Advice needed was New Member - Stewart is a sugar cat.

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Thurbers

Member Since 2013
Hi, my sweet Ginger tabby has a recent diagnosis of diabetes.
Here is the background: He is a seven year old sweet purry boy adopted from Bide a Wee when he was two. Mom has been unemployed, temporarily employed or part time employed for the last three years. So he and I aren't on the regular check up schedule. At his last vet visit before all this, his vet told me in no uncertain terms he needed to lose weight. Now, Stewart loves dry food. He is a kibble fiend. So he was on a dry food diet. Despite the cost I was buying him expensive no grain dry food, trying to find the one that he liked that worked best. I've probably been through them all. A few months ago I changed litter boxes, and found myself fixated on his litter habits. And realizing he peed like a race horse, so to speak. That started the "Is this normal?" exploration, and I determined that he could be flirting with high blood sugar. There weren't any other symptoms, but I started reading and determined that I had to change his diet just to be sure. So we began the 'you will eat wet food battle'. I bought a wide variety of low carb canned cat foods (thank you, Binky and Dr Lisa). And I cut back on his latest no grain dry food mixing the two.
For various reasons, we have now had to visit the vet. First blood reading was over 500. But I knew that one was abnormally high due to the circumstances (stress and sneak eating of stuff not so good for him in the amounts he ate it). I knew it would take a couple of days to work out. So went back then and new reading 350. No doubt he needed insulin. My doctor prescribed 2 u-100 units of glargine twice daily Stewart and I are on a new adventure of injections and ear pricks - things I'm not real adept at yet. I do feel I have gotten better on the injections (muscle injections and fur shots are hopefully in the past), I have a very hard time pricking him to get blood - he's actually very patient and thankfully loves having his ears petted, but does now jerk when he senses I have my second hand close. Most certainly a mom failure. :oops: He is now on wet food low carb fancy feast or nine lives with an occasional more expensive wet food (all 6 or under on the lists) with a few nuggets of dry Innova Evo as his insulin/test treat after I stopped mixing it into the wet food. (We have had only a couple of I'm only going to eat dry food, I'll go hungry show downs).
Unfortunately I also didn't take the best notes when I was reading up, and instead of NOT getting the trutrack glucose monitor, I got it. I managed to replace it with the arkray mini, using the link from this site, but the first week's readings are well probably about 80 points off (considering the comparison reading when I got my first arkray reading). The doctor had suggested one reading a day, 4 to 6 hours after his shot. And since I knew I was going to change monitors I stuck to that. And right now Stewart's numbers are ranging between 211 and 283 using the better monitor (it was 149 to 201 with the trutrack cat(2)_steam and even intellectually knowing it was probably off, I admit to hoping...). I'm currently trying to get a range of times with a couple of readings after every shot. Unfortunately yesterday was a no blood per prick day so my graph will probably be less then complete for awhile. I have to clean up my chart a little (add carb levels to the food, write them out), but both will be emailed to the vet in the morning.
I'm pretty sure we are going to have to up his dose somewhat, but I'll know better after tomorrow.

I just want to thank everyone here. Reading the posts and the information has been incredibly helpful. I'm sure I'll be asking for help and advice as this 'adventure' continues. Thank you all.
 
Re: New Member - Stewart is a sugar cat.

Welcome to FDMB!

Since you've ventured into blood glucose testing, here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers.
(May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
Re: New Member - Stewart is a sugar cat.

I will get some testing supplies for the urine and the ketones. And learn to do that as well.

Thank you.
 
Re: New Member - Stewart is a sugar cat.

Hello and welcome to the board,

It sounds like you are doing everything right.. How long has he been totally off dry food now?

The only thing I would recommend is you set up a spreadsheet to track your readings. It will help us advise you better and you to track how he is doing and you can even share with the vet, here's how but let us know if you need help with it.. http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

I usually recommend 4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but will be reduced over time.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

Let me know if you need spreadsheet help, I am looking forward to seeing it.
Wendy
 
He isn't entirely off dry food yet. I admit I'm using it as a bribe. I'm still looking for a low carb treat he likes as much, but I haven't been successful so far. I alternate between low carb treats and a dozen or so pieces of kibble (Innova Evo - ) as his treat following testing or shots.

And I'm not sure if kibble is even going to work now. Both last night's and this morning's shots were problematic. Last night as I injected the insulin, Stew jerked and gave a small pained cry. Read up, and decided to try a new location, as maybe he was tender or I just hit muscle. He didn't make it easy this morning. Finally found a spot on the saddle that tented in a manner that looked right to me. Inserted the needle, so far so good, pushed the plunger and he hissed at me. Stewart has never hissed at me. This is not good. I'm using short 3/8" 30 gauge needle syringes, and the insulin is out for twenty minutes waiting at least twenty minutes after he eats for a shot, so I don't think it is too cold or the syringe. AND I just don't know what I'm doing wrong. confused_cat He has to have his shot, he needs his insulin. But I don't want to hurt him either. :sad:
What should I be looking out for, what am I missing?
 
So sorry it took a while to reply.
Not swabbing alcohol, and I make up a fresh syringe for every shot. I'm going to just have to prepare as much as possible and calm myself for the next shot. I'll take my time and hope it was me giving him clues and upsetting him.
 
Its interesting though how he reacts to the insulin being injected and not the insertion of the needle. Lantus does sting but usually they only feel it in higher doses. If it continues to be an issue you might want to consider moving to Levemir instead since it doesnt sting.

Maybe before that you can get him used to it though - try a different area on his body - his flank or something - could be the current area is also sensitive.
 
Frog used to complain about his shot (as injected) until I started warming it between my fingers (or occasionally my lips if my hands were busy) before injecting. (his dose is low now so maybe I don't even need to keep doing it, but it only takes a few moments)

(eta ... Any chance he's just telling you he doesn't want the shot? Frog does that with me occasionally... and so far he's been right)
 
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