8-23-20 New Member - Please Give Advice on Buying Meter, Supplies, and Treatment

Status
Not open for further replies.
Wendy 17 and Merlin

Wendy 17 and Merlin

Member Since 2020
Please give me advice on which glucometer to buy. I am a new member and never had to treat any of my cats for diabetes before. This is all new to me. The vet has prescribed low-dose Prozinc (1 unit) to start out with. I bought the insulin and now need to buy the glucometer ASAP. I am looking for reliable readings and low-cost test strips.

I looked at previous posts about the Relion Confirm that is now no longer available. I am confused about what to get. Please help.

Please also give me advice on food or anything else I can do to help Merlin get better. He keeps losing weight at an alarming rate and has chronic diarrhea. He was 13 lbs 2 years ago, now is 8.1 lbs.

My kitty's name is Merlin, a very sweet, loving, super intelligent, exceptional 11-year old lilac-point Ragdoll. He has gone through so much. I love him dearly. He is my baby.

His problems started in April 2019 with pale, yellowish stool and loose bowels. The diagnosis was IBD and pancreatitis. There were multiple hospital stays, numerous suggestions for euthanasia due to the very poor prognosis for Merlin. He needed/needs constant buprenorphine. Numerous ultrasounds. Dx of pancreatic abscess. Outlook very poor. Meds over time: prednisolone, metronidazole, Zeniquin, Cefpodoxim, Cerenia, buprenorphine, Budesonide, Ursodiol, amoxicillin, chloramphenicol, other antibiotics, probiotics, Endosorb, sub-q fluids (LR daily for over a year) … Chronic diarrhea, probably in part due to IBD and side effects of all the meds and antibiotics.

Despite all antibiotics and treatments, cyst/abscess grew bigger: to 6cm roundish. The only choice given was euthanasia or (high risk) surgery. On May 18, 2020, pancreatic surgery for a pseudocyst (cyst fluid cultured enterococcus bacteria) and insertion of a stent in nearly blocked torturous bile duct. The surgery helped a bit but did not cure anything so far. Active/chronic pancreatitis continues. Feeding tube for 3 months. It just got taken out yesterday.

He was for a year on dry food (due to IBD: Royal Canin Hydrolyzed Protein), as well as prednisolone and later budesonide (ending March 2020). Over the last year, especially when there was a pancreatic flare-up, his blood sugar occasionally went up. I started in March 2020 giving high protein wet food in addition to some hydrolyzed protein kibbles. The surgery worsened his pancreatitis. During the last month, his blood sugar went up more, he started drinking a lot of water, is quite weak and tired all the time. The vet repeated labs a few days ago, including fructosamine: 439 (ref 191-349), 365 in March 2020. My vet urged me now to start treatment with Prozinc insulin for diabetes mellitus.

Diabetes treatment is totally new to me, and I need advice.

I spoon-feed Merlin 5-6 times a day (FF Gourmet Naturals Pate, Dr. Elsey's canned pork, home-cooked ground chicken + liver, broiled salmon, canned sardines). He eats only a little on his own (cooked salmon and chicken). With the quantity of food he is getting, he should be easily gaining weight but is not. I suppose that weight loss is likely due to diarrhea and diabetes. Current meds: Cerenia 12mg for vomiting, Ursodiol to enhance bile flow, B12 shots weekly, Endosorb (for persistent diarrhea), and daily sub-q fluids (LR). He gets taurine, multivitamins, egg shell powder.

With Merlin, there are constant ups and downs. As soon as one crisis is handled, there comes another one. I am always hoping Merlin will recover.

Wendy 17 (and Merlin)
 
Welcome. You and Merlin have a lot on your plate.

We can help you manage the diabetes around the other conditions. A number of members are dealing or have dealt with multiple issues such as IBD and chronic pancreatitis.

Quite a few members in the US use the Relion Prime. The strips are inexpensive.
You also need to get 28G lancets.

I'm tagging @Sarah&Soph @Sienne and Gabby (GA) @Marje and Gracie for starters.

Thank you for going the extra mile for Merlin.
 
You are clearly your kitty's advocate. Thank you for caring for him so much!

A couple of suggestions. Please take a look at this website on feline IBD. Its focus is on raw feeding which may or may not be your thing. There is a huge amount of information on IBD, supplements, etc. in the tabs at the top of the page which may be helpful. If you go to the group's Facebook page, there are wonderful people there who will offer answers to many of your questions. I have an IBD (non-diabetic) kitty and I feed a partially raw diet. I found the information a life saver. You may want to consider getting Merlin on a novel protein diet. It will help with reducing the intestinal inflammation. I like ZiwiPeak as a canned food or air dried raw option. They have novel proteins (e.g., venison) and there are no gums or carrageenan in their foods.

If you are cooking food for your kitty, are you adding the necessary supplements? Many of us who feed a raw or partially cooked diet use EZ Complete. You can't just feed your cat a protein. There are a range of supplements that are needed to make food nutritionally complete. EZ Complete is a pre-mix that contains everything your cat needs.

I use a probiotic, S. boulardii, to manage diarrhea. Either ReNew is a good brand or Jarrow's S. bollardi with MOS is also very good.

This is a post on pancreatitis that one of our members put together. It may be information you already know but I'm including it.

So after thoroughly inundating you in things to read without even mentioning diabetes. I'm going to provide one last link. We have an insulin forum specifically devoted to Prozinc. There is information about the insulin, the supplies you will need, food, and a guide to dosing with Prozinc. it's basically one stop shopping. You will want to look at the sticky notes which are at the top of the Prozinc board. I lied. There's another link that will help us to help you. This one is about getting your signature and spreadsheet set up and other useful information.

If you're now feeling completely overwhelmed, that's perfectly normal! There's a lot to absorb. The good news is that much of diabetes management will become routine in a surprisingly short period of time. And, of course, we're here to provide support and guidance. There are often people here 24/7 and members are very generous with their time and knowledge.
 
Last edited:
I second ReliOn as it has the most affordable strips, 100for $17, and I find it fairly easy to use.

I also second S Boulardii for the diarrhea. It’s a long term probiotic and I also give Minnie Visbiome which is a probiotic for colitis and IBD. She gets a 1/3 of a capsule once a day. Minnie is on budesonide for her IBD and it’s been helping a lot. Another anti nausea option is ondansetron, but if Cerenia is working for you stick with it. Did the metronidazole not help with the diarrhea?

what’s his daily calorie intake? A good rule of thumb is 20 times his ideal weight. Minnie is on about 300 calories a day. Diabetic cats will lose weight because they can’t process the nutrients in food well so they eat but still lose. If you can manage to over feed him a bit it may help...? Once the diabetes is regulated, it should help him keep the weight down.

I’m very sorry for all of Merlin’s issues, but he’s certainly lucky to have you for his human!!! :bighug::bighug::bighug:
 
WELCOME:bighug: Wendy and BEAUTIFUL Merlin. Boy hes been through the wringer hasnt he. Your head must be spinning with this new DX. I'm here to let you know you have landed in a SAFE place. We have TONS of knowledge and information here. Not only technical but PRACTICAL information, from folks that, eat, sleep, breathe, feline diabetes. As you see you've already been given good advice from some of our best I;m just here to say BREATHE ITS GOING TO BE OK.;)
We all are eager to help, Merlin be, the best Merlin, Merlin can be and to give YOU peace of mind.
jeanne
 
Last edited:
You can post either here on Health or on the Prozinc board.

However, you'll need to provide us with more information. I'm linking information on how to help us help you. The post included information on how to set up your signature. This will give us information about your kitty so we don't keep bugging you with the same questions repeatedly. You will also need to set up a spreadsheet.. The spreadsheet will allow you to track Merlin's progress and allow us to follow along so we can provide an educated response to your questions. We are crippled without having your test data to rely on.
 
Wendy 17 said:
How (and where) do I post questions about evaluating my test results (urine glucose and blood glucose)? I am confused about what my tests mean. I am using low dose ProZinc.
Click to expand...
You can post here just start a new thread.
Also you will want to start a spreadsheet it will help you track how that insulin is working for Merlin AND more important help our veterans give the best advice possible going forward!
FDMB SPREADSHEET INSTRUCTIONS

This is for your signature . It will appear at the bottom of each of your posts ansd give helpers an at a glance look at all Merlins
particulars:
  • Click on your user name in the bar that runs across the top of the page.
  • Scroll down to "About You". Use the message field to tell us about you and your kitty. Please include a general location (e.g. state if in US or province if in Canada so we know your time zone).
  • When you're finished, be sure to click on "Save Changes" at the bottom of the message field.

Helpful information you may want to include in your FDMB profile:
  • Your first name (so we don't have to say, "Hey you!") :D
  • Kitty's name, age (a guesstimate is fine), sex
  • Date of diagnosis
  • Name of the insulin used
  • Are you hometesting? If so,
    • Are you using a pet-specific meter or a blood glucose meter calibrated for humans?
    • How often do you test kitty's blood glucose?
    • What's the name of the meter you're using?
  • Has kitty experienced any complications from diabetes? Common complications include:
    • Polyuria or PU (urinating a lot)
    • Polydipsia or PD (drinking a lot)
    • Ketosis (manifests as spilling ketones in the urine)
    • Diabetic ketoacidosis or DKA
    • Neuropathy (nerve damage, usually manifests as difficulty walking on hind legs/feet)
    • Nephropathy/CRF (kidney involvement)
    • Others as described by your vet
  • Is kitty currently taking any other medications or supplements?
  • Does kitty have any health issues (current or in the past)?
  • Has kitty ever taken corticosteroids?
    • Examples include cortisone, prednisone, deltasone, other "-sone" medications.
  • Food: What are you currently feeding kitty?
    • Canned/wet low carb options?
    • Dry low carb or dry high carb kibble?
    • Both wet and dry foods?
  • Other information:
    • Any information about your cat which is important, but hasn't been covered above
    • Do you have other pets you'd like to include/mention?
    • How about you? Do you do anything neat? Job? Retired? Student? Slacker? Married? Single? Kids? Anything you'd like to share?
    • Your general location. For safety, please don't list your home address.
Don't forget to click on "Save Changes" when you've finished.
 
Thank you for this great list of instructions. I love to answer all this in detail and understand why you need to know to be most helpful. I will do it when I can. Merlin is such an around-the-clock job that it is very difficult to find the time to do anything extra. I have to take from sleep time, and I am only getting 4 hrs lately. The other problem is that I find this website really challenging as far as my computer skills go. I have not yet attempted to download the SS and do not yet understand how to read it nor how the website functions. It requires time to learn which I do not have right now. In the meantime, I am frantic with my lack of understanding about diabetes and not knowing what to do.

This is my latest problem:

Merlin's diabetes is due to severe chronic pancreatitis and pancreatic abscess/cyst. He never had ketones in urine. Merlin gets high protein food all day and night long (ca. every 2-3 hrs). He is very underweight. I started Prozinc insulin 8-23-20 at 1 unit BID. I kept track of urine glucose with test strips that I know to be accurate. There were quite a few negative or 1+ readings. Merlin suddenly showed signs of hypoglycemia on 9-4-20. I treated him with honey and food. He recovered within a few hours. I seemed to be dealing with the Somogyi effect (which I poorly understand). Does anyone have a link to a good explanation?

I decreased the dose of Prozinc from 1 unit to 0.6 units bid. I bought the Relion Prime meter and test strips and took my first blood sample on 9-6-20. Merlin experienced another hypoglycemic event on 9-10-20 at 4.5 hrs after insulin injection. His back legs went sideways. Relion meter read 51. After honey and feeding, his glucose was 233 after 2.5 hrs and he felt ok.


Yesterday, I got the Henry Schein glucometer (Vet GlucoGauge) and got the first readings today from the same drop of blood. The two meters give vastly different readings. WHY is the difference so big, and what do I do about it? How do I evaluate the readings?

Insulin Injection 0.6 Units ProZinc : 9-12-20 4:15 pm​
Blood Glucose measured (prior to feeding) at 4:15 pm
Relion Prime Prime : 244
Vet GlucoGauge : 459
Urine glucose at the same time: 3+

--------------------------------

8.5 hrs later:
Blood Glucose measured (prior to feeding) at 12:45 am
Relion Prime Prime : 161
Vet GlucoGauge : 432
Urine glucose at the same time: negative
Urine glucose 4 hrs earlier (8:30 pm): 2+

Thanks.

Wendy (and Merlin)
​
 
Can either of you help with the spreadsheet?
@Chris & China (GA)
@Bandit's Mom

Either Chris or Bhooma can help you get a spreadsheet and signature set up. Without a spreadsheet, I seriously doubt anyone will be able to weigh in regarding Merlin's dosing. It's too dangerous to give any kind of guidance without benefit of data.

This is the link that explains the spreadsheet.

Wendy -
I can appreciate that this is a time consuming process. Most of us here do not have the luxury of copious amounts of free time. What helps is that we follow certain conventions, like having a spreadsheet, so we can see the effects of insulin on your cat's BG readings. You are costing us precious time by not helping us out with creating a signature or a spreadsheet. Frankly, I know I don't have time to re-read a thread every time you post. I don't say that to be mean spirited but like you, I have limited time and do my best to be available to as many people as possible. We can provide the help you need if you ask. As you can see, I linked to a couple of people who can help.There is also a forum for technical assistance.

First, Somogyi doesn't exist in cats. It was first coined in 1938 by Michael Somogyi, an MD, in St. Louis who published a small human study in a local medical journal. Recent research on cats disproved its existence. Frankly, it's existence was disproved in humans quite a few years ago. It amounts to an urban legend. The range in readings that you noted may be due to what we term a "bounce." Without a spreadsheet, I can't say if that's actually the case.

Urine glucose readings are, by their very nature, not entirely accurate. They do not give you an up to the minute reading on your cat's glucose levels since it takes hours for urine to be produced, collected, and excreted. In addition, the strips do not read accurately for very low (hypoglycemic) numbers or very high numbers. Their use is eschewed except in 3rd world countries where glucometers and strips are not readily available.

There is a difference in how human and pet meters are calibrated. As you get into higher numbers, the width of that range increases. Unfortunately, there is no formula that helps to convert the numbers from a human meter to a pet meter.
 
Sienne and Gabby (GA) said:
Can either of you help with the spreadsheet?
@Chris & China (GA)
@Bandit's Mom

Either Chris or Bhooma can help you get a spreadsheet and signature set up. Without a spreadsheet, I seriously doubt anyone will be able to weigh in regarding Merlin's dosing. It's too dangerous to give any kind of guidance without benefit of data.
Click to expand...

Hi Wendy,

I can set-up a spreadsheet for you. Do you have a google ID? Could you share that with me via PM please? Just in case you don't know how to, I will send you a private message and you can respond to that! :-)

Bhooma
 
I’m not familiar with the second meter you bought, but I’d stick with the ReliOn. It’s used by a lot of us here and it’s very reliable. Comparing meters is not wise because there’s an accepted 20% variance between them and it will drive you crazy.
 
Thank you all for being so helpful. I appreciate it very much. I am working on supplying what you need. At the moment I am too tired to function. Bhooma, thank you. I need to set up gmail. Sienne, it eases my mind to learn that Somogyi does not exist for cats and get your insight on urine testing and meters. Thank you.
Wendy (and Merlin)
 
Status
Not open for further replies.
Back
Top