Cleo- New Diabetic Kitty

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Cleo & Jane (GA)

Cleo & Jane (GA)

Member Since 2013
Hi everyone, and thank you for the wealth of information found on this board. It is a lifesaver. My 15 y/o kitty, Cleo, was diagnosed with diabetes yesterday. She had been drinking ALOT, and peeing giant size balls for about 2 months. She also seemed to be losing weight, but eating alot. It started gradually, but was getting worse. Thinking back, I should have realized something was wrong, but she was acting normal in so many ways. She was a stray my daughter brought to me in FL from NJ in 2001. She was about 3 when we took her in. She has always been a no-fuss kitty. Doesn't like to be touched (except on her terms), does not socialize much with her humans or her cat/dog siblings. Loves hanging out on the screened in patio watching the nature! But never creates any problems, eats well, and is very neat in the litter box. My hubby is her favorite.

When at the vets yesterday, her sugar was 496, and the doctor (not my reg. vet, she was on vacation) gave her 2 units of Humulin R insulin. They also gave her fluids under the skin for hydration. He gave me a rx for Humulin R insulin, with a dose of 2 units twice a day. I came home and began investigating. We had an appt today at 8 am for them to check her sugar again. It was 546 at vets this morning (8AM), but we had a heck of a time catching her to get her into carrier. We had to resort to chasing her, she was panicking, and she stopped and peed a half-gallon against a floor lamp! Anyhoo, different vet covering this am, and I loved him! He listened to me, got out his RX book and agreed she should be on Lantus insulin. So, she received more fluids under the skin, got her first dose of Lantus 2 units, and he and his tech spent alot of time discussing/educating me, and I gave them some tips I read on this board that they did not know! He wanted me to give her fluids under the skin this evening, but I recently took her bs (with my hubby's kit) and it was only 50!!! So, I am hoping to skip the fluids, as getting the bs reading was stressful enough - on me anyway. I read, watched utube videos, and still did not get enough blood. I wanted to give up, but what a feeling of success when I finally did do it. :)

I will give my first insulin injection to her at about 8 pm, and then start her off at 7 am tomorrow morning. She is scheduled to go to vet next Thurs for a "curve" test. I am so happy to be able to test at home, so I can compare. I wonder how much stress can raise her blood sugar? I am feeding her Fancy Feast classic, and I have removed the dry food from the counter. She did not eat dry too often, but her brother, Simon, really only eats dry. He is picking at the Fancy Feast, but he is looking very confused (Hey mom, where is my food??

I will be out of the house from 8 - 5 weekdays, and wonder if I should leave out some kind of dry food for her to nibble on? She eats more than 2 x a day now, usually am, dinner, and then late night. Is that ok? Plus dry food was left out during day, but I don't think she was a big eater of it.

I welcome any suggestions, sorry for this long, rambling post, and again Thank You for the wonderful board :-D
 
Re: Cleo's new diagnosis

Welcome to FDMB! You have found the right place to get excellent care for Cleo. This can be very overwhelming at first. We all know since we've been there but it can be done. I suggest you get another blood test before giving any insulin. That 50 is the very lowest level of normal cat blood glucose. If she is that low and you give her a shot, she will probably go hypo.

What does Cleo weigh and what is a good weight for her? The 2u dose may be too high. We recommend 0.25u per kilogram of weight.

Dry food is bad for all cats, but especially diabetic cats. It has way too many carbs and it lacks enough fluid for good metabolism. Check out Dr. Lisa Pierson's web page on feline nutrition. There are automatic feeders that will open at programmed times or you can freeze wet food into catsicles and leave them out for her. Multiple small meals are going to be much better than a few large meals.

Ask away on your questions. There is an incredible wealth of knowledge here and people are amazingly generous.
Liz
 
Re: Cleo's new diagnosis

A bit of housekeeping: we keep track of the BG readings in a spreadsheet. Everyone uses basically the same format so that dosing experts can quickly see what's going on with a cat and help you with dosing advice. Here are the instructions on how to set that up.
Liz
ETA: Lantus is a depot insulin, which means the insulin forms a reserve under the skin and is released slowly into the bloodstream. One of the requirements is a shot time of every 12 hours. So if you shoot at 8 pm tonight, you should shoot no earlier than 7:30 am. You can adjust the dose by 30 mins per day, either at one shot or split 15 mins in the AM and PM. Lantus works best if you shoot the same dose at the same time AM and PM.
 
Re: Cleo's new diagnosis

Hello and welcome to the board!

You are making such a great start with her - the right insulin, right food, home testing and everything.!!

Can i ask however how many hours after the shot she went to 50? I am thinking this lantus dose is too high for her. You might want to take her down to 1 unit and see how that goes and raise it more gradually. Cats routinely have high BG at the vets so thats not a number to go on.

I wouldnt give her dry ever - it just makes the issue worse. With wet food she may go into remission (which is something we always aim for). But if we go with a safe dose, and you leave out the fancy feast during the day when you are out, we should be ok. You can also freeze it and let it defrost during the day if you are worried about them eating it all too soon.

Sounds like she is seriously stressed at the vet. Not sure why you need the stress and $ of a curve. The issue with vet curves is that the cat is so stressed their BG is high, and then the vet prescribes a insulin dose based on that high level. Then the cat comes home and BG drops and you give too much insulin... which causes a possible hypo. Since you are testing at home I would just say no thanks to the curve and do it at home - its more accurate, less stress on the cat, and saves you some $ too.

When you test tonite, if she is under 200 dont shoot, dont feed and post here so we can advise - we dont advise newbies shoot under 200 until we have enough tests to know how she will behave. And dont feed for two hours before shot time so that the test isn inflated by food.

Wendy
 
Re: Cleo's new diagnosis

Vet stress can raise the BG levels 180 points or more in 5 minutes and last for 90 minutes.

I read this information in one of the University of Queensland documents but for the life of me, can not find the right article again. If I ever do find it , I will be sure to bookmark it.

If you do make the catsicles from the canned wet food, please take it out of the can first. It's much harder to remove from the can after it's frozen. People either plop a can out onto a cookie sheet, cut into quarters and freeze on the sheet. Or pop the food into a no-stick muffin pan and pop in the freezer to chill. It depends on how big of a can you are using, how much food you want to leave out for your cat while you are gone. The frozen chunks of cat food, catsicles, will slowly defrost and provide food for some time during the day.

Do you have your hypo tool kit ready?
Several cans of high carb cat food such as the Fancy Feast gravy lovers food
a simple sugar like karo syryp, honey or maple syrup
a blood glucose meter to test the blood
plenty of test strips at least 50 recommended.
And these instructions,printed out and nearby. http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887
Phone number and directions to the nearest emergency 24 hour vet.
Credit card to pay for the vet.
Syringe for rectal administration of karo/other simple sugar of cat loses conciousness.
and last but not least A designated driver so you can keep rubbing the karo on the cats gums while you drive to the emergency vet

If you are on a tight budget, you can do the curve at home. A curve done at the vet will be no better than the numbers you will get. In fact, the numbers you will get will be more accurate, non-stress induced numbers. I have seen people here quote between $100-225 dollars for a curve done at the vet. With the Relioin Prime monitor and 6 test strips, it will cost you $1.08. yes the decimal point is in the right place. Which would you rather do?
 
Re: Cleo's new diagnosis

I can't believe the first vet gave you a prescription for Humulin R. That is way to strong and harsh of an insulin for normal everyday use in a cat. It is sometimes used in emergencies to get a cat's blood sugar down fast, and 2 units of R is a huge dose! :o
I'm glad you found the 2nd vet today, and were switched to Lantus.
I would advise you to start by reading the starred stickys at the top of the Lantus forum and asking all the questions you have. Lantus works best with consistancy in both the amount of the dose and the timing of the shot. We would recommend that you pick a time 12 hours apart that you can give the shot that works best in your schedule.
For instance, I shoot at 6:00am, which gives me 1 and 1/2 hours (until 7:30am) to test and feed, before leaving the house to go to work, and I get home by 6:00pm, and give my cat his PM dose right after testing as soon as I get home.
If you are planning to shoot at 7:00am tomorrow morning, then you might want to give his insulin tonight at 7:00pm.

The most important thing is that you want to test before every shot you give. If you get a test result at shot time under 200, then please post your number and ask for assistance. Eventually, when you get more data, you will shoot under 200, but in the beginning, we need to see how your kitty is doing with more data.

Lantus dosing is based on nadir (the lowest point in the cycle) which is typically about 4 to 6 hours after shot time, so whenever you can, we'll want you to get mid-cycle tests, so we can see how the current dose is doing.

When you can, please set up a spreadsheet (others will provide the link to help you get one set up), and post your test result numbers, so that we can help you with the dose. Please let us know what the test result is before you give any insulin tonight.

I feed at shot times, and I also leave out all low carb wet food during the day, and some out at night.
 
Re: Cleo's new diagnosis

OMG! I gave her the shot before I read this! I am worried. I gave her 1.5 units, not 2, but if she is going to go hypo, when would it probably happen? I do have the karo syrup, but what kind of syringe do I use if I have to give it to her rectally? And how much? She is eating, and acting normal now. She actually did a smaller sized urine too. I was able to get the blood sugar reading about 7 hours after the vet gave her the insulin. Should I encourage her to eat more now? Thanks for any info.
 
Re: Cleo's new diagnosis

Its ok dont worry - lets just keep an eye on her tonite. Do you have strips and syrup handy just in case?

Also can you take a BG reading now.. I am guessing you didnt get one before you shot? (you always want to test, shoot then feed) When did she last eat?

let us know
Wendy
 
Re: Cleo's new diagnosis

ok cool. Hopefully the reading wont be too influenced by food. Lets see where she is at. We might want to test again in 2-3 hours to see what she is doing then too. I am glad you reduced the dose!

Typically the lantus curve looks like this

Example of a typical Lantus curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

Wendy
 
Re: Cleo's new diagnosis

Good job on reducing the dose! :-D She will be fine as long as you monitor her BG and give her food or karo as needed. First thing is to breathe and to stay calm so that Cleo will stay calm. You don't need to give the karo rectally. In the mouth will be fine. What kind of wet food do you have? If you can tell us the brand and flavor, we can recommend what to feed her. Does she have a good appetite? Right now, do not overfeed her. You need to keep her hungry so she will eat when needed.
Liz
 
Re: Cleo's new diagnosis

I would start testing every 30 min. I know that's a lot to ask given that you have limited experience with testing but in reality, it's the only way to keep Cleo safe. Probably a better alternative is to take Cleo to the ER so they can monitor her safely. If her numbers drop, they can put her on a dextrose drip. You don't yet have the experience to manage her numbers safely. Given the limited information your vet gave you about when or if to shoot, you didn't do anything wrong. I'm just glad you posted here. Frankly, if this were my kitty, I'd give her some food laced with Karo or other syrup and go to the ER.

We don't sugget that you give a shot when you're this new to managing your cat's diabetes if her numbers are below 200.
 
Re: Cleo's new diagnosis

Wendy&Tiggy said:
(you always want to test, shoot then feed)
Click to expand...
Actually, I would recommend test, feed then shoot but our cat has an iffy appetite so we want to make sure he eats before giving insulin.
Liz
ETA: I agree with Sienne. The safest thing to do is to give some food with karo then take Cleo to the ER.
 
Re: Cleo's new diagnosis

I agree with Sienne....I'd be in the way to the ER. Most of our new members in the Lantus forum have been testing and gathering data for several weeks before they shoot a number this low. We don't know if you can reliably get blood as her ears aren't used to it yet and we don't know how she will respond to food. Please take her to the ER and let us know what they say.

Once you are back, we can help you with dosing, testing, feeding, and managing her diabetes.
 
Re: Cleo's new diagnosis

Cleoinfl said:
OMG! I gave her the shot before I read this! I am worried. I gave her 1.5 units, not 2, but if she is going to go hypo, when would it probably happen? I do have the karo syrup, but what kind of syringe do I use if I have to give it to her rectally? And how much? She is eating, and acting normal now. She actually did a smaller sized urine too. I was able to get the blood sugar reading about 7 hours after the vet gave her the insulin. Should I encourage her to eat more now? Thanks for any info.
Click to expand...

I'm confused. Did you give Cleo a shot this evening? If so, do you know what her blood glucose reading was prior to giving the shot? If not, can you get a test now?
 
Re: Cleo's new diagnosis

I called our EVet and was told to give her some karo syrup (1 cc) on her gums. So, to recap: 4pm bs was 50. Stupid me still gave her 1.5 u of lantus at 7:30ish. 9:05, her bs was 56, gave her the karo. 10:20 bs is 125. I know the karo is fast acting, and may not hold the reading up. Should I give her some Friskies turkey/cheese shreds in gravy? Should I wait awhile before I do that?
She is still acting completely normal, except for running from me :( She also has dried karo on her. I am sick to my stomach (literally), and cannot believe I gave her that insulin.

The vet's instructions were to just give that 2 units every 12 hours. They did not even know I was going to be able to test. I feel horrible. My poor baby, it is like waiting for the axe to fall :(
 
Re: Cleo's new diagnosis

1ml of karo is a lot. It will temporarily spike her BG but she could come down again quite rapidly when it wears off. I would keep testing her every 30minutes for now unless sienne and Marje come back and say otherwise as they are more experienced than me on this.

So Don't feed her right now, just test again at 11pm and come back and tell us where she is... If she has dropped again give her 1tsp of the gravy food .

You might be doing this for a while tonite, if you don't have lots of strips, or don't think you can stay awake you may want to take her to the vet.

PMPS unknown 1.5units
+1.5 56, 1cc karo
+ 3 125
 
Re: Cleo's new diagnosis

Edit your 1st post to change topic to "possible HYPO"

You've got some hours to go monitoring and you shot really low. I'd be inclined to start feeding small amounts even though you're not under 50 yet, to prevent getting there. But that's me.
Coffee may help.

Basic hypo protocol
Test
If < 50 on human glucometer or < 70 on and AlphaTrak meter
Give 1-2 teaspoons of gravy or high carb food or low carb w/ syrup added
Wait 15 to 20 min
Re-test; gravy & syrup wear off fast; food lasts longer
Repeat until advisors say you're good.
 
Re: Cleo's new diagnosis

cleoinfl said:
When will the worst be over? 6 hours after shot? 1:30?
Click to expand...

You started low. Nadir is as late as +7 on average. If you get stable and rising numbers after that, and the Latus/hypo experts say you're good, you can sleep ... but not unil they are OK.

... did I mention coffee? (Tea, cocoa)
 
Re: Cleo's new diagnosis

I sent a message to Marje and sienne and hopefully one will be here soon to advise. Please get a test now and let us know how she is doing. And grab a coffee.

Wendy
 
Re: Cleo's new diagnosis

Please don't beat yourself up. You were following the vet's instructions. You're not the first person to arrive here and experience a trial by fire. I'm glad you called your local ER.

Actually, I think you should give Cleo a bit of low carb (LC) food -- about 1 - 2 teaspoons of LC. While the Karo may wear off, feeding a LC food will also help to level things out.

My hunch is that Cleo is hungry. Low BG will do that and you can use it in your favor. You don't want to over feed. You're simply going to test and feed in small amounts, either with or without some high carb (HC) to supplement and to make sure that Cleo's numbers are in a safe range. You're going to test then give some food every 30 min. until you are sure Cleo's numbers have stabilized. You may want to give Cleo a treat, as well, so she begins to associate testing with something good. Re-testing in less than 20 min. is useless. The LC/HC food hasn't had a chance to get into the digestive system and raise BG levels.

I'm linking a set of instructions on what to do in order to steer low numbers and keep Cleo safe. (I think this is far more practical than the hypo info.) These instructions are at the top of this Board and all of the insulin support boards. I know this is scary. In a month, you'll be able to look at tonight with a very different perspective. We've all dealt with a cat in low numbers. I'm just hugely relieved that you're dealing with Lantus and not Humulin (and are you sure it was R and it wan't Humulin N?).

Unfortunately, there's no way to predict how long you're going to need to monitor. The good news is that Cleo's numbers didn't drop into truly dangerous territory after you shot. However, we've seen caregivers have to monitor for as long as 16 hours to insure that numbers weren't dropping back down. Or, this could be a complete non-event.
 
Re: Cleo's new diagnosis

BG reading at 11:30 is 132. I will offer her a treat. She is still acting okay. Already had coffee~
 
Re: Cleo's new diagnosis

Ok holding steady for now. Please give her the low carb as sienne said and get another test in 30. We are waiting and watching by the way..

Tomorrow - drop her to one unit and don't shoot if she is under 200.. Don't feed for two hours prior, then test, shoot, and feed if over 200... You won't shoot under 200 until you have enough data to know what she does when she is dropping.. Let us know.and you will want to set up a spreadsheet too, so you can track this stuff. I can give you the link later.

Wendy
 
Re: Cleo possible hypo

I am not sure where you are located, but I have the EVet's number programmed. I don't want to keep you all up - I thought I should make sure she is eating before I give her the shot in the morning, ONLY IF THE READING IS 200 OR ABOVE.
 
Re: Cleo possible hypo

Lantus takes roughly 2 hours to begin to have an effect on BG. Most of us test, feed, and shoot withing about 10 min. I actually give Gabby her shot when her head is in her food bowl.

Don't Panic sticky note said:
  • Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of food with high carb (HC) gravy or HC food only. (If you have a cat with GI issues, using syrup plus LC food is an alternative.)
  • Test again in 15 – 20 min. Depending on the numbers, give more HC food.
  • Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
  • Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
  • Test in an hour and follow the same steps.
DO NOT become complacent. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.
Click to expand...

See the section I put in bold. You want to make sure that the numbers are stable and not dropping back into the 50s. Once you get tests separated by an hour, you're good to get some sleep.

I'm in Central time. One of the other experienced Lantus users is on Pacific time. Marje will most likely stop by to make sure you're OK. We really don't let you go through a tense situation like this alone.
 
Re: Cleo possible hypo

Would she be acting a little "off" as the BG is dropping? Or if she is in front of me grooming, can I wait a bit?
 
Re: Cleo possible hypo

Hi there....stopping in to stay with you.

Some cats act differently if their BG drops....many do not so its not a safe way to gage how they are doing. Testing is the best way. Could you please let me know when you last tested and fed and the number you got?

We state the tests in hours from her shot so what I have last is her +4 was 132. You should be getting ready to test again. Just post the number first and then we can discuss whether you should feed or not. :-D
 
Re: Cleo possible hypo

Hi and wanted to welcome you to your baptism by fire. Congratulation on getting all of those tests in already; you're doing great! :thumbup

To recap:

AMPS +9ish = 50
Unknown PMPS @ 7:30 pm - 1.5u given
+1.5/56
+3/125
+4/132
+5/ :?:

cleoinfl said:
Would she be acting a little "off" as the BG is dropping? Or if she is in front of me grooming, can I wait a bit?
Click to expand...

Some cats show no symptoms until they're really low.
 
Re: Cleo possible hypo

Some cats show no symptoms when they are really low. That's why we test. You are in control as long as you test and have food.

Doing ok there?
 
Re: Cleo possible hypo

Would she be acting a little "off" as the BG is dropping?
Click to expand...
One of the truisms here is "every cat is different (ECID)." The only way I usually know that Gabby is in lower numbers is she'll sit near me and stare at me as if will power will get me to go put food in her bowl. I don't think that any of us would really want our cats to be experiencing hypo symptoms. We differentiate between low numbers and a symptomatic hypo situation.
 
Re: Cleo possible hypo

I thought I p osted this already, but I don't see it! BG reading at 12:30 is 143. She had 6 crunchy treats at 11:45, 1 1/2 tsp of FF Liver and chicken at 11:50. I also gave her one crunchy at 12:30 to get her out to test.
 
Re: Cleo possible hypo

Are you ok and awake? Can we at least get her to +6 before you crash? I wouldn't feed any more so we can see if she's coming up on her own although the crunchy treats will probably bring her up and keep her there a while.

If you need to sleep for an hour and then get up and test, that's fine. I'd like to get her to mid cycle and know she's still on the way up. Sound like a plan?

Please let me know if you have any questions and if not, I will see you at +6.
 
Re: Cleo possible hypo

She's surfing...that's what we call it when the numbers are just flat.

How are you doing? We typically like to see a rising, non food influenced number before you sleep. We can either test in a other hour so you can go to bed if she's up OR we can give it 1.5 hours and you can lie down for a bit.

I wouldn't give her any food. What is your preference?
 
Re: Cleo possible hypo

And to answer an old question, yes it was Humulin R. I cannot wait to talk to my vet on Monday when she returns, just to let her know what happened. I think I will cancel the curve test at the vets, and maybe do it myself next Saturday. Much less stressful, and I am more confident in getting her blood. If someone would have told me last night, that I was going to be sticking a lancet in my cat's ear rim to get a bs reading over and over, I would have told them they are out of their mind!
 
Re: Cleo possible hypo

Ok. I will be here. You have been doing super! Cleo feeling ok? Did you tell us your name?

I'm reading through your entire thread and will put some thoughts together for you for tomorrow....a summary since its all spread out in the thread.

See you in a bit.
 
Re: Cleo possible hypo

A few suggestions for tomorrow:

- I would reduce her dose to 1u every 12 hours; if you shot at 7:30 tonight, you'll shoot at 7:30 a.m. Tomorrow
- here on Health, they have a no shoot number of 200 so if she is less than 200, skip the shot
- it's best to not feed for two hours prior to her Preshot tests; you want to be sure and get a PS test every single time before you shoot....we don't shoot blindly
- you'll need to do a Spreadsheet. If you have any problems, PM me and I will take care of it for you although I'm on West Coast time and am not up early ;-)
- it would be great if you can move over and post in the Lantus TR Forum because there are many, many lantus users there; it really does help us for you to have the spreadsheet first, though. We also have a lower number for shooting there than there is here in Health
- Cleo was in normal numbers tonight....she wasn't in hypo numbers; you did a great job.

Let me know if you have questions. I will wait for your next test.
 
Re: Cleo possible hypo

Boy she is hanging on to these numbers!

Go ahead and feed her a good portion of LC food and you can leave some out for her. If you'd like to sleep for a couple hours and then check her, that's fine. It's probably best to get a +10 so you can see how she is heading into a.m. Shot time.

Any questions? Is that plan ok for you?
 
Re: Cleo possible hypo

Oh, my name is Jane! Cleo is feeling good - sitting on counter hoping for a treat or something. She is a small kitty, but is not afraid of the others. Doesn't bother anyone, but has no fear of her younger brothers.

So, ok for bed till 7am?? Sounds great!
 
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