Anyone in my area?

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So, I took him in. The vet was very nice about answering my questions. She said when they tested him last week (urinalyses) his glucose was in the 1,000s. I asked about if they tested for Ketones, she said they don't usually test for ketones. Should I be concerned? And what do I do if he tested positive to ketones at home.
 
Sorry, I'm really puzzled here. You should see the puzzled frown on my face. ohmygod_smile

Urine glucose in the thousands? Are you sure? What was the exact value? and the exact test that was done?

What was the Blood Glucose test value done at the vet?

How was the urinalysis sample done? Free catch? Cytocentesis?
What did they use to test the urine? Urine dip stick? Lab test? Which lab? In house or Idexx or someone else?

The numbers you are giving us from the vet do not jibe with what you are getting with your BG testing, (316 BG yesterday) . Something smells fishy here, and it isn't the cat food.
 
I think you need a new vet. I cant believe they dont test for ketones. Thats just irresponsible. and you are right, if you see ketones its very very serious and I am not sure that vet will be able to handle it. So unless you find a better vet it looks like you will be on your own.. with us of course.

Wendy
 
Uh....Im confused now lol
Im pretty sure it wasnt on his own accord of peeing, since when I took him in he wasnt eating/drinking at all. She said a bit over 1,000. Which, if he wasnt eating I can see because of the high carb diet he has always had and fatty liver??
Not sure how they got the results, I think lab in house.
I did tell her I tested him last with the meter and he was 316. I also requested she test him with my meter as well as hers so I can know the difference between the numbers I am getting and she is getting.
 
And to further answer your question last night about poking techniques - I always poke from front to back (meaning the inside of ear) I never poked the back of Maui's ear. I have pierced her several times and did promise to get her a nice earring to put in the hole. :lol:

She told me to poke myself and wear the earring instead. So, I got another hole pierced and wear a special earring in her honor. :lol:

I'm surprised the vet did not ketone test. If the vet had a urine sample, then it's just a matter of dipping the stick in the urine and seeing what color it is. And if the vet only tested the bg level from a urine sample and not a blood sample, then that is not necessarily current information.

As you saw it can be hours before a cat pees and the sugar in urine can be several hours old, not current like with a blood test.

Did you leave the cat at the vet for the curve? If so, did the vet explain just how and where they will test the cat? Ear pricks, paw pricks, neck vein? There are some vets that will test using the neck veins which I think is painful and should only be a last resort if they can't get from ear.
 
Well of course eating dry food will cause very high levels. That is not surprising, which is why you started the Fancy Feast foods.

If you are leaving him there for the day, did you bring food with you and if not, please instruct the vet on what food they are allowed to feed him. Cause, they may just open any can and use it as well as put kibble in his cage. Both things you don't want done. Tell them what flavor/type of Fancy Feast they can use and if they don't have Fancy Feast ask what they have and we can help you decide which to have them use. Or better yet, give them 2 cans of what you want fed.
 
Yes I actually brought in two cans of my FF and told her to use that food. When I gave her my meter and asked for her to compare numbers, she did ask where I planned on pricking him and I told her the ears, so I assume that is where she will be doing it. She even offered to help show me the proper way and demonstrate for my boyfriend how to home test when I come to pick him up later, which I thought was nice.
 
When you have a chance, ask the vet how many diabetic cats she has treated and what methods did she use and what is her success rate for remission.

I have a feeling she is not as schooled in the knowledge/treatment of diabetes, which is fine, as long as she is willing to learn.
 
Yes I definitely plan on it, I have also called a vet my sister used to go to to ask about her experience with diabetic cats and ketone testing. I must say, I was expecting some kind of speech on how I shouldnt bother home testing or changing his food off of the DM but she came with no adversity to it. She was not the vet I had dealt with last week though, who initially took his temp., gave him an anti-biotic and took him again the next day when he sh- till wasnt eating.
But this one seemed nice enough -sigh- Well with all this reading I've been doing I am writing a few more questions down for her, and told her I'd have more when I came back lol
I just called actually and they said they use ProZinc. Good Bad?
 
The Prozinc is one of the top 3 insulins we recommend. Lantus, Levimir and Prozinc. Glad to hear it's not Vetsulin, Humulin N or Novolin N which work great in dogs but lousy in cats.

Lantus has a savings card program from the manufacturer. $25 for the first six prescriptions on the Lantus Solostar pen and some Target pharmacies sell the pens individually.

Levimir might have some savings programs also, but I don't know what they might be.

Don't know of any savings programs for Prozinc.

Would you please add one more tidbit to your user control panel for us? I'd like to see your location. User control panel, profile tab, edit profile, go down to location field and enter country, state/province, city or general area if you would please.
 
So when I give him his shots, test hom before he eats, then feed, the give shot check two hours later, check again around 3, check again for night shot, feed, shoot, bed check sound good?
 
KaySpiess said:
So when I give him his shots, test him before he eats, then feed, then give shot, check two hours later, check again around +3, check again before night shot, feed, shoot, bed check sound good?
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Yes that is a good basic testing plan. Only one variation. The +3 check could be a +4 or +5 on different days. Suggested test times depend on what insulin you are using. We don't know when the nadir or lowest point in the cycle is yet. So you need to mix up the test times a bit in the beginning until we get a better idea.

If the numbers are really low, <200, you want to retest in 30 minutes, without feeding.

Testing needs will change over time. Sometimes even day to day. Somedays that bed check test may be at +3 other days, it may be at +4 or +5.

p.s. Thanks for the location info.
 
That 200 shoot/no shoot threshold is a rule of thumb when you are starting out. That is the rule here on the Feline Health forum as you are learning. Over in Lantus TR forum the shoot/no shoot limit is 150.

With some insulins, you can go lower than that after some data collection. With some insulins, like the NPH types (Humulin, Novolin, Vetsulin) you would probably never want to give insulin at lower numbers, <200.

If the number is low, <200, you want to hold off on insulin and food, retest in 30 minutes and see if you have a rising number. You may have to repeat the testing over a couple of hours. Sometimes, you do not get a number that increases fast enough to give any insulin that cycle, and you need to skip the shot.

Three basic options.
1. Shoot - number is high enough to give the insulin.
2. Stall - hold the food and insulin and retest
3. Skip - numbers too low or other factors so do not give the insulin this cycle.

We take a lot of factors into consideration when we suggest to someone that they shoot low. What insulin are they using? what meter do they use for testing? do they have a hypo toolkit prepped and waiting? do they have plenty of test strips? HC (high carb) gravy type food? how are their home testing skills? will they be home to monitor for most of the day or do they need to go to work or elsewhere? what test data do they have to support shooting that low? when is nadir for this cat? what is the insulin duration in this cat? is this cat prone to ketones? ever had DKA? how new is this member?......................

We put a lot of thought into our recommendations as you can see.
 
Lol yes I do see. Well, I'll prolly be on here every time I get a number and do not know what to do and post it. It'll take a bit before Im comfortable doing this all on my own so thanks!
 
KaySpiess said:
Lol yes I do see. Well, I'll prolly be on here every time I get a number and do not know what to do and post it. It'll take a bit before Im comfortable doing this all on my own so thanks!
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You've only been here for a week, and have already learned so much. There is so much to learn in this sugardance. We try not to overwhelm but it's difficult. I equate this to a crash course, college masters degree level, in managing feline diabetes. It's hard!

Keep those questions coming. Ask for clarifications wherever and whenever needed.

Remember, take care of yourself too. Something fun you love to do, at least for a little bit every day.

Let us know what insulin you get. And any test numbers. Just to see how things are going.
 
You've made great progress. The next item would like is a spreadsheet (SS) to track the BG numbers, insulin dosages, food intake etc.

For those people home testing, we have a wonderful way to keep track of the test data and shots. There is a google spreadsheet template you can use so you don’t have to start from scratch and figure out what you want it to look like.

We have instructions on how to set one up. how to setup a SS and link to your signatureThe color coding is helpful to see trends over time in how the insulin is working. We even help set them up for people that may be technology challenged. Please ask if you need help.

Having a SS set up and linked to your signature is a great way to get some suggestions from the experienced people on FDMB. You can even share the spreadsheet with your vet, by email. It's totally optional but it can get you some great advice on how to manage your cat with his BG numbers.

What do you think? You can look at Wink's SS in my signature to see what one looks like. I found it invaluable.

If you are not able to do a spreadsheet set up right now, providing your data in this format would be helpful.

Date, pre-shot test, Units of insulin given, + hour since pre-shot given, BG number.
e.g. 6/1 AMPS 293 1U +1 289 +3 150 +6
PMPS 350 1U +2 340 +6 200
6/2 AMPS 400 1U +6 203
PMPS 189 0U +3 289 +6 458 +9 590
Click to expand...
 
Well I just got a call back from a vet I was looking into. And I think Im going to switch him over to her. She has a few diabetic patients, and some of her own cats are diabetic. A lot of her patients home-test, so she's familiar, and she also understands the risks of ketones and says she does it during a standard urinaylsis.
My only thought is, Bellos already at his GC and will I have to start this process over again? We've spent like 500$ in two days initially, and I have no idea how this curve is ganna cost ):
 
1) At a minimum, get copies of the lab tests which were run. If possible, get a copy of the medical record. You paid for them. There may be a token fee per page if your state law stipulates it. (Ohio's does.)

2) Provide your spreadsheet of home glucose tests, doses, and notes; you do not need to run a curve at the vet's where stress will elevate the numbers up to 180 mg/dL. Your home numbers are more representative.
 
Vet called, he's doing an extra GB test.
His glucose dropped from 318 last night I believe about 157 (was out didnt have a pen to write it down) So (:
 
get the vet to give you the details, exactly what time were the tests taken, when was food given, etc.

this is good, if he's at 157 - means the diet change is working and possibly may not need insulin

when do you bring him home and start monitoring at home?
 
He was given insulin today. Thats why it dropped, he's only getting one unit once a day. ): Im ganna monitor him, make sure he keeps being okay.
He said he's treated a lot of diabetic cats, he knows someone who home monitors, but the only time he's ever seen remission is with Lantus and the wet prescription food. And never for more than 6 months. -_- Im ganna stick to what Im doing, check his levels at the end of the day and in the morning.
 
and it is important to give insulin every 12 hours, not once a day. Cats metabolize faster than humans and need to get shots every 12 hours not 24.

and yes, Maui's been in remission (OTJ) for over 4 yrs now and still going strong. while remission can end, for many who continue to feed low carb canned and the cat is overall healthy, then remission can happen and can last the rest of the cat's life.

some cats have come out of remission, due to illness, dental issues, etc and can go back in remission once the issue is corrected.

so sorry, your vet is wrong, remission can and does last for more than 6 months.
 
ok cool. Now there are two tweaks I think you need to make which will help you know whats going on in terms of dose etc and to keep an eye on him

1 Spreadsheet - see Debs post above. It will help you, your vet, and us track trends and see how he is doing on a particular dose

2. tests -preshot tests are great to keep him safe - after all you dont want to shoot if he is too low (under 200 for newbies at first). But to know how well the dose is doing, or if he is going too low , you need to take a test mid cycle - so like 5-7 hours after the shot, and then one before bed (2-3hours after the evening shot)


let us know if you need help with the spreadsheet.

Wendy
 
Well Im not feeling too comfortable with this stuff.
Yesterday was his first in-home shot. And by 3 o'clock when I got home from babysitting, Matt said he wasnt eating and sleeping a lot. He was down to 60mg! I called the vet, rubbed karo on his gums and he started eating looking better.
The vet told me to drop him to .5 units a day. And she had the gall to tell me "It must be from the FF your feeding him, since your not giving him the prescription. Its hard to regulate on that." She is so rude trying to push this food on me, after spending almost 1,000 on him the past few days Im SO broke. The male vet who showed me how to do this said if I have to test him, test him after 12 hours to see how he's doing. Thank GOD I tested him this morning before I gave him the shot and went to work. He was 71mg this morning. If I would have blindly gave him his shot he would have went into hypo with no one around to notice. ):
 
thank goodness you tested him! it will be interesting to see where he is tonite. Can you set up the spreadsheet to see how things are trending?
 
Im having trouble with the SS -_- lol I have been writing it all down in a notebook though. I'll try and test him tonight. For some reason I can no longer get blood using the lancet pen to I have to free hand, and I always feel like Im sticking him too hard or something.
Something just doesnt feel right, Im leaning towards thinking he's fine. Isnt half a unit once a day really low? Is it even worth the risks....
 
well we typically recommend giving insulin twice a day, not once a day.

However, seeing that he is under 100 and being this new to the process, you don't want to give insulin at all if he is under 200. Being under 100 is way in the NORMAL range - yes NORMAL without insulin in system.

so it is very possible, that with the food change, getting over the illness he had that he may not be diabetic and may not need insulin at all.

this is a good thing if that is the case!

keep testing him and post the numbers here and hold off on giving any insulin at this point, since he is in normal BG levels.
 
Yeah, and I better get a damn refund for the insulin as I only used it once. If he is not diabetic, there ganna hear some **** from me for mis-diagnosing him. He could have been killed today!
Poor baby has a nice big red spot on his ear from this mornings poke ): I should get smaller needles if Im free-pricking him, just a bit too much blood than is really necessary. right now he is at 75mg.
 
75 is a lovely number! MY guess the vet will not refund the insulin, since it was used, even if only once. If it is not needed, then you can donate it or sell it on supply closet forum - sure there is a prozinc user who could use it.

and for now, just smile and be thankful that you tested and he is doing so well.....

since you are free handing the poke now, do you put something behind the ear to cushion the poke (other than your finger) ;) . you can wad up a tissue or fold a paper towel.
 
I have been putting something behind the ear. (: its just SO frustrating spending all that extra money and then finding out he's fine. -sigh-
How many consecutive days of low numbers should I have until I can safely say he's in the clear?
And thanks everyone for the help! Who knows what would have happened if I never did my own research and talked you all!
 
typically we say 14 days. if he stays below 120 and mostly under 100, then we say that the cat is OTJ or in remission (in your case - probably a transient diabetic - due to illness).

If this is the case for him, I suggest that you continue feeding him the low carb wet food, keep your testing kit, so you can test him whenever you want and keep in mind that you always need to be vigilant with his food and health to avoid him becoming a long term diabetic.

and if anytime in the future, you have questions (doesn't have to be diabetic related), you are part of this group now and always welcome to come here and ask questions. chances are someone here probably knows the answer.
 
Too early to tell if he was misdiagnosed. We need to see readings of 40-130 for 14 days before knowing for sure if he is in remission.

Can you get a test before and 1-2 hours after food and let us know?

Also I find something hard behind the ear like a pill bottle lid is easier for me to press against.
 
Ya tomorrow I will try to get it in. I feed him before work, and then 3:30 when I get home so I'll get a test in.
I gatta tell ya, the hardest part is the sticking He doesnt seem to mind tooo much, just shakes his head, I think it bothers me more than him lol
 
Ya tomorrow I will try to get it in. I feed him before work, and then 3:30 when I get home so I'll get a test in.
I gatta tell ya, the hardest part is the sticking He doesnt seem to mind tooo much, just shakes his head, I think it bothers me more than him lol
 
So the b/f fed him at 1 while I was at work so I was unable to get a before food test. I got home at 3:30 though and he was at 65mg.
 
It's only the pre-shot tests where we ask you to try to withhold food for 2 hours. Any other test during the day, we expect to be food influenced.

You can give him a little freeze dried or other pure protein treat to make him used to those tests. Soon, he'll be jumping up to his test spot, asking to be fed, just so he can get his treats. :lol: :lol: :lol: :lol:
 
Ya I'll have to get him some.
But he was 65 without any shot again today. This is his 2nd day without a shot and he's been in the normal range both days. (:
 
Deb & Wink said:
It's only the pre-shot tests where we ask you to try to withhold food for 2 hours. Any other test during the day, we expect to be food influenced.
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Deb, I think she was doing a Food Test per Wendy. ;-) If so, that's a great number! When was the last time you gave him a shot? Tuesday? Yay for 2 days no shot! Only 12 more to go!
 
We'll keep our fingers and 3 sets of paws crossed that this low BG trend continues.

As Wendy already said, 14 days of low numbers like that and we can consider him OTJ.

Yes, it's not technically pre-shot testing. It's the AMBG or PMBG and + hours numbers in between.
 
Here is what I would like to see for the 12 days - I would like you to test 2 times a day - once in the morning and once in the evening.

You pick the time and make sure they are different times each day and it's ok to test him after eating or before.

So, tomorrow let's say you test him before you leave for work and before you go to bed. Then the next day, test him when you wake up and an hour after he eats dinner.

Just get two random tests in each day, as I have feeling you are going to be quite happy with the numbers you see - WITHOUT insulin!

Easy, breezy, peasy!
 
All Rightttttttttttttttt on that 85, at the vet's even! :cool: :-D :cool: You must be so thrilled.

Vet Dr. Lisa Pierson has this nice article on feline obesity

I recently spent a year, getting my civie Monet down from 16.5 to 12 pounds. Portion control was the key for him.
 
I've been feeding him half cans at intervals. Once int he morning, lunchtime(when Im not working and if the bf is awake) at 3 after work and then again before bed. ^,^ Vet said to keep feeding him like this, and weigh him in 2 weeks and yes Im VERY happy (:
 
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