8/18 Saima AMPS 317

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Jennifer & Saima (GA)

Jennifer & Saima (GA)

Member Since 2011
Hi everyone, I am very new here so I apologize if I'm going about this wrong. I tried to start a spreadsheet but Google Docs won't let me copy the template at the moment.

We took my 12-year-old cat Saima in to the vet on Monday because she wasn't feeling well and didn't seem to want to eat, and vet reported her BG was 486. That was the first we knew of her being diabetic, though looking back she has been having mild neuropathy for a while, and she did have a BG of 277 at her last vet appt. in July, which we REALLY should have followed up on. I feel terrible about it. In any case, vet prescribed 2.5u Lantus BID and we started shooting that amount Monday night. I will post all her BG #'s below, but they have mostly been in the 200s. My concern now is that since yesterday afternoon, her BG has been steadily increasing. We give insulin at approximately 7 p.m. and 7 a.m. The dose was 2.5u until last night (8/17 7 p.m.) when I started giving 1u instead.

We have had an ordeal with her refusing to eat since about Sunday (I truly thought she was going to starve to death... she ate a little more over the past 24 hours and I feel less panicked now) so I was strongly advised in the Feline Health forum to drop her back to 1u and provided with scientific evidence that this probably should have been her starting dose anyway. Frankly she hates the vet more than I can describe, and flies into a complete panic when we are there, so the 486 #--though certainly very scary--was probably artificially high. She has obviously been feeling crappy, though... she has to lie down and rest after walking from one room to the next, and having trouble getting traction with her hind legs.

I have had negative ketostix all along (and negative ketones Monday per vet) though I haven't been able to get them into the urine stream, so the samples have been "contaminated" with litter. Not sure if that makes a difference.

To be frank, I'm afraid I'm killing my cat by going against vet's advice and dropping her dose. Can someone help me through this?

BG #'s:

8/15 (received initial 2.5u dose of Lantus at vet's office, 6 p.m.)
8/15 8:07 p.m.: 164 and 199 (two readings close together, this was the first time I used the meter)
8/16 6 a.m. (PS): 255
8/16 8:30 a.m.: 238
8/16 10:50 a.m.: 220
8/16 5:06 p.m.: 206
8/16 7:11 p.m.: 155 (there seemed to be a "bubble" in the strip so I took it again)
8/16 7:18 p.m. (PS): 209
8/16 8:24 p.m.: 215
8/16 9:53 p.m.: 190
8/17 7 a.m. (PS): 231
8/17 11:56 a.m.: 224
8/17 5:34 p.m.: 239
8/17 7:11 p.m. (PS): 248
8/17 10:18 p.m.: 260
8/18 6:44 a.m.: 317
 
I had just seen your post on health this morning and am posting the link here for history for others.
http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=50089

Just wanted to stop by and try to give you an encouraging word. We were in the same boat as you about 8 months ago. There is so much information and it is hard to keep it all straight. Your kitty will be fine with a lot of patience and time.

I know you are worried about hurting your kitty by not doing everything your vet says all too well. Let me start off by saying that your vet is giving you advice based on a very general rule. Our original vet did not want us home testing and put Tarragon on a very high dose of Lantus to begin (3U) with based on BGs at the vet office. Tarragon stresses a LOT at the vet and his BG can jump 100 - 150 just because of the trip, so his BG reading at the vet was very inflated. We changed vets and made it very clear from the beginning that WE were in control of Tarragon's diabetes and that we would be home testing and this vet has been great. The first thing we did was to drop Tarragon to 1U and start following the protocol on this board. It does take a few days for the "shed" to fill with Lantus.

Lantus dosing is not based on preshot numbers, but on nadir, or lowest point in the 12 hour cycle. It is very important to get regular mid cycle tests to know what and where that low point in your kitties cycle is. We both work during the day so I make sure to do testing at AMPS, PMPS, +2, +4, and +6 at night, as well as a full curve each weekend.

Tarragon was also a crunch addicted cat and turned his nose up to every canned food I tried, and, believe me, I tried them all! We also used boiled chicken breast, chicken dust, salmon dust, ForitFlora, mixing dry with wet, etc. to get things going for him. I still have to trick him every now and then to eat it. Also, one thing that really worked well for us was to mix 1/2 can of Fancy Feast chicken classic with 1/2 can of Fancy Feast gravy food. Then add water to it so it is like a heavy soup. I still do this to get water into Tarragon and keep his kidneys healthy, I just use Fancy Feast roasted or flaked instead of the gravy since it is lower carb. (Side note: Flortiflora can be bought on Amazon at a reduced price.)

Remember to breath. This is a marathon, not a sprint. You are doing great and your kitty will be fine. Be sure to get on here and ask lots of questions. This is an amazing place.

Melissa
 
here's your last post: http://www.felinediabetes.com/FDMB/viewtopic.php?t=50089

we link them together so people can get the whole story . . .

i think you're not in a crisis - those are ok numbers. they'll come down. lantus is an insulin that likes consistency - as you give the shots at the same 12/12 times and remain on a dose for at least 3 days, we'll be able to see better what it's doing for saima.

in the meantime, there are sticky's at the top of the lantus forum with a ton of good information. I like the one "New to Lantus/Levemir, Start Here" for starting with.

If you fiddle around with the spreadsheet and can't get it going, post again here and there are people who are more tech-savvy who can help.

In the meantime, read, hold the dose the same, and see if you can get tests every 2-3 hours if possible. if that's too often, the most critical for dosing decisions are mid-cycle - and the preshot tests are what tell us if it's safe to shoot.

Test often if you can, if not, when you can, and add them to your header by editing teh first post of the day. Just keep editing and adding posts and we'll see and respond. ask as many questions as you want. we've all been there.

and welcome - saima is in a great spot right now! :YMHUG: we'll help you.
 
ok, i had to stop and shoot my cat (with insulin :-D ) and read your previous post. you're not hurting saima by dropping her to 1unit. that's good starting advice and a good starting dose.

what you're seeing in the numbers going up and down is a normal response to insulin and food. we expect that. so it's ok. an ideal curve looks like this, but it often is wonky until you've gotten her stabilized:

Example of a typical curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.
Click to expand...

the other thing to understand is that changing doses or times of shots will result in wonky numbers for as much as 3 days. so for now, you're doing everything right. we'll hold the dose for several days, try to be consistent about the shot times as much as possible, within 15 minutes, and keep posting and testing your results so we can track her.

what is the status of her eating now? ideally she should be eating canned, low-carb, ideally with her shot and in the first 3-4 hours after each shot, but most important is eating. an update of that would help.

ask lots of questions. we really do get it. we help each other - and some people here have been doing diabetes 24/7 for years on end. there is a wealth of experience.

oh yeah, and what's your name?

and as marjorie told me - it's a marathon, not a sprint. breathe and we'll help you learn to run a marathon. (see how i gave you credit, marjorie!) :lol:
 
Hi and welcome from us! I know all of this can be overwhelming to take in, and kinda scary to go "against" what your vet has recommended. Just remember that everyone on this site deals with their own diabetic kitty every single day, all day .. while a vet may see a diabetic kitty once a month, give or take.

You won't find any other people more dedicated to helping you and saima on the road to recovery!
 
I'm Jennifer. Thanks so much to all of you for helping me.

OK, so within 15 minutes... that gives me a good target to shoot for. The vet wasn't that clear on how important it was to be exactly on 12 hours.

Her eating has been better in the past 24 hours. Between yesterday afternoon and evening she ate a bunch of Pounce treats (I realize this is a terrible thing to feed any cat, but I gave them in desperation and she ate them, so I figured calories were better than nothing), then 3 "small human bite-size" pieces of raw steak, and overnight she went to her food dish while we were sleeping and apparently ate 10g of dry food. This is the first time she's eaten on her own in days. We were thrilled even though I know dry food isn't good for her. (It's "grain-free" but senior/weight control formula so probably sky-high in carbs.) Then this a.m. we got her to eat about 1/2 can of Fancy Feast Cod, Sole, and Shrimp pate thinned with Cat Sip, and she also ate a freeze-dried salmon chunk and a couple of bites of deli turkey. For the first time this week I'm comfortable that she will get a reasonable number of calories if she continues on this track (which of course she may not).

As for getting her on a healthier diet if she makes it through the current crisis... she has free fed on dry food her whole life, except over the past year or so we have dragged her kicking and screaming (metaphorically) into eating half Hill's d/d duck formula dry or Now! senior/weight control turkey/duck/salmon (for allergy/ear infection issues), and half Feline Instincts Kidney Support Diet made up with Wysong Duck Au Jus instead of raw meat, once we learned that wet food was better in general. She had been eating that pretty good as long as there was a good amount of dry on top, but then again I don't know if that was the diabetes increasing her appetite. We tried things like Blue Wilderness Duck or Turkey formulas and Addiction duck or rabbit flavor instead of the Feline Instincts, but she was pretty "meh" on all of it. (She doesn't have CRF as far as we know, but has slightly high kidney enzymes, so we try to feed her as if she did have CRF.)

All that to say, we have tried various kinds of commercial canned foods over the years, and she really doesn't eat any of it. If it's mostly dry food she'll take a few bites of the wet (probably just in the process of eating the dry) but she pretty much turns her nose up at it. We are committed to getting her on a low-carb diet, but we have a struggle ahead of us for sure. For now I'm leaving her dry food out all the time in case she wants any, as I feel it's more important for her to eat something since her appetite is so poor.

Do you know if any of the commercial raw diets are safe for diabetic cats? She ate the raw steak really well last night. I was shocked as I always just assumed she wouldn't eat raw. I have mixed feelings about the safety but if that's what she'll eat and if it's suitable for her, I'm willing to give it a try.
 
there are people who feed a raw diet on here. i think ann feeds tess raw - i'll ask her to come talk with you about it.

have you tried fancy feasts low-carb? most cats seem to like them - i get the classic pates, which are all low carb: chicken feast, turkey & giblets, beef feast, salmon feast, the cod one you mentioned . . . do you have the Janet & Binky's list?

you can pulverize the favorite dry food and use it as dust on the canned food.

a good trick to keep them hydrated and away from ketones is to add water. i add about 50% water to punkin's canned food. apparently diabetics are just in general dehydrated, so water's a good thing. cats have a poor natural thirst instinct.

and hi, jennifer. i'm glad you've found this site!
 
Great point about adding water. She'll eat it better that way anyway (she seems to have issues with the "mechanics" of eating wet food, if that makes any sense... she just licks it and doesn't get very far) and although I haven't had to worry about her drinking too little in the recent past, I may have to if/when her BG improves.

P.S. My childhood cat was named Punkin. She was awesome. A beautiful calico and she lived to age 20, if I am not mistaken.
 
:-D sweet. i'm afraid my punkin won't make it to 20, but he's had a super life and he's 13+ now - i adore him!

i know what you mean about the "mechanics" of eating - sometimes punkin seems to work it around in his mouth a bit too.
 
You definitely want to get through this initial crisis before you worry about making a complete food change. If you get Saima completely off of dry, it will change the insulin need as well.

We too add the water. It has been great to keep away any UTI's and keep Tarragon's kidneys healthy.

I don't do the raw diet, but there are quite a few here who do so they should be along soon. If you ever have a question, just edit the title of your original post to let people know to look at it.

Some links that you may want to bookmark that are not on the stickies are:

Making the Most of Your Lantus ISG Experience: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=46014Don't Panic or How To Handle Low Numbers: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=46003
Dealing with Low Preshots: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=46005
*** DISCUSSION: "FEED KITTY AS MUCH AS THEY WANT?" ***: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=31942
 
I don't feed Champ a raw diet, but I do feed him raw chicken, beef, and shrimp as snacks, though sometimes I nuke it to cook just the outside. Champ has always been very picky when it comes to wet food so I ALWAYS crush up a piece of freeze dried salmon or chicken on top of his food and he gets so into eating that, he doesn't realize he's finished off the wet food too!! Sometimes, if they don't seem to want to eat it out of their bowl, try sitting down next to Saima and finger feed her. Just scoop some up with your fingers and see if she'll eat it out of your hand. That has worked for me on many occasions when I need to get some food into Champ.

And just as a note, my vet also started Champ on 3u b.i.d. right from the get-go (I think Saima's and Champ's initial BG's were identical!) and didn't even mention the fact I could hometest. I found this site on day 11 of blindly giving Champ 3u b.i.d. and immediately dropped his dose to 1u b.i.d. He has not had any bad effects from this. In fact, Saima's numbers are looking pretty good!!! Take a look at as many spreadsheets as you can so you can be reassured that the numbers Saima is getting are not bad at all. Champ usually had pinks and yellows and then got to where he was almost always green. It does take a while to get to that point, but just follow the protocol and you'll do great!!!
 
Hi Welcome to LL! That really isn't too bad an AMPS for just starting out and as others have said once the shed has filled and if you can get her off the dry "kitty crack" you will see a remarkable change in her numbers, her appearance and her attitude. It is remarkable how this disease actually makes a better bond between us and our cats.

I don't have a close source for most of the commercial raw food, we live in a rural area. We make raw for Tess useing a powdered supplement and just chunked raw chicken meat. I wanted to see how she would like it before I invested in a grinder. (BTW: old fashioned hand grinders DO NOT WORK. Take it from the voice of experience! ohmygod_smile ) Just raw meat is lacking in many vital minerals and nutrients, but you can add up to 15% plain meat to a daily diet w/ out extra supplements. Chicken hearts are a great treat, are loaded w/ taurine which cats need and chewing on them is very good for their teeth.

I don't feed raw regularly any more, but it is a great way to feed. I found that what we made is so low in carbs (<1%) that w/ insulin Tess tends to bounce all over the place. I do use it to stimulate her appetite when she is off her canned food. We will go back to more raw if we ever go OTJ.

I'm going to give you a few sites to check out on feline nutrition and feeding raw (yeah, I know, more to read and process :roll: ). Don't get intimidated by the process of home made. Thee are alternatives and ways to ease into it.

Food references

Nutrition Very good information on cat dietary needs. Also home made raw recipes.

Supplements These are added to your own raw meat. Meat alone is lacking many minerals and other nutrients vital to cat health. I use the TC Feline and Tess loves it. I just cut chicken boneless/skinless thighs and a little breast meat in <1/2" chunks and mix the powder w/ water, easy and fresh!

Commercial Raw FoodsFeline's Pride and Nature's Variety are found at the end of Janet and Binky's list and are low carb. I've heard Primal is very good, but I don't know the carbs.

Ground meat/bone sources If you want to make your own raw food, but don't want to invest in a powerful grinder for the bones. At least one of them has a supplement mix as well. One is east coast the other west coast. Shipping can get expensive.

Wow, thank you! That just made me clean up my bookmarks list! :lol: :lol: :-D
 
Welcome to Lantus Land!! Sorry you have to be here but under the circumstances, this is a great place to be.

I used to feed my guys a raw diet. I used both a commercially prepared raw (Feline's Pride) and then made my own using a dry premix that provided for all of the vitamins and additional nutrients. I opted to make my own because the shipping on the Feline's Pride, while very well packaged, was expensive. I used either the grinder attachment on my stand mixer or my food processor to grind the chicken. I did not use bone but the supplement tat I used included calcium. The only reason I went back to feeding canned was that I ran out of pre-mix, the delivery was late, and my guys decided they liked Wellness -- which they previously turned their noses up at.

I don't know if anyone has linked Dr. Lisa Pierson's site on feline nutrition for you. She discusses transitioning a cat from dry to canned food, has a recipe for raw food, and has links to good resources for a raw diet.

As far as Lantus and dose, you're doing fine! The first week of being on Lantus typically involved building an insulin depot. We refer to it as a "shed" and it acts as a reservoir of insulin. Lantus is also not like the shorter acting types of insulin that yank numbers down in a harsh or abrupt fashion. It's action is much more gentle but is also can take a bit longer to start bringing numbers down. The biggest lesson you will learn while your cat is on Lantus is patience.

Please let us know how we can help. People here are incredibly generous with their time an knowledge. Welcome again to the ISG and I hope you will post regularly.
 
Welcome to lantus land and to our family. We're here to answer questions and to help. You've gotten lots of good info today so bring on the questions!

and as marjorie told me - it's a marathon, not a sprint. breathe and we'll help you learn to run a marathon. (see how i gave you credit, marjorie!)
Click to expand...
:lol: :lol: :lol: :lol: :lol: :lol: Thanks, Julie!!!
 
I just wanted to say thank you so much to ALL OF YOU for all of this information and support. Ann, that is a huge wealth of information and I really appreciate you taking the time to compile it. Thank you again. I'm trying to get Saima's 8/19 thread and spreadsheet around now.
 
Hi Jennifer & Saima,
Welcome to Lantus Land. You are in the right place to help Saima. I can't add to the raw-food discussion, but can say that watering down wet food to make a "slurpy" really works. I rarely see my cat, Rusty, drinking water from his bowl or from his kitty fountain, but he gets lots of moisture from his food (Wellness turkey, which "soups"-up really well).
My GA kitty, Stu, was a dry-food addict until he discovered how good wet food was. We fed EVO dry, which is the lowest in carbs (7%) of the dry foods. That would be a good choice to aid in the transition to wet (try Sienne's tip of grinding some up and putting it on top of the wet food).
Good luck with your spreadsheet (Google has been "difficult" lately when it comes to setting up new documents; the problem is with Google, not with anything you are doing).

It is definitely a good idea to start with 1 unit of Lantus every 12 hours and to follow the protocol when increasing the dose. Our vet started Stu on much too high a dose and kept raising it when the numbers didn't get better (we were up to 7 units and the poor kitty was peeing all the time to try to get the excess glucose out of his body). After I found this board and started a sensible dose and followed the protocol, he improved greatly.

As Marjorie and Julie and everyone else say: patience is the key word when it comes to FD!!

Ella & Rusty
 
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