyond belief after my cat, Olive, was diagnosed on the 14th. So I've been where you are in so many ways. Sleepless nights. Not knowing what to do with the BG numbers, when to step in, how to step in, afraid to leave the house, how to measure out those teeny insulin amounts that seem impossible. I haven't read everything as I should actually be trying to catch some ZZZs before I need to test Olive again, but I did read the bulk of it and simply had to add my two cents worth before I head off and to tell you that you are doing a wonderful job. Diabetes alone is a whole new universe, and dealing with other health issues with Isy on top of not having much support at home is even harder. I know that I'm blessed in having a husband who is there for me during this, and all I can tell you is that if you can't rely on your husband, you CAN rely on us! What's important is Isy. Your husband is a grown man who can take care of himself...animals rely on US for their care. So keep on doing what you're doing. Isy needs you. I've got so much I want to say from experience. You need to step back, take a breath, and remind yourself that this is all just as new to Isy as it is to you. I promise that things will get better even if it doesn't seem like it right now. It's a process. And as some great folks on here have reminded me time and time again "It's a marathon, not a sprint." It will also help if you pick one meter and stick with it. I started off with the AlphaTrak2 and switched to a Relion Classic because the strips were so much cheaper. You'll get used to using it. The pet meters run high. And each kind has it's own "take action" number you'll go by. Trust me, you will drive yourself BONKERS if you switch between them. I have found that the more YOU relax, the more your cat will and they definitely get better and better at testing with time. My Olive used to take off, but now I've actually tested her while she was trying to sleep and even though she knew what I was doing, she didn't even lift her head. They get used to it. And, the more you stick her ear, I've found the easier it is to draw blood over time. One thing I found helped Olive initially was to set the meter beside her and don't touch it. Then rub her under her chin and work your way up to her ears and top of head. Do this without sticking her. Make your presence and the meters less of a stressful trigger. Then after every test while you are holding gauze to her to stop the bleeding, gently praise her and rub under her chin as a reward for being so good. You'll get an error code when there's not enough blood on the strip, as I've learned many times over. There's error codes for a lot, but that is probably what you have dealt with. If you switch to the Relion Classic meter that uses the "Premier" strips, you won't need as much blood as the Relion prime. I don't know which meter you have. And the biggest worry is in measuring out the insulin...I KNOW. been there...done that. I have driven myself MAD over this and I know not many on here use calipers, but that's now become my daily go-to piece of equipment so I can help you with that if you'd like. I learned through trial and error with it but now I couldn't live without it. It makes dosing consistently a snap! Because all syringes are inaccurate as I've come to learn, and calipers are the only way of knowing for certain what you are dosing when it comes to those smaller amounts. I tried the "droplet" method but I found calipers so much easier. And a HUGE problem you are having can be resolved by purchasing yourself these: https://www.amazon.com/YOCTOSUN-Rec...eable/dp/B07T4KPYN2?tag=felinediabetesfdmb-20 A member suggested them a few weeks into my growing insanity and it was the BEST purchase I made. Makes seeing the syringe so easy now and it leaves your hands free. Once you get them you will wonder how on earth you got along without them before. Between these and the calipers you will be well on your way to solving a few of the problems anyways. And one final note before I leave. You've always got to do what YOU feel in your gut is best for Isy. You know your cat better than anyone. When in doubt, reach out. Do what you feel is comfortable. From the get-go I've been dealing with various vets and I can say with all honesty that the people HERE have helped me more than them. It's a leap of faith, but the best leap I've made. Try and keep in mind that even the sweetest, nicest vets don't have all the answers. They know "text book." And not all animals fall into that category, especially cats. You will find a lot of varied opinions and the only one I can offer is my personal experience with Olive. I listened to the vets at first, after all they are supposed to be the experts...but I started doing the research and listening to the folks stories on here and it changed the course I was on. I learned that "text book" wasn't going to help Olive. She needed to start LOW and SLOW on her amount of insulin and not the amount I was told to give her from the start. I know you like your vet (mine is the sweetest lady you'd ever meet) but they are only human. Once I started listening to the folks on here I started to progress in Olive's care. There's a lot of information to take in...I KNOW. It's scary. You're tired. You're overwhelmed. You wonder if things will ever get any better. I'm here to tell you that YES, things will get better. Knowledge is power. And every single person here only has you and your cat's best interest at heart. Again, you are not alone! I hope this helps.

 

[Sherri & Isy]

Hi Sherri. I just stumbled upon your post and first off I want to say WELCOME and YOU ARE NOT ALONE! I came to this place in August overwhelmed beyond words and scared beyond belief after my cat, Olive, was diagnosed on the 14th. So I've been where you are in so many ways. Sleepless nights. Not knowing what to do with the BG numbers, when to step in, how to step in, afraid to leave the house, how to measure out those teeny insulin amounts that seem impossible. I haven't read everything as I should actually be trying to catch some ZZZs before I need to test Olive again, but I did read the bulk of it and simply had to add my two cents worth before I head off and to tell you that you are doing a wonderful job. Diabetes alone is a whole new universe, and dealing with other health issues with Isy on top of not having much support at home is even harder. I know that I'm blessed in having a husband who is there for me during this, and all I can tell you is that if you can't rely on your husband, you CAN rely on us! What's important is Isy. Your husband is a grown man who can take care of himself...animals rely on US for their care. So keep on doing what you're doing. Isy needs you. I've got so much I want to say from experience. You need to step back, take a breath, and remind yourself that this is all just as new to Isy as it is to you. I promise that things will get better even if it doesn't seem like it right now. It's a process. And as some great folks on here have reminded me time and time again "It's a marathon, not a sprint." It will also help if you pick one meter and stick with it. I started off with the AlphaTrak2 and switched to a Relion Classic because the strips were so much cheaper. You'll get used to using it. The pet meters run high. And each kind has it's own "take action" number you'll go by. Trust me, you will drive yourself BONKERS if you switch between them. I have found that the more YOU relax, the more your cat will and they definitely get better and better at testing with time. My Olive used to take off, but now I've actually tested her while she was trying to sleep and even though she knew what I was doing, she didn't even lift her head. They get used to it. And, the more you stick her ear, I've found the easier it is to draw blood over time. One thing I found helped Olive initially was to set the meter beside her and don't touch it. Then rub her under her chin and work your way up to her ears and top of head. Do this without sticking her. Make your presence and the meters less of a stressful trigger. Then after every test while you are holding gauze to her to stop the bleeding, gently praise her and rub under her chin as a reward for being so good. You'll get an error code when there's not enough blood on the strip, as I've learned many times over. There's error codes for a lot, but that is probably what you have dealt with. If you switch to the Relion Classic meter that uses the "Premier" strips, you won't need as much blood as the Relion prime. I don't know which meter you have. And the biggest worry is in measuring out the insulin...I KNOW. been there...done that. I have driven myself MAD over this and I know not many on here use calipers, but that's now become my daily go-to piece of equipment so I can help you with that if you'd like. I learned through trial and error with it but now I couldn't live without it. It makes dosing consistently a snap! Because all syringes are inaccurate as I've come to learn, and calipers are the only way of knowing for certain what you are dosing when it comes to those smaller amounts. I tried the "droplet" method but I found calipers so much easier. And a HUGE problem you are having can be resolved by purchasing yourself these: https://www.amazon.com/YOCTOSUN-Rec...eable/dp/B07T4KPYN2?tag=felinediabetesfdmb-20 A member suggested them a few weeks into my growing insanity and it was the BEST purchase I made. Makes seeing the syringe so easy now and it leaves your hands free. Once you get them you will wonder how on earth you got along without them before. Between these and the calipers you will be well on your way to solving a few of the problems anyways. And one final note before I leave. You've always got to do what YOU feel in your gut is best for Isy. You know your cat better than anyone. When in doubt, reach out. Do what you feel is comfortable. From the get-go I've been dealing with various vets and I can say with all honesty that the people HERE have helped me more than them. It's a leap of faith, but the best leap I've made. Try and keep in mind that even the sweetest, nicest vets don't have all the answers. They know "text book." And not all animals fall into that category, especially cats. You will find a lot of varied opinions and the only one I can offer is my personal experience with Olive. I listened to the vets at first, after all they are supposed to be the experts...but I started doing the research and listening to the folks stories on here and it changed the course I was on. I learned that "text book" wasn't going to help Olive. She needed to start LOW and SLOW on her amount of insulin and not the amount I was told to give her from the start. I know you like your vet (mine is the sweetest lady you'd ever meet) but they are only human. Once I started listening to the folks on here I started to progress in Olive's care. There's a lot of information to take in...I KNOW. It's scary. You're tired. You're overwhelmed. You wonder if things will ever get any better. I'm here to tell you that YES, things will get better. Knowledge is power. And every single person here only has you and your cat's best interest at heart. Again, you are not alone! I hope this helps.

Hi Olives Mom!
Thank you so much for taking time to write your helpful post and kind words of support and advice. I really appreciate it! I’m sorry for being slow to respond (got lots going on in my family life and especially on my weekdays, get swamped with helping my 8yr old son with online school (with No in-person school here in my part of California due to Covid) and he has some challenges etc. and also I have to take him to many weekly appts etc).
So it seems I mostly get a chance just at night to catch up on emails and computer stuff (like read threads on FDMB or post).

I appreciate the input re using calipers and the head light for giving small doses. Is there a link for the calipers? Maybe I missed that in other posts?

I still don’t know if I’ll be giving Isy insulin right now - my vet in consult with the internal med specialist vet who has also treated Isy in the past are saying right now they don’t want to proceed with treating Isy with insulin. They are saying given Isy wasn’t eating and latest blood work on 9/21 suggests she may have been heading into hepatic lipidosis and also had pancreatitis, they recommend to first try changing Isy to a lower carb diet, continue daily fluids, keep her eating etc. Also because Isy’s BG number dropped so much on 1/2 unit they think she’s going to be tough to get her regulated on insulin right now and I’d need to be home with her 24/7 - which isn’t possible ongoing due to my family obligations, upcoming travel I have to do etc.
So my vet is suggesting I try the diet change and then recheck her bloodwork and maybe even do a BG curve while Not on insulin but on lower carb diet. Then maybe reconsider trying insulin if the BG numbers etc are still elevated.

I guess I need to think about all this! I know you mentioned that people here say “it’s not a sprint it’s a marathon”- but Isy is 17yrs old with other health issues so I don’t know realistically how much more time I would have with her even if she didn’t get diabetes. I think my vet feels it’s possibly not going to make sense to spend the time and money trying to treat the diabetes if Isy is going to be very sensitive to insulin/hard to regulate, and taking quite awhile trying to find an insulin dose and get her stable and maybe not get there within her remaining time with me.
But on the other hand I don’t want Isy to start feeling miserable from elevated BG or maybe ketones leading to DKA! I want her to have quality of life in her remaining days. It’s so hard to know what to do. But for now my vet is not in favor of trying insulin again right now.
I guess best case we could hope for is that a low carb diet helps control the BG for now, if Isy is maybe borderline diabetic (And pray Isy will actually even eat the low carb foods - she is soo picky! I’m struggling even getting her to eat much more Fancy Feast pate and get off the dry i/d and so my vet is suggesting try a RX low carb dry food with FF.

I’ll write a separate post here also highlighting what my vet is recommending and see what others think.
But I’m somewhat limited - I need my vet’s support and she’s trying to advise what she thinks is best for Isy and also doable for me, especially considering the stage of life Isy is now.

 

[Bron and Sheba (GA)]

Hi Sherri, how are things going? I hope you are managing to get some sleep.
I think it is fine to see if changing her over to a low carb diet helps the BG. My only concern with that is the fact Isy is showing ketones in the urine. And if they are left untreated it can lead to DKA.
What did the internal med specialist say about having ketones in the urine and not starting insulin? Is he experienced with FD? Not all internal med specialists are experienced with FD.......I saw one for Sheba about something else, not FD and she was asking me lots of questions about FD and it was obvious that I knew a lot more than she did about FD.
I think if you are not going to start the insulin you must test the urine every day for ketones. But even then I am concerned.

Just because Isy dropped low in 1/2 unit of insulin does not mean she will be hard to regulate at all. That is a complete untruth. It simply means that the 1/2 unit was too much insulin and the dose needs to be reduced down to 0.25 units. We do it all the time here. Needing a reduced dose means she is more likely to be regulated or go into remission. And you won’t have to stay with her 24/7....that is another untruth.
I think you need to ask them to do a fructosamine test to start with so that a definite diagnosis of FD can be made or dismissed.
We know some cats can get a higher BG when they are sick with things such as pancreatitis and then the BG goes back to normal when they improve.
Have you tested Isys BG again to see what it is doing? That may tell us if things are settling down or the BGs are getting higher.
I know you need you vets support, I understand that, but I’m not sure she is giving you the correct information about FD.

Thee is no reason why Isy can’t have a good quality of life if she is being treated with insulin.

 

[Lisa & Oberon]

Instead of the urine strips (since blood in the urine may be messing with the interpretation), I wonder whether you might want to consider a home blood ketone meter. I've got one (KetoSens, recommended by someone here, but I suspect any brand would be ok), and it uses a tiny amount of blood. I'm nearly always able to get a reading from the same drop I use to test Oberon's blood glucose, so testing ketones doesn't mean having to poke the cat a second time. In fact, most of the time I do the glucose first and end up with some excess blood on the top of the glucose strip, and then just touch the ketone strip to that drop on the glucose strip.

 

[tiffmaxee]

Some cats that start in a tiny amount of insulin actually don’t need to be on it for long . Others as they gain weight do great. Many of the cats here have complicated medical histories and multiple diseases. It may be harder for her to gain eight with untreated diabetes. Here’s the information on dosing with calipers.
https://www.felinediabetes.com/FDMB/threads/dosing-with-calipers-updated-w-videos.79851/#post-862835

 

[Sherri & Isy]

Hi Sherri, how are things going? I hope you are managing to get some sleep.
I think it is fine to see if changing her over to a low carb diet helps the BG. My only concern with that is the fact Isy is showing ketones in the urine. And if they are left untreated it can lead to DKA.
What did the internal med specialist say about having ketones in the urine and not starting insulin? Is he experienced with FD? Not all internal med specialists are experienced with FD.......I saw one for Sheba about something else, not FD and she was asking me lots of questions about FD and it was obvious that I knew a lot more than she did about FD.
I think if you are not going to start the insulin you must test the urine every day for ketones. But even then I am concerned.

Just because Isy dropped low in 1/2 unit of insulin does not mean she will be hard to regulate at all. That is a complete untruth. It simply means that the 1/2 unit was too much insulin and the dose needs to be reduced down to 0.25 units. We do it all the time here. Needing a reduced dose means she is more likely to be regulated or go into remission. And you won’t have to stay with her 24/7....that is another untruth.
I think you need to ask them to do a fructosamine test to start with so that a definite diagnosis of FD can be made or dismissed.
We know some cats can get a higher BG when they are sick with things such as pancreatitis and then the BG goes back to normal when they improve.
Have you tested Isys BG again to see what it is doing? That may tell us if things are settling down or the BGs are getting higher.
I know you need you vets support, I understand that, but I’m not sure she is giving you the correct information about FD.

Thee is no reason why Isy can’t have a good quality of life if she is being treated with insulin.

Hi Bron,
Thanks for your post! I’m getting some sleep but still sleeping on the couch in the living room by where Isy has her bed/sleep spot.
(Actually I fell asleep last night while writing this and am now waking up on the couch and coming back to keep writing this post! Ha!!)

Isy basically has this little area now beside our living room fireplace (we don’t use it) where I have her little bed on the floor and some cushions also around it, and she mostly spends all her days and nights in that area. She can watch us through the day from her area, and I feed her in her bed. She gets up to drink and to “go potty” (beside her bed area I put a “makeshift litter box” - a low plastic storage bin with a big pee pad lining it that she can step into, so she hasn’t gone on the floor rug and she can use that if she doesn’t want to walk to her usual pee pad off the kitchen.)

Isy is eating pretty well but she mostly only wants the dry I/d and now isn’t eating as much Fancy Feast pate as she used to eat (which wasn’t much before). I had hoped to transition her off the dry food and increase her wet food/Fancy Feast pate but the last few days she only eats small bites of the FF (maybe 1/3-1/2can max).

So my vet said the internal med vet said if Isy is still eating dry food, to at least get her transitioned over to a lower carb dry food - they suggested Royal Canin Glucobalance or Purina DM diet.
I know dry food is definitely not good for Isy to eat, but it’s challenging because she’s a very picky eater and doesn’t have an overly good appetite, and only eats small amounts at a time and it’s critical to keep her eating (with the recent likely early stages of hepatic lipidosis and weight loss and pancreatitis, and apparently some ketones).

Also I know in general many people don’t like the Rx foods/ingredients that vets suggest.
So the key for Isy is going to be to find a low carb food(s) that she’ll eat in sufficient amount and also not be an issue for her IBD.

My vet and internal med vet are advising not to start Isy on insulin right now and see if we can get her BG numbers down and get back to no ketones with keeping her eating but low carb food and also continuing with daily fluids.
We would still monitor her BG and likely do a BG curve after 7-10 days transitioning to low carb food.

My vet mentioned she knows Isy has been difficult to test, and if we did start insulin if the diet change didn’t work, it would require me being home daily most of the time until she is regulated to monitor her etc. Also I have to travel in about a month for 5 days and don’t know I how I could leave Isy even with her current level of care needed. My husband is not able or willing to help with any care (I wouldn’t feel comfortable with him even trying - he’s not able to handle Isy and has no idea about her medical care, could not even do fluids).
My vet did mention that she has a few owners who use the Freestyle Libre to monitor their cats so they don’t have to be pricking them frequently and using a meter (especially those who travel and use pet sitters etc) - does anyone have any experience using it or thoughts about it?
She said it’s expensive and maybe not something I could do (she knows my husband has a problem with the financial side/money being spent on Isy’s care at 17yrs old and may not continue to allow me to have high vet expenses).

Anyway I need to figure out what are the next steps - and for now I guess it’s starting with trying to get Isy to eat low carb food. I hope she’ll eat!

 

[tiffmaxee]

People have successfully used the Libre and one did exclusively and her cat went OTJ quickly. It has to bd changed every 2 weeks and sometimes falls out sooner. I will find her ss for you.