A new case. How I am coping

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Sarikali

Sarikali

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Hello fellow diabetic cat owners!
My cat Philemon was just diagnosed with diabetes about 6 days ago. Thank goodness I brought him to the vet! Now that I know more about the condition, can you believe he was at 37,02mmol. It is a relief that I did catch him before he could crash... because I am certain that given maybe another few weeks he would have!

So now he has his own little insulin vial and tons of little needles. I went full-throttle research on cat diabetes and got him a little glucometre (all on my own initiative).

So now I've just recently tested him for the first time 2 hours and another 5 hours after his 7th 2 unit dose since he's been treated on insulin. I am also slowly changing his food. He's still very high (24.5mmol 5 hours after eating) but I want to wait a week or 2 before bringing him to the vet again to have a green light on increasing his insulin dose (I think he actually might need 3 or 4 to get him controlled).

So all-in all. his Neuropathy is down (he can move his back legs better now) and he stopped urinating as much as a regular human adult (omg so much $$$ is going to be saved in cat litter @-) )! I'm very happy about all of this and hopefully going to get him to where he was all happy and healthy! This site helped me alot. I look forward to posting his improvements and pictures along with how his treatment is going.

Just because your cat has diabetes, it doesn't meant the end of the world! Philemon is teaching me alot about himself.

Thanks!
 
Great job on hometesting and changing his diet!!! This site has so much good information....I don't know how I would have managed Zoe's diabetes diagnosis without the people here.

What insulin are you using?

Welcome....we are happy to meet you....sorry you have to be here, though!

Sherry
 
Welcome! You are doing such a great job. Yes, let us know what insulin you are on and then the right people can give you advice!

You're going to see other people's blood glucose numbers in US measurements. Before you get confused or freak out, here's info on how to convert your mmol/L into mg/dL.
http://binkyspage.tripod.com/faq.html#glucose
 
Sherry & Zoe said:
Great job on hometesting and changing his diet!!! This site has so much good information....I don't know how I would have managed Zoe's diabetes diagnosis without the people here.

What insulin are you using?

Welcome....we are happy to meet you....sorry you have to be here, though!

Sherry
Click to expand...

I am using Lantus Glargine (which is what the Vet prescribed and sold me). I'm just happy my cat's been diagnosed so I can start helping him!

To me, when you adopt a pet, it's part of your family! What mother would not give insulin to a child that needs it!? Sure it might cost a few extra buckeroos, but I feel closer to my pet than before. The little guy needs me even more than just for food and shelter now. He's been such a real sport with the shots and even the glucometre tests and it's odd... he's usually such a grump with being handled. Its like he knows its all making him feel better in the long-run and he's working well with me with all this new (wo/man)-handling.

So as an update:
My cat is still doing fine! Yay! No crashes (*sigh of relief*). But he's still 29mmol 1hour before eating! (ARGH! ITS SO HIGH!) I'm thinking 2 units is incredibly low with how he still is after a week! So I'll call my vet to let him know I'm going to give him 3 units instead of 2.

Hopefully I'll be able to get him under the 20s in the 2nd week of treatment. I know it's not too good for his body to go too fast on this, so a week at a time and we'll see how it goes.
Our new goal Phil is 18-20! Yayz goalz!

Hey hey! If you were curious here he is (before getting that nasty neuropathy): http://www.youtube.com/watch?v=hdH1pxICiIA
 
Hi there! There are lots of people here who can help. I will put a message in the Lantus forum to see if I can get more experienced eyes on this. I'm new:) how many shots have you given so far? It can take awhile to see progress. Be patient! If you can set up a spreadsheet for your glucose values and publish it in your signature, it will help people advise you.
Just follow these instructions:
http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
AMPS means morning (am) pre-shot and same for PMPS (evening). That stumped me at first!
 
I'm a little confused on something so I will ask for clarification...Are you giving him insulin once or twice a day? With cats, even the long lasting insulins like Lantus, Levermir and PZI all need to be dosed twice a day. If you are only giving it once a day, you might want to split his dose and give 1u in the morning and then 12 hours later give the other 1u. Insulin is pretty potent stuff and very few cats need much more than 1u - 2u twice a day, unless there is some other underlying health issues. But because a cat has a very fast metabolism rate they do need it to be given twice a day.

Especially with Lantus, part of the problem might be if you are only giving it once a day, because it needs to be able to build up a shed or depot under the skin before the cat can use it to help bring down their bloodsugar.

The other reason he might still be fairly high right now is if he is still getting any dry food, some cats are really carb sensitive even a couple of pieces of kibble will send my Musette's BGs through the roof, while my Maxwell can be caught up to his whiskers in the pasta pot and only have a slight rise, one of those every cat is different type of things.

Mel, Maxwell, Musette & The Fur Gang
 
Hello and Welcome!

Good for you taking the initiative to home test - it's key to safe management of feline diabetes.
Have you kept track of his shot times and test times? If so please enter them onto the spreadsheet (link provided by Kim and Simon in earlier post).
I believe there is a template that will automatically convert your readings (for hose of us in the US).

The transition from dry to low carb (<10%) wet food can make a huge difference in BG levels.

Lantus is a great insulin. For cats dosing is every 12 hours. Regarding the dose, I recommend you gather as much data and enter it onto the spreadsheet before increasing.
Changes to Lantus dosing are made based on the lowest number in a 12 hour cycle (nadir) rather than the number just before giving the shot (preshot or PS).

I recommend you read the new to the group "sticky" It will provide tons of helpful information and help you decide which protocol you feel you can manage.
 
Sandy and Black Kitty said:
Hello and Welcome!

Good for you taking the initiative to home test - it's key to safe management of feline diabetes.
Have you kept track of his shot times and test times? If so please enter them onto the spreadsheet (link provided by Kim and Simon in earlier post).
I believe there is a template that will automatically convert your readings (for those of us in the US).
Click to expand...

Cool! I didn't know about the "World" template. See, you learn something new every day :razz:
 
Welcome to FDMB.

I actually had the same question as Mel (MommaOfMuse) -- are you giving a shot once or twice a day? Lantus is dosed twice a day in felines. (Lantus is a once a day insulin in humans. A cat's metabolism is considerably faster than a human and you need to give insulin every 12 hours.) Typically with Lantus, you want to hold your initial dose for 5 - 7 days. Also, with Lantus, when you increase the dose, it's recommended that you increase in increments of 0.25u. You would not increase by a full unit. There's a good chance that it would be too much insulin. You may want to take a look at the dosing protocol we use. The protocol is based on research that has been published in a leading veterinary journal.

What are you feeding Philemon? With a diabetic cat, you want to be feeding a low carbohydrate (i.e., under 10%), canned food diet. I'm not sure where you're located so the foods on the lists we use may not all be available in your area. Janet & Binky's chart dose have international information. There is a newer chart that contains some of the more recent varieties and premium cat foods.

Congrats on getting started with home testing!! This is the best possible way for you to manage your cat's diabetes. You may want to provide treats every time you test. Many of us use freeze dried chicken treats. There is information on low carb treats available if you need it.

Please let us know if you have questions. There is a huge amount of information to absorb at the beginning of this process. The people here are very generous with their time and information.
 
MommaOfMuse said:
I'm a little confused on something so I will ask for clarification...Are you giving him insulin once or twice a day?
Sienne and Gabby wrote:
Typically with Lantus, you want to hold your initial dose for 5 - 7 days. Also, with Lantus, when you increase the dose, it's recommended that you increase in increments of 0.25u. You would not increase by a full unit. There's a good chance that it would be too much insulin. You may want to take a look at the dosing protocol we use. The protocol is based on research that has been published in a leading veterinary journal.
Click to expand...

Twice daily 2 units at 12 hours intervals. I am feeding him a diet perscribed by the vet. Until I get him managed to a healthy level I don't want to switch his food again too fast, so I'll stay with what the Dr.'s ordered (for now). It's 'the' high fiber diet (which I heard isn't all that great) and I've been mixing (phasing out) from his old food... so I'll need to do more research on food generally.

I can only check him on his 2nd dosage in the day in the afternoon. That's when I'm checking him: before he eats, 2 hours after and 5 hours after to see his curb. How much testing do I need to do? LOL! I'm feeling bad that I have to prick his ears all the time!

Since starting on his insulin on the 24rth Febuary; Philemon has gone from 37.5mmol to around generally 24-29mmol. So steadily it's going down. YAYZ!!! :-D
As of today (29th) it will be his 11th, 2 unit dose. I'll keep monitoring his levels and will post them up once I get more (since I only have about 7 results so far) to get a better medium.

BTW! Thank you Sienne & Gabby for that Protocol, I've been gobbling all this info down pretty well and I'm not intimidated by my cat being diabetic and all. It's a bump in the road compared to what I'm ready to do for my kitty.

roooonzzzz-1.jpg
I'm Zzzzzzzzzzz'ing Stop pricking my ears!​
 
Hi and welcome to FDMB! You are off to a great start and have a wonderful attitude about all this. As Sienne said a full unit increase is a huge amount for a cat. We usually use syringes w/ half unit markings, it makes drawing the partial units much easier and consistent.

I am feeding him a diet perscribed by the vet. Until I get him managed to a healthy level I don't want to switch his food again too fast, so I'll stay with what the Dr.'s ordered (for now). It's 'the' high fiber diet (which I heard isn't all that great) and I've been mixing (phasing out) from his old food... so I'll need to do more research on food generally.
Click to expand...
It is really difficult to get to that healthy level until his food is changed to a low carb wet food. That is really the first step. Many of us have seen dramatic reduction in BG numbers w/ diet change. Unfortunately, the prescription diets are often much higher in carbohydrates than diabetic cats should get. Since Philemon is already on insulin it is important to monitor carefully during the change. These websites http://catinfo.org/ and http://maxshouse.com/feline_nutrition.htm have an enormous amount of information an proper nutrition for cats.
 
In the link to the protocol, you'll note that it's helpful in the beginning to test every 3 hours. (Please don't stay up all night to test!). Basically, you want to get a pre-shot test. This lets you know if it's safe to give insulin. Lantus dose adjustments are based on the lowest point in the cycle, the nadir. If our cats only would read the rule book, they'd know that the nadir would be 6 hours after their shot. As you know, our cats do not follow the rules! At the minimum, you should be getting at least one spot check each cycle. Most of us test more than that. You can click on the links to our spreadsheets in our signatures to get an idea of how different people test. (I have a cat that has an early nadir and who's prone to diving early in the cycle. As a result, I get frequent tests early.)

A curve involves testing every 2 hours or a mini-curve is every 3 hours. Getting a curve is useful in terms of informing you when Lantus onset begins and where the nadir falls. It also tells you what kind of duration your getting with Lantus. Getting random spot checks may involve less testing but can be just as useful .
 
good for you for being so proactive, getting the glucometer and hometesting! that's 90% of the battle!

we're lantus users also - cats can be difficult to regulate, so having the support and education here readily available is fabulous for learning how to take care of our cats. many vets don't see too many diabetic cats so this is a wealth of experience and knowledge. you'll find answers to anything you want to know about diabetic cats here among the members.

is there any dry food at all in the picture?

here's information on how to take care of your lantus so it remains effective as long as possible: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=151

keep posting and asking questions and we'll do our best to help you. after you've read the information from sienne on the protocol we'll be glad to answer questions. it's a proven protocol for dosing with Lantus, published in scientific journals. and yes, dose changes are made by .25u (1/4 of one unit) because cats are unbelievably sensitive. you have to be patient with lantus - every change in dose has the potential for numbers to get a little wonky for a few days. we've learned to put our BG numbers into a spreadsheet and those of us with experience are able to "read" the spreadsheet and let you know if it's time to increase/decrease a dose, or if you're running into wonky numbers and need to be patient.

we'll be glad to teach you how to help philemon get back to being healthy in a safe way. we have members from all around the world.

btw - neosporin ointment with pain relief will do wonders for helping his ears heal overnight every night.
 
I wanted to ask you about the dosing you are giving and how you are giving the shots.

So now he has his own little insulin vial and tons of little needles. I went full-throttle research on cat diabetes and got him a little glucometre (all on my own initiative).
Click to expand...

What caught my eye is your mentioning tons of little needles.
are you attaching a needle to the insulin container or are you using syringes to draw the insulin out of a vial/bottle? I am asking because there have been a couple others who have been attaching a little needle to the end of an insulin pen and then dialing the dose, in full units.

This method of using the insulin pen will not work well as most dose changes are made in small increments as has been mentioned, as small as .25units and .5units.

If you are using syringes, can you check if there are 1/2 unit markings on them?
 

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Gayle Shadoe & Oliver said:
What caught my eye is your mentioning tons of little needles.
Click to expand...

I live with my younger sister who is (thankfully) also a young vet. technician! Ahaha! Which is why I'm not so worried about my cat being diabetic (too much... :? ).
She is geared more towards 'horses' and 'cattle' rather than cats or dogs but helping me a little. She wasn't surprised he was diabetic (what with all the peeing he was doing) but she'd never seen diabetic neuropathy before. Now we both know!

I am using small injection needles. Yes, I noticed they have the .5units dose marks on them and I am drawing from a100ml bottle of Lantus (which I wrote the date I opened). I've also found out I can purchase Lantus from behind the counter at the pharmacy where I live so I won't need to go to the veterinarian every 2 months for it (unless it's to have Phil checked up).

So I'll go the 'take it slow'. It's all new and I want to do right by my cat and I guess getting overzealous won't do him any good.

sayshi-1.jpg
Philemon says: Purr purr, slobbers over keyboard, Zzzzz Trans: Thanks all for the support and information!​
 
Hi sarikali
First of all I wanted to let you know I think you have the most wonderful attitude! Your cat is lucky to have a mother like you who's not afraid of needles, insulin and glucometers! :)

May I ask what food you are giving to your cat and how many meals a day?
 
Lucky you to have a vet tech in the g=family! :-D If you can buy insulin without a prescription I'm guessing you live in Canada. I think the questions about the "needles" were just a little language difference. We usually refer to them as syringes, mainly because there are also needles that (for humans) can be used w/ the insulin pens. When you go to buy more insulin consider getting the pens. Insulin can lose it's potency over time. Basically the pens are just smaller vials, so there isn't as much waste from being open too long. We still use the regular syringes and draw form the same way we draw from a vial. There is just less waste w/ the pens. While the initial outlay may be more, in the end it is more economical to get the pens. You may even be able to purchase individual pens, rather than the 5 pack. Just don't let them sell you the needles that attach to them.
 
Hill's perscribed: low fat, high fiber diabetic cat food (its semi moist) was what the vet asked me to give him.

I am aware that it would cost me ALOT in the long-run but for the moment I will probably have him on it for the next couple of months as I`m getting him to a 'normal' glucose range before switching slowly to something else. Yup! I live in Canada (and I am *hoping* that I can actually trick my insurances into covering a part of the insulin! Mwahah! wouldn't that be sweet!?). :lol:
So here's my curve as I can test him only in the afternoon.

1/2 cup of food (2x daily) at 6am and 6pm with 2 units of insulin after he eats since diagnosed with Diabetes. He receives a small snack before I go to sleep about 6 hours after (he's too used to it for me to get him to stop meowing non-stop).

When diagnosed 24th: 37.5 mmol at 2pm (8 hours after eating) @-)

27th of Feb (after 3 days of treatment)
Before eating 27.2mmol ,
2 hours after eating 29.6mmol,
6 hours after eating and before snack 24.7mmol

29th of Feb (after 5 days of treatment) NOTE: I gave him 2.5 units instead of 2 at supper.
Before eating 29.5mmol,
2 hours after eating 26.3mmol,
6 hours after eating before snack 22.3mmol

I'm aware that this isn't enough to get a medium, but its going down very slowly so I'm happy with those results. At least he's not ver 30! YAY!
I am curious about the mornings, I don't have time on account of work to be able to give him a glucose test.
I'll try to get it on Sunday. I`m going to stick to 2.5 and see if it's better. Because he's hitting near the 30s after eating otherwise... I don't like that personally.
 
Sarikali said:
...he stopped urinating as much as a regular human adult (omg so much $$$ is going to be saved in cat litter @-) )! I'm very happy about all of this and hopefully going to get him to where he was all happy and healthy!
Click to expand...

I realized I was going through a LOT of kitty litter, but since Grayson started insulin, the (scoopable) litter is lasting MUCH longer! So the cost of the Fancy Feast offsets what I was spending in litter! ;-)

Great initiative! Keep up the good work!
 
Sarikali said:
Hill's perscribed: low fat, high fiber diabetic cat food (its semi moist) was what the vet asked me to give him.

I am aware that it would cost me ALOT in the long-run but for the moment I will probably have him on it for the next couple of months as I`m getting him to a 'normal' glucose range before switching slowly to something else. Yup! I live in Canada (and I am *hoping* that I can actually trick my insurances into covering a part of the insulin! Mwahah! wouldn't that be sweet!?). :lol:
So here's my curve as I can test him only in the afternoon.

1/2 cup of food (2x daily) at 6am and 6pm with 2 units of insulin after he eats since diagnosed with Diabetes. He receives a small snack before I go to sleep about 6 hours after (he's too used to it for me to get him to stop meowing non-stop).

When diagnosed 24th: 37.5 mmol at 2pm (8 hours after eating) @-)

27th of Feb (after 3 days of treatment)


Before eating 27.2mmol ,
2 hours after eating 29.6mmol,
6 hours after eating and before snack 24.7mmol

29th of Feb (after 5 days of treatment) NOTE: I gave him 2.5 units instead of 2 at supper.
Before eating 29.5mmol,
2 hours after eating 26.3mmol,
6 hours after eating before snack 22.3mmol

I'm aware that this isn't enough to get a medium, but its going down very slowly so I'm happy with those results. At least he's not ver 30! YAY!
I am curious about the mornings, I don't have time on account of work to be able to give him a glucose test.
I'll try to get it on Sunday. I`m going to stick to 2.5 and see if it's better. Because he's hitting near the 30s after eating otherwise... I don't like that personally.
Click to expand...

what is the exact name of the variety of the Hill's food you are feeding.... I have seen only cans of wet foods and bags of dry foods at the vet; I did not know there was a semi-moist option.

I ask because you mention about numbers rising so much after food; maybe the food is a bit too high in carbs, so until you can switch to a lower carb wet food, you may have to give alot more insulin to get to good numbers.
Once you are ready to switch to a lower carb wet food, be ready for the numbers to drop and you will also see a drop in the insulin dose.
 
Grayson & Lu said:
Sarikali said:
...he stopped urinating as much as a regular human adult (omg so much $$$ is going to be saved in cat litter @-) )! I'm very happy about all of this and hopefully going to get him to where he was all happy and healthy!
Click to expand...

I realized I was going through a LOT of kitty litter, but since Grayson started insulin, the (scoopable) litter is lasting MUCH longer! So the cost of the Fancy Feast offsets what I was spending in litter! ;-)

Great initiative! Keep up the good work!
Click to expand...

Ahahaha! True that!
Still doing good, having trouble pricking his ears now (he's caught on!) Arrrrgh! Ok so what now? I think my lancet totally sux... either that or defective! It's not very accurate or it jams or something. So I'll look around for another. I don't feel comfortable with a needle near his head to draw blood (someone suggested it) cause he tends to shake it without warning! And... well I tend to throw stuff when startled. BONZAI needle! (That's not good :shock: ).

A friend of mine has mentioned she re-uses the needle at least 4 doses (2 days) sterilizing in alchool. I've seen the re-used needle images here somewhere and I don't like that thought! Maybe for 1 day... but not for 4 doses!

playingDND-1.jpg
He watched us play for 30 minutes in this position. He also rolled a few dice for us!​
Philemon: Ok I move forward 10 feet back the corridor and cast a fireball at the werewolf! I rolled 3d6, is it dead yet?​
DM: Yup!​
Philemon: Woot 3pic l00tz!​
 
Sarikali said:
Still doing good, having trouble pricking his ears now (he's caught on!) Arrrrgh! Ok so what now? I think my lancet totally sux... either that or defective! It's not very accurate or it jams or something. So I'll look around for another. I don't feel comfortable with a needle near his head to draw blood (someone suggested it) cause he tends to shake it without warning! And... well I tend to throw stuff when startled. BONZAI needle! (That's not good :shock: ).
Click to expand...

Grayson has learned to lie down on the table in front of me, facing R (I'm R-handed). Once he lays there and gets petted, licks my hand, my L arm is around him, easily able to scruff if need be. He no longer tries to run. Holding his R ear w/ my L thumb & forefinger, I poke freehand w/ my right hand. Sometimes scoop the blood onto a fingernail or draw it up directly from the ear. Then probably 15 seconds of light pressure, and we're done. More love, and frequently, a freeze-dried chicken treat!

Someone else (sorry, I can't remember exactly who) calls "Pokeys!" and her sugarcat comes running to get poked! It's all in how we present it to them! ...and the treats afterward!
 
i'm wondering how we can best help you? i'm unsure how to move ahead.

we can give you advice on things you can change that will improve philemon's diabetes and health and help bring his blood sugar and insulin dosage down. is that what you would like?
 
When you guys had your cat diagnosed, how long did it take for you to get him at normal readings... or respectful levels at least?
I'm trying to figure out how long it will take for me not to worry every day and every hour and be worried while I'm at work about him.

Generally, I'm sharing his case to relieve stress and learn other's tips and tricks.

I love the poking story! lol. My cat comes when I call: 'Bouffe!' which is french for 'chow' (like food-wise). I can't get him to stay still though, he usually is fairly calm for a few moments until I grab an ear.
 
i'm running out to work so this will be sorta short - but for some cats it takes years. newly diagnosed cats who get the appropriate diet and correct insulin support may go off of insulin in a matter of weeks - i've seen as little as 2-3 even. we've seen them go off just with the appropriate diet. every cat is different. our goal is to get a cat out of high numbers - over 250 or so - as quickly as possible to prevent organ damage is done. damage is reversible if the situation is changed as quickly as possible. i don't have time to figure out what 250 is in world measurements, but i think you're describing fairly high numbers.

you've already gotten a lot of good advice and good links of things to read. have you had a chance to read yet?

if i were you, i would read more, ask more questions. we really like to have people start spreadsheets. a spreadsheet allows us to see at a glance how philemon is doing and what he needs next.

for the best results, he needs to go off of dry food entirely, even the prescription, and get onto a low carb canned food diet. but because you're already giving him insulin, we would want to make the transition slowly over several days, all while you are monitoring so he doesn't dip dangerously low. we've seen cats go off of insulin just with diet change. but keeping him safe during the transition is critical.

it also matters when he eats in relationship to the insulin shot.

i've gotta go - will be back later.
 
A friend of mine has mentioned she re-uses the needle at least 4 doses (2 days) sterilizing in alchool. I've seen the re-used needle images here somewhere and I don't like that thought! Maybe for 1 day... but not for 4 doses!
Click to expand...

If you are talking about the syringes to give insulin, NO, you must NOT re-use the syringes. Ever. They are single use syringes and the coating on the tip of the needle is good for the first use, but then attempts to sterilize may just result in destroying what is left of the coating, and would be painful for the cat. I think if you are going to be giving daily injections as well as poking ears for testing BG, painful needles is not a great way to win over your cat.
 
julie & punkin said:
you've already gotten a lot of good advice and good links of things to read. have you had a chance to read yet?

if i were you, i would read more, ask more questions. we really like to have people start spreadsheets. a spreadsheet allows us to see at a glance how philemon is doing and what he needs next.

for the best results, he needs to go off of dry food entirely, even the prescription, and get onto a low carb canned food diet. but because you're already giving him insulin, we would want to make the transition slowly over several days, all while you are monitoring so he doesn't dip dangerously low. we've seen cats go off of insulin just with diet change. but keeping him safe during the transition is critical.
Click to expand...

I really agree with Julie. Let us help you get him on a low-carb, wet food diet. It doesn't have to be prescription! I have seen tremendous results with Simon in just two months. I had some initial resistance because I could only get Simon to eat Fancy Feast. I thought grocery brands were terrible. In the end, I've gotten him to eat some Wellness food with a powder called FortiFlora sprinkled on top. But Fancy Feast (or even Friskies, purina's lower line) are still WAY better for your cat than any fancy, prescription dry food. Some of the prescription canned foods actually have lots of byproducts and are more in line with a lower-end grocery food. Fancy Feast is in the mid-range of quality--you will see some actual meat and some by-products. It depends on the formula. Since you're in Canada, I would imagine some of these brands are available. I think someone also gave you Janet and Binky's food lists.

You can trust the advice you're getting, you just need to decide to do what's in your cat's best interest (even if it may conflict with the vet). I have a really good vet, and he got us off on the right track with Lantus and the right dosage, but learning to home test and managing him myself--that I can attribute to the FDMB folks!)

Click on the spreadsheet link in my signature to see Simon. He was just diagnosed in January, and he is really looking great. He MAY go off insulin, but there aren't any guarantees. To give your cat the best chances, follow the advice of the experienced people on the board! The sooner you get his glucose under control, the sooner his body can start to recover. Cats are really good at bouncing back--their pancreas can recover, but we need to get his blood sugar down for that to happen.

Also, do get a spreadsheet set up. I think I gave you the link in an earlier post? It's not hard at all. Google docs is really easy to use! Use the WORLD template and I believe it will translate your mmol values to values that all the people in the US can identify with quickly.
 
Gayle Shadoe & Oliver said:
A friend of mine has mentioned she re-uses the needle at least 4 doses (2 days) sterilizing in alchool. I've seen the re-used needle images here somewhere and I don't like that thought! Maybe for 1 day... but not for 4 doses!
Click to expand...

If you are talking about the syringes to give insulin, NO, you must NOT re-use the syringes. Ever. They are single use syringes and the coating on the tip of the needle is good for the first use, but then attempts to sterilize may just result in destroying what is left of the coating, and would be painful for the cat. I think if you are going to be giving daily injections as well as poking ears for testing BG, painful needles is not a great way to win over your cat.
Click to expand...

Additionally, since you have the 10mL vial of Lantus you want to do everything you can to avoid contaminating it so it lasts as long as possible past the 28 day mark. Inserting a syringe into your insulin after it's been in the cat (even after attempting to sterilize in alchohol) seems like a bad way to keep your insulin pure. Consider the added syringe cost as a preventative measure to save on insulin:).
 
Good morning and welcome to you and Phil. Julie asked me to pop over from the Lantus Insulin Support Group.

Sienne gave you a link to the Tight Regulation Protocol that most of us in the Lantus TR ISG use. It is based in clinical research and that has been published in leading veterinary journals. It is referred to as the Tight Regulation (TR) Protocol (or by other names as well, the Tilly Protocol or the Rand/University of Queensland Protocol). They are all the same. A modified version of the protocol and links to the formal versions is available in the link you were provided. This approach will give your cat the best chance of going into remission or keeping his/her blood glucose numbers in a range that will prevent organ damage.

The majority of cats do very well on this protocol; some cats do not. Every cat is different (ECID). Also, results do not occur overnight. Lantus will teach you patience. It is more time-consuming than most other protocols but still definitely doable if you work a regular full-time job. Many people here have challenging schedules.

We strongly urge you to test for ketones regularly to start with and know about diabetic ketoacidosis (DKA). Be aware that ketones don't occur once a cat is (and remains) properly regulated. Most of us buy ketostix at the pharmacy and test urine...it's easy and quick. Philemon should be eating a the right diet: high-quality low-carb canned food or raw food exclusively. It is best to feed your cat lots of small meals spread over the day, free-feeding canned food can be an option for some cats.

If you can't find the means to incorporate these steps into your cat’s diabetes management, for whatever reason, using a TR protocol may not be right for you. As overwhelming as it may seem right now, these steps are not that hard to carry out and we've seen many people who didn’t think they could do this, slide into a TR approach once they got started. Home testing is a critical part of this approach. As with any other insulin, in order to insure that blood glucose levels are high enough to safely give a shot, you need to test prior to injecting.

There is an alternative protocol called "Start Low Go Slow" and the link to it is here: SLGS Approach

With either protocol, dosing changes are made primarily on the nadir with only some consideration given to the preshot number. It sounds to me as if you are wanting to increase his dose based on the PS. Please reconsider as basing dosing changes on a PS number could possibly cause your cat to become hypoglycemic. Also, neither protocol increases the dose in more than .25u increments at a time unless kitty is well over 300 for the nadir. Increasing in larger increments could cause you to bypass Phil's fitting dose.

It would help us help you if you could do a spreadsheet. Here is the link to set one up...it's fairly easy and provides us all with a way to look at his numbers in a manner which is most conducive to helping you: Spreadsheet

Once you have a Spreadsheet working, you may stay in the Health Forum for assistance or choose to move to one of the Lantus ISGs; you can follow the TR or SLGS protocol in the Lantus TR ISG or the SLGS protocol in the Lantus Relaxed ISG. You will find a warm welcome and a community of people who are devoted to their cats and just as interested in yours and who will generously share their knowledge with you.
 
julie & punkin said:
our goal is to get a cat out of high numbers - over 250 or so - as quickly as possible to prevent organ damage is done. damage is reversible if the situation is changed as quickly as possible. i don't have time to figure out what 250 is in world measurements, but i think you're describing fairly high numbers.
Click to expand...

I think he's around 420-50. In world measurements he's incredibly high 20+mmol when he should be a few units shy of 10. So yeah. Right now I'm trying to get him to respectful levels.

Btw, called my vet yesterday and said I'd up to 2.5 units instead of just 2 cause he's still in the 20s. (10 points from when first diagnosed) He's fairing very well on his new foods and has gotten rid of his semi-runny poopies ohmygod_smile with the diet change! Tonight I'm testing him again before he eats to see how he's fairing number-wise with the new dose.

I totally agreed with all of you on the *not re-using* needles issue. I was just sharing what my friend was doing. I would have no idea how her cat reacts to those shots. Her cat is much older than mine and has been diabetic for longer. From my understanding they don't regulate as tightly so I think it's penny-pinching and lazyness maybe.
 
I'm glad Philemon is doing better! If you can try to get one mid-cycle test (maybe 4-6 hours after his shot) it will give you a better idea of how low he is going. That may also encourage you (you may see a nice lower number!)

What food is he eating now?

Also, can you try to set up a spreadsheet! It will help you gather the info in one spot so we can see it.

Good job, keep up the good work!
 
the ss also is set up so that you can enter the world MMOL and we can see a ss in US numbers. if you need help with that, the tech forum people will give you a hand. it really is difficult to know what's going on without the ss. not to harp on it, but it's an essential tool for us. we all use one. you can click on the link in everyone's signature and see how they look.

when we look at tests on a spreadsheet we are looking at trends. we're not looking so much at individual numbers but what the cat's trends are. cats are notorious for "bouncing" which vets often call "rebound." that occurs when a cat has been in a particular range of numbers, then drops down into a new range. so for example, if your cat is accustomed to being in the 400's, a drop into the 300's can set off a bounce.

when the cat's liver senses a drop in numbers, it *thinks* that the cat is becoming hypoglycemic. it will let loose a flood of counter-regulatory hormones and stored sugars to save Philemon's life. that will cause the BG to go even higher. this phenomena eventually settles down as the cat's body gets used to lower numbers. but this is one reason that a spreadsheet is so helpful and why we don't go too much by a number here or there. if you take a reading and it's 400 we don't know if it's "real" or a bounce unless we can see it in context.

using lantus, it's really important not to increase a dose if the number reflects a bounce. all bounces will clear, and if the dose has been increased while the cat was bouncing, then the cat could be over-dosed and that creates a new problem.

lantus also needs to be adjusted by small increments and slowly. please believe me when i say that .25 is plenty of increase and will cause a change for the cat. especially while you are changing the food to reduce the carbs, increasing by .5u and not knowing if the high number is a bounce or not can really set up philemon for problems. i'm not trying to scare you, but that's the reality that we see here.
 
Ok so:

1- I will check his glucose tonight and start entering all my results into the spreadsheet
2- I will buy low-carb canned wet food tomorrow (Most of you seem to agree Fancy feast is a good choice) and start switching his perscribed vet food for it mixing it slowly in so he doesn't get stomach problems or wierd with the insulin.
3- I will not increase over what I've already been giving him the last 2 days (2.5 units) he seems to be doing fine with it, but the test tonight will reveal more.
4- Once I bring him back to the vet around the 20th of March, we are checking for Ketones in the urine and how he is doing all-in-all. I'll give my vet the spreadsheet and we'll be able to figure if he needs a dose change with the new wet-food canned diet.

Thank you very much for all the good advice. I'll be sure not to re-use any needles!
kittynow-1.jpg
Philemon says: Thank you all! We'll let you know if a few days how it's going!​
 
It sounds like you have a terrific plan in place!
Wish Philemon good luck on your plan.
What a handsome looking cat!
 
sounds like a great plan! i think you'll find those changes will help Philemon feel better!

as you are changing the food, be aware that his need for insulin may drop dramatically. make sure you continue to test his BG as you change the food.

a "low" number that requires intervention and carbs is anything below 50.

don't give a shot if he is under 200 at shot time - post here or on the Lantus forum and ask for advice. at least on the lantus forum we can give you an answer usually within a few minutes.

if he is below 100 at any point that you test, ask for advice as well. below 50 means you should give him a little bit of karo syrup, post immediately and ask for help. hypoglycemia can occur below 40ish. Don't wait for visual hypo symptoms, with lantus we often don't see the typical hypoglycemic symptoms until the cat is dangerously low. that's why we test.

those numbers apply to a regular human glucometer. if you are using an Alpha Trak meter (which is calibrated for animals) increase each of the numbers above by about 30 points higher.

if you are concerned about something you see with Philemon, just ask. many people post daily for help, to learn more and get support. you're welcome to do that.
 
Great news!
Philemon is now under 10mmol with 3.25-ish dose with his new food (fancy feast cans!). I had a scare once he was at 1.9 (which is a bit low...) So I gave him a bit of his old dry food as a snack in the evening I tested him at 6hours after his super.
He's been with it for the last 2 weeks and I think that's going to work out with this dose.
He's due for a vet visit and his K checked, along with some other things. This is 2 months after diagnosis. So the glucometre and all the tips I've received here have helped tremendously so far.

I've been cooking some boned chicken (obviously going to strip it from the bone... it's just less costly with the bone in! lol) to give him as a distraction-snack when I do his glucose testing. From what I've heard it should be ok and low-gluc snack for him to eat it.

Hurrah!

PS should I get a dietary supplement in his water or other... I don't like the idea of JUST feeding him canned food.
 
Glad to hear that he is responding well to the dose that you are giving!!! Under 10mmol/l...yay! :-D

You must be in Canada...me too :) I finally got used to reporting here in US numbers.

I think I was reading that your kitty has some neuropathy...our guy has that also and we've been giving him Amino B-plex (as given to us by our vet) liquid vitamin complex. There is another really good one that a few here have recommended...I'll try to get the name of it. It helps the nerves to heal and repair over time and also the B vitamins are super helpful for "cell metabolism", or in general terms, helping the body use energy.

I hear that Hills M/D is a diabetic perscribed canned food that is supposed to be pretty good. We tried a can, but found that it raised his blood sugars more than a lower carb cat food. Not by much, but a bit. Medi Cal Reducing did the same. (We now feed Friskies Mariners Catch, Whitefish and Tuna and Chicken pate, but want to switch to a better food soon, like wellness). Many people feed Wellness canned food, and we have tried a few cans...it's real food!!! You can actually see shrimp and fish!!! :o :o :o Some people here do raw...but I don't know enough about it to advise.

All the best to you!

T
 
i think the supplement you're looking for the neuropathy is methyl B-12. many people order Xobaline http://www.amazon.com/LifeLink-Xoba...MSPU/ref=sr_1_1?ie=UTF8&qid=1331963459&sr=8-1 for their kitties. i've heard people report that it is extremely successful at helping the cat get back to walking normally.

i'm glad you're continuing to test. just so you are aware, often as the same dose is used you'll see better and better BG numbers in the body, resulting in a need to decrease the dose. don't assume that one dose can stay the same - insulin is a hormone, not a "regular" drug. your testing is what will keep him safe! if you have changed him from dry food to low carb canned (the fancy feast classics) then his insulin needs may dramatically change. that 1.9 is getting close to dangerously low. i would encourage you to decrease his dose. if you were following either of our protocols, you would decrease the dose for that number.

the last time you posted was on march 3 and at that time he was getting 2.5 units. how did he get from 2.5units, which you said then was pretty good, to 3.25 units?

i would really encourage you to look at the link marje gave you for the SLGS approach and to follow it. if you have switched from dry food to all canned, there should be a dramatic decrease in his BG and the dose should be decreased, not increased. you've gotten explanations above about bouncing - if you aren't testing regularly, you may be seeing bouncing numbers, thinking those higher numbers indicate a need for more insulin when they do not, and increasing. increasing during a bounce can be dangerous. i'm just a little concerned. most cats (not all, but most) who are on all low carb canned food should need about 1 unit or less of insulin per shot. when you say 3.25u with an all-canned diet, my thought is either he's getting too much insulin or he has something else going on.

has he had his teeth cleaned? that is often a source of inflammation. if he hasn't, that would be something you could look into. if he has, there may be something else going on.
 
A couple of things that others haven't yet addressed:

We go with a philosophy of start low and go slow. Meaning start with a small dose 1 unit or less and after several days on this dose, if the BG's warrant, change the dose in .25 or .50 increments.

I'm wondering that you started at 2 units, it is very possible that you skipped his ideal dose. Considering you are new to this, would you consider starting over at 1 unit BID and see how that goes. You can always increase the dose and 2 units may become what is needed, but also may not.

Also, reusing syringes and lancets are not a good idea - not only can you contaminate the insulin with a reused syringe, but both the syringe and lancet dull after the first use and injection/insertion becomes more painful.
 
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