Cat - Not responding to insulin.

Hello everyone,

I'm new here to the forums and hope some of you have advice for me.

In November my 14 year old male cat was diagnosed with diabetes. We started out at 1 unit in the morning and night and I went back to the vet a week later to have his blood sugar tested again. It was in the 500s. So the vet raised the dose to 2 units in the morning and night and I went back the following week to have his blood sugar tested again. Once again he was in the 500s and didn't seem to be responding at all. The vet said maybe the cat being stressed on the ride to the clinic caused his levels to spike, but he proceeded to raise it again. I think he bumped it up to 4 units twice a day and on the following check up his blood sugar was a little lower I think in the 400s but still way to high. Anyway, this kept going on until reaching 7 units. The cat still isn't responding at all so I took him to the vet today and they're running a glucose curve and seeing if he's responding at all. The vet called and said things aren't looking well and the cat isn't responding very well. He said he got the sugars down to the 300s but said that was still way too high.

I'm at my wits end and the vet is suggesting to put the cat down. I really don't want to lose my cat as I've had him since I was 4 years old and am really attached to him.

I'm worried the cat is suffering and I really don't want him to suffer any longer. I'm hoping maybe you guys can suggest something more I can do to try and save my cat.

Please give me any advice that could help, I really appreciate it.

Thanks in advance,
Brad

EDIT:

I guess i've left out some details. My cat LOVES his wet food and I have no problem getting him to eat. He has lost a lot of weight due to the diabetes but doesn't look too unhealthy.

The cat urinates a lot and fills up the cat box in a day and I have to empty it almost completely to clean it. This has not got any better since starting his insulin injections. I have been using ProZinc insulin.

Thanks for your time.

 

Brad,

We will help you with your cat. What's his name?
You do NOT have to put your cat down. It's just a matter of getting to the right dose, and using the right insulin for your buddy. Don't worry so much. You have come to the right place for lots of help. The people on this board have tons of experience with diabetic kittys.

 

My cats name is Shadow.

Thanks a lot! I am very worried because he hasn't showed any signs of improvement at all and I'm afraid he's just getting worse.

I DON'T want to put him down but I'm just afraid he's suffering and not feeling well. He's had a very long and good life and has never had any health problems prior to this. Especially because the vet recommended to put him down that's what makes me uneasy and not very hopeful.

I will do whatever it takes to get him feeling better, and I see you guys recommend testing at home. I don't mind at all investing in this stuff as I do have the money to pay for it. Just let me know what to do!

Thanks a lot for the reply.

 

Hi Brad,

I am a Prozinc user and have had very good success with the insulin. I have seen cats on Prozinc whose doses were increased too much at a time and their ideal doses were missed. They ended up having curves exactly like you are describing. We prefer to increase doses in .25 increments -- whole unit increments are a large increase, regardless of the BG. We had a cat a few months ago that came into the Prozinc forum that was on 8 units of Prozinc and was remaining in the 500s and Hi all day long and the vet was encouraging another unit increase. This cat's dose had been increased at 1 to 2 unit increments and his dose had been missed. The cat was still eating dry food, but after a change in diet the cat became regulated on 3 units of Prozinc.

I am going to cross post your post in the Prozinc forum and see if I can get some additional eyes on your post.

Please do not consider putting the cat down at this time. Diabetes can be managed. Regardless, if the cat needs more or less insulin, there is help within this forum for him.

Kim

 

You don't need to put your cat down!

What you need to do is start home testing.
Go to the pharmacy and pick up a blood glucose meter.
That dose you are giving is HIGH and it could be causing the problems!
It's VERY easy to home test and find out exactly what's happening to your cat with all that insulin.
Testing on cat’s ear

Get the curve numbers from the vet, what time insulin was given, how much, and all the times and numbers of the tests done by the vet.

Curves at the vet are stressful and the numbers obtained are artificial.

one of my cats tests higher at the vet and one tests lower. When I get them home, they return to their true numbers.

 

Vets are not used to people who test their cats, and sadly a lot of people choose to put their pet down when they get the dx of diabetes, thinking it's too much for them to do.
My kitty J.D. is a healthy 17 year old and has had diabetes since he was 10. Because he's older, he gets his complete bloodwork and check up done every six months. We go for walks together outside, he sometimes goes to work with me, and he goes on vacations with me. We have become a lot more closely bonded through all our trials and triumphs.

Most of us here on this board, do dose increases and decreases in 0.25 unit increments. So, you will want to buy syringes with 1/2 unit marks on them. And you'll want to buy some ketone test strips. You'll want to get the lowest carb food you can find, and start home testing. Once you're home testing, you (and we) can see how Shadow is doing on a particuliar dose and help you to adjust it.

Hope is not lost, by a long shot. Hang in there.

 

I'm not a PZI user so I'll leave the dosing to the experts over there.

However, there is one big thing you can do for your cat: learn to test his BG levels at home! The stress of being at the vet's makes vet's reading suspect at best. You can use a human meter (many on here use the Relion Confirm or Micro from Walmart as they have some of the cheapest strips) There are several good videos to help you learn how to draw the blood; it's very easy once you get the hang of it! By testing, you can start to see your cat's day to day patterns and how he's handling the insulin. Too much insulin can cause high numbers, and your vet did raise the dose by a LOT very fast; it's possible you missed the best dose.

Also, with continued high numbers, you should probably test for ketones daily. You can by Ketostix at the pharmacy and you test by dipping it in the urine stream when he pees. Ketones are a life-threatening emergency condition. But so is hypoglycemia, which is also a risk of increasing insulin without home testing.

Finally, what are you feeding? Many on here have found that feeding low-carb wet food only significantly lowers BG almost immediately. You said you feed wet, but if it has gravy or other sauce, it may still not be low carb. The catch: If you are not feeding a low carb wet diet, DO NOT switch cold turkey without home testing of BG. It's likely that a switch will immediately require a reduction in insulin, and not making the change carefully could result in a life-threatening hypo! If you make the switch immediately, you will probably need to drop your insulin dose way down right away. Again, the PZI folks can help direct you. You can make food switches more safely by changing over gradually and checking the numbers very carefully and often as you go.

We've all been there, wondering if we would ever find the right dose or the right food

 

Hi Brad and welcome!

Agree, if kitty is not having serious complications right now there is no need to consider putting him down just because his blood sugar continues to be high.

there's plenty of reasons for his BG (blood glucose) to be high. it's a matter of ruling them all out and changing things that need to be changed to rule them out. for instance, what has he been eating? the goal is low carbohydrates or proper diet, just like humans. if he's getting too many carbs, his levels are going to stay high. perhaps the insulin isn't one that is going to work for him. in all honesty though i think it's too soon to tell that though. also, there's also other illnesses that could be causing it, like acromegaly for instance.

what i would suggest is getting kitty home and relaxed and yes, start hometesting. it's really the only way to know for sure what is happening with the insulin. sporadic testing in a clinic setting is often inaccurate just due to the stress kitty is feeling. just so you know, things like stress, pain, infection, etc....can all raise BG levels.

there's directions to doing up a spreadsheet in the tech forum here. it's a real easy way to log your test numbers and because it's color coded, it's real easy to see trends or problems with the doses. dose changes need to be done in smaller increments in all honesty. raising the dose based on a number every few weeks is a bad way to go about things. that often leads to missing the perfect dose and people getting frustrated because it's not working. cats are teeny weeny creatures compared to us. their doses are much more fine than ours. for instance, my Mousie gets 1/2 a unit twice a day. that's HALF a unit.

we also have individual forums here for each insulin. if you want you can check out the PZI forum and get more info on how to work prozinc and it's dosing. yes, down the road a little you may find you'll need to try another insulin, but i'd try working the prozinc a bit longer just because the dosing has been done incorrectly so far, in my opinion

 

Hello,

Thanks for the reply. I do recall reading that if the dose is increased to rapidly that it could cause levels to spike. Do they have needles that have smaller increments like .25 or do you just eyeball it? I did think the vet was increasing the dose way too fast but i figured since he is a vet he would know what he's doing. Basically the vet told me that nothing else could be done and that it's time. I am very glad I came and posted on here, it was my only option left before letting go of my cat.
What type of diet is recommended for a cat with diabetes? Is ScienceDiet a good brand? Or what do you guys recommend?

Thanks a lot for cross posting it, hopefully I can get even more advice now! I'm taking everything I can get.

I'm very glad you all are so confident that he can get better! I really do hope he gets better and I would forever be grateful! Do they sell the glucose meters at walmart's pharmacy? I will go by there later tonight and pick up all the testing supplies.

I will get the numbers from the vet tomorrow and all the stats and post them here tomorrow. My cat gets very stressed out on the ride there and meows very loud the whole time so I can only imagine how stressed out he is not being at home and around unfamiliar people.

Thanks for the advice!

Later tonight I will be making a donation to the forum, I'm very thankful I found it!

Thanks again for the responses.

 

Glad to hear your kitty is doing well. I don't mind taking care of my cat since he needs it and has always been here for me when I need him!

The thing I worry about most is him suffering, and I don't want that. I'll get some ketone test strips also. What is the lowest carb food that you have found? I could order it online if I can't find it at any local stores.

Thanks for your response.

I am definitely going to buy a glucose meter at walmart later tonight and get the test strips.

Scary about the ketones, the vet has never mentioned anything. He doens't seem very knowledgable whenever I ask him questions.

I am feeding him fancy feast "gourmet" classics. I also purchased a bunch of plastic packets from amazon and all of those have 'gravy'. The cat also has ScienceDiet dry food sitting out for him at all times.

Do you guys think I should just restart his dose at 1 and do home testing and go from there?

Thanks for the response!

Thanks for the warm welcome! The only reason I was considering putting him down is because the vet recommended it and I think his quality of life can't be very good.

I will definitely follow all of the advice given here and make the jump and do home testing. Anything to get my kitty better!

Shadow will come home tomorrow and hopefully we can start home testing. He is such a mellow cat and would let me do anything to him. He doesn't even fuss when it's time for shots and actually wants me to give him it so he can get his wet food! He loves that stuff.

I will look into the tech forum and into doing a spreadsheet once I get the meter and testing supplies.

I am almost out of the ProZinc but will purchase another bottle. Is it cheaper to get it from a pharmacy rather than the vet? I think I paid $94 at the vet last time.

 

Brad,
We are confident because we KNOW we can help you!
I forgot to add for your shopping list.... get a container of KETOSTIX as you want to start testing urine for ketones.
Walmart is great.... get the Relion meter and the test strips and lancets for it.
Do not get any of the FreeStyle meters.

you are using U40 syringes with the Prozinc? I believe you can use U100 syringes for smaller doses.

Once you are home testing, you will see that your numbers at home are not like the ones at the vet!
What dose are you giving at the moment and what times are your shots.

don't you worry now; the good people here will get you and your cat fixed up in no time.
You are going to see your old cat back again very soon.

 

Create your Spreadsheet

 

I buy my ReliOn syringes from Walmart. They have the syringes with the 1/2 unit marks for $12.58 for 100 syringes. You can also purchase the ReliOn meter and test strips while you're there, and don't forget to pick up the Ketostix, too.
Then you can go to the pet section, and pick up some low carb canned cat food. A lot of us feed Fancy Feast.
See this chart or this one. The carb %s are in the 3rd colomn. I've been known to take a print out of the chart with me :lol: That was an important point that MikeysMom made regarding the switch to low carb food. If Shadow is now eating higher carb food, then you will want to make the transition slowly, until you are testing, and able to monitor him closely.

 

Oh, my mistake then, maybe the ReliOn syringes at WalMart won't work for PZI. I'm sorry, I don't use PZI, so am just used to buying U100 syringes. Others will be able to help you more with that.

You're going to want to take that dry food away, and when you do there could be a dramatic decrease in BGs, so don't take it away until you're home testing.

Best of Luck, to ya.

 

Brad,

You have already gotten some great advice so I'm not going to add to the information overload, but want to tell you a tale of two kitties so you can see that there is hope for Shadow.

I have 13 cats, 2 of which are diabetics, and it is those two that I'm going to talk about...Maxwell & Musette both of whom I adopted as diabetics because their former owners where going to have them put to sleep. Maxwell survived hurricane Katrina but when he became diabetic and his first mom after the hurricane also got sick and had to go into a nursing home her family was going to have Maxwell put down. He was in sad shape when I adopted him, he was a walking skeleton at 10.5 lbs and had to be shaved because he was so matted...a year and 6 months later Maxwell is flipping catnip mice in the air and chasing 6 week old kittens through the house. He is a lean 17lbs and if you didnt know he was a diabetic you would never guess by looking at him and the best part is that he hasn't had insulin in over a year either. He's about 13 years old as close as we can figure.

Then this June my husband and I adopted Musette after her family of 11 years were going to have her put down as well. If I had thought Maxwell was in bad shape, Musette was worse. She had already survived DKA, she could barely walk because she had diabetic neuropathy (walking on her hocks) and weighed a mere 6 lbs, she is the same kitty that you now see as my avatar. Not only does she now weigh a purrfect 8lbs and rules this house with a velvet paw. :lol: She is still insulin dependent but is doing great on .6u of Levemir.

SInce there are so many cats at my house and everyone needs to eat what the diabetics do, we feed just good old fashioned Friskies Pate style cat food, this is the same diet that got Maxwell off insulin and has gotten Musette down to suce a small dose.

Mel, Maxwell, Musette & The Fur Gang

 

The dry food could well be a HUGE part of the problem. Taking my cat off all dry food lowered his BG by over 100 almost instantly. The FF classics (pate style with no gravy) are fine;many of us use them, including me!

Most Science Diet foods are pretty terrible, most of us avoid them. I would start by removing all dry food and lowering the dose. Again,not a PZI user, so I'm not comfortable suggesting a dose, but someone will help you. Again, pulling the dry WILL require an immediate dose reduction!

I'm glad you are so willing to take the steps to help your kitty! This DOES get easier!

 

Well known big brand such as Fancy Feast and Friskies are just fine to feed and are avaialable nearly everywhere, from supermarkets to the chain pharmacy store to chain pet stores to discount stores :smile: There are many other brands you can feed. Wellness is popular as is Innova EVO and Special Kitty. Whatever brand your cat likes to eat and you can afford is just fine :smile:

But not all varieties are low enough in carbs for a diabetic. We use Binky's food charts http://binkyspage.tripod.com/canfood.html and the Pet Food Nutritional Values chart. Look at the column for carbs and choose foods that have a number 10 or less.

And there's a list of low carb gluten free Fancy Feast http://www.felinediabetes.com/glutenfree.htm

One more food list: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=12846

Gravy based foods are too high in carbs to be fed but do keep a few cans to use in case your cat hypos. The high carbs will raise blood glucose levels. Any of the Fancy Feast varieties in gravy (over 18% carbs on the chart) work well.

Limit seafood to once in awhile meals/treats. Too much seafood can be hard on the kidneys and some cats just get addicted to eating it.

Low carb treats are best: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=9172

Pouhces of foods tend to be too high in carbs because of the thickeners used for the gravy. If your cat will eat canned food there is no reason at all to feed dry food. Science Diet dry foods have well over 20%, some even at 40% carbs :shock: All those carbs keep blood glucose levels too high despite the huge amount of insulin you are giving.

BUT... don't stop the dry food just yet. Doing so will result in blood glucose levels dropping a lot and giving that usual amount of insulin will very likely cause a hypo. Learn how to test your cat's blood glucose levels and then slowly change the diet and decrease the insulin as needed.

For U40 insulin syringes, no. Neither do U100 insulin syringes.

But many people here use U100 insulin syringes with half unit markings to dose U40 insulin (like ProZinc). There is a conversion that you must do in order to accurately give U40 insulin with the U100 insulin syringes: http://www.felinediabetes.com/insulin-conversions.htm

 

Prozinc is a U40 insulin and I would start out using U40 syringes. I get my syringes from my vet. Yes, you can use U100 syringes, BUT you MUST use a conversion chart. The U100s are used mainly when dosing small units of Prozinc. I use only the U40s and I have two cats receiving the insulin. One cat get 3 units three times a day (tid) and one gets .3 units twice a day--- right or wrong, I eyeball all doses. There are some cats that are fine tuned and are dosed using U100s, but my cats are not that sensitive to the small doses.

My cat, Kitty, is 16.5 years old and is well regulated on Prozinc and dosed tid. The other cat I am caring for, is a foster (kind of...maybe mine!) from DCIN (Diabetic Cats in Need). He came to me from a shelter and was eating dry food. I switched his diet to wet low carb Fancy Feast. He was switched to wet food for a week before starting insulin. The first week with me, his blood glucose levels were in the 300s at preshot-- this is his forth week with me and he just went 67 hours with no insulin! I have hopes that he might become a diet controlled diabetic.

There is A LOT of help here for you! I am not sure my cat, Kitty, would have survived without this forum. Don't give up on Shadow...you have come to the right place!

 

Hi Brad... I too had a vet that didn't understand diabetes. My cat turned out to be a high dose kitty with acromegaly, something my vet said was too rare to exist. It wasn't until I change vets that I was able to get Silverado's numbers under control. The new vet recognized the problem, was thrilled that I was home testing, and worked with me to get Silverado on the right insulin. If the vet you have now is not encouraging home testing and is not willing to help you find the right dose and the right insulin... shop around for a vet who is open minded enough to give you that help. They do exist. Where are you located? Maybe someone on the forum can recommend a vet in your area. I promise you that once you have the correct dose, the correct doctor, and a testing routine, this gets much easier and you'll have a healthy happy kitty again.

Best of luck to you and Shadow.

 

Hi BradB & Shadow.
I am Jenn & my big brown cat is Baxter. We are ProZinc users.
You are definitely in the right place to get Shadow feeling better. There are so many people here with amazing experience.

There was a point when my vet told me to increase insulin. The only thing it did for Baxter was increase his BG. I got so much experienced help from the PZI family Baxter has much better BG now. You should come over to PZI support board & get dosing advice. Once you get Shadows BG lowered you will start to see a improvement in how he acts.

There are smaller needles. ProZinc is U-40 insulin & general you use U-40 needles. You can use U-100 needles, but you have to use a conversion chart to use U-100 needles. They are easier to use for smaller dosing. Again, I would suggest you come over to PZI & let the experienced memebers help you.

Everything is going to be ok...Promise. There is no reason to entertain the thought of pushing Shadow to the bridge.

See you in PZI!
Jenn & Baxter cat_pet_icon

 

That's great I'm glad I found the forum. I am indeed using the u-40 syringes with the ProZinc.

So my shopping list looks like this:

1)KETOSTIX
2)Relion meter
3)test strips for the above
4)lancets
5)Fancy feast low carb wet food

Anything I'm missing?

The current dose I am giving is 7 units at 9AM and 9PM.

My cat currently weights 9.5 pounds and has lost weight since his prior vet visit.

Thanks for the link to the spreadsheet, I've saved it to my computer.

Thanks for the chart, I bookmarked both pages. I will be going with fancy feast since I know he likes it already.

@MommaofMuse

Your story gives me a little bit of faith that things will get better and that there is some hope afterall. Thanks.

@MikeysMom

From what i've read a lot of people have success by changing their animal's diet so I think the dry food is a big part of the problem also.

It's kind of that the science diet food is so bad, the vet told me if I can get him to eat it that I should switch him to that only... Ugh.

After I get all the testing supplies I will remove the dry food from the equation and lower the dose.. Hopefully someone familiar with prozinc will recommend a starting dose.

@squeem3

I know my local walmart carries fancy feast and amazon does too. My cat likes some variety so I guess I'll pick up a few different cases of it. Although it sucks because I just bought $40 of the pouched food. I guess I can donate it to the local shelter since my cat won't be eating anymore of it.

I will keep a few of the pouched foods on hand incase he ever hypos. Thanks for the tip!

I never feed my cat seafood but he does enjoy his treats. I wasn't aware it was hard on their kidneys so thanks for the info!

I bookmarked the insulin conversion page and I will possibly pickup some u100 syringes. thank you,

@kse

I have a bunch of U40 syringes that have the prozinc labeling on them so maybe I'll just stick to using them for now.

I'm glad you have your cats regulated! I'm happy so many of you have success with treating your cats diabetes and it gives me lots of hope!

@Jane & Silverado

I've actually been to 2 vets in my town and both of them were pretty much useless when I asked them questions or looked at me like I was stupid for asking them. I live in a small city in Nevada so there aren't many choices to go to. I could drive an hour away and most likely find a good one, it just may be worth it.

I would like to thank you all for replying to my thread so promptly and giving me newfound hope! I hope you all have a great night -- I'll be heading to walmart in a bit.

 

Hey Jenn & Baxter.

I posted in the PZI forum! viewtopic.php?f=24&t=66167

See you there

 

Get 25-28 gauge lancets. (humans can use smaller gauge lancets 30-31 gauge and they are usually the size in lancet packages). Diabetic cats often need the larger gauge.

 

Brad,
you are going to find that FDMB is a one stop shop; there is not much in the way of help and info relating to feline diabetes and all related issues that you will not find here.

All you need your vet for will be vet stuff like prescriptions, and fixing broken bones, and dentals, and running tests, etc. The rest is right here.

 

Hi Brad,

I was in the same boat as you just a couple weeks ago, vet had my cat on hills w/d dry, and wanted to keep increasing insulin...but it was just making her worse. I did a diet change about 2.5 weeks ago and immediately had to cut insulin doses in half, within a week I was shooting 1/10 to 1/20th the original dose, and I haven't checked her lately but she has now gone 75 hours without insulin and had BG readings from 54-78 for the last 48 hours or so. Some cats go into remission, most cats can have their diabetes managed. Fire your vet, I did!

Cathy

 

Brad,
Did you get all the food info and an answer for what dose with wet food?

Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition
List of Low Carb Healthy Treats

You may see her dose drop off a cliff when you take away that dry food.
There was once a cat who was getting 20 units twice a day of Caninsulin and eating dry food....
the dry food was removed and that cat dropped to something like 1unit twice a day, so yeah, you will see a change.

It would be wise to get the testing started, and ask if you are having any problems so people can help you.
Then you can take away the dry and drop the dose.
I am not familiar with this insulin but I would not see a harm if the numbers warrant it, to drop down to 1unit twice a day and work your way up to a good dose.
Who knows? Maybe a food change is all you need to get off insulin!

Be sure to post and ask any questions you have.

 

Hi Brad,
I read that you are posting in PZI and I hope you will get some great help there. I've been away for a long time, but I was one of the first using Prozinc shortly after it came on the market in Nov 2009. Here's a little info I put together from things I noticed in my boy when he was on it. (We have since switched to levemir) It may help you learn WHEN to get those blood glucose readings to give you the most information.

Prozinc = "PZIR"
typical nset +2 ,
nadir +4 to +7, (low point of the cycle)
duration +10, (or +11.)
steeper curves than levemir, (which caused reactive bouncing in Cody)
dose TIME more flexible because of shorter duration (you can shoot early if needed because its worn off, 12/12 less strict)
came to market Nov 2009, FDA approved for cats
U40 insulin = 400u in a vial
usually approx $90-130/ vial
durable long shelf life after opened (if refrigerated, handled gently, and kept out of the light)

After you get the Relion meter, strips and low gauge (fatter) lancets; and start testing; try to create the SPREADSHEET,( and linked to your signature) so that you can post your dose and readings for help.

You may ned a little patience at first TESTING, but it become easier quickly. This is my technique:
grab a tissue
I rub ear vigorously.
fold his ear over my finger,
HOLD the lancet on for a good 3-5 sec waiting for the spot to turn pink (helps to have a clear top lancet pen),
then pop it CONTINUING to hold it on the spot until enough blood oozes out,
carefully lift it off, test,
then immediately pinch on the bleed spot with your finger, and hold for 3-5 sec to stop future bruising.
then he eats- YAY! reward!
use a clean lancet everyday to reduce ear irritation and clean the needle after each use (stab a tissue) to not contaminate the next reading.

Best of luck!

 

Oh, the special ProZinc 12 unit syringes. http://www.prozinc.us/understanding_insulin.aspx You can certainly use those for now :smile:

As a general FYI, there are also U40 insulin syringes with 20 units and the more common 40 units.

If you later decide to use U100 insulin syringes with the conversion chart, buy the 3/10 cc ones with half unit markings so you can more easily measure small doses. You may need a prescription to buy U100 insulin syringes at the local Human pharmacy. Some people here buy online from Hocks.com or AmericanDiabetesWholesale.com

 

Hi, Brad,
Another supporter for you here. I also have a 14 y/o male cat, first diagnosed about 2.5 years ago. Once I changed to wet food (in my case it was Friskies Mixed Grill), he went into remission after only 3 months of insulin. However, last year he got very sick, stopped eating (the diabetes wasn't an issue), so I needed to change his diet to Fancy Feast Elegant Medleys Chicken Fare with Garden Greens, he recovered but his diabetes came back around December, so he's back on insulin. I'm changing his diet again as he refuses the Mixed Grill, currently it's FF Chicken Classic, and his insulin dose seems to be decreasing as he's dropped his glucose too much a couple of times. Currently he is at 0.8 units twice a day.
So, there is a lot that you can do for your kitty, as long as you have the commitment to monitor closely, you should be fine, just be aware that it can be a roller coaster but this is a great community for support. I certainly can't promise you a quick or permanent remission, but talk of euthanasia at this point seems very premature.
I see there's already a ton of good advice in prior posts so I won't repeat it all over again, just welcome and hang around the PZI forum if you like, have some coffee , relax, learn and share!

 

Keep some of the gravy foods for your hypo kit. As you never know when you may need to use it. Here is a link to setting up your hypo kit. viewtopic.php?f=14&t=2354

And yes you can use U-100 syringes with prozinc - you just need to convert the dose, here is the conversion chart: http://www.felinediabetes.com/FDMB/view ... 19#p340819

 

Hi guys .. I just wanted to welcome you to the board! I am so glad you are ready to hometest and get your little guy back on track! I used lantus with mocha, who just last week celebrated one year OFF the "juice" all thanks to this board! She is fed special kitty from wal mart, she get's the 5.5oz can's for .43 each (it fits best into our budget) she LOVES the turkey and giblets which is low carb, around 3 or 4% .. You CAN do this!!

 

Welcome to the FDMB!

There has been absolutely fantastic advise here already.

Just want to let you know- with the lancet pen didn't work with me. I just free poke with the lancet as I couldn't get the needle above the hole. Sneakers is okay with that as she didn't like the click of the pen (or the beep of the meter) next to her head. You learn how hard to push so it doesn't go through the ear. Larger lancets are a plus at the beginning because those ears are like turnips and they don't want to give up any blood .

My routine:
rub ear- she LOVES the ear rubs- to get warm
take out a strip, close container and place strip on lid
rub some more, poke at edge (you have plenty of links for that)
get a drop to form, scrape the drop up on your fingernail
hold the spot between two fingers for about 3 seconds (longer if it is a gusher) to stop it bleeding
you can let go of Shadow- give treats
place the test strip in the meter, wait for the drop signal, and let the strip suck up the blood at the tip
if Shadow is still in the 'position' give skritches and sweet talk

DO NOT: dump the blood on the strip as it will give an incorrect reading. I did this frequently at the beginning and then went to a health fair and they tested my blood and I saw them use the meter- that is when I realized I was doing it wrong.

 

I wanted to say welcome, as well! Everyone has given you some great advice. Science Diet dry is pretty horrible for diabetic cats, so I suspect once you change the diet to low carb canned food only and lower the dose, and are dosing according to your home test data, you should see a HUGE improvement. I used Lantus with Bandit so I don't have experience with Prozinc, but I would probably lower the dose down pretty dramatically to 1-2u after removing the dry food. You'd be really surprised what a difference that can make in lowering BG, especially with something like Science Diet.

I would stick with the Prozinc for now and see what kind of results you get after a few months home testing and dosing correctly, but another option for you down the road if you're still not seeing good results with the Prozinc is to switch to even a slower acting insulin like Lantus or Levemir. You still have many options left to get your kitty better, so definitely don't give up on her. Unfortunately your vet didn't take you down the right treatment path, but you're getting there now! :smile:

 

make sure you get the relion micro or confirm. takes a smaller drop of blood and sips much faster. The ULTIMA is the older meter. Make sure the strips match the meter.

I also started out on PZI which was a U40 insulin. I used the conversion chart and 1/2 u marking u-100 syringes. I needed to micro dose my cat and U-40 just did not cut it
actually, way back when we started. it was a rare few that used U-40 syringes and even some of those folks switched over to y-100 and the conversion chart

welcom.
also, if you say where you are from,city and state, maybe someone from here can lend a hand to get you started

 

How's everything going with Shadow, Brad? How is he feeling? And, do you need help with learning to test?

 

Hey guys,

Shadow is actually still at the vet so I haven't got to start yet. The vet called yesterday and said he got his sugars down to 300~ with a different type of insulin and that it looks promising.

Either way, I'm still going to be regulating his diet and testing at home. I think I should get him back today, I miss him!

Thanks for all your input guys/girls and when I get all the curve numbers I will be sure to post them so you can examine them.

Thanks again! -Brad

 

If your vet tries to switch her to Humulin N, please ask for a different insulin, or say that you want to continue with Prozinc with home testing. Humulin N will cause steep drops and huge climbs, and does not last a full 12 hrs per shot. It would be a step backwards.

Lantus and Levemir have the best results in cats, with Prozinc not far behind. You want to use one of those three insulins to see good results. Humulin N is good for dogs, but not a good insulin for cats.

 

Hi Brad. I don't have a ton of experience like the rest of these folks, but I had my cat Skipper on Prozinc from mid-December-yesterday (5.5 units twice a day) and saw no improvement. We switched him to Lantus yesterday. The first two blood glucose readings were under 400, which is way lower than they were on Prozinc, but I realize it's still early.

I had to deal with what you're dealing with early on when Skipper went into ketoacidosis in January and was hospitalized for 3 days. I had debated whether to put him down, too, because he also has some other issues, but am determined that the diabetes can be fixed with diligence. The people on this forum have really helped me, as my vet never once mentioned home testing or changing to a canned food diet. I'm still having some issues there, but I'm working on the diet and have started home testing, thanks to the free supplies they sent me. So take the advice of the others here, as they know what they are talking about.

Take care, and good luck.

 

Hey everyone!

I just got Shadow back from the vet, and the vet gave me a piece of paper with his testing results on it.

Unfortunately he switched Shadow to Humulin-N and I know Julia & Bandit said that would be a step backward. I couldn't do anything about it because my mother had to pick Shadow up as I was at work when they called.

Hopefully I will be able to take the bottle back and get a different kind... Any thoughts?

Here's his numbers:

3/13/12

8:15am 696

4 units PZI (New Bottle)
10am 634
11:30am 388
1:30pm >400

3/14/12
7am 378
1unit nph insulin @ 8am
10am 399
2pm 424
4:30pm 2 units nph insulin

3/15/12
7am 394
12 noon 315
3pm 415

I think today he was testing with the Humulin N.

What are your guys' thoughts on this and his numbers?

The vet told my mom that human meters would not work for testing the cat and I would have to get one for animals, is this true?

Thanks!

 

NO, you do not need to get the expensive animal meter from the vet. Everyone here uses normal human meters and have no problems, except the Freestyle meters are horrible.

For insulins, my first choice would be Levemir then Lantus and then PZI.
Any one of them will be much better than Humulin N, much much better.

 

Do you still have the PZI? If so, I would use it. I think you are still feeding dry, right? I would slowly change over to all wet, lower the insulin dose while you do that and monitor carefully. Come over the PZI forum and you will get on going help and advice.

Some people here have regulated their cats with Humulin. But it's harder on the cat and the human, and in many cats, not possible. PZI is milder, longer lasting and easier to work with.

 

His numbers are a little high, but you have to take the fact all those numbers where tested in a vet setting. Vet setting BG are always going to be higher because the cat is usually stressed which rise BG. Once Shadow is at home & gets settle down you could some of the numbers go down a little.

I'm a ProZinc user so of coarse I would say get back on ProZinc. I have only read bad things about Humulin N.

Keep in mind it takes a little bit to get settled into a dose. It doesn't happen over night.

 

Hmm..... Why is a so called "professional" feeding me so much inaccurate information? This bugs me!

So you recommend getting off the ProZinc and switching to levemir or lantus?

I don't have any more PZI left just a brand new bottle of Humulin-N. He is still on dry food as I just got him back today. I will be making the switch soon, I still haven't got the needed supplies as I wanted to make sure I got Shadow back first. I am headed to walmart tonight for sure so I will pickup the food and other supplies.

I think I will stay away from the Humulin-N. Will the vet let me take it back? I don't have any insulin for Shadow tonight and the vet is closed -- What should I do? If I open the Humulin-N I'm sure they will not let me return it.

I'm sure shadow was very stressed and I know that will cause a spike in his BG. He seems happy to be home and doesn't look too bad.

I will be patient and consistent with his dosing and will follow all advice I am given..

Thanks for all the input guys! Here's to hoping Shadow gets better.

 

​

I donated $40 to the forum guys. Hope it helps with the server costs and what-not.

Thanks.

 

You could get the testing down tonight, ditch the dry and see how his numbers look without insulin. Then take the Humulin back and tell the vet you want to use another insulin?

Donations really help - thanks!

 

I agree with Sue. Ditch the dry tonight. It's easier to transition to can food without insulin. If you transition to can food while giving insulin you have to do it slowly or you could increase chance for hypo. The can food could bring him down 100 points on its own.
If I could do this all over again (which i dont want to do) with what I know. I would have changed Baxters diet the second I found out he was FD. Then started insulin a week later. All while I was home testing. It would have given me a better idea of true BG numbers & could have dose occurdley. In the beginning I wasn't home testing. I was transitioning dry to canned food, adminster insulin blind. About 2 hours after a shot I noticed Baxter was walking strange & ran into the wall. I couldn't get ahold of the vet. It was late at night & all I had was a piece of paper telling me how to treat a hypo situtation. I stayed up all night with Baxter. It was scary. I will never know how low is BG got. He was diffently showing symptoms. Its because his body was coming down from the high carb dry with insulin.
I know it might be a little late to turn back & start low carb without insulin. So just slowly transition the can food if you are going to give insulin. I don't want to log on here & see a 911 by a post from you. It will make me sad like all of the 911 post.

Jenn & Baxter cat_pet_icon

 

I agree with the others about ditching the dry food and testing while she's temporarily off insulin--it's far easier than trying to do the diet change while on insulin.

I would ask your vet for a prescription for Lantus or Levemir, since the PZI is gone anyway--they have the best remission rates in cats. I'm attaching some articles for you to print out and give to your vet. If your vet won't write you the script, I would switch vets to one that is willing to work with you. Your vet may not necessarily be a bad vet, just behind in his research. Not many vets are versed in all of the recommended treatment guidelines for diabetic cats (the current guidelines just came out in 2009-2010)--what is important is that you you have a vet that is willing to work with you and is supportive of the information and education that you're seeking and providing him/her. I lucked out with Bandit's vet--she handed me a prescription for Lantus and a list of low carb, commercial canned foods in different price ranges, showed me how to home test with a human meter in her office and then sent me to the store to buy one. It wasn't until I showed up here a few months later that I realized my experience with my vet was unfortunately not the norm.

Here's a link to the AAHA diabetes guidelines: https://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf. See page 4 (218)--where it states the two recommended insulins are glargine (Lantus) and PZI. Humulin N is a faster acting insulin that works like the lente (vetsulin) insulin mentioned. Levemir is not mentioned, but it is a slow acting insulin that works the same way as Lantus. Cats' metabolisms are twice as fast as humans or dogs, so they do best on the slow insulins because they last a full 12 hrs in cats (Lantus and Levemir are considered 24hr insulins for humans). They also have much gentler curves, and are much, much safer for the cat.

Once you get your spreadsheet set up, you can come here for dosing advice. There are experienced, knowledgeable people in both the Lantus and PZI forums here who would be happy to help. My vet started me out in the right direction, but her dosing recommendations were way off (she was dosing Bandit like a dog), so I came here for dosing advice instead, until I understood the protocol and was able to make adjustments on my own. Bandit's been in remission for well over a year now, and he's healthier now than I think he's ever been.

 

Bad news. I didn't give shadow his shot last night or this morning and took away the dry food and he just didn't look well. And then he vomitted on the floor so I ended up putting the dry food back down and giving him his insulin.

Any ideas/advice? It scared me how he's acting and how he puked, I'm sure it's because of not having his insulin.

 

I would return the Humulin and get a refund. You will find plenty of research on the internet and on this site that shows that Humulin N is currently considered a poor choice for cats, you could print that out and bring it with you for more "ammo". In the past, it was often the insulin of choice, so your vet might just be a bit out of date on the best treatment.

In layman's terms, the reason it is a poor choice is it comes on strong and doesn't last long so the cat his high numbers for much of the day with a possibility of a hypo or feeling yucky when the insulin hits. Consider how you feel when you drink a sugary soda on an empty stomach. Sugar high! Two hours later you might feel a crash... a foggy feeling, irritability, dizziness, lethargy. That's what it feels like when a strong insulin suddenly kicks in. Regardless of whether the blood sugar drops to 300 or 50, a huge drop will cause a diabetic to feel pretty awful. Then sometimes the liver panics and dumps sugar into the blood to compensate. Then more high numbers! This pattern won't help your cat feel better. Having a gentle insulin is like eating a low carb, high protein diet... blood sugar stays more constant and there is no sudden drop so the liver does not dump sugar. When the cat has both going for them, they can often heal enough to start producing insulin on their own.

I used PZI and it worked well for my cat. My cat would have around 8 hours of low numbers during each cycle. Lots of folks here like Lantus and Levemir which are even gentler. (I believe you can get these two from a human pharmacy if the vet doesn't have it). I would stick with one of those three.

I will second "wet food". It made a world of difference with my Scout. The day after I took away all dry food was the last day she needed insulin.

I know it's tough to choose to listen to "crazy cat people on the internet" over your vet, but the folks on here have done the research and have first hand experience caring for FD cats. Some of us are diabetics ourselves. My vet is awesome, and I trust her to diagnose my cat and recommend treatments... but for a chronic illness or if my cat is not improving on the treatment, I go home and the research myself. I've suggested alternate treatments to her before and she's been receptive to them. She was not up to date on FD care when Scout was diagnosed... but she certainly is now.

Keep us posted!

Lori

 

Has he been tested for ketones, either by you or at the vet? Vomiting is not normally a sign of high blood sugar, but it can be a sign of diabetic ketoacidosis, which is a dangerous complication that arises from high blood sugar. If you're not testing for ketones, that should be your first priority. DKA can come on very suddenly and be deadly. You can pick up ketostix (urine test strips) at any drug store.

Dry food doesn't do anything to "settle" a cat's stomach, so taking away the dry food is not what caused the vomiting. And unless there is a complication like diabetic ketoacidosis, lack of insulin would not have caused vomiting either. Have you started testing him yet? Also, how much insulin did you give him? Humulin N is an insulin you especially don't want to overdose because of the fast drops. Any way you can ask for a script for a different insulin?

If you're going ahead with the N until you can get him on something else, you need to make sure you're testing before each shot, and 2 and 4 hrs into the cycle. N has a greater danger of hypoglycemia, so vigilance is necessary.

 

Some cats are literally addicted to dry food. We call it kitty crack. Keep in mind you know what's best for him he doesn't. Try mixing the canned with dry. Maybe it was the brand or the flavor you tried? Keep trying some cats don't start eating canned over night. Keep with it don't get frustrated. When you get a chance read this it will help you with transitioning to canned food. www.catinfo.org.

Test for ketones please. When BG are high it's so important to be testing. I know another test for you to do....things are going to get better & easier. ;-)

 

im on my phone so i wont be able to reply to the other posts right now...

i went to the vet and spoke with one of the vets and she wouldnt give me levemir. she said she would give me detemir because she was familiar with it and said it was similar to levemir... any thoughts/advice? should i go somewhere elsle?

 

Detemir is the generic name, Levemir is the brand name.

 

And for what its worth, yes I think you should get a new vet ASAP.

 

So is it the same stuff then?

Honestly the other vet is just as bad and was of no help at all when my cat was really sick one day. I don't care for either of them but they are the only ones here.

I'm at walmart and can't find the ketostix! Guess I will look elsewhere.

 

Ask the pharmacist. some stores have them behind the counter for some reason.

Carl

 

I have heard of Levemir, but not the other. It's very important to have a vet that is supportive of your suggestions & ideas. Its also important to have a vet who is more up to date on FD. Its surprising how many vets arent that knowledgable about FD. Your vet works for you. You have the freedom to fire them when you don't like their ideas or lack of support. Get coipes of the charts first. I am sure there are other vets in your area. Put a new post about searching for a vet in your area. Members will advice you what to ask & how to interview the vet. Your ultimate goal is remission. Its not always possible, but it is possible. Having the right insulin & protocol is a huge factor. Just keep that in mind.

I know this is so darn frustrating. It will get better. :YMHUG:

 

Yes, "levemir" is detimer. Just like lantus = glargene. Just name brands. Sort of like kleenex = tissues.

If you haven't yet made a decision which insulin to pick, please understand that all of us are biased, whether we intend to be or not. We all believe we know what the "best insulin for a cat is", but our opinions are somewhat based on what worked for "our cats". For instance, I'm a huge fan of PZI. For me, it had a 100% remission rate. It's the only insulin I have any first hand experience with. Some cats don't do well on Lantus, but do well with a switch to Levemir. Some cats don't respond to Prozinc/PZI but do better on a "depot" insulin like the L's. And vice versa.

There is only ONE "best" insulin, and I was told that by one of the most experienced and wise lantus users. The BEST insulin would be the insulin that works for YOUR cat. Unfortunately, there's no way to know that up front. Would Bob have gone OTJ on Humulin, Lantus or Levemir? Don't know, maybe so. What I KNOW is that he did with PZI. But I wouldn't advise you to use it on your cat.
What I would advise is that you visit each of the insulin support groups and read some threads. Look at some spreadsheets. But most importantly, read the "how it works" sticky threads. Understand the protocol, how it works, what to expect in terms of a response to the insulin, how it is dosed, how often, etc. They all work differently, they all have different protocols, they all get great results in some cats, not so great results in other cats. Some cats go OTJ in a matter of weeks, some take months or years. Others never do. But they all live better lives than they would have otherwise had, and can live for years on insulin.

I think the reason you haven't gotten positive results up till now is because your vet doesn't understand how to treat the disease, what a logical dose is, or how to base dose adjustments on the numbers the meter is giving you. He doesn't seem to have much faith in home testing, and more or less told you it was time to "give up". The fact they sent you home with Humulin is enough evidence.

Carl

 

Yes, Levemir=detemir. The fact that your vet does not know that, but claims to have significant experience with detemir would probably send me to a different vet. But for now, as long as she'll give you that script, that's all that matters. You can get help with dosing here--there is a lot of information for you in the Levemir forum. And definitely ask at the counter for help with the ketostix--I've bought them at Walmart before so unless they ran out they do carry them.

I understand your point that every cat is different, Carl, but there are studies that prove a significantly high remission rate for the "L" insulins. I would have no problem suggesting PZI along with them if there was any research that pointed towards a similar remission rate--however, what research is out there actually shows a lower remission rate for the old PZI, and no research has been done with the newer Prozinc. So my opinion is not just based on my personal experience, but rather the existing research.

Not that Prozinc is a bad insulin for cats--but given the choice between a known 84% remission rate and an unknown 40+?% remission rate, I would start with the better odds first if given the choice, so that is the basis behind my recommendation.

 

Hey guys,

I did get the Ketostix, and I just got back from my weekend trip and am ready to start testing tomorrow. I was away for the weekend so haven't been able to pick up his prescription yet. She did say she would call it in on Friday, so it should be ready to be picked up.

When testing for ketones, do I have to catch him when he is urinating?

I am still unsure of how to switch to the other insulin -- What dose I should start at, when I should test his blood, etc. I would like to start tomorrow AM and am free to do it since I work from home.

Just to be clear, she did say she would call in a script for detimir (levemir apparently) and that is what I'm going to be using. I would like to get him off dry food as well, but I'm unsure how often/how much wet food I should be feeding him. What kind of syringes do I need for the levemir?

 

Hi Brad. That's a lot of questions. I'll try to answer some of them. For the Levemir you will need to use U100 syringes. Did you pick those up, yet? You can get them at WalMart in most states without a prescription, but here in New Jersey you need a prescription.

I would do the switch to all wet canned food gradually and only while you are testing.
So, tomorrow will be your first BG test?

For ketone testing; I just take a little plastic cup (like the little cups they supply for ketchup at McDonalds) and wait for J.D. to be in the middle of peeing and then walk up and slip the little cup under his tail. Others use a ladle, and some can just dip the strip into the stream. If that fails there are other ways like catching a puddle before it is absorbed by the litter or adding some saran wrap over the litter, or replacing the cat litter with fish tank gravel. You wet the strip with the pee and wait exactly 15 seconds, and compare it to the bottle. Please let us know what the test result is when you get it. Also, I always write the date I opened the bottle on the outside as they are good for 6 months from that date.

We'll get some more advice for you on that starting dose. If you don't get any, please change the Subject Line in the first post of this thread to add or change the words to "Dose Advice For Tomorrow Needed" or something like that.

Best Of Luck with the Levemir.

 

Brad, did Shadow get his insulin over the weekend while you were gone? That throwing up on Friday, and then you being gone just has me worried. How is he feeling now?

 

Hey Dyana,

Thanks for the quick response! You guys are always quick to help me out, its great!
When I pick up the insulin I will get the syringes as well. Sorry for not being on the ball guys. Things have been somewhat hectic but I'm ready to start now and will be getting the insulin and needles tonight along with the testing supplies. The weekend kinda screwed me up but I'm going to take care of everything tonight. I live in nevada, hopefully law allows me to pick them up w/o a prescription.

Yes, tomorrow will be the first day I do testing. Do you test before you give him the insulin, food, etc? Or before and after and then every x hours? It all seems kind of overwhelming and I'm sure there's a learning curve but I'm generally a fast learner and catch on very fast. Hopefully I don't have many issues with shadow. He is pretty mellow and doesn't ever fuss with his shots so hopefully he doesn't mind me testing his blood!

The ketone testing seems like it would be difficult to do but I guess I could just do the saran wrap method or use fish gravel. Thanks for the suggestion I will do that asap. He pees quite a bit so I guess it shouldn't be too difficult.

 

And yes he did get his shots over the weekend my mom gives them to him while I am away. He hasn't been sick since, but overall he doesn't look like he's feeling too well. Hopefully tomorrow is a better day for us.

 

Hi Brad,

Just wanted to say hi and add my two cents. My Racci started on PZI and was all the way up to 5 units when I found a vet who switched her to Lantus. She immediately started getting better numbers and once I was able to switch her food they were even better. PZI is a good insulin too but some cats just don't do as well on one as another insulin. I would definitely not use the Humulin but ask for Lantus and give it a try.

Also you would need to buy the U100 syringes with it and I didn't see anyone mention to get the 31 gauge. It is much finer and will hurt less. I use the ones that are 30 units or less, w/ 1/2 unit markings 3ml 5/16" short needles.

Good luck.

I'm appalled that a vet would recommend euthanasia for diabetes in an otherwise healthy cat!

Melanie & Racci

 

Hi Brad. I see that you're online. How is Shadow doing?

I don't see any other advice given on starting dose. You won't want to start with 7 units of Levemir. Maybe 1 unit or maybe 2 units. The insulin should be given every 12 hours, so what would best fit your schedule? I'm sure it's like 3:00am in Neveda right now.

 

Please get his pre shot test first (before eating) and post the number, so someone can help you determine a starting dose.

 

@MelanieAndRacci

I'm glad your cat is doing better! Hopefully I can have a success story as well. I already have the script for levemir so I will be going with that instead of Lantus. I will get the syringes today when I pickup the insulin. They gave me 10 U100 syringes with the Humulin (I think). Thanks for the input :smile:

Hello Dyana,

Sorry I missed your post I must have got off before you posted. I know we should start out on a low dose just wish someone would recommend what to start at. Once I put some numbers up I'm sure someone will chime in though. I already fed him this morning because he came to me for food. I give him his shot around 9am~ and 9pm~ every day.

I did get a relion meter and test strips last night. The pharmacy was closed so I didn't get to pick the insulin up but I'm going to pick it up in a minute. I gave him the Humulin-N today since I didn't have the other insulin. Is it best to wait until tomorrow to give him the levemir or should I give it to him tonight at 9?

Thanks for the input!

 

I believe you can go ahead with the shot of Levemir tonight. Have you tried to get a test, yet?
9:00pm is midnight for me, and I will be long asleep by then. I would try to get a test or two today, and definitely get a test before giving the shot. We strongly recommend at the very least to get a test before every shot, to know it's safe to give the insulin.
When you get your first test, I would start a new thread and post the number in your new Subject Line with the words Starting Dose Help Needed Please, or something like that. I'm sure someone will be up to help you decide.

 

I just got the Levemir at the pharmacy. $135!!! Hopefully it works out. They gave me the wrong kind of needles though so I guess I will have to get them from the vet. I am kind of nervous about doing the first test -- But I'm going to bite the bullet and just do it! I'll report back with my findings. His shot was 5 hours ago.

 

Boy that didn't go very well ha! He was real fussy and definitely didn't like me trying to do it. But I got it done and it read 396. Atleast it's not as high as it was at the vet.

I would like to start the spreadsheet, but I'm not quite sure how to do it.

 

Also, the pharmacist told me the bottle is only good for 28 days. Does this hold any weight or what do you guys think?

Thanks! I'm happy I finally got started. I have a good feeling about it and am feeling pretty confident that we can get this under control! Thanks for all the support, I really do appreciate it.

 

You are doing a good job! I was a nervous wreck first test. I almost passed out giving the first shot. I put it off for almost a hour. I guess in hopes I was having a horrible nightmare. It gets better with time.

My ProZinc cost $140 from the vet. He said it would last me about 4 months. I am still on the same bottle & have less then 1/2 left. It's been 4 months. I don't know about the Levemir.

Make a new post for help on the SS. You will get excellent help.

Jenn & Baxter

 

Brad:

I'm just picking up on this now but I have read through the condo. I used lantus with Gracie for a year and now use levemir, as does Dyana, and love it. It has a very different curve from the other insulins but it is a very nice, gentle insulin.

Julie and I are on the West Coast and are up at night at your shot time (9 pm) and usually cruising the board until midnight at least. There are two protocols for using levemir insulin. One is Tight Regulation and the other is Start Low Go Slow. Because one of the requisites of doing TR is that the cat be on a low carb canned or raw food, then you should use the SLGS protocol until your kitty is entirely off dry food. But, as everyone else has said, you need to remove the dry food slowly.

Here is a link to the SLGS protocol: SLGS Protocol

Here is some basic info regarding Levemir: Levemir

The SLGS recommends

I scrolled back through the thread but might have missed his weight. There are two ways to approach it: you could be really conservative and start at 0.5u bid (every 12 hours)...that way you are very unlikely to miss his fitting dose by starting too high. Or, if he's a large cat and since he's been in the 300s and more, it might not be a bad idea to start him at 1u bid (every 12 hours). FWIW, I would probably start him at 1u bid just based on the information you have provided and I think that would be a really good place to start. Then we can adjust as needed per the protocol.

Gayle left you the link to doing a Spreadsheet but I'll put it here because we will definitely need it to give you the best help: Spreadsheet

Please let us know what questions you have.

BTW....did you get a vial of levemir or the flexpens? A vial should last you close to six months if handled correctly and that would be about what a vial would cost. The 5-pack of pens is normally about $200 at Costco and each pen will last up to 42 days....and sometimes much longer...if handled properly.

 

hi brad, i'm just checking in with you too. i think you'll be very happy with the change to levemir.

as marje said, we're both late night people, on west coast time, and we'll be looking out for you tonight to see if you need help. hopefully others will be online as well.

so your job is to
1. start a spreadsheet with the link above
2. test him tonight & post the number
3. begin to transition him off of dry food and on to canned. read http://www.catinfo.org for tips on how to do that. very important to get rid of the dry, but we want it done over a few days so that there are no sudden plunges in blood sugar from the reduction in carbs.

see you 9ish.

eta - what did you mean about the store having the wrong syringes and having to get them from the vet? one critical point is that you want to have u-100 syringes. make sure they do NOT say u-40 on it. do you have the u-100 ones?

 

Hey! Thanks for the reply. All I hear is wonderful things about the levemir so I think it will be a good fit for Shadow.

So before his shot tonight I will test his blood and update my spreadsheet accordingly.

My cat is decent sized, but has lost 2-3 pounds I would say.

Hey! Thanks for the reply. All I hear is wonderful things about the levemir so I think it will be a good fit for Shadow.

So before his shot tonight I will test his blood and update my spreadsheet accordingly.

My cat is decent sized, but has lost 2-3 pounds I would say. He weighs 9.8 pounds now as of his last vet visit.

I think I will start him out at 1 unit as you suggested.

I got a vial of levemir for $135. The pharmacist said the insulin is no good after 28 days which is why I asked.

I will be sure to do all of those and start tonight.

About the syringes -- They gave me needles that go in increments of 2 and all the way up to 100. The needle was quite thick too compared to the one the vet gave me. I do have u100 syringes that they gave me with the Humulin-N. I think I have 10 so I will go by the vet before I run out. Shadow's backbone is getting very skinny and he just looks like he's withering away.. I hope this will start working for him soon.

Thanks for the replies guys -- Will try to keep my hopes up!

 

Brad:

Julie's point is very important.....and I'm surprised the pharmacy would not have U100 syringes. So be sure whatever you get is U100...not U40.

To further her comments, just so we kinda see where he is, IF he will let you, it might help for you to get a +10 number (so that would be 7 pm your time) and post it for us. If not, then just post his PS number at 9pm.

Since you haven't been testing alot yet, if it's possible, it would be great to get a +2 test and post it for us. Julie and I should both still be up. We can then advise you on when you need to test again.

Normally, we would just recommend that you always get a PS test (we test, feed, shoot within 10 minutes roughly), and then at least a mid-cycle test around +6 during the day. At night, get a before bed test. If you can't get a mid-cycle test, then we would recommmend a test before you leave for the day. Any time you get a number at PS that is 200 or lower, please do not shoot and do not feed. Post the number FIRST and ask for help. If you get a low number during the cycle (for now let's say 100 or under), then post and ask for help.

I would recommend that, once you get your SS up, you move over to the Lantus TR ISG....tonight if at all possible. The only reason I recommend this is because there are many more people over there all hours of the day and night. You would find that forum by going to "Board Index", scroll down to "Insulin Support Groups", and click on "Lantus TR ISG". There are many of us there using levemir and we have several people doing the Start Low Go Slow protocol.

Once you get your feet on the ground with this and feel more comfortable, then you can decide if you want to stay in the Lantus TR ISG or move to the Levemir ISG or the Relaxed Lantus ISG. Both of those groups can help you as well but there are less people on them.

When you do move over, just open up a new topic and put in the subject line the date, "Bart's Shadow", and something like "new to group" or "need help".

Just saw your post....Uh.....I don't know what those insulin syringes are that are in increments of 2u and go up to 100 but that is not what you want. The syringes the vet gave you...are they in the packages still? They should be U100, 3/10cc...you don't want the 1/2 or 1cc okay?

If the syringes the vet gave you are not U100, 3/10cc, then I'd go back out to Walgreens or Wal mart and tell them: U100, 3/10cc, 1/2-unit marking. The gauge and needle length are up to you. The needles come in 1/2" or 5/16". That is a personal preference...some say the 1/2" give better absorption BUT it's easier to give a fur shot. Also, the gauges would be 29, 30, 31 with 31 being the smallest. Typically the 31g only come in the 5/16" needle.

The vet is going to charge you an arm and a leg for the syringes.

Also...the pharmacist is wrong about the vial. What pharmacy did you go to and are you sure it was a pharmacist and not a tech?

Here's info about handling the vial and it includes a very, very good video about drawing a dose from a vial. Please be sure you look at these before you shoot tonight:

Proper Handling and Storage

 

Hey,

I just tested the blood as you suggested, although 30 minutes late and he tested 517. Any suggestions?

Thanks!

 

Good job. I'd go ahead and plan to shoot the 1u of levemir on time. You will still have to get a test before you shoot.

 

brad - i didn't see if you mentioned - how many test strips do you have at home right now?

 

I bought 50 strips at walmart just to start.

 

super. that should keep ya for a couple of days! just kidding - but we do go through them quickly.

do you have a preshot number about now?

 

Hey guys..

Bad news. His preshot test wouldn't even read on my meter. It just said Hi. Which means it was over 600+.

And then I have my mom telling me how she thinks we're just going to wake up one day and he's just gonna be dead. That got me kind of down and made me angry.... I gave him the 1 unit of Levemir and a can of Fancy Feast. Will test again in 2 hours..

 

it's ok brad - we've seen lots of highs. good start. don't be discouraged.

i think you got ketostix, didn't you? as you're making this transition, we're going to want you to check him for ketones daily.

also, because we're dropping the dose and changing the insulin all at the same time, several of us talked about it and we'd like you to just make the switch all at once to low carb canned food. might as well make all the changes at once - that'll help his bg as well.

check back in when you have the next test.

 

I know, but it just seems his health is getting worse and he's losing more weight.

I did get ketostix but haven't tested yet, I will put saran wrap over the litter right now, i just changed the whole box.

So to confirm take away his dry food right now? How often should I be feeding him wet food?

Thanks!

 

for the moment, give him as much as he wants, just dole it out in perhaps 1/2 can amounts per hour. he needs to not lose weight. pick up the food 2 hrs before his next shot so that you can get an accurate blood test.

yes, take away the dry food.

yes, get a ketone test. that's important.

what time did you actually shoot?

 

I buy the tiny cans of the food, give him half a can of those per hour? But okay, makes sense. thank you. I put the saran wrap in the box.

I gave him the shot around 9:10pm.

 

you can poke it down so it makes little cups. hopefully he'll still use it. some people stick a spoon in the stream after he starts to pee.

i edited the last post before you just posted - take away all the dry if you have enough canned food.

i'll check back in at 11:10 to see where you're at, but i'll need to go to bed shortly after that. please post when you get that test. in the meantime, if you have questions or get a ketone test in, post. i'll watch for you.

 

great job getting the spreadsheet up and going! can you go back and try to recreate any BG tests you've had and somewhat match them with times? i know you've switched from prozinc to humulin to the levemir, but every single bit of data you can pull up will help us help you.

the way the spreadsheet reads, from left:

date,
AMPS = preshot BG number in the morning (am preshot)
dose shot
the +1-+11 means how many hours after the morning shot. we have members from all over the world and that's how we "talk." each kind of insulin has a pattern, or cycle. we can "read" the numbers in the ss and it helps us with dosing.
PMPS = preshot BG number in the evening (pm preshot)
then same thing as the morning, but for the evening cycle. that covers 24 hours
the comments section is for anything that might be important - how he looks, what he's eating or drinking, if he's getting meds. it helps us know the rest of the story besides the numbers.

the spreadsheet is an essential tool for us - that's a quick way for anyone with experience to be able to take a quick look and give you help. so every time you test his BG, just get in the habit of updating right then.

when you give shadow his canned food, would you also add as much water to it as he will tolerate? that will help with these high numbers.

 

I tried recreating some of the testing that was done and punched in the numbers from the vet. Atleast it's a start.

When my cat wouldn't eat one day I found putting water in with the food and heating it up for 15 seconds was good for him and he drank/ate quite a bit of it. But I will start doing that.

 

Hey,

Just tested Shadow's blood and he came out to 479. I made the mistake of letting go of his ear and he shook his head and blood went everywhere! Oops! Lesson learned. I thought I had read not to do that but it slipped my mind.

Any thoughts on his numbers? Thanks

 

i should temper that food advice - do you have an idea of what he ought to weigh? i think you said he's around 9lbs now, is that correct? the food should be enough to keep him from losing any more weight. the insulin dose is in relation to the amount of the food a cat eats, so if he really eats 1/2 of a 3oz fancy feast every hour that would likely make his numbers high and probably be too much food.

my cat weighs 13ish lbs and eats 3 cans of fancy feast every day, plus a little bit more. we don't want him to lose any more weight - that's important.

any luck with the ketone test yet?

yay - actually the fact that it moved at all is very encouraging.

no worries on the flying blood. we've all looked like a crime scene with some tests! :lol:

how late are you good for tonight?

 

I'm not sure how much he should way. I would say he should be 12-13 pounds normally, he was looking kinda fat before all this diabetes stuff started. The vet just told me to feed him with every shot, which is what I do. I give him a 3oz can when i give him a shot, and usually a can in between (he usually comes and finds me when he's hungry). He usually eats it all.

I checked his box and nothing yet. I will put him in the garage and hope he goes...

Yeah the blood went everywhere! Oops. What a mess.

I am going to be up for another 4-6 hours. Should I test again at +4?

BTW: Am I doing the spreadsheet correctly?

 

just fyi - the carbs from dry food can take a while to leave a cat's body.

small meals of the canned food spread out would be great. water added is good, heated up is fine.

are there any other health issues going on? i apologize for asking what i'm sure you've already answered, but your thread is overwhelming! so many posts! can you give me the short version of his recent health?

yes - the spreadsheet looks great.

i'd test again at +4 and if you are up, also at +6. at this point you are gathering data. all the tests you do help. as we learn how Shadow's body responds to the insulin we'll get a better picture of how to help him.

if i'm doing my math right - you're 18ish - and i want to give you HUGE kudos for taking care of your cat. you're doing great!

 

um, i just re-read the "put it in the garage" - i think the urine has to be fresh for the ketone test. ya might have to stalk him! :lol:

when he does pee, you want to time the reading of the ketone strip exactly. it will continue to change as time passes, so watch it carefully.

edited to add - would you also add the early-on parts of his diabetes treatment into his spreadsheet. even if you have to kinda guess - you can do something like this:

november 2011 - diagnosed with diabetes BG #____ (if you know it) started on Prozinc 1unit dose
dosage increased by 1 unit amounts up to 7units in March (or whenever it was)
tests ranged from x to x.

3/16 switched to Humulin, 3 units blah blah - you get the idea. any dates, insulin, dose amount and BG#'s that you have - stick them in there.

something like that - we just want that info to be part of the story. we don't know at this point if he needs a high dose or not, but it's an important detail that he was getting 7 units at one point.

 

I just took the food away too so I'm not sure when the last time he had some was.

I will start feeding him smaller meals more frequently then, sounds like a plan!

There are NO other health issues going on. The vet diagnosed him with this and that was it. I'm not sure all the testing they did but I'm sure i've spent over $800 on all of this. I can't believe the response my thread has had! It really is overwhelming, but not in a bad way. Just lots of information to take in. I see a lot of the other threads don't get near as much attention as mine has gotten. But I appreciate it guys, keep the posts coming!

I will definitely do the tests then, I'll set an alarm on my phone so I'll remember.

And yes, I'm 18 turn 19 in may. He's been my bud since I was 4 years old which is why it's so hard for me to let go and I'll do anything to make him better, even if it brings him only a year more of life -- that's fine with me. I'll take what I can get, I just don't want him to suffer. It's nice having a flexible schedule so I can take care of him. If I had to work away from home I'm sure it would be much more difficult.

Thanks again for all the support guys :smile:

 

hmm. I thought one of the previous posts had mentioned that I could use aquarium gravel or something to get the urine and test it. Maybe I misunderstood.

 

you can use aquarium gravel, but read the instructions on the ketone strips - i'm thinking the urine has to be fresh. you can't have him pee during the night and test it in the morning. i'm not sure because i don't use them much - just read the directions.

you're doing a great job answering all my questions! i was editing a prior post - so scroll up and see where i added in red not knowing you were posting.

i'm headed for bed. you're doing great. you can thank dyana for some of the attention - she sent out an SOS for help for you! ;-) sounds like we better make sure others aren't getting missed!

if you need quick help during the night, post here and post on the Lantus TR forum. those are the most likely to have traffic during the night.

 

Thanks for the info.

I updated the spreadsheet with the background info and will test again in an hour and ten mins and post the results. Thanks! have a good night.

 

Okay so I tested again at +4. The first result was 396 and then I thought maybe the test strip didn't have enough blood on it so I tested it again and it was 441 about 5 minutes later... Could he have gotten stressed because I was messing with him causing it to shoot up? The second time around the strip was filled to the same mark, so I think the first one had a sufficient amount of blood after comparing the 2 strips.

I will go ahead and put the first result in my spreadsheet, and if you guys say to put in the latter I will.

Thanks!