Adopting a senior diabetic kitty tomorrow- need advice.

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JudyD88

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I have had two diabetic cats. One is in remission but I lost the other one just recently. I decided I would adopt another senior. I spoke with his foster mother tonight. He is not in any kind of control. She has him on 10 units of Vetsulin q12 but says he tests at 300+ most times. It isn't clear to me if she tests him before every dose or how often she actually tests him. I intend to start him on Lantus. I will give him his first dose of Lantus 12 hours after his last dose of Vetsulin. My question is what dose of Lantus should I start him on?. There's no way I'm going to give him such a high dose but on the other hand if he really is that difficult to control should I chance starting him on 1u and SLGS? I am comfortable testing and intend to start him on LC food. I have never tested for ketones but will start if needed. Any advice you can give me would be very much appreciated thanks
 
Wow. Chuck is on 15 units BID but we switched over at 8 units with 7 months of data on ProZinc.
I would be tempted to start at 1 unit. With the diet change and different insulin it could be worth (dare I say it?) skipping a shot and doing a mini curve to see what his body is doing? I'm sure if I'm way off on this, others will let us know. (I hope so anyways!) So check in again for the other responses.
If you get him with enough time before his shot is due, testing in that time frame might give you a glimpse of what he is doing with the ten units.
Bless you for taking in another senior sugar kitty! :bighug:
Edited to add: I would definitely start testing for ketones right away.
 
Thanks for the advice. I'm going to pick him up around 4pm. I think I may do a mini curve till midnight to see what's going on.
 
I think it's great that you are adopting a senior sugar kitty :bighug:

I am not sure how it works when you switch type of insulin, am sure someone with experience will chime in. However if he is a High Dose kitty that is on 10U, not sure I would want to take him down to 1U, unless you are planning on TR. If he is on HC dry food, then switching food will have an effect on the amount of insulin required. I wish I had more experience to help :( You are at the right place for help :cat:
 
Without any data and if you're going to start transitioning him to a low carb diet, I think decreasing the dose is a good idea......but not all the way down to 1U....that's too much and if he needs a high dose, you'd lose a lot of time working him up

I think I'd start at something like 5U and test my ever-loving heart out to see what happens....We can always fast track him up if we have to, but that might be something to consider

Let's see what @Wendy&Neko thinks too
 
10u is a lot for Vetsulin. :eek: I am happy you're going to be testing him. (I don't have any wisdom for your Lantus starting dose... but as long as you're prepared for anything, you will be fine. :))

And bless you for adopting a senior diabetic :bighug: when i volunteered at the humane society for a few years, diabetes was one of those conditions that would lead to euthanasia because they didn't have the funds to control it. (Or any fosters I guess.) Its so nice to see them get their second chance to shine!
 
Chris & China said:
Let's see what @Wendy&Neko thinks too
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I am not sure what to say. My Neko started on Vetsulin (Caninsulin), got up to 5 units, then we switched to Lantus as 1 unit. Big mistake. Turns out she had two high dose conditions and we wasted a lot of time as she ended up at 8.75 units on Lantus. And I followed TR which allowed us to get to a good dose much faster. If the kitty you are getting really needs 10 units, it will take a long time to get there via SLGS.

On the other hand, we have seen kitties on high doses of insulin (on on 11 units of Levemir, another on 7 units of Vetsulin), that made the switch, including food change and were just plain overdosed before and the high carb food is what was keeping them alive.

We have no data on your kitty and he's transitioning food (which can make a huge difference). Are you able to monitor a lot the first few days? If so, I would try something like 3 units and monitor closely. If after 4-5 days he is still stuck in high numbers, we could try an accelerated method for increasing him - again provided you can test frequently.

You don't need to skip a shot as Vetsulin is an in and out insulin.
 
Thanks I appreciate your help as well as the quick responses and advice I have received over the last 12 hours. This is a great group! I tend to agree with you that he might very well wind up on a higher dose of Lantus than I am used to and I'm prepared to test him quite a bit to evaluate his response to the insulin and diet changes. My plan right now is to do a mini curve starting this afternoon when I bring them home, then give him a medium dose of 4 units that will be about 12 hours after his last insulin dose. I will continue to monitor him through the night to see how he does and going forward I will titer the Lantus doses and the LC food as indicated (with HC and Karo on hand) over the next week. I need some other advice. I have not monitored ketones in my cats to date. I am familiar with the test strips and will figure out the best way to get the specimens once I meet him. My questions are: 1)should I rely on urine or is blood recommended? 2)is there a BG range (or minimum value) when I should check ketones? 3) if positive what treatment is indicated eiher immediately or over a period of time.?
Any other advice is very welcome. I am so grateful for the ideas you have all offered!!
 
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First, God bless you for taking in this kitty. I have tremendous respect for anyone that takes on a senior FD cat like that. He is one very lucky kitty. I plan to do that eventually, but right now after several years of caring for 4-5 seniors, we are enjoying having kittens in the house again!

My condolences on your loss. It is so hard to lose a furbaby. :bighug:

Were your other diabetic cats on Lantus? I am just wondering how familiar you are with it. If they weren't, you'll need to read up on the depot insulins, as they are a lot different from the "in and out" insulins.

I agree about starting on a mid dose, like 3-4 units, and monitoring carefully. You didn't say what he's been eating, but if it wasn't LC, then you will need to be extra vigilant. We have had cases where just changing the food brought the kitty down FAST. We will be happy to help you in any way we can! Once you have him and know more about him, please add as much info as you have to your signature block (age, weight, food, other conditions, date of diagnosis if known, your location, kind of meter, etc.). If you need help setting up the spreadsheet, just ask. That will help us help you.

Here is a post we put together to help people new to Lantus & Levemir Land get acclimated: http://www.felinediabetes.com/FDMB/threads/updated-tips-for-new-members.173572/

Again, blessings on your for what you are doing! :bighug:
 
Ok so "Boy" is home. He was surrendered in November presumably because of the diabetes diagnosis. So I am assuming his name was actually Boy. I've decided to call him Sweet Boy. A bit of a pun I know but he really is sweet- he's very laid back. He came into this house with 4 other cats and three Golden Retrievers with very little reaction. ( though after I tested his BG I think that might be why) He seemed a bit overwhelmed but no hissing or hiding. First things first - tested BG at 6pm - it was 564!!!! (Advocate PetTest) He had received 10 units of Vetsulin at 7 am. So I gave him 5 units of Lantus and a small can (3.5 oz) of LC food. I am aware that Lantus is long acting. I intend to test him several times through the night realizing the effects of Lantus won't peak for around 8 hours. I will continue to offer him LC food periodically tonight. If he does have a sharp drop in BG anytime before the next dose at 6am I have both HC food and honey on hand. I have a dentist appointment in 30 minutes which should keep me out till 9 pm. I will stop on the way home and get ketone strips. Hoping he's not spilling but I fear he is. Looks like he has been out of control for months. Poor boy also has two nasty looking lumps on his mid back. They are swollen and irregular shaped (bumpy within the lumps), the skin is stretched and translucent and it could be pus or tissue that is visible under the skin. I am worried they may be mast cell or another type of tumor. Foster mom says they have been there since she's had him but size increased recently but slowly. Ok so that's the update to now. More later. Thanks for all your support and advice
 
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JudyD88 said:
I intend to test him several times through the night realizing the effects of Lantus won't peak for around 8 hours
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Usually (but not always) it takes 5-7 days to "build the depot" ....Lantus is a "depot" insulin, which (in simple terms) means that only part of each shot goes "to work" ....the rest goes into the "depot" and slowly dissipates back out into the body....that's one of the reasons it's so long acting and gentle.

But at first, you're "filling" the depot.....once it's full, it will release the amount that corresponds with the dose.

Another thing about Lantus.....it craves consistency, so you want to give the same dose both morning and night. The dose is based on how LOW it takes them, not the Pre-shot number (which is different from the faster, harsher insulins like Vetsulin)

Once we see some data on him, we'll be able to help guide you on his dose since this is all very new to both of you and he's been on such a high dose to start with. Read the "stickies" at the top of this forum....there's lots of information there (probably too much!) but it will help you know what questions you might need to ask as well as help explain how it works
 
Thank you for rescuing Sweet Boy! He is also Lucky Boy! We are all here to help. Had he been on dry food when with his foster mom? I hope that the lumps turn out to be nothing to worry about. What does the shelter vet say (I assume that he got shelter vet care when he was a foster)?
Welcome to you and Sweet Boy (I call my Rusty "Sweet Boy" too).
 
Sweet Boy had a great night. I got up and did his BG twice and by the morning he is 420. He is very happy on LC food and thankfully ketones are negative. I gave him 5 of Lantus at 9 this am. ( I needed to get him on a 9-9 schedule) Now the plan is to get a BG q2 hr till midnight and see how he is responding. My plan is to get a spreadsheet started (I've got all the data to date ready to enter) and let him chill and get comfortable in his new home. He's very good with my other cats but he's definitely a bit afraid of the dogs, I think just because there are 3 of them and they are big. They are not showing any interest in him. They were afraid of my last diabetic boy who was big, grumpy and downright mean to them. So actually Sweet Boy has nothing to worry about from them but he needs to come to that on his own. Thanks for your support. I will probably have questions about setting up the spread sheet once I read directions and get started. Stand by for future questions and updates!!
 
God bless you for adopting him, is a great thing you are doing.!! He's a really lucky cat.

If he´s been with those high numbers for a while and if you can it may be a good idea to get him a full check up specially his kidneys
 
Yes I will be taking him to the vet in a few weeks. I would like to get his BG under control and let him settle in here first unless of course he is obviously sick before then. I want to have the bumps on his back checked out. His foster mom reported that she believed he had gained weight with her though she had not had him weighed. I agree I think he is heavier than the 9.5 lbs he weighed in at last November but he is carrying a lot of weight in his belly. It's not distended and hard but does seem out of proportion to the rest of his body. Hoping this isn't being caused enlarged liver, spleen or thickened bowel - hopefully will get answers when vet examines him.
 
JudyD88 said:
I will probably have questions about setting up the spread sheet once I read directions and get started. Stand by for future questions and updates!!
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If you have any problems setting it up, feel free to send me a private message and I can set it up for you....it takes about 30 seconds once you've done it a few times so it's no bother at all. To send a private message just click on my name and choose "start conversation" so I can get some information from you
 
Hi Judy,

I was away all weekend and just wanted to check in on you and your Sweet Boy to see how it's going. I'm so glad he's home and seems to be coping well.

Great job getting your SS up and running! Do you have any of the data on his BGs while he was on Vetsulin? If so, it might be useful add those to the SS, with a line dividing and indicating when Lantus was started.

I've asked some of our members that have experience with high dose cats to take a look at your chart and comment.

 
Thanks for your feedback. I finally began to see some downward movement of Sweet Boy's glucose today. Now I have to get some sense of how to and went to titer his insulin doses. He settling in quite well at home. He seems to be tolerating the LC food without any difficulty and seem satisfied on a 3 1/2 ounce cans every 12 hours. I just updated the spreadsheet for today so I'd be glad for any kind of feedback
 
JudyD88 said:
I have had two diabetic cats. One is in remission but I lost the other one just recently. I decided I would adopt another senior. I spoke with his foster mother tonight. He is not in any kind of control. She has him on 10 units of Vetsulin q12 but says he tests at 300+ most times. It isn't clear to me if she tests him before every dose or how often she actually tests him. I intend to start him on Lantus. I will give him his first dose of Lantus 12 hours after his last dose of Vetsulin. My question is what dose of Lantus should I start him on?. There's no way I'm going to give him such a high dose but on the other hand if he really is that difficult to control should I chance starting him on 1u and SLGS? I am comfortable testing and intend to start him on LC food. I have never tested for ketones but will start if needed. Any advice you can give me would be very much appreciated thanks
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You are awesome! Bless your very sweet heart! :bighug:
 
JudyD88 said:
I just updated the spreadsheet for today so I'd be glad for any kind of feedback
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with that 172 at AMPS this morning, I think I'd hold the 5U dose a couple more cycles....but you also need to make sure you get at least a "before bed" test on the PM cycle.....Most cats go lower at night and without some testing on the PM cycle, he could drop too low and then bounce back high by morning and you'd think he needed more insulin when he may need less
 
Chris & China said:
with that 172 at AMPS this morning, I think I'd hold the 5U dose a couple more cycles....but you also need to make sure you get at least a "before bed" test on the PM cycle.....Most cats go lower at night and without some testing on the PM cycle, he could drop too low and then bounce back high by morning and you'd think he needed more insulin when he may need less
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I missed this last night. I will try to get a +5 or +6 tonight since the two this morning were in the 200s. Unfortunately the other boy I rescued last week (8 yo non diabetic) developed a URI yesterday and Sweet Boy's eyes are beginning to look a little drippy. Since he's 16 and diabetic if he turns a hair I will be taking to the vet. I just hate to get them involved in the management of the FD. I've yet to be satisfied with their approach. Fingers crossed
 
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JudyD88 said:
I just hate to get them involved in the management of the FD
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China hasn't seen the vet for her diabetes since we got the diagnosis.....Now of course her current vet knows she's diabetic, but when we have to go in for other reasons, I start the conversation by saying "She's on X units of Lantus and her blood glucose usually runs between Y and Z"......and that's usually the end of the conversation.....but if the vet has to put her 2 cents in, I nod, smile, say "I'll think about that" and come right back here to listen to the people who know what they're talking about!

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My vet asks to see his SS. Makes notes from it and since I have all his med/supplements on the med tab she just checks to see any changes. Then physical exam and blood draw and nails trimmed if he needs it. She calls with bloodwork results and we go over any issues. The vet or vet tech calls periodically in between check ups to check to him and make sure we are doing ok. I love my vet.
 
A lot of vets don't think people can handle taking the BG, and I don't think they realize how the numbers can fluctuate as much as they do, or they would always want people to check pre-shot and mid. My vet was cool about, a bit concerned at first that too many tests and concerned about getting blood from ear if over done. However I think I won her over on that part, she even complimented me on researching and finding a workable solution for Marvin :) ... We all love our kitties so much
 
LizzieInTexas said:
My vet asks to see his SS. Makes notes from it and since I have all his med/supplements on the med tab she just checks to see any changes. Then physical exam and blood draw and nails trimmed if he needs it. She calls with bloodwork results and we go over any issues. The vet or vet tech calls periodically in between check ups to check to him and make sure we are doing ok. I love my vet.
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Lizzie, you are making many of us green with envy!
 
After looking like we were making progress his last two BGs were =>500. Received 5 u q12 yesterday as usual (n fur shots) and ate well though an extra 2 ozs over previous daily intake. Drinking well but not copious amounts His nose is stuffy but he otherwise seems good. He's not due to eat and get insulin for another hour. But he certainly seems active and I expect he will eat fine unless the stuffy nose affects his interest in the food because he can't smell it. I'm inclined to think that if he has a URI that may be what is pushing the BG up right now. I will be getting him to the vet this afternoon. In the meantime I plan to stick with 5 u for next dose and test q3 hr the rest of the day. Does that sound reasonable? Advice welcome
 
Hi Judy!
I think it could be 3 things:
  1. He is bouncing from the 172 Tuesday morning. Bouncing can take 3-6 cycles to clear.
  2. He might have a URI so as we know, infections can keep BG higher.
  3. His dose is too high.
q3 is every 3 hours? Since he'll be going to the Vet today they might stay higher from stress anyways :oops:. I see you did a ketone test last Thursday, are you planning to get another one soon? I know I was recommended to test weekly (as best I can) :)

Hope Sweet Boy starts feeling better with the snufflies :cat:
 
Yong said:
Hi Judy!
I think it could be 3 things:
  1. He is bouncing from the 172 Tuesday morning. Bouncing can take 3-6 cycles to clear.
  2. He might have a URI so as we know, infections can keep BG higher.
  3. His dose is too high.
q3 is every 3 hours? Since he'll be going to the Vet today they might stay higher from stress anyways :oops:. I see you did a ketone test last Thursday, are you planning to get another one soon? I know I was recommended to test weekly (as best I can) :)

Hope Sweet Boy starts feeling better with the snufflies :cat:
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Yes I will test ketones today when I can catch him peeing! Good idea thanks

Yes q is "every"

I don't understand your comment that his dose may be too high?

Thanks
 
As someone who had a cat with two high dose conditions, I would disagree that Sweet Boy may be on too high a dose. It looks like he's bouncing from that 172 he got to the other day. Bounces can be delayed. The worst part of Neko's bounce was always three cycles after the cycle that had the "low to her" number in it. Sweet Boy may be the same. A URI also doesn't help the numbers. Sending healing vines (thoughts) your way. :bighug:
 
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