? Brand new - how to tell if lethargic or just normal lazy kitty?

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milolane

milolane

Member Since 2023
Hi there, brand new to this diagnosis. Pudge (12 yr M) got diagnosed with diabetes yesterday. I just gave him his first dose as prescribed by vet (2 units of glargine (guess that's lantus)/12 hrs). He weighs 12.75 lbs, was previously 15 lbs but has lost weight before we got him diagnosed. I'm very nervous about the whole thing haha, had a little break down at the vets but we're doing it haha. My glucose meter will be in sometime tomorrow, but vet told me to start the dosage anyways.

I'm planning on staying up all night to watch him for any signs of hypo. He's always been lazy and sleeps a lot (who would have guessed he would get diabetes haha). Just gave him his injection about an hour ago, now he's napping in his usual spot. Just concerned on how to tell difference between lethargy and having a lazy boy. Is there anything specific to look out for?

Thank you so much :)
 
some additional information - we (believe) we caught it pretty early. Noticed him using the litter box a lot more often (and going on rug which he's never done before) and drinking a ton of water on top of weight loss (though he was on a diet, I thought it was a great thing at first). He still has an incredible appetite, fed 30mins before injection and gave him a freeze dried chicken treat while we did the injection. Vet prescribed the purina DM food, we're working on switching it over but he's still also having some of the hills science diet senior dry food (he's pretty picky)

I had called my vet like 8 different times today asking different questions, they're closed right now and I'm panicking (just a little bit) so that's why I'm writing here haha. Once the meter comes in they said I could bring him back in and they'd show me how to use/about levels and monitoring, but to definitely start the first dose today.

Since writing, he has gotten up and had a drink and has gone to lay back down, didn't seem wobbly. Just concerned reading over other posts saying 2U is a lot to start out on!
 
A healthy (non lethargic) kitty should react to your pets and voice, maybe blink his eyes and roll over and go back to sleep. He would get up and come the kitchen when you open food.

A lethargic cat however doesn't react to your touch or to anything in his environment, not even that canned food you opened.

Here’s a good link to read and print out, it’s all about what to do with low numbers and the signs to watch for.
https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

I do want to talk a little about the starting dose and food.

The dose is higher than what we usually start kitties off on (0.5u - 1u) as you’ve read. Without testing I do worry that he might drop too low - I wouldn’t change the diet until you’re testing. Tagging at @Bron and Sheba (GA) for some dosing help, I think this dose should be reduced at least until you can start testing but probably best to continue with, as well. When you start higher you risk missing the perfect dose or worse a hypo. IF (big IF) there were ketones present at diagnosis or any history of ketones, please let us know, that will need to be considered into the advice given.

That said, once you’re testing, I would return that DM dry food and save some money - there’s nothing special about it. Both those hills food are too high in carb, yes even the DM. We recommend low carb wet foods - fancy feast or friskies pates are popular ones but again… please don’t make the switch just yet but think of it in the near future… the kibble atm might be keeping him from dropping too low.
 
The starting dose for Lantus is usually 0.5 to 1 unit as mentioned by Kim. If you are feeding dry food you could start at 1 unit. If you are feeding a wet diet I would start at 0.5 unit.
2 units is too high a dose to start with. I would reduce to either 0.5 or 1 unit depending on what he is eating as mentioned above.
I would also give him some snacks during the cycles to keep the BGs droppi
Keep asking questions...we are here all the time
 
Welcome to FDMB.

A few additional thoughts...

How was Pudge diagnosed? Did the vet get a fructosamine test? This is a blood test that provides an average of blood glucose (BG) over longer period of time than one time test from a glucometer. BG numbers can be artificially higher at the vet's office due to stress so a fructosamine test can be helpful for diagnostic purposes. It sounds like he has symptoms of diabetes so it's likely that the diagnosis is correct but stranger things have happened!

Were there any other medical issues present? Infections, inflammation, or pain can also cause BG levels to run higher than normal. Lethargy can be a symptom of diabetic ketoacidosis (DKA). Hopefully, the vet tested for this. You can also test for DKA at home. You can get Ketostix at any pharmacy. They are dipped into your cat's urine and you get a color-coded result. DKA can be dangerous so it's helpful to have a way to test if you're concerned.

I would encourage you to get a human glucometer. The pet-specific monitors (e.g., the AlphaTrack or other brands) are pricey. More specifically, the strips are very expensive. Many people here use the Walmart Relion brand meter. The AlphaTrack strips cost about $1 per strip. The Relion strips cost about $0.17 -- that's a huge out-of-pocket difference. You really do not need a pet meter! In addition, with the pet meters, you can't walk into a pharmacy and get strips. They are only available online. If you run out -- which always happens at the worst possible time -- you will need to get a human meter anyway as a back-up. All of our dosing information is based on human meters since that's what was available when FDMB was first started. With the dose of insulin you're giving, which is higher than what we typically suggest, I would encourage you to start testing.

Part of my encouraging testing, is that the lethargy may be related to too high of an insulin dose. At this point, you don't know. We're all about keeping your cat safe.
 
Hi all, thank you for your replies :) we made it through the night with no issues and he's actually been pretty perky this morning! My glucose meter is coming in today so I'll start testing as soon as I can, and also running to the store to pick up some tiki cat and fancy feast pate as described by the spreadsheet and other post I've seen. Hopefully he'll like them, we'll try to get him on an all wet diet as soon as possible. Going to work with vet to insure the dosage is right!

He was diagnosed based off a urine sample I collected while he was home and bloodwork they ran at the vets - I was pretty overwhelmed at the time so I can't remember what exactly they said the ran, I'll give a call and see if I can get actual numbers. I have urinalysis strips already at home (for humans), that test for ketones that test on s scale of 0.5 - 16 (40 sec.(mmol/l)), would those be usable for my cat?
 
Cats and people use the same urine test strips so you're good to go. Just make sure that they are not past the expiration date.

Just for your information, diagnosing diabetes by a urine test is not reliable. If they ran labs at the vet's office, there's no way to know exactly what they did unless you have a copy of the report. Most of us will ask for a copy of our kitty's labs. (I actually have my vet email me my cat's labs and I don't have a diabetic cat!) Once you have your spreadsheet set up, there's a tab on the spreadsheet where you can enter the lab values. It makes it much easier to track what's going on over time when it comes to your cat's health.
 
I would reduce the dose to 1 unit at least to make sure your cat is safe regardless of what your vet says. Most vets don’t know a lot about feline diabetes and are not the best at dosing correctly. If your vet didn’t do a fructosamine test, the diabetes diagnosis may not be accurate.

Can you tell us if you ordered a pet or human meter and which one?
 
Alrighty, sorry for taking a while to respond! I ordered the alphatrak3 because it's what the vet recommended, but I'll get a human one for back up like suggested (thank you!). We just did his first test which was 381 @ 3:40pm est. He had his insulin dose @ 9:30am this morning. So I guess it's good I'm not worrying about his levels being too low for now!! Going to test again before his next scheduled dose @ 9:30pm est unless you would suggest to do it more. It didn't seem to bother him at all, he's such a good boy :) I emailed my vet to see if they could send over the results they had there, haven't heard back yet. We also have his next appointment scheduled in a week

He also has a UTI which they gave us antibiotics for, they said that's pretty common since there's a lot of glucose in their urine before it's under management.

Thank you all so much!
 
I am lucky to currently be in a position where I'm not worried about costs of anything, just want what's best for Pudge (but without being ripped off of course), thank you all so much for your suggestions! I still have a ton of reading to do, so thankful to have found this site with so much info!
 
As Sienne said and we also don’t know what his prior numbers were. This could be a bounce from a low number yesterday or even overnight. Keep testing, especially if he doesn’t mind, yay!

We recommend before each shot and at least twice more. Once during the day at around +6 to try to catch his nadir, the lowest point the insulin takes him in a 12-hour period. And one more test before bedtime so you know how he’s going to do overnight. Did anyone post a link to our spreadsheet template for you yet? If you could set one up and start recording the numbers you get, that would be great and helpful when members give you advice. One note on the preshot tests, make sure he hasn’t had food for at least 2 hours before you those 2 tests to make sure the number you get is not food influenced.

Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.

With a diabetic cat you need

  • A low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs
  • A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
  • We recommend hometesting the blood glucose with a human meter…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.
 
Also meant to ask what food you’re feeding him right now?

FOOD CHART have a look on this chart and choose foods that are under 10%.

You will also need some higher carb foods for that hypo box..information in hypo link someone already posted for you.

This is an excellent site for diabetic cats…it has been around for more than 25 years and has very experienced people to help you.

Keep asking lots of questions!
 
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