Another newbie....so confused

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ChrisRena

Member Since 2013
Hello, My name is Christi & my tuxedo girl, W.C. found out on April 18, 2013 that she is a diabetic. She is 11 yrs old and is overweight, which is slowly going dow, she's lost 1 1/2 lbs. since February. That's a slooow process. She also had a UTI, which he gave an injection of Convenia. Without goin all into detail, I wanted a holistic/homeopathic veterinarian here in the Atlanta area, plus it's bad when you have to teach them, shouldn't it be the other way around?
I found Dr. W. Made an appt. for April 25th,2013, had to drive a ways, but sometimes that's what you have to do. Her blood glucose was 449 mg/dL. She put her on a diet, which was only a slight decrease of what she was getting. She was already eatting Fancy Feast & the other vet talked me into getting Royal Canin dry for Diabetic cats. She gets only 1/4 cup daily, not all at one time. Dr. W. wanted to find a vet that was closer to me to act as a liaison, if you will, to get the insulin regulated and they were to show me how to home test. She also stated that she wanted Lantus to be the insulin to place her on. All of that was in her notes to them. Also the Convenia had done nothing for the UTI that the previous vet had administered.
Okay, we found a VCA practice, met Dr. T. on 4/27, 2013. He questioned the Lantus, but prescribed it anyway. One unit of Lantus twice a day at 12 hours a part. Gave me some Clavamox for the UTI, but was not about to show me how to home test. Scheduled a glucose curve for 5/03/2013. Her highest was 340 mg/dL. at pick-up time (5:00 p.m.) and the lowest was 291 mg/dL. at Noon. I really like one of the techs in there & I told her to talk to the vet about home testing, that if he wouldn't I would find somebody that would. It was ALL about my cat! So when I picked her up, he had agreed on the next visit to show me and of course he suggested the AlphaTrak. But he also wanted to up her insulin to two units twice daily. I was concerned with that.
I had been staying in touch with Dr. W via email, didn't hear from her til that following Monday & she seems okay with that, so we gave her two units Monday morning & evening. But Tuesday morning, 5/07/2013, I got to the vet as fast as I could since her eyes were looking different & she was acting sooo sleepy. Dr. T was off so Dr. R was the there. He said that that was too much. Her blood glucose was 275 mg/dL. w/o insulin that morning. Told us to go back to the one unit & made an appt. for May 16th, 2013 for a fructosamine test. He also opposed the Glargine insulin, said he would discuss with Dr. T about changing her insulin, had to tell him 3x that she had finished the Clavamox in which Dr. T had wanted her to be check for the UTI. There was a trace of the UTI so we got some more Clavamox. Excuse me...we're not changing her insulin, she's just today been on this insulin for 2 wks. She is not spayed, I know, I know, so all he wanted to discuss was spaying her, I'm like, can we get her Diabetic issues taken care of please! I don't particularly like this guy either. Why is it so hard to find a good vet?
I know I really watch her even more now and I'm trying to learn in between working. I have learned a lot from reading in my spare time, which isn't often, especially from the FDMB, but still confusing. It seemed that she was doin good when she first got on insulin, but now, she's started back to being hungry more often (I must say that she doesn't beg to anyone else but me, especially when I'm at work).
I am going to get a glucometer in the morning & probably go back to Dr. W. and let her be her ONLY vet, I know she'll show me how to home test. It just would've been nice to have a vet close by in case of an emergency (during daytime hours). We do have an emergency clinic tho.
Sorry to go on & on, it just worries me so. She's been with me since birth.
The Message from your cat-Dear Mom really helped, Thank You for that :-)

Christi & W.C.
 
Lantus is a good insulin for use in a cat. Lantus has a gradual onset, long duration two important points with any insulin for use in a cat. Recent research in the last 10 years shows Lantus as being one of the best insulins for use in cats. Even the Merck Vertirinary Manual recommends using Lantus( also called glargine) as the first choice for cats.

Levimir and PZI are also good insulins for a cat.

the other vet talked me into getting Royal Canin dry for Diabetic cats. She gets only 1/4 cup daily,
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We recommend wet/canned foods with less than 10% carb. The Friskies pate style and the Fancy Feast classic pates are good low cost choices for a diabetic cat. The Royal Canin DD dry is high in carbs, 38%. Not a good first choice to bring those blood glucose numbers down.

You were much better off feeding the Fancy Feast, as long as they are the pates.

Your cat must be starving on so little food. Unregulated diabetic cats can require up to 50% more calories than a normal or regulated cat. Without enough insulin, the food can not be processed properly and the cats body will pull resources from the muscle and fat layers. This accounts for some of the dramatic weight drop in diabetic cats.

Please feed more food, a low-carb canned is your best alternative.

This food chart lists most of the wet foods available in the US and some of the prescription diet foods are at the end. http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

The AAHA Diabetes Management Guidelines for Dogs and Cats, a vet journal published article from 2010, lists some good information about managing diabetes. Here is the link to the article: http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf
 
Thanks to you all for replying....
She eats almost 1/2 can fancy feast 3x daily...one before the 8:00 am insulin, at 2:00, & before the 8:00 pm insulin. Is that enough? I have been reading the labels & watching for the fat & fiber percentages, the ones that I get says crude fat (min) 2% & fiber (max) 1.5%
I am supposed to feed her before she gets the insulin right? These vets don't seem to know what they're doing around here.......
I have already seen on this site that Lantus is the best insulin...maybe I neeed to print & show these vets huh.....
So Royal Canin is NOT good! And this was what the first vet had suggested.......UNBELIEVABLE!
I would like to get her off of the dry food altogether, but have read not to do this when she's already started on insulin (not change anything).
Would it hurt her to replace the fry food with a small amount of baked chicken or rabbit (unseasoned)?
Gee. Wish that I had found you all before now......

Christi & W.C.
 
She eats almost 1/2 can fancy feast 3x daily
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How much does she weigh? Knowing this, we can calculate how many calories she should be getting.

Is that enough?
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Not sure yet. See request for her weight above.

I am supposed to feed her before she gets the insulin right?
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As long as she has a good appetite, the food can come after the insulin Lantus shot. This is not true for all insulin types. Lantus takes about 2-3 hours to onset. As long as she has eaten oh, 1/2 can of FF, she should be fine.

Is she a slow eater?

I would like to get her off of the dry food altogether, but have read not to do this when she's already started on insulin (not change anything).
Would it hurt her to replace the fry food with a small amount of baked chicken or rabbit (unseasoned)?
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any change from a higher carb food like the Royal Canin DD to a low carb food like the Fancy Feast pates or even to baked chicken or rabbit, requires a drop in the insulin dosage.

I would recommend that you are comfortable with home testing first before you do the diet change. A switch to a low carb food can drop the BG numbers by 100 points or more. Hypos are no fun to deal with.

Gee. Wish that I had found you all before now......
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You've found us now. Keep asking any questions you may have.
 
Welcome! You've definitely found the right place to be. :YMHUG:

It sounds like both vets are getting it half-right. Lantus is a fantastic insulin so ignore the vet that is doubting that. Convenia is not a good antibiotic to use for UTIs (it's more for skin conditions IIRC) and won't make any difference. Clavamox is great for UTIs... If it's actually an infection and not caused from crystals. If it's crystals, wet food mixed with extra water usually works wonders and it clears up in about a week.

As for food, I would return the dry and say your cat doesn't like it because there is no dry that is good for cats. There are a couple of dry food that are "okay" if the cat won't eat wet, but Royal Canin is not one of them. Check out the food lists linked above for some better options. :-D
 
Right now she weighs about 12.5 lbs. Seems to be staying in this area. Yes, she has a good appetite...she can always eat, she has always been that way. She eats normal...not slow nor fast, but if I'm a half hour late, she lets me know & is more interested in eating.
But she has been on a diet since February & has lost about 1 1/2 lbs since then. Sometimes she doesn't always eat all of her wet food.
I will not begin any diet change until I start the home testing and know what I'm doing, this is what I had already read. Thanks for verifying.
I have read about the glucometers on the catinfo.org website & others to compare accuracy & availability. From what I've read the Accucheck Aviva or the ReliOn Confirm or Micro are good.
It feels like nothing has been accomplished. I thought we were on our way, then he upped the insulin. Like we're right back where we started.
 
My vet recommended Wellness Core Original Formula when first diagnosed. It is a little pricey, BUT it is low carb, grain free, and protein based. My cats really liked it. (Their coats had a noticeable difference too- shiny and fuller) I have 1 sugar cat and 2 others, one of which is obese. My obese kitty did lose weight on the Wellness. After I got my sugar kitty straightened around, I slowly switched to all wet because I am so afraid of just a dry diet- or dry period (mold spores, bone meal, the rise in BG levels) I don't have a lot of info to help here, but my vet is wonderful and she knows what she is talking about and doing. You may try the wellness and ask around here how much to give. My kitties were getting a little under 1/4 of a cup 2 to 3 times a day and it was easy switching them to the Wellness. Was even easier once things were straightening out to switch them to FF pate or Friskies pate- not as high quality, or so I have heard, but they will all eat it and my sugar kitty has been in remission, hasn't had a high reading for almost a month. I bought the Relion Confirm and it works fabulously!!!!
 
Hi Christi,

It feels like nothing has been accomplished. I thought we were on our way, then he upped the insulin. Like we're right back where we started.
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You are not right back where you started.You have to remember that dealing with feline diabetes is a marathon, not a sprint. Your cat was only diagnosed on April 18th, only 24 days ago. That is not very long at all. This will take time.

Yes, cats need changes in their dose of insulin. Yes, the blood glucose (BG) numbers will go up and down, up and down. Yes, it will take time for you to learn to home test. Sometimes, we take baby steps forward, and teensy tiny steps back. Everything you are doing is another step to help your cat.

Three cheers for you for being willing to learn to home test. That is a wonderful step forward.

Here are two wonderful links about home testing.

This first link is the how to's with lots of tips and tricks. https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

This second link is how to make it easier for you and your cat, the psychology of testing. https://sites.google.com/site/michelangeloprofilefdmb/feline-diabetes/ear-testing-psychology
 
Food, let's talk more about the food in this post.

I see that your girl kitty W.C. has been on a weight loss plan and has successfully lost 1.5 pounds since February. Good job! It is good to have an overweight diabetic cat lose weight, because the extra pounds can contribute to insulin resistance. Obesity is considered to be one of the factors contributing to diabetes in cats. The weight loss is already one step forward in managing this sugardance.

Did your vet say what the ideal weight for W.C. should be? In other words, how much more weight does your vet recommend W.C. should lose?

One calorie calculation for food is (ideal weight * 15 calories) + 70. I'm using a slightly lower weight for the calculation than W.C.'s current weight, thinking she may be a little overweight still. So 12 pounds * 15 calories = 180 +70 = 250 calories a day.

One can of Fancy Feast pate is roughly 90 calories on average. So 90 calories per can * 1.5 cans = 135 calories from wet food. You did not say how much of the Royal Canin DD dry you are feeding?

Let me know and I'll calculate the calories for that, then add the wet and dry food calories together to see if the calories are enough.

She is 11 yrs old and is overweight, which is slowly going dow, she's lost 1 1/2 lbs. since February. That's a slooow process.
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You want the weight loss to be a slow process. A safe goal for weight loss is 1% to 2% weight loss a week. More than that and cats can lose muscle mass too quickly and have other issues. Dr. Lisa Pierson article on her catinfo.org website had this on Feline Obesity. http://www.catinfo.org/?link=felineobesity
 
Thank you for replying......this is really getting to me.....
Dr. W. suggested for her to be 11 lbs.
Right now W.C. gets 1/4 cup dry Royal Canin daily (1/16 (about 12 pieces) in the am, 1/16 at noon, 1/16 in the evening, & 1/16 at night---she use to be grazer, I took it away & just give her a few pieces at these times before she started the insulin, so I have been afraid to take it away). She's like an alarm clock, she knows the time to get her pieces.
Question: Is the frequency of her being hungry caused from the diabetes, the insulin, or just her just begging me? She doesn't do that when I'm at work & my deskclerk watches her. And does that mean the BG is high (this is what got my attention to get her to the vet in the beginning).
Question: When after you give the insulin, does it make them sleepy (since thats what they all do), or is it because she's just ate, or is it because its not the correct insulin dosage (don't know if you read about the vet upping her insulin from 1 unit to 2 units), or am I over reacting?
Is anyone on this FDMB in the Metro Atlanta, Georgia area or surrounding counties?
 
I think Georgia and Simon are in Atlanta. I sent her a private message. They use Lantus.

You can get low carb treats and sub during the day for the dry. My guys like Bonito flakes and PureBites. The hunger may be a combination of things - attention needed could be part of it. But when unregulated, the insulin is not being used well by their body so she may actually be hungry. We generally say feed a little more when first diagnosed.

The sleepiness could be just being a cat or be too much insulin and low numbers. The best way to find out is to test.
 
Thanks for sending them a message.....
So it would be okay for me to substitute with PureBites?
Goin to get a glucometer.....time to get it rollin.....can't wait on these vets anymore (one is wanting to do a fructosamine test Thursday).
 
PureBites are a low carb snack - would be a great substitute. There are more in the info below. Here's a shopping list for hometesting:

A human glucometer. Any one that sips and takes a tiny sample is fine. Some members stay away from any meter with True in the name and the Freestyle meters. Some people think they are unreliable and read lower than other meters. The meters are often free at drug stores; it’s the strips that are expensive. You can, however, buy them on ebay at less than half the price of stores. Lots of people here also like the ReliOn from Walmart. It is an inexpensive meter and its strips are the cheapest around. Try the meter out on yourself or someone else before you try it on your cat. You want to be familiar with it before you poke the cat.

Lancets and a lancet device. Usually, until the ears “learn” to bleed, a 26-28 gauge is good. Any brand will work as long as the lancets match your device.

Ketone strips. (Ketostix) Just like human diabetics use. You will sometimes need to test urine if the numbers are high.

Rice sack. Make this out of thinnish sock, filled with raw rice or oatmeal and then knotted. You heat this in the microwave until very warm but not hot. Then heat the ears before poking. You can also use a prescription bottle filled with very warm water. It provides a good surface to poke against.

Also nice to have. Flashlight: so you can look at the ears and find the little capillaries that come off the vein running down the ear. Vaseline: Put a tiny smear where you want to poke. It will help the blood bead up.

And some lo carb treats to give your kitty, successful test or not Lo carb treats

How to get the cat ready for home testing

First pick a place where you want to test. Some people use the kitchen counter, a blanket on the floor, between your legs while sitting – whatever works for you. Take the kitty there and give him/her lots of praise while you play with his/her ears. Give a treat and release. Next time, add the rice sack (thin sock filled with raw rice, heated in the microwave until very warm but not hot) or a prescription pill bottle filled with very warm water. Lots of praise, treat and release. Finally add the lancet so he/she will get used to the noise. The hope is that when you finally poke, they will be used to the process and know a treat is coming!
 
One calorie calculation for food is (ideal weight * 15 calories) + 70. I'm using a slightly lower weight for the calculation than W.C.'s current weight, thinking she may be a little overweight still. So 12 pounds * 15 calories = 180 +70 = 250 calories a day. One can of Fancy Feast pate is roughly 90 calories on average. So 90 calories per can * 1.5 cans = 135 calories from wet food. You did not say how much of the Royal Canin DD dry you are feeding? Let me know and I'll calculate the calories for that, then add the wet and dry food calories together to see if the calories are enough.
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Recalculating from this morning. 11 pounds (ideal weight per your vet) So (11 * 15 calories) +70 = 235 calories.

The Royal Canin Diabetic DS 44 has 239 calories per cup. 239/4 = 59.75 calories per 1/4 cup (let's round it down to 59)

Adding the wet food 135 calories + the dry food 59 calories = 194 calories is roughly what W.C. is eating now.

Unregulated diabetic cats are nearly always so hungry and may need up to 50% more than a normal cat. If you added another 1/2 can of Fancy Feast a day, that would be another 45 calories. 194 + 45 = 239 calories, bringing her food intake up to what it should be to maintain her weight.

Question: Is the frequency of her being hungry caused from the diabetes, the insulin, or just her just begging me?
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Probably a combination of the diabetes and her begging for attention. Diabetic cats can not process the food they eat without enough insulin. That makes them very hungry. In my opinion, you could add another 1/2 can of Fancy Feast to the diet and still get her to lose weight, slowly but safely.

Do you have a scale so you can get a rough idea of how much she weighs each week? Stand on a scale while holding her, note weight, let her down, note weight, subtract the difference to get her weight.
 
Christi,
I got Sue's PM and am happy to help you. Where in Atlanta do you live? I can definitely help you with hometesting and also finding a vet that may be in your area. My cat, Simon, was diagnosed about 2 1/2 years ago, and without FDMB, Simon would have most likely hypo'd because of the large amount of insulin Simon's former vet put him on. Without hometesting, I would never have known that Simon's BG had gone so low.

You are getting some excellent advice here. I know it is all very overwhelming at first, but with all of our help, you will be able to take good care of your kitty.
 
Praise the LORD! I need it....I live in Fairburn....that would absolutely be wonderful to find a vet that knows what he/she is doing. I have learned more from the FDMB than any of the vets. What area in Georgia are you? I just got the ReliOn Micro glucometer. Thank you for responding.

Christi & W.C.
 
Hello there
As soon as you can get home testing the better, removing the dry food should reduce her blood glucose levels but also so will treating the UTI so you could see a change in BG and a need for less insulin very soon..

The relion micro is a good meter - let us know how you get on with testing - some cats can be a challenge at first

Wendy
 
Hello everybody....Update on White Chin.....
We already started the routine you all explained to me about the home testing, putting her in one place, talking to her, rubbing her ears, then give her a treat. Did that twice. Third time, it went well, just couldn't get the blood to surface, but she did excellent, I was proud of her.
She had the fructosamine test today.....don't really understand the numbers yet, hoping you all can help. The vet said it was good...359 (supposed to be in the "good" category, 400-350 is in the Good category, 350-300 is in the Excellent category) ?????? And this is over a 2- 3 week time span, I think.
Her BG was 256 this morning, (tech showed us how to do it, I didn't let them know we were one step ahead of em') took my glucometer to compare, mine said 252, so that was good to know that the numbers were close.
Yes, I have scales, she stays in the 12.1 - 12.5 range.
I took some of your advice & have added a small amount of food to each feeding.
She seems to be doing better since yesterday....let's hope that continues....
Thank YOU ALL for your Help....

Christi & W.C.
 
Congrats for us......W.C.'s first BG home test......162 mg/dl.....before given insulin......
I will need to find out her BG #'s 1/2 way between injections which are at 8:00 am & 8:00 pm, right?
I only have the BG curve that was done on May 3,2013.
Yes, a spreadsheet would be good.....I'll begin working on that this weekend.....may need some help :-)
 
Slow to get the spreadsheet up, but have been home testing...did a small curve on 5/20/13 before insulin at 8:00 am was 349 mg/dL at 1:00 pm before food was 183 mg/dL then before insulin at 8:00pm was 251 mg/dl.
I have slowly been taking dry food away, so far a couple of feeding times, replacing with PureBites treats, this morning before insulin was 223 mg/dL and just now before insulin it is 192 mg/dl...She should still continue getting the one unit of Lantus correct?
 
Since you're fairly new at this, I would wait and test her again in 15 minutes to a half hour to see if the number is rising and if she's over 200 yet.
 
Thank you for responding so quickly, just re-tested, it is 208 mb/dL. Is 200 mg/dL or above the number that I should be looking for before giving the insulin?
 
Yep! :thumbup We suggest all new members to not shoot if under 200 since 200 has proven to be a "safe" number to shoot at for most cats. Eventually, you'll want to work your way down into shooting lower numbers, but that's a bit farther down the line. For now, as long as she's over 200 at shot time, you should feel comfortable with giving her a shot.

I would also suggest getting a +2 test since this sounds like it might be the lowest you've shot her before and it's a good idea to see how she does the first time.
 
Dd you get another test in at +2.?

I think you really need that spreadsheet.. It will help you and us be ready for when you need to start shooting at lower numbers..
 
Okay....I started the SS but now I can't add to it...I'm sure i checked the auto republish...
Any suggestions?
 
Great! Nice lowish PMPS too, can you get a mid night time test tonite? Like a +4? I am feeling green or at least blue vibes...
 
I'm gonna try my best...you can actually see the difference after I have started taking the dry food away. I don't think she minds......
 
No need to be scared. Do you have extra strips, syrup and a high carb food with gravy in the house? Put an emergency vets info on your fridge. Then you are prepared for most issues!

Generally I would always get a preshot, a mid cycle (day) test and a before bed test. That gives you an idea of what's going on, especially the before bed test as it tells you what the nighttime plans are. However we also need to work on filling up those blank spaces so you know generally how he trends etc.. Hence tonites test. If you can I would also get a before bed test and you can see what his nighttime plans are. ..what time is bed compared to his nighttime shot time?

Wendy
 
Yes....Just bought some more strips...syrup on counter & food w/gravy...ER# in cell.
How fast does the food enriched gravy get BG back up?
Let me make sure I've got this right....PS must be at least 200 mg/dL? If not feed, test 15-30 minutes right? Same goes for the + 4 (which will be 12:00 midnite), I should give a treat to raise it or how low should go?
 
Great! One teaspoon of the gravy food works pretty fast, it brings them up quick. The syrup even quicker. I woke up one morning and found bailey comatose on a stair. He was at 16. I rubbed syrup on his gums and he was on his feet in a couple of minutes and back to normal and at 68 within 15minutes. So it works great if you need it. And bailey was totally fine.

Anyway yes, as a newbie you don't want to shoot under 200, you wait and don't feed and retest in 30mins. Meanwhile you come on here and ask advice. Over time, and with more data, you reduce your no shoot number until you are routinely shooting anywhere down to about 50! Here is a primer on shooting low and what to do when you get a low number http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

Tonite at +4 i would post on the tight regulation board if he is low to get help using a 911 icon if you are worried as there are usually members around. But hopefully and probably you won't need to. If he is very low ie under 50, I would give 1-2tsp of high carb while you wait and test again in 30mins. http://felinediabetes.com/FDMB/viewforum.php?f=9

Where are we right now? How many hours since his shot?
 
Are you EST? I am here so I will keep an eye and see how he is at +4 but why don't you get a test in now? We can see where he is going now.
 
Ok cool, the drop isn't too steep.personally I would go to bed and set the alarm for 3am or 4am to see if he goes lower, and how low.

Wendy
 
Welcome to the Vampire Club & FDMB!

Some reference numbers:

< 40 mg/dL
- at any time = HYPO: follow hypo protocol

40 - 50 mg/dL
- at nadir, dose reduction for new diabetics (roughly < 1 year)
- well before nadir, steer numbers with food to prevent hypo. This means to give 1-2 teaspoons of food every 15-20 minutes and test to check how the glucose levels are doing. Done to keep the numbers from dropping into a hypo.

50 - 130 mg /dL levels between shots
- on insulin, very well regulated
- not on isulin, normal

200/240/280 mg/dL
- depending on source, the renal threshold where glucose starts spilling into the urine and levels may be damaging organs in the body
- test for ketones, especially if not eating or if infection present
 
Thank you for the numbers info....
Looks like she's slowly coming down, I hope not too fast....
Still so much to learn it seems like....
 
Its a process, not an event!

My signature link on Learning Tips might be helpful. Picked that up during school and found it useful when doing lots of reading.


By the way, if this thread hits more than 50 posts, it'll go to a new page. There's a "Next" button on the lower right to get to it, as well as page numbers to click on if that happens.
 
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