Cat just diagnosed with diabetes. Can't afford testing.

Status
Not open for further replies.
P

PandorasMom

Member Since 2013
Hi everyone. I am new to the forum. My 9 year old cat Pandora (Panda for short) was diagnosed with diabetes on Friday. Needless to say, I am devastated.

I took my cat to the low-income vet last week for her annual check up and shots and to discuss some peculiar behaviors she has been displaying. Despite acting a bit odd, she didn't seem sick/lethargic until a couple days before taking her to the vet. She kept trying to jump into the sink, would refuse to drink her water from the dish, and her coat was suddenly a disaster, but I didn't think too much of it since she didn't actually seem sick. All of these issues really started when I went home to Texas for the month of August and Pandora was under my roommates' care, so I thought it was behavioral. She also lost weight, but she has a problem with getting bloated, so the weight loss really just seemed like she wasn't bloated. (I'm feeling defensive about her symptoms. Our new vet is making me feel awful for not getting her in sooner.)

To my horror, the veterinarian said he thought she had kidney disease or diabetes, and he referred me to another vet, Dr. J, since the low-income vet only provides basic services. Almost $500 later, we got a diagnosis of diabetes (and some antibiotics and fluids). Her blood sugar was over 300. Panda also has a 104 F fever that Dr. J can't seem to explain based on the blood work.

Dr. J, has quoted me around an additional $1,000 as an upfront cost to be able to start managing her diabetes, plus the cost of insulin and other supplies. I'm not exactly sure what that $1,000 entails; it sounded like it was the testing/blood work to initially figure out how much insulin she needs (including the glucose curve) and maybe doing the blood work again a couple weeks later. Plus more money for more blood work in a couple months. He sounds like a very knowledgeable vet, but he inundates you with so much extraneous information that it is hard to follow. Rather than explaining what is most likely to happen, he explains every single possible scenario that could ever transpire in every single possible situation ever. It's overwhelming.

I adore my cat, but I am a grad student living in Boston. I am a full time student, I have an unpaid internship 25-30 hours a week, and I'm writing my dissertation. I live on $600 a month. If I had the money, I would pay as much as I needed to in order to get the best care possible for Pandora. Unfortunately, there is no way I can afford to spend another $1,000. As I was trying to get an estimate from Dr J on how much it would cost to stabilize Panda and if there were any things I could do at home with a glucometer to save money he said "Well, if you put her down you wouldn't be the first one." Then he launched into this story about a rich client he had who put her diabetic cat down because she couldn't be bothered to deal with it. It kind of sounds to me like he is the one who doesn't want to deal with it.

I am completely willing to put forth the effort and lifestyle changes needed to manage diabetes, but I don't have that kind of money. I tried asking him about Panda's quality of life, and he basically said he couldn't make any guarantees because she has a strange presentation. He has never seen a diabetic cat who is under weight, which she is (6.6 pounds; should be 8 or 9). She has never been obese. He said she is fragile and frail and "very sick", and I feel like he is angling for me to just put her to sleep, although he hasn't actually advised me to do so. I can't even adequately write a sentence to convey how much I do NOT want to put Pandora to sleep. It's unthinkable. But I also can't let her go untreated.

On Sunday, an acquaintance told me about her diabetic cat who is now in remission. She used a glucometer and did the glucose curve at home by herself in order to figure out how much insulin to give her cat. From what I have read while researching feline diabetes, others have done the same thing. Dr. J didn't seem to be a fan of this approach though. I feel like my options with him are to either do it the expensive way or put Panda down.

I think that putting Panda to sleep without trying to do SOMETHING is ridiculous. Even if it isn't the ideal method, if it is possible to do a glucose curve myself and figure out the insulin dose with a means that I can afford, isn't that better than just giving up on her without trying? It's pretty messed up to have to put my cat down just because I can't afford fancy testing, and I'm not ok with that, especially if there is another option.

I feel like I should tell the vet that this is what I want to do and he can support me in this, provide guidance around the results I get, and advise me on a dose based on that or I can take Panda's records somewhere else where they will support me in this process. From what I have read and heard, this sounds like a possibility. Am I way off track here? Am I missing something or being unrealistic? I don't really know what else to do.

Sorry this was so long. I appreciate any advice you can give me.
 
Hi Panda's mom! Welcome to the FDMB! You've come to the right place!! (would love to know what to call you other than Panda's mom)

First of all, the members here live and breathe diabetes every day and have more experience with it than the vast majority of vets. Vets just can't keep up to date on the latest treatments for every species of animal they see.

You do NOT need expensive curves at the vet. You can get a human glucometer and do all your testing at home. Tests that are done at the vets office are unreliable anyway because the stress of going to the vet can raise the blood glucose up to 200 points.

The meter a lot of us use is the Relion Prime or Confirm/Micro. The meter is available at WalMart for about $15. The test strips for the Prime are $9 for 50...for the Confirm or Micro, they're about $18 for 50..the Confirm/Micro take the smallest blood sample to get an accurate test.

What food are you feeding Panda? We suggest only wet food with less than 10% carbs. Just a diet change can bring the numbers down too. Here's a Food chart with Carb %. Carb numbers are in column C
The good news is that Friskies and Fancy Feast pate versions both are under 10% so you don't have to spend a fortune on any "prescription" food.

Did your vet say anything about starting Panda on insulin? There are 3 kinds that work best with cats. Lantus, Levemir and Pro Zinc. You'll need a vet to give you a prescription for Lantus or Levemir. The start up costs can be a little high, but once you have the supplies you need, you can totally do this from home without paying a vet $1000.

The most important part right now is to transition Panda to the lower carb foods and get the supplies you'll need to home test.

Getting started shopping list
1. Meter ie Walmart Relion, Confirm or Micro.
2. Matching strips
3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool.
4. Cotton balls to stem the blood
5. Neosporin or Polysporin ointment with pain relief to heal the wound
6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against
7. Ketone urine test strips ie ketodiastix - Important to check ketones when blood is high
8. Sharps container - to dispose of waste syringes and lancets.
9. Treats for the cat - like freeze dried chicken
10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast
 
Welco8me Panda's Mommy! Chris gave you all of the pertinent info on what to get to do home testing but I just wanted to welcome you and to tell you that you really should find another vet, one that will work with you in your efforts to home test and keep Panda safe from the wild swings that could happen when you give too much or too little insulin, both of which could be bad for your sugar baby. Home testing is easy once you and your cat get the hang of it. I just say the word "Ears" and my Simon comes running cause he knows he will get his freeze dried chicken treat. I buy the big bags made for dogs (same thing as for cats but larger) and break them in small pieces cause it is cheaper. The brand is Purebites and it is just plain freeze dried chicken so it does not raise the glucose level. You can't use things like Temptations etc due to high carb content.

I feed my kitty Fancy Feast classics and I test 4 times a day except when doing a curve once in a while. I test in the AM before his shot, hubby does the nadir (+6 hours after his shot) and then we do a PM pre shot test. I also do one more, at +5 or +6 before I go to bed so I know whether to leave out a few tbsp. of food for him if he is on the lower side because my kitty tends to self regulate and eat when he is getting low.

Home testing is easy when you get the hang of it and can save you money AND, more importantly, can save Panda's life because if you are not testing, you might not know if your baby goes really low and hypos until it is too late.

You can do this! I promise! My kitty is on ProZinc which is less likely to have overlap because we are out of the house a lot and so is better for our lifestyle but Levemir and Lantus are really excellent as well. Welcome and good luck!
 
Good morning and welcome to FDMB.

You have already received excellent advice. One suggestion I have is if your vet prescribes either Lantus or Levemir, ask for the prescription for the pens instead of vial. The initial cost will be about twice that of a vial but because the way it is packaged, you will be able to use almost every drop before it becomes ineffective. With a vial, you may only be able to use about 1/2 the vial before the insulin becomes ineffective. Depending on your dose, one package of pens will be enough insulin to last almost a year.

There is also a discount coupon that you may be able to use for the Lantus for $25 a pen http://www.lantus.com/starting/save...px?WT.mc_id=LNWB4333&WT.srch=1&iq_id=58228303 so that will save you money.

By hometesting, you will avoid unnecessary expenses at the vet and also be able to manage Pandora's diabetes more effectively. You want to test before every shot to make sure it is safe to give insulin. With insulin we recommend that you start at a low dose - 1/2 to 1 unit twice a day and gradually increase it over several weeks to get to the optimal dose. Don't worry, we can help you determine if you need to change your dose.

You said that Pandora had a fever. That also may cause higher BG readings. I see that she is on antibiotics. By treating the infection and also a diet change to a low carb diet, may be all that is needed to get her BG levels under control. If you will start to hometest, you will be able to find out if this is all that is needed.
 
You and Panda have come to the right place. We know all the tricks to treating this disease without breaking the bank. It is all affordable! You have the right attitude as well about being willing to do what it takes. It is a lot of work and may seem overwhelming for the first few weeks but it gets easier and this disease is so treatable. Many of the sugarkitties who come here go into remission or become regulated.

Welcome to the sugardance. We look forward to working with you to make your kitty feel better again.
 
I will donate to help you. Please contact Diabetic Cats in Need and ask them to set up a chip-in for you. Then private-message me back with the link.
 
A big FDMB welcome to Panda's Mom and Pandora. Would you please tell us your name?

Please contact DCIN ASAP. There may be a chance they can help you with supplies to get you started.

I live just north of Boston myself. I'm going to another members house this afternoon to help her learn to home test her sugarkitty.

Please, let us know how we can help. You can do this at a much lower cost, but you need to get a prescription for insulin from your vet first. A prescription for Lantus solostar pen, would enable you to use the $25 dollar savings program they have.
 
Welcome to FDMB.

{{hugs}}

You've had the bad news, now here's the good news. We may be able to help you manage your kitty's diabetes, much the way human diabetics manage theirs - low carb food, home glucose testing, and if needed, appropriate insulin

Note on insulins: Lantus, Levemir, ProZinc, and PZI last 12 hours in the cat, give or take. Vetsulin/Caninsulin lasts about 10 hours in the cat and was designed for dogs. Humulin/Novolin/Humalog/Novalog only last about 8 hours in the cat and may require dosing 3 times a day.

If you decide to go vet shopping, there is a list of Vet Interview Topics in my signature link.
 
Thank you all so much for the warm welcome, advice, resources, and support. Pandora and I can't thank you enough! My name is Alison, by the way.

I ambushed my vet today. I figured if I just showed up and caught him off guard, he wouldn't have time to argue with me. I showed up, got Pandora's records and lab results from the lady at the front desk, and then spoke to the vet when he noticed I was there.

I started out by telling him he needed to prescribe the Lantus SoloStar Pens. He originally suggested glargine, so I managed to make it sound like it was his idea to butter him up before I laid down the law. I basically told him we weren't putting my cat down just because I can't afford the in-hospital testing. Then I told him a number of resources I have found that state that I can do the glucose curve at home. That's what I can afford. That's what I'm doing. As I'm standing there with Panda's records in hand, I told him I'd like his support. It was not a question.

He acquiesced pretty quickly, and went on to list the benefits of home testing. I made sure he knew I was aware of those benefits, as well as the pitfalls of in-hospital testing (ie: articificially elevated BG levels due to stress). He said he'd give me a call to coordinate getting the prescription since he had to go into surgery and didn't have any more time. I feel satisfied that I got my point across. I think this veterinarian is knowledgeable, but I do not like his personality, and I agree that I need to find a different vet. If there is one thing I know how to do, it is how to talk to narcissistic doctors and put them in their place. This momma bear doesn't mess around when it comes to my babycats.

Thanks for the reassurance that I can do the home-testing. It definitely sounds like the safer option.

This is where I am at right now:

I have a working One Touch Ultra glucometer that my friend's mom gave me. However, the test strips are expired so I think I am going to get the Relion because the strips for it are significantly cheaper.

I have lancets and the lancing tool, as well as cotton balls.

I have Karo syrup and Fancy Feast with gravy.

I have some baby socks so I am going to fill those with rice to support the ear when I test Panda. I read that warmed rice-filled socks can be soothing and make pricking easier.

I am working on the DCIN application. Thanks for the suggestion!

Pandora is a very picky eater, and I have never been able to get her to eat anything other than kibble. She has never eaten human food. She won't eat treats. We feed our other cat wet food, and Pandora won't touch it. We are switching her to Go! Fit + Free Grain Free kibble. It should arrive Friday. This kibble is 14.5% carbohydrates (Still high, I know) and is the lowest I could find for kibble. It is 48% protein. I know kibble is not ideal, but the GO! brand is a huge improvement from the Frisky's indoor cat food she has been eating. The plan is to transition her to Go! and, after she is more stable and has gained a little weight (to put her in the normal range), transition her to wet food. I am afraid she would starve to death if I tried to make her eat wet food now. Does that sound reasonable? If anyone has any suggestions or resources (besides the eat or starve approach) for how to transition her to wet food, that would be a huge help.

My understanding, and please correct me if I am wrong, is that we should change Panda's food before doing the glucose curve. Does that make sense? I know that if I change her food, I need to adjust her insulin dose because a change in carbs affects how much insulin she needs, and I don't want to send her into a hypoglycemic crisis. Then we would need to do another curve when we transition her to wet food. I'm not exactly sure how the logistics of that would work, though, if we are slowly introducing the wet food and changing the proportion of dry to wet.

I took Panda's temperature today and her fever has broken, so that's good news.

I'm feeling better about all of this. Definitely more optimistic.

*EDIT: I forgot to mention that I also enrolled for the Lantus savings card.
 
If you have the stuff to start testing, you should go ahead and start doing it, just so you get Panda used to it, and so you can see if the GO dry food is going to have any effect. We do have some great tips on transitioning cats who are hard core dry addicts to help you convince them that you're really not trying to poison them with wet. :lol:

Tips on Transitioning

Once you're testing, you always test before shooting. These are called AMPS and PMPS tests (AM pre-shot and PM pre-shot)
During the morning cycle, get at least 1 test somewhere between +5 and +8
During the night cycle, get a "before bed" test.
If you can also get a +2 or +3 during the cycles, you can use that information to help guide you...whether the cycle is going to be "active" or "quiet"

You can do a curve once/week.. a full curve is every 2 hours for an entire cycle. A mini-curve is every 3 hours for an entire cycle.

GOOD FOR YOU on laying down the law to your vet!!

Would you please take the 911 icon down now? We use that for when there's a medical emergency. Just go to your first post and pick "none" or if you have a question, just use the ? icon
 
If you are not yet on insulin, proceed with the food changes you have planned. Other low carb kibbles include Evo Cat and Kitten, Stella And Chewy's freeze dried, and Young Again 0 Carb (its 5% the way we calculate it, as % of calories from carbohydrates, and internet orders only. You may want to call for a sample.)

Food changes should be gradual, to avoid GI upsets. Change about 20-25% of the food each day and in 4-5 days, you'll be switched over.

If you are already giving insulin, please focus on home glucose testing before changing the food, for safety. The insulin needs can drop substantially with a change in the % calories from carbohydrates - When I switched Spitzer, he went from 3 units to about 0.5 units per shot.
 
Alison,

If there is one thing I know how to do, it is how to talk to narcissistic doctors and put them in their place. This momma bear doesn't mess around when it comes to my babycats.
Click to expand...
You go girl! Show them you love your cat and aren't ready to say goodbye. Diabetic cats can live long and healthy lives.

Sounds like you are on top of things, bearding the lion (vet) in his den worked, you have a plan for going forward and you sound like you are psyched that you can help out your lovely Pandora sugarkitty.

I second the 'start testing now" folks. It's never too early to start, even if you are not giving insulin yet.

I'd recommend picking an AM and PM time, 12 hours apart that will fit your life and work schedule most of the time. We never expect that this will be able to be the same every day, but you try. Those are the times you will start to test. If you need to add the insulin after the food change, then those times will become your new test, feed, shoot times.

Please, keep us posted on how things are going. Let us know what other questions you may have. Sounds like you are a take charge type of woman. Go for it!
 
Nicely done! You'll find that once you get into a routine, this becomes normal very quickly. And this forum is a godsend.

My cat only gets 1.5 units twice a day, so I buy one Lantus pen, and it should last about three months--so that's $20 a month. I use the Relion glucometer. I buy the syringes at Walmart for $12 for a box of 100. And I feed Friskies. So all of that keeps costs down.
 
Hello and welcome to the board!

Can you confirm where you saw that the GO Fit is 14.5% calories from carbs as fed? Many nutrition sites provide it as a % of weight or volume which isnt the same thing. and unfortunately grain free doesnt always mean low carb.

I am hoping she will like the friskies pates or fancy feast classic pates so you can get her off the dry asap (or feed a confirmed low carb dry as recommended above). Because that will make all the difference to her - even remission - and being regulated will help her gain weight too..

I am looking forward to see her test results at home too - any infection can cause his blood sugar and now the infection is clearing, her blood sugar could drop from that too

Wendy
 
Here are some agencies that you might want to check with. I got the list several years ago from a canine addison group. I've never used any of them but it ccouldn't hurt to try. aahelpingpets.org help-a_pet.org imom.org thepetfund.com
 
Hello Panda's Momma - welcome to the Board!!

I haven't been very active in a long time because my sugar kitty, Bashful, has now passed away (from cancer, not diabetes) at the ripe old age of 19. The AMAZING and selfless people on this Board LITERALLY saved his life. Bash was in diabetic ketoacidosis when he was first diagnosed and almost died - and an idiot vet was helping that process - so YAY on you for being assertive with your vet - it has to be done and if they don't respond well, see another one. I'm seriously impressed - you go girl!! With proper care, your kitty can live to a ripe old age. Through diet control, Bash actually eventually got off insulin entirely until the last couple years of his life (which I found out later had a lot to do with having a Hyper-Thyroid - common in older kitties - and once he was on the meds for that he was almost off insulin again, until he was diagnosed with the cancer).

Long story - not so short (LOL) - I still have left over supplies from Bashful's care - boxes and boxes of lancets and some boxes of needles. If you would like to have these (free), please feel free to private message me your address and I will ship them to you. I'd love them to go to someone in need who is doing such an awesome job of taking care of their sugar baby.

I know it feels really overwhelming at first (lots of information to absorb), but before you know it, it will all be second nature and you can do it quickly and economically. :) Ask all the questions you need to and lots of wonderful people here will help you.

Best,
Theresa
Momma to Sugarbaby Bashful (GA) and civies Tinker, Baby, Nymph and Willow
 
Hi Everyone,

Sorry to be silent over the past few days. It's been a busy week, both with Pandora and catching up on the things I've neglected over the past week.

We have started trying to test Pandora. The old One Touch Meter I have doesn't seem to be working correctly, so I'm not sure what her levels are, but at least I have gotten in a little practice with pricking the ear and getting the blood on the strip. Getting it down to a one-person job will take some definite practice. My boyfriend just walked in the door with the Relion meter and strips, so we will give that a try.

Thanks for the advice on the glucose curve and testing. We plan to switch the food and then start insulin, since we aren't on it yet. I got the new, lower carb food in today, and both of my cats seem to like it. Yay! There was a question of where I got the info on Go! from. I called the company and spoke to a nutrition specialist there, although I am not exactly sure how they calculated the percentage. I'm hoping to transition to wet food asap, though.

The vet is really making me angry. I am supposed to go in tomorrow morning for an in-depth tutorial on how to test, do a curve, administer the insulin, etc. However, he didn't call the insulin prescription in until yesterday, and I wasn't able to get to the pharmacy until this evening. Turns out, he called in the wrong prescription. Idiot. He called in the Lantus vial, not the Solo Star pen. During our conversation, I specified the pen at least half a dozen times, and he wrote it down. We also had a follow-up phone call in which I, again, specified the pen. So now I'm not sure if we are going in tomorrow. I will call in the morning. They open at 9 and the appointment is at 10, so I doubt that is enough time for them to call in the prescription and give me time to pick it up before our appointment. Not that we are actually administering insulin tomorrow, but I'd like to go over the mechanics of it with the pen. Very frustrating. He waited two days to call in the prescription and did it wrong. Once he calls in the correct one, this guy is so fired. I'm tired of his crap. I get the impression that he really just does not care. Not acceptable.

On a brighter note, Pandora is more vocal and active. She has been purring, as well. She and my other cat are also interacting again.

I have been very touched by the outpouring of support Pandora has received--both here and from people in my life. It definitely makes me feel better about all of this. Thanks.
 
We understand "hectic"!! It's great that you're getting some testing in now too. Make sure you give lots of treats whether you get blood or not..it can be helpful to just take Pandora to the spot you want to use to test/shoot, and just rub her ears a little, and reward. Eventually she'll get more used to the routine, and probably won't even notice you're poking. China objected to having her ears touched in any way, but after awhile, the chicken yummies won her over and now she comes when I call her...and occasionally she reminds me it's time to test/shoot!

As for the pen, there's really nothing special about it. You take the cap off, and there's a rubber stopper just like there is on the vial. You put the syringe in (don't put any air into it though) and pull out the correct dose. Think of it as a small vial that only holds 3ml instead of 10ml. Just a reminder..don't use the "dial a dose" needle on the pen..it's meant for people only. Our sugarcats need tiny doses and the needles that come with the pens aren't exact enough.

Here's what it'll look like
4113.jpg


We're all happy to support you any way we can! We all came to this board needing advice, help, support and occasionally, a shoulder to cry on. The least we can do is pay it forward!!

Great to hear she's feeling better too!!
 
Alison,

You may want to call around and price check. Solostar Pens come in a 5 pack box. Some people have had great luck getting the pharmacy to dispense a single pen. other not. I personally have not had any luck and had to buy a full 5 pack box or a single 10ml vial. There was a $100.00 difference between the 2 of them.

So check so you don't have sicker shock :)
 
Welcome to the board!

I hope you do find a new vet, this guy sounds like a jerk.

I did want to say, as far as learning how to test and give insulin... I learned to test here and by watching YouTube videos. My vet didn't say not to test, they just said I didn't have to. They now recommend it since Hobbs is doing so well. As for giving insulin, they showed me how to do it using water. That way I could do it a couple of times to get used to it and not give him any actual insulin.
 
Remember when you get the pens you want to buy syringes , not the tips that come with them. You want syringes with half unit markings i.e.
Relion 3/10cc 30 & 31 gauge short OR BD Ultra fine 3/10cc short OR Terumo Thinpro Insulin Syringe 31G 3/10cc OR Kroger 0.3cc 8mm, 31 gauge


Did the vet recommend a starting dose?


Wendy
 
How are things going? Have you gotten the correct prescription? Have you been able to get a test in yet? :-D
 
Hi and Welcome!

I have just glanced at your thread but looks like you are getting lots of great advice. I did notice one thing I wanted to quickly comment on. I also feed Go! Fit and Free kibble to my civvie (non-diabetic). We have only recently tried it after searching options during the last Evo recall. The carbs% are not as low as Evo, but the actual ME carbs% is 13% , so less than you thought. The 14.5% is not the ME% of carbs which is what we go by. They have the actual nutrient profiles posted via a link at on the Guaranteed analysis page. It's the last entry bottom of the page. At time we ordered it however, the carb number showed to be 11% and at some point since then it was changed to 13%. (was not so happy about that) I called and it was explained as a calculation adjustment not a formula change. After multiple Evo recalls we were glad to find another option to try, but Evo is so much lower in carbs so jury is out on whether we'll stick with it. In the end everyone is correct that low carb canned only is what you want to be working toward feeding. I was able to get my kitty off insulin in a very short time frame with the diet change to all canned. So much great advice and support here. It really is manageable once you get the hang of it. Good luck!
 
Hi Everyone,

Today is my first day off in over a week, so I am finally able to update. Between internship, school, and caring for Pandora things have been very hectic. We also had a bake sale (ironic, I know) for Pandora last week, which was helpful in helping me raise money for some of her vet bills. My roommate also set up a Go Fund Me for her. Between the two we have raised $350, which is a big help.

Pandora started her new kibble a little over a week ago. We got her completely transitioned a few days ago. Good bye potato chips! (That's what we call the higher-carb food she was eating.) Both of our cats seem to like it, so that's good for now.

We finally got the correct medication for Pandora. We got a Lantus SoloStar pen, which we are administering (starting today) with syringes from the pharmacy. We are using 30 gauge short 3/10 cc insulin syringes with half unit markings. I ended up paying $25 for the pen by using a savings card.

The vet is fired. We are looking for a new one. We ended up cancelling our appointment with him. Youtube and posts here have been very helpful in teaching me how to administer the insulin and do the testing. Going to him for instruction would have been a waste of time and money, especially since he has no idea what to do with the pen. And he is a jerk.

We started the glucose curve and administered insulin for the first time today. When we first got the diagnosis, Panda's BG level was at 384. The test we did before starting to switch her food was 303. Before administering the insulin today, her BG was at 226. I guess the lower carb diet is helping. Two hours later it was at 199. It's almost time for her next test, and I'll keep tracking throughout the day. I only administered half a unit. The vet said 1 unit twice a day. Had she still been around 300, I might have done that, but with her at 226, I felt uncomfortable going with a whole unit to start. I'm going to see how half a unit works this week with frequent testing. Then I will reevaluate. I'm hoping to do another full curve either Monday or Tuesday next week.

How important is it to administer the insulin exactly 12 hours apart? My schedule is so all over the place, that I'm having a tough time finding 2 times 12 hours apart that I will consistently be home.

Thanks,
Alison and Pandora
 
Welcome back!

What a good idea about the bake sale. I hope Pandora didnt get into any of those goodies! :)

With Lantus you want to hold the initial dose for a week before making changes because its a depot insulin and needs time to build up in her system. You need that time to see the full effect of the dose. Unless she drops under 50 in which case you reduce dose. more info: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

I usually recommend 3-4 tests a day instead of a once weekly curve - it gives you a much better picture of whats going on and lets you see how low she is dropping. The low is what you base dose changes on.. not the preshot levels.

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low she is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what her overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

Lantus works for 12 hours so you want to shoot every 12 hours - give or take 30 minutes. If you know you will be home late you can slowly adjust times by 15 minutes a shot or 30mins a day. You can shoot further apart than 12 hours if you need to though its not ideal. just dont shoot less than 12 hours apart as you get overlap.

Wendy
 
Now that you're home testing, this should be helpful:

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- the lowest level pre-shot for ProZinc, PZI, or other non-depot insulins.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as mid-cycle data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
Thanks for the really helpful information, BJM and Wendy!

Pandora is not liking the testing process very much. She's starting to struggle more. On the bright side, she is feeling strong enough to struggle.

I administered 1/2 unit insulin for the first time Monday and checked her BG levels about every 2 hours (there are two 3 hour blocks in there at the end because of failed attempts that needed a break before trying again) for 12 hours. Her numbers are:
226 (AM preshot)
199
183
219
264
246 (PM preshot)

I taught my boyfriend how to test Pandora and administer the insulin last night. I was a nervous wreck. lol Fortunately, he managed just fine by himself today. He will typically be giving Pandora her morning test/shot, and I will do the evening one. I'm a bit of a control freak anyway, so when it comes to my baby, it's REALLY tough to let someone else do it. It is a relief, though, that he has proven himself capable of doing it, as it takes a little bit of the pressure off of me to have another person I can count on.
 
Alison, it'd be really helpful if you'd start using our spreadsheet program so we can see Pandora's numbers and be able to really see what's going on. One "curve" really isn't enough to advise you regarding if you might need to increase the insulin or reduce it. How to set up a spreadsheet

You need to try to get at least 4 tests in per day.
1 at AMPS and 1 at PMPS...these are crucial to keeping Pandora safe!
one test somewhere between +5 and +8 to try to find out when his nadir is
one "before bed" test...most cats run a little lower at night

Those 4 tests really are necessary before we can advise you on dosage. If you can get more, that's great but it's also good to "spot check" at unusual hours

Sorry...I wish I could be more helpful.
 
While you work on the blood glucose testing, you might track some of the assessments listed in my signature link Secondary Monitoring Tools. These will give you additional clues to how well your kitty is doing.
 
Status
Not open for further replies.
Back
Top