8/3 Sox - update

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Soxtiger

Soxtiger

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Hello everyone, just signed up for information and experience sharing. Sox is unfortunately newly diagnosed with feline diabetes. He's no stranger to the vet, after having spent may visits to get his hyperthryroidism in check. He was diagnosed 2 years ago and has been succesfully treated with I-131 last year and the results have been remarkable. Recently our nearly 13 year old kitty has been very sluggish and we suspected either kidney's or arthritis flare up or worst of all hyperthyroid re-appearance, yet a blood panel brought clarity and it's confirmed that Sox glucose level has been high and requires insulin treatment. Now I know it's no joke to try to slip a cat a pill (Sox is outsmarting pill pockets at this point, eats around the med's) so I wonder how the experience of pet owners has been trying to administer twice daily insulin shots. Hopefully this is temporary and can be controlled with weight management and proper diet.
Any insights you have, please feel free to share. Thank you!
Gabi & Sox
 
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Welcome Gabi.

I think shots are much easier than pills. Having had hypert's in my life who took Tapazole and cats with other issues, I would love it if all meds were injectible.

We use short needles and the cats don't even seem to notice. Cats have a layer of fat under their skin so your not shooting directly into muscle. This may be why it's easier on them. In the beginning when I was nervous I think I made Tucker nervous and that may have been our difficulty at first.

Changing Sox's diet is important, and it's equally important that you learn to hometest his blood sugar as you make this change.

Did your vet recommend a diet change and special food? Many do, but feeding a canned food that is low in carbs, high protein from the grocery or pet food store works great. Raw food is great too. As you change the food, the need for insulin will go down as the blood sugar wont be as high so home testing is important.

Did the vet say what type of insulin to use?
 
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Hi Jennifer, thanks for putting my mind at ease about the shots. :smile:
My Dad was a long time diabetic, so I don't exactly have fond memories of needles and I know Sox hates to be probed and prodded (the vet assistant got away with a heartfelt hiss last time). Sox has shall we say "character" ;-) , would he be human he may be called excentric..haha
We'll find out details regarding insulin tonight. It's likely we'll have to inject twice daily, we're also scheduled once more to get instructions on how to handle sox' insulin shots with Sox present (i know he'll be thrilled about yet one more vet visit, just thrilled). He's already on a special diet (K/D) due to higher kidney values which he choses to eat (although he needs encouragement occasionally), we just tried Royal Canine Renal can food and he just loved it..I hope his 3 other feline friends feel equally strong about it. It's difficult to feed special diets when you are a 4 cat household. Fortunately all other kitties have no health issues, but they're all senior in age 10-14. I noticed that petromalt perked Sox up the other day, when we were still clueless about his diagnosis. The vet ok'd it and I think we have to be careful going forward, how much of what we feed him. Will post more info when I have details. Thanks for the feedback!
Gabi
 
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Hi Gabi

You'll see that insulin shots aren't a big deal in general, and you can hometest his blood with an ear prick without much issue. Once people start doing injections, they start wondering why aren't all cat meds injectable :)

Starting insulin right away is associated with better outcomes, both in terms of regulating diabetes and getting cats off insulin for good. I'd be looking to start it ASAP. Recent studies have shown good outcomes with a human insulin called Lantus (glargine); there is a similar super-long acting insulin called Levemir which hasn't been studied but seems also to give good results in cats on this board.

Read the FAQs, ask tons of questions, visit often. We're all here to help each other so never be shy to ask a question or shout for help :)
 
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Thanks Jess & Earl, we picked up the Insulin prescription from the vet, but pharmacy had to order so we'll get it tomorrow. Sox is scheduled in the afternoon so the vet can show us how to administer the insulin. I've had a chance to read a bit more over here and it does sound like people have few issues with the shots themselves, but maintaining the glucose level and diet seem to be a task that requires careful oversight. We'll see how that goes. Sox is having a better day today. I'm just glad to hear his usual vocal self again and see him up and about a bit more than yesterday. :smile:
 
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Welcome Gabi and Sox!

You will find loads of great information here, so good luck to you and kitty!

-Breayle and Jake
 
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If your cat doesn't care about you grabbing them by the scruff of the neck, then giving a shot should be no problem. Many will give the shot while their cat is distracted by eating.
 
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Thanks Brian! We'll see how thing will go. The vet indicated injection into the nape of the neck may not yield best results, although you're right that area is less painful. I guess we'll have to try several times until we find out when, where and how is best..:)
 
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Day 1.5 - Last night Sox' vet administered the first dose of lantus 2units. Today we we're on our own, it went much much better than I had anticipated and I didn't even hear a hiss, a swat of a paw and not a single scratch on my hands / body..pew..:)

I'm lucky, I share caring for Sox and his 3 pals with my boyfriend who was able to adjust his work schedule to monitor Sox from home the first couple of days. So far so good, there's already improvement, Sox was very affectionate when I came home and much more like his vocal active self than in the recent weeks. I had a question about the blood test how he was diagnosed, the Vet took blood and ran a regular glucose test which was at 459. I think the range here was 67-150, but the test alone could mean the glucose is high due to stress from the vet visit.

She also ran a fructosamine panel that came back at 750, very high I belive the top range is 450 here. The vet doesn't think that Sox has been diabetic for very long, we monitor him closely but still our kitty is quite the actor..Friday we'll do a glucose curve at the vet. I've had to face the initial high cost of the blood tests, insulin, supplies like everyone else on here and I'm shopping around and already found pharmacies that offer Lantus at lower cost thanks to tips here on this forum (this is awesome btw).

Now I'm searching for info on Glucometers, seen only a few posts here, but no specifics. Maybe I'm not looking in the right place? Is there a difference between human / pet meters? Recommendations on where to get them, average cost would also be helpful? Any tips are greatly appreciated! Thank you so much. Gabi & Sox
 
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Some here give the insulin shot int he flank...that's the loose skin just in front
of the hip joint.

Just grab some fur, pull up a little bit to make a 'tent' of skin. Shoot at about a 45-degree
angle into the tent.

The smallest insulin syringes (30 gauge, 31 gauge) can hardly be felt. REALLY !!!!

Wayyyyyy easier than giving a pill, most of us find.
 
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you can get a cheap glucometer at wal-mart. it's the relion brand. otherwise what i'd do is buy the contour glucometer with a free rebate and get the test strips on ebay.

probably don't need prescription food or special food (unless maybe kidney prob is end stage). you'll save money getting food at the store. look on the health links page here and you'll find links on diet. janet & binky's food charts are there and show nutritional info on a lot of cat food. for diabetics you want something under 10% carbs, and canned food. if your cat is eating dry now, tho, don't change food til you can start home testing blood glucose. read up on diet at dr lisa's site, http://catinfo.org

don't need a glucose curve at the vet if you can home test using the glucometer so rather than waiting i'd just get the relion.

initially, here's what i'd buy at the pharmacy:

1. regular human blood glucose meter (glucometer)
2. test strips for the glucometer
3. lancets (28 to 30 gauge) to poke the ear and get blood
4. cotton balls to hold against the other side of the ear when you poke, and then to apply light pressure to the ear to minimize bruising
5. ketone test strips to test urine periodically to make sure your cat doesn't have ketones, a serious condition that could result from inadequate insulin, inappetance, or a possible infection
6. the vet will give you syringes, but you can buy them cheaper from hocks.com, which is linked thru FDMB and gives it a small commission. link should be on the top or bottom left of this page. you'd want U100 syringes, 5/16" needle, 3/10 cc, 31 gauge. i buy the GNP brand as it's cheapest. get the ones with half-unit markings, too, so you can use small dose increments

if kitty ears are cold, you can put some regular rice (not instant) into a sock and nuke for 20-30 seconds til warm, then hold it against the ear.

i reckon in the first year alone i saved thousands of dollars in vet visits by learning to home test, plus i had a ready measurement of how my cat was doing on insulin.

i'm in san francisco, so i think i'm relatively nearby if you need help. but another of our members, chet, is in walnut creek, so he may be a big help.
 
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Thanks ChrisCleo, this is very useful advice! I'm thinking home testing is the way to go, less anxiety for Sox and seems easy enough to handle without a trip to the vet. We have the BD 30 gauge syringes and they seem to work really well. So far Sox receives 2 units, but if we need to switch I saw they have the half unit-mark syringes. I injected Sox at the nape of his neck, the vet recommended it, seems everyone has a different method. Right now Sox gets wet food he seems to like Royal Canine renal diet we also have some K/D from Hills. I have to mix other wet food under, sometimes dry kibble as well. It's difficult to figure out our formerly voracious eater who is suddenly so finicky. I saw some folks live here in the East Bay, I'm sure we'll be in touch. :)
 
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many of us find that shooting in the flank or closer to the belly (which short needle syringes like the 5/16" are great for) gets the insulin to them faster and better (more absorbent). if you look on the BD website they say the same thing: http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7374

but, again, keep doing what you're doing, and look into changes as you start home testing so you know what's going on.
 
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Thanks all for the useful info on the glucometers. Putting a kit together now. Today is Sox's blood curve at the vet afternoon & evening. I just heard his afternoon results and they're higher than Tuesday (459) , today is (481). Sox is dehydrated and the Vet placed a subcutaneous waterpouch under his skin. It's strange he drinks so much water, yet it must be going right through him. He eats regularly and apr. similar amount, wet food mostly, some dry kibble in between. The food doesn't seem to take yet either, his weight dropped again from 12.6 Tuesday to 12 pounds even today..He used to be a 13-14 pounds which is a good weight, he's a very long cat. The vet said to use caro syrup to perk Sox up, but I'm thinking his glucose is already high, wouldn't you want to take sugar out of his system to bring the level down? Is there some info here or does anyone have experience with that? We're still giving 2 units of Lantus twice daily and it's only been a few days that Sox has been on insulin, but I worry...

I'll definetly ask the vet tonight when I bring him in later for his evening blood check..
 
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Gabi, do not understand your vet's reasoning with the syrup. If Sox's numbers are high, why would he suggest adding sugar? The only time we suggest syrup is with very low numbers (under 40) and before then, we would urge higher carb food. This is not good advice or practice.

I know it is hard to take advice from strangers over the internet, but it does not seem that your vet knows much about feline diabetes. And everyone here has successfully treated a diabetic cat. Has your vet?

I urge you to get a glucometer and start hometesting. You just cannot be sure the numbers at the vet are accurate because of the stress Sox may be under. You need to get some at home numbers and get a handle on what is really happening with the insulin.
 
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Thank you Sue & Oliver, I hope it's just a misunderstanding, but the caro syrup and Sox being hyperglycemic didn't make sense to me. Our vet has treated diabetic cats before herself, but I also know each cat is different, and adjustments need to be made as you go along. It just struck me tho that the glucose went up instead of down, maybe it was wishful thinking on my part after just a couple of days on insulin. How long did it take to get your cat regulated and what kind of foods do you use? We'll get more info tonight, but ultimately I want to be able to test daily ourselves, to avoid having Sox go through the stress of going to the vet. ..he certainly didn't sound happy when my boyfriend called me from the car on his drive home..
 
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Hi Gabi,

My story is that my vet started us on 4 units of insulin twice daily and said to just stay with the dry food we had been feeding. She didn't know about hometesting. We came home, searched the internet and found this site. Everyone urged us to hometest, change the food (we went with Fancy Feast) and lower the insulin. Although it was hard to go against our vet, it was over Christmas and we couldn't reach her, so we went with the advice here. Oliver's numbers went down 100 points overnight when we changed to wet lo carb. Thank goodness by then, we were hometesting and we lowered the amount of insulin we had planned to give him that morning. After 6 months, he was off insulin and had lost needed weight and was in great shape. Unfortunately, he developed heart disease a year later and died at 16.

We still use the vet and like her. She now encourages new patients to hometest. I think it is like a GP doctor - vets know a little about a lot of things. But they don't see too many diabetic cats.

I was so grateful for the help we received, and the extra year we gained with him, that I continue to post here and try to pay it forward.
 
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Thanks Sue, I kind of feel the same way, doing my own research to double check what the vets tells me and also find out additional info. This board has been full of good tips so far, I'm continuing to learn each day. The vet said this community will probably be most helpful as other owners share experiences and good advice. Our vet has been great, we do like her. Sox has had other ailments in the past, so she's really familiar with him. I dread weekends and holidays tho when the only alternative is emergency and that's a boat load of cash. What we're struggling with right now is finding out carb content of foods were giving..Even the distributor websites only reference fiber, protein and fat..why not carbs so the diabetic kitty owners know what to do? Any advice on that, I'm trying to double check if our diet really is the best way to go (we feed mostly wet food, some dry kibble).
 
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Hi Soxtiger

I would strongly advise you to get a meter tonight or tomorrow AM at the latest and start testing. Sox has been hyperglycemic for some time now, is dehydrated, and not feeling well, so it is important to bring his diabetes under control to avoid complications. I know you're planning on hometesting, but I'd take the bull by the horns ASAP. I think Sox is on Lantus? There is a Lantus forum within this one where people post their numbers and learn from each other, that might be helpful once you've got some at-home BGs.
 
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We started home testing this morning. My bofriend and I voluntered for the initial calibration of the device and I'm glad we did this, to avoid pricking Sox unnecessarily. By the time I tested him it still took two attempts but went better then expected. Sox reading last night was 371 and today's is 422, still to high for comfort. The subcutaeous waterpouch took care of the dehycration and he eats with a better appetite now. I hope that will remain this way and allow us to decrease his glucose level. I'll take another reading later today prior to Insulin in the evening. I feel a bit more at ease now that we can test at home and have confirmation of the number, it does help judge his condition better. Thanks for the links to the site withe carb chart for canned and dry foods. Our foods are actually low carb but the K/D wet food is fairly high and I'll stop feeding it and stick with the Roycal Canine & Friskies instead.
 
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trick to learn if you don't have the food charts handy and want lower carb food.
don't get the kinds with any gravy or sauce, or grains like rice, corn, or flour.
make sure chicken or turkey is the first ingredient. that way you know you're getting protein from muscle meat instead of poorer sources of protein.

we like wellness grain free varieties for diabetic cats. plus if you sign up your email address you'll get discount coupons regularly ($3 off for wellness core dry food and $1 for canned cat food). the meat quality is good enough for humans rather than pet quality meat. here's a link. to the right of the page should be a field where you can join their club to get emailed specials: http://www.wellnesspetfood.com/categories.aspx?pet=cat&cat=2 but really many other cat foods are cheaper yet still low carb. most of the fancy feast classic recipes without gravy are low carb, too.

the sugar/syrup recommendation is really for hypos. maybe your vet is wondering if the higher numbers indicate rebound. but really higher numbers are common for cats just starting out. eventually they should work their way down. cutting out dry food will make a huge difference. when you did that i'd probably drop the insulin dose by a third just to make sure your cat doesn't go too low on fewer carbs (raise the dose back up if the blood glucose doesn't drop enough).
 
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The lower carb wet fiid and no dry food seems to help Sox. He's quite active tonight, jumped even to the window which he hasn't done in a at least 2 weeks. He seemed more "there", not spaced out like we've been seeing him lately. We spent some time playing outside after I came home and he was quite his former playful self..That put my mind at ease a little, like something good is happening with what we're doing. His number tonight pre-shot was 432, still high, but not as scary like Sunday morning's 600 reading. :smile: We'll see how he does on the RC wet for a few days and hopefully the numbers come down but not way down. We're still at 2units insulin, I want to see how the food affects him first before making any adjustments just yet, he's on Insulin less than a week now. I finally had success at first attempt priking his ear for blood prio to food & insulin tonight..yeah me..so proud. Hopefully it will be just as easy tomorrow. The canned food/dry food charts are such a huge help, and today I finally learned what +1, +2 in many of the threads actually means..huge aha moment..I still have a standard spreadsheet, but consolidated it to a one pager with all the necessary info, maybe more than what you guys have here. In the coming days I'll try to convert it to the google spreadsheet, seems easier to share.
 

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Re: Newbie Intro

Now that you are home testing, you do not need to waste your money on any curves at the vet. Tiger's numbers will be higher at the vet and be misleading.
Also, you can give the fluids yourself at home to save even more money. I do and so do many others. You should be able to get your vet to show you how, just a larger needle in the scruff and you are already giving shots there so should be no problem. Picking up a fluids kit for $40 or something and giving a bit every day is alot cheaper than what it costs to take poor tiger into the vet and have only one treatment of fluids.

Just wait; in no time at all, you are going to be an old hand at all of this and you will be helping the newer guys!

I hope Tiger has a good evening and feels better in the morn.
 
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gonna laff but pretty soon you'll be thinking of everything in terms of +2, +3, etc. like, i have to go out at +3. people outside fdmb will wonder what code you're speaking. ;)

congrats on the successful poke! welcome to the vampire club!! :)
 
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The google spreadsheet is used by people here because there are many who may not have Excel so they would not be able to see the numbers. Also, what I love the most is that once I make my update to the sheet, anyone can access it to see the latest info and I don't have to send it to anyone.

Anytime you want to change the subject that is seen in the posts, just go to your first post in the thread, then select edit at the bottom right.
You can then change anything you want or add info.
For this post, you could change the Newbie Intro to read as 8/3 Sox Intro or anything else you want to put to catch people's attention.

I know that you may think the poking hurts and Sox will hate you, but it does get easier, the ears bleed more readily, and Sox won't mind. I am pretty sure that they connect the tests to either treats, foods, or meds that make them feel better. In time, you may have Sox going to your testing spot close to the time for testing. I don't know how they do it but my Shadoe appears out of nowhere quite often and when I check the time, it's usually very close to time to test her! Oliver just sleeps through the pokes LOL.

I hope you start to see some good numbers with the food changes.
 
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The succesful poke last night was again short lived..rats! Tried this morning and no luck, little cooperation from Sox and the fact that I was not 100% just yet didn't quite help the matter. I decided to give him a break and just test later today. We're both away from home today, but I work close by and will be checking in on the kitties in a few hours. We may have to be satisfied with one reading a day (goal is two with the occasional curve), just to judge if the numbers are coming down. He seemed in good spirits, ate all his food and sure appreciated the fresh fish that came his way after I clumsily tried to get a drop of blood from his ear this morning. Hopefully he'll associate the treats in a good way and in time does move to the "poking spot".
 
It sounds like things are improving. Don't worry - the getting blood is on and off at first for some. But eventually, it will be second nature for both of you.

Have you tried put a drop of vaseline on the spot where you want to poke? (You are aiming for those small capillaries that run off the main vein along the side of the ear. You can find them with a flashlight.) The vaseline helps the blood bead up.) And heating the ear is very important at first. Try to get it nice and warm.
 
i'm hoping you'll be able to get at least 3 pokes a day in: one before each shot, and one sometime near the middle between shots or even right before you go to bed at night.
without a midcycle check we won't really know how the insulin is working.
for example, sometimes a high blood sugar level at shot time could mean the cat went too low sometime during the day and bounced, or it could mean that the number didn't really go down during the day at all. each of those scenarios would mean a totally different situation in terms of whether the cat's getting too much insulin or not enough, and what you'd do about it.
 
You want to get a test before each shot so that you know if it's safe to even give a shot.

You would like to get at least one mid cycle shot because with Lantus and Levemir, the more important number is in the middle of the cycle - you need to know how low the BG number goes on a dose.

If you test around +6 or near to that point, 6hrs after the shot, and the number is really low, you need decrease your dose. It does not matter if the pre shot numbers are high or not, you base your dose on the number at mid cycle with Lantus and Levemir.

Often people are away during the day and cannot get the daytime mid cycle test, so that's why it's a good idea to get that before-bed test. I had to stay up late the other nite because my before-bed test on Shadoe was very low and I had to feed till she rose up a bit. Kitties often drop low numbers at nite, so it's safe to test that pm bedtime test.
 
I came home to test +5 at lunch, no luck. Sox faught me off hard and wanted to bite me, had the blood droplet and missed putting it on the test strip b/c it's not easy to contain cat and maneuvering BG equipment at same time when by yourself. We had more luck tonight pre-shot, however....562!! : :shock: OMG another one of those high readings. So far the problem is scary high levels, we're not anywhere near a lower level just yet. Will have to re-test tonight +4 / +5.
 
Thanks for that idea..when I tried it in the afternoon, I had tried scooping the blood into the strip, but missed and it went under..oh well. :roll: Just re-tested his +4 / +5 is 473, looks like a 90 point drop from the previous reading. He's loving the chicken associated as reward with the poking, but the poking he sure hates. I tried just the lancet free hand this evening, with better result than the lancet device. Hopefully it will be easy again in the morning to get another reading.
 
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