Brand new member, brand new diagnosis

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Sarah & O'Malley(GA)

Member Since 2012
My 8 year old male, 12.6 lbs, was diagnosed today. I'm really scared, not sure what to do. Already picked his insulin up, but it is the kind everyone says not to use, even though the vet prescribed it. Any advice?
 
Welcome! Does it help to know we were all completely overwhelmed when we first signed into this forum? And we all survived and so did our kitties!

What kind of insulin is it? Where are you - in the US/Canada or overseas? (Options for insulin depend on location) How was your kitty diagnosed - frutosamine test or just blood test in the vet's office? What has he been eating?

Advice: Start on the Board Index page and do lots of reading. I copied off everything so I could read and reread. Read Health Links: http://www.felinediabetes.com/FDMB/viewforum.php?f=14 Read about nutrition here: www. catinfo.org and this: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=33671

Ask lots of questions. We would love to help you help your kitty.
 
The blood tests were the diagnostic tools, and the insulin, and this seems like so much, she prescribed him Humulin N, 4 units to start off with. His reaction to his first shot was scary. He just laid there and acted so tired. I am still watching him.
 
Four units is a lot of insulin, and particularly with a harsh insulin like Humulin. How long ago was the shot? Is he acting disoriented or strange in any way? Is he sleeping? Can you sure wake him up?

I don't want to frighten you, but giving that large dose of a harsh insulin is irresponsible of your vet. We suggest staring at half a unit to one unit twice daily.

We test our cats at home to be sure it is safe to give the dose we are planning on. We use mild, long lasting insulins like Lantus, Levemir or ProZinc. Can we help you find a vet who might know more about feline diabetes?
 
Unfortunately I can't afford the more expensive insulin. The shot was about an hour ago, and he is sleeping, but I went in and woke him and he gave me kisses. I guess his blood glucose was like 520 or something. I asked the vet if she has a lot of experience in feline diabetes, and she said yes. How long would it take for him to go hypo if he was going to? I can't afford a test kit for him, either, as I am recently unemployed.
 
Hi - what is your name?

I live in Walled Lake and work in Plymouth. I'm kind of familiar with Westland because my grandparents lived there for years.

My husband and I have been treating diabetic cats since 2006 -- after our first guy Norton died from cancer, we adopted another diabetic cat Tiggy. We have used Humulin N in the past, and now use Levemir. We just bought a pack recently and could give you a cartridge - with careful handling and refrigeration, it should last about 4 months.

We could show you how to test your kitty's blood sugar at home and give you a meter and some test strips to get you started. We always keep a couple spare meters on hand especially to help out newly diagnosed kitties and their "beans" (human beings).

4 units is way too much for a starting dose -- it is safer to start at 1 unit every 12 hours.

My husband Charlie might be able to meet you on Wednesday -- I'm working M-F. I'll send you a Private Message with my phone number.

Hang in there!
Phoebe & Charlie, Tiggy, Norton (GA)
 
Sue, can you cover diet recommendations?

Charlie will arrange to meet Sarah tomorrow to demo testing -- we have Levemir, a test kit and lancets, and can take a few cans of low carb Fancy Feast. We're low on test strips so I just ordered more (we love the Maxima AST meter with the down-side of having to mail order the test strips). We can give Sarah some more test strips on ~Friday. We also have a good supply of syringes at this time.

Also - we don't use a rice sock to warm Tiggy's ear before pricking it. Some people believe in it -- (dry rice in the toe of a sock - microwave for a few seconds to get it warm -- to help the blood flow).

I need to head for bed now --
 
Thank you so much, Phoebe. This is wonderful news! Once Charlie shows you how to hometest, you can keep your sweet kitty safe. And Levemir is a wonderful insulin.

Re diet. This thread has all the links you need:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=115

The catinfo site has great ideas for transitioning from dry food to wet. On the food charts, we feed foods below 8% carbs. Lots of people feed Friskies or Special Kitty from Walmart if money is an issue.

You might spend some time with your kitty tonight messing with his ears and even heating them up. Some people use the rice sack; others use a prescription bottle filled with very warm water. Getting him used to the process will make the testing easier.

Please post tomorrow to let us know how things are going!
 
Sarah, I also live in MI but further away than Phoebe. I'm so glad her hubby is going to meet you tomorrow and get you started. Please, do not give him 4 units of that insulin tomorrow morning. That is such a high starting dose for any insulin. I would like to know how long the cats your vet has treated previously have lived once they were diagnosed. Thank God you found this board and that Phoebe and Charlie will be able to meet you tomorrow and give you all the help you need.
 
Excellent point -- asking your vet what the life expectancy of the diabetic cats that he (or she) treats...

this can be very telling --- one vet said his diabetic cat patients go blind and pass away within 6 months of diagnosis --- and he was one that started cats off at a very high dose of insulin.

Tiggy - adopted in 2009 - has been diabetic for 9 years -- and he is healthy and active on a low carbohydrate canned food diet and a tiny dose (0.5u) of Levemir insulin twice per day.
 
This place is so awesome :-D

Sarah, I am so happy you found this board when you did. You are in "good hands".

Carl
 
You all are O'Malley's Angels!!!!! I'm never going to give him 4 U's of any insulin, ever again, and I am switching veterinarians. As soon as he recovered from last night's 4 Unit shot, he woke me up this morning, asked for breakfast, and ate like normal O'Malley!!! I can't believe that an "experienced" vet, as she says she is, would prescribe him that much!!! cat(2)_steam
 
Unfortunately, many vets really do not know much about proper treatment of diabetes. So, it is not surprising that your vet prescribed an inappropriate insulin and a huge dose. The vet may have based the dose on the bg level from a test taken in the vet's office and/or based on weight.

Either way, it's a huge starting dose regardless and not a safe one, especially if the vet didn't discuss the importance of home testing - again, another thing many don't do.

Sounds like you are now in good hands and will have this under control in no time.
 
O'Malley was fine overnight,and I reduced his shot from 1U to .5 U. Unfortunately when he tested at 74, that was my last test strip. His numbers for yesterday Aug 22 were as follows

330, 1U
+1, 310
+3, 230
+9, 74
+ 11, 88, .5 U
 
Sarah,

Because new diabetics have no history of doses/reactions, we tell them not to shoot under 200, but to wait 20 minutes without eating (which can raise the number so it isn't "true") and retest to make sure the number is rising and over 200. Going forward this would be the best approach until you know how he reacts to lower numbers.

You were going to get strips today, right? Please post here on Health before each shot for advice until you get the hang of this sugar dance. O'Malley is giving you some nice low numbers and we want him to be safe and not go dangerously low. The Levemir forum is just not very busy so posting here is probably wisest for awhile.

For reference, a regulated cat ranges from the 200s at preshot to below 100s at midcycle, but not under 40 - which is approaching a number too low. A cat in remission, off insulin, ranges from 40-120.
 
Yes, Ma'am, I have the new strips on order already, but unfortunately they will take a couple days until they get here. Should I postpone the shots until I get the strips to test him? He's seems fine now, sitting by the door stalking a bird outside, but I will continue to watch him.
 
Hi, O'Malley's Grandma here. Thank you all for the help you are giving Sarah with O'Malley's new diagnosis. O'Malley is my favorite grandcat, and I can't stand the possibility of something happening to him. You have all been doing so well at guiding Sarah through this! I'm sure she will get the hang of it in no time, and this is good for me, too, as whenever Sarah come down to visit me, O'Malley is always in tow!!!
 
It's a bit of a crap shoot to give insulin without knowing the number - but you don't want him going really high either. Maybe give a token dose of .25u?

Did you change his diet to low carb food after you talked to Charlie? That will also lower the BG - that together with even a short course of insulin could get him into remission - so this is a time for caution with the insulin. Another thing we used to see was cats given overdoses of insulin Rx'd by the vet to start too high, which caused a very low BG (hypo with or without symptoms) and that seemed to reboot the pancreas (together with the diet change). Getting your strips is important right now so you can find out just what is going on.

FWIW, my Beau was started at too high a dose of a fast acting insulin (2u) and raised from there to 7u (!!!) by the vets. But he was also still eating dry food so that probably saved his life daily. Once I started testing and changed his diet his dose and numbers came down pretty fast.
 
Yes, I changed him to a low carb food, and just in the last couple days I have seen him slowly getting back to normal O'Malley, he seems to have more energy now, asks me to play with him, and is a lot more sociable :-D . I will continue to monitor his progress and post his numbers on here daily until I am positive that I know what I'm doing. I deeply appreciate all of everyone's help!!! :mrgreen: cat_pet_icon
 
when I was putting together the care package, I realized that we were nearly out of test strips - no spares, so I placed an order Tuesday night. They arrived Thursday, and Charlie took 100 strips to Sarah and O'Malley yesterday.
 
It's good that you put together O'Malley's numbers, Sarah. That document must be downloaded on people's computers and many are unwilling to do that. The google doc we use is shared with everyone; it is also color coded which really helps everyone see what is going on.

I put together a quick copy for O'Malley:

O'Malley's SS

If you would like to make one for him, here are the instructions:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

It's a little tricky; if you need help, just let us know.

You are shooting at pretty low numbers. Keep up the good monitoring and be ready to intervene if you see numbers under 40.
 
Your SS is not viewable through your link. I think you are almost there, but just need to "publish" it. That should be the last step in the instructions linked in Sue's post.

Please make sure you get some tests in at +3 to +7 today after giving 1u on a 148. He may drop a little low. If that happens, feed him some medium carb food.

I am suggesting that you drop back to .5u and give that a few cycles to settle - about 3 cycles. I am going back to my vetsulin days - a similar insulin to humulin - and you need to be cautious of shooting a full dose on PS numbers below about 180 - especially until you have several weeks of data to show you how he is likely to respond.

Unlike the longer acting insulins that most folks here use, humulin can not be safely shot on very low numbers - well, you need to greatly reduce the shot. There is something called a sliding scale that can be used with the short acting insulins. Basically, the lower the PS the lower the dose, but it is really dependent on the specific cat. You may find that .25u can be used down to about 150.

Just remember that normal, non diabetic numbers are about 45-125.

You are getting the hang of it! There is a steep learning curve that's for sure.
 
Hi Sarah - glad you're able to test this much. Looks like 1.0 unit is a bit too much. Try 0.5u for a few days. Don't worry if he is over 200 some -- his body is getting used to the insulin injections.

If you have a chance - stop by your old vet's office and ask for a copy of O'Malley's most recent bloodwork. When you take O'Malley to the new vet, she will want to either see the recently done bloodwork or she will want to do it over again. The bloodwork costs ~$100 so -- it is worth stopping by and asking for a copy.

Keep up the good work!
phoebe
 
Hi Sarah

You are doing so well :smile: awesome job on the testing :-D in fact you are doing enough tests to be able to follow the tight regulation protocol which can be found here http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581 This protocol, when followed soon after diagnosis, is scientifically shown to give you the greatest chance of remission for O'Malley.

It's wonderful that you managed to set up a spreadsheet but I would recommend you use this one http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=50130 it is the one most people use and makes it easier for people to read the chart and pick the patterns. I see that Sue has already posted that but we have posted different links - I'm not sure which is most current so I'll leave this one in as well.

I would also highly recommend that at this point you are ready to move to the Lantus (Glargine) - Tight Regulation (TR) forum (Lantus and Levemir are similar insulins and users of both post there) to post your daily numbers. Even if you choose not to follow tight regulation you can post there (although given that you are able to test frequently and the scientific support for TR I don't know why you wouldn't, following that protocol with the assistance of the TR board certainly fixed my Vyktor :smile: ). The board there is very busy and the people there are very experienced with these types of insulins and will be able to assist you with dosing and any other issues you may have.

I must say it was lovely to see a post from Nanacat too, it's great when the whole family pulls together :-D :-D :-D

Serryn
 
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