Balki - Newly Diagnosed

[JC & Balki]

This is actually my first time posting on any forum! Balki was diagnosed with diabetes on September 23rd. I feel incredibly overwhelmed, especially as Balki is very timid and I am worried how he will cope with all the stress. He spends a lot of time sleeping in difficult places, such as under beds, and it's quite traumatic for him when we constantly have to coax him out for tests, shots and vet visits. He has never had any health problems before, so all this sudden stress has been a massive shock to him. He has almost been to the vet more times in the last week, than in the past 11 years combined.

Balki has been prescribed the Lantus pen. Our vet initially did not want us to home test, and has become really annoyed with us in the last few days, concerned that we are endangering Balki. He says we are making this very difficult for him as we have gone against his advice on a couple of occasions. As a result, we are seriously stressed and confused about the best way to go - Start Low, or Tight Protocol? Any advice would be greatly appreciated.

Juliet & Balki

 

[Larry and Kitties]

Welcome. A couple of questions:
- You said you are using the Lantus pens. Aye attaching the pen needle to the pen and injecting that way? If you do you can only dose in one-unit increments. Very frequently cats require partial-unit increments. You can use a ordinary (1/3 CC capacity syringe with 1/2 unit marking) and draw out insulin and then inject with the syringe.
- Just how does you vet say you are endangering Balki? I test my five diabetic kitties at least once before each shot.

Most users here start at one unit twice daily and then adjust as necessary after about five days on a dose. Increases are usually in 1/2 or 1/4 unit increments.

 

[JC & Balki]

Thanks for the welcome and reply. Yes, we are attaching the needle to the pen and can only dose in one-unit increments. We were told the pen is much more accurate. We didn't realize we had the option to draw out the insulin and inject with syringe. We definitely want to have more dosage control, but don't want to anger our vet either.

With regards to endangering Balki, I think the vet is just worried we will cause him to go hypo. He just was not keen for us to home test, saying it wasn't necessary and it's better just to go slowly.

Thanks very much for your help.

 

[Hillary & Maui (GA)]

You are absolutely doing the right thing for Balki by home testing. Home testing is key to ensure you DON'T have a hypo episode. Think about it this way, if this were a human child, would any doctor tell you to inject insulin and not test? Why is it different because the patient is a cat and not human?

Regarding using syringes, if you can get U-100 syringes with 1/2 unit markings, this will give you the most control over dosing and the ability to adjust in micro increments.

What type of food are you using? Food is a key element in the management of diabetes. We recommend wet food (canned or raw) and getting low carb foods. There is a food chart viewtopic.php?f=14&t=115 (Janet & Binky's food chart).

We do have other Aussie members so I know you can find low carb canned products locally. They may have different names. You want foods that do not have gravy. As gravy is high carb. However, you do want to have some of these cans in your pantry, so if you do have a hypo situation or Balki's bg's goes very low, you can feed him the gravy foods to bring it up.

I don't want to overwhelm with too much information. I will leave you with this - you are doing the right thing by home testing! Remember that and besides, this is your cat, not the vet's and what will he do? Call the home testing police and have you arrested? (Sorry, just wanted to lighten the situation).

For what it's worth, my former vet forbade me from home testing Maui and went so far as to tell me that she would not treat my cat if I home tested. Needless to say, I have a different vet. And I just tested Maui this morning, for the heck of it, and she's at 59. An excellent number for a cat in remission and off insulin.

 

[squeem3]

Welcome :smile:

Here's an old thread with Australian low carb foods for your cat: http://www.felinediabetes.com/phorum5/read.php?8,1863468,1863592

There are Australian members here but I don't know how often they come by the board to post and read messages.

You can definitely use a U100 insulin syringe to get the insulin out of the SoloStar pen :thumbup Inserting the insulin syrigne needle into the rubber stopper at the end isn't any different than screwing a pen needle onto the end. Both still have to pierce the rubber stopper. Here's a thread about using insulin syringes with an insulin pen vs using a pen needle: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=48255

Here's basically what you do with an insulin pen:

Do not inject air into the pen. The pen is designed to work with negative pressure. There's more info on how to handle and use the insulin pen here: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=151

A cat can hypo if you are not testing the blood glucose level before giving the insulin injection. Blindly giving a cat insulin can be dangerious. You don't want to give any insulin if your diabetic cat has a normal blood glucose level. That would most likely result in a hypo and hypos can be very serious if not treated right away. Here's a list of common hypo symptoms and how to treat: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=1122 Items to keep in a readily accessible box at home to use for a hypo: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=2354

 

[Jennifer and Katie]

Welcome to the site!

I was one of the really nervous ones when it came to home testing. Now, I wouldn't have it any other way, and frankly, I am surprised more vets don't recommend it. Last night Katie's PMPS was 88. Now, imagine if I wasn't home testing and was still doing the vet prescribed 2 U. I would quite possibly have a dead cat on my hands. Home testing doesn't endanger them, quite the opposite. It can save their lives. If the vet is getting fed up with you not following his instructions, can you find a different vet?

 

[JC & Balki]

Hi,

Thanks so much for all your information! It's truly a relief to find such awesome, caring, knowledgeable people here to help. I am severely needle phobic, so this will be something I must overcome very fast. At the moment, another family member is doing the tests and injections whilst I hold Balki and keep him calm.

I agree, and there's definitely no way we would not home test. We started it the day after the vet tests were completed. I tried to do a spreadsheet, don't know if the link works. I will do whatever it takes to keep Balki as safe as possible.

Our vet is happier with us home testing now as he saw proof a few days ago that our results were reliable, so perhaps that's his main concern. He has been our vet since I was a child, and I have been very happy with the care he provides. He is the expert and I want to follow his advice as much as possible, but at the same time, I will make a different decision if that's what I feel is best for Balki. Basically, our vet is more annoyed with our interest in Tight Protocol, which he doesn't think is safe or necessary, and perhaps he is correct. We're just not sure what will give Balki the best chance of remission.

We will definitely look into the syringes for finer dosing today. I'm just sorry we didn't realize this was possible sooner. Thank you so much for the instructions and diagram.

I do have to say, I am still feeding a little dry food (Diabetic and Evo). Balki won't eat the proper nutritional canned food, and I also fear that his teeth and gums, which have remained healthy until now, would rapidly deteriorate if he didn't have a little dry. If there is no possibility of remission whilst feeding even a small amount of specific dry, then I guess I will have to reconsider. I just want to do the best thing for Balki. I have always given him some raw meat each day too, but he doesn't always eat that.

Though we do have a good variety of pet food in Australia, it's nothing compared to what you have! Many thanks for the link to Australian foods. I do have the ZiwiPeak food they mention, but Balki doesn't like that either. He is a very picky eater, which I don't doubt is my own fault. He does eat some Fancy Feast varieties. To make it worse, Balki prefers the canned food in gravy too, so altering his diet after all these years is not going to be fun.

So happy to hear your Maui is in remission. I so hope we can achieve that for Balki, it's definitely my goal and the only thing keeping me positive right now.

 

[Larry and Kitties]

The theory today is that unless the dry food is specially formulated to clean teeth (it has to be in big pieces and not fracture but instead stay together and clean the teeth as the teeth penetrate the chunks) it provide no teeth cleaning capability. If Balki will eat enough canned I would only feed canned, no dry.

 

[ohbell]

Welcome Balki & mommy bean,
Do you have fora flora? Perhaps he would eat the wet with some of that on it? And Parmesan cheese or tuna water is a goody for some kitties. My civvie Slappy is 15 and NEVER eaten wet food, is sooo picky too. When she decided not to eat at all and I had to dropper feed her, the only thing I could get in the dropper was prescription A/D or babyfood. NOW, this girl will NOT TOUCH anything other than A/D!!!! Very frustrating but at least the dry is finally gone. I will start trying the low carb that the other 2 are eating on even if I have to dropper feed again. She needs to switch so that my Sugar Bean does not sneaky sneak to her food, which is high carb!
My 2 girls, sugar Bean and civvie Lil Sista are in process of transitioning to raw. Just got the grinder Thursday and grinded about 2 lb of meat. The night I made it, they took right to it, now the next morning I served it up and they dont act that interested. But, I will continue to set it out with their other food. WE WILL DO THIS, it is just going to be a slow process.

Good luck w/ Balki and sooo glad you are home testing!