Desperate Newbies - Dara & Bob

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Lkldcatlady

Member Since 2013
Hello - my name is Dara and my kitty's name is Bob and we live in Lakeland, Florida. He is 9 and was diagnosed diabetic two weeks ago. We are having a rough time of it right now. All of the information I have is confusing and my vet is being helpful, but not really, if that makes sense. Luckily Bob is very laid back and I have had no problem giving him shots or testing his blood. I am using a Wal-Mart relion meter, although the tech at my vet's said I should be using the alphatrak (a mere $200 for the meter an $65 for 50 strips). Bob is using Prozinc insulin. The vet kept him for 2 days to do the glucose curve and determined he needed to start at 2 units in the am and 3 in the pm. I've been in very close contact with the vet and for the last two weeks they've changed his units every day based on his numbers. He's been everywhere from 118 to today (the highest) over 600. My meter won't even tell me the exact number and Bob has drank at least a full bowl of water by himself today. Most recently they told me to give him nothing in the one hundreds, 2 units in the two hundreds, 3 units in the three hundreds and so on over the weekend. What I'm noticing is when we lower it based on low numbers, he goes high again. Although the vet says he wants to be cautious now and Bob WILL get regulated eventually. I'm happy they are being cautious because I work full-time and I can't stare at Bob all day, but I guess I expected some better results by now. Bob was in the 300's last night and this am. I don't understand why he jumped so high today (he has been in the 500's here and there. I'm starting to feel hysterical because if the vet can't make this work, what am I going to do?? One other thing I should mention is I am slowly introducing purina dm into bob's diet. He will NOT touch canned food - acts like I'm trying to poison him. I feed him 1/3 cup of dry food in the am and one in the pm after he gets his shot. I do have two other kitties (one with a urinary problem) so the food issue has been very frustrating. I'm going to continue to read the great information on this site, but if anyone could give me some advice, I would be so thankful!! PS. I LOVE the letter from your cat - I've caught same things. I needed that laugh.
 
Hi Dara and Bob,

Welcome! You are doing lots of things right! Good, mild insulin, hometesting. Yes, dry food can make a big difference. When we switched from dry to wet, our Oliver came down 100 points overnight. Many cats don't like the taste of DM. It is liver based. Lots of us feed Fancy Feasts - the pate flavors are low carb.

We suggest starting low with the dose and going slow. We'd suggest starting at one unit, getting midcycle numbers to see how low the insulin takes Bob and then adjusting up or down by .25 or .5 units. Just looking at preshot numbers is missing an important part of the puzzle. If the dose takes him down low at midcycle, then he can bounce back up for the next preshot. It's called rebound or symogyi effect:

http://www.felinediabetes.com/concurrent-somogyi.htm

If he were mine, i would get some midcycle numbers (5-7 hours after the shot) to see how the dose is working. Then you can figure out whether he needs more or less.
 
The Relion meters from Wal-Mart are good meters and used by many diabetic cat owners on this message board. I have both a Relion Confirm and a Relion Prime. The Prime has much lower priced test strips.

Which of these Relion meters do you use?

The Alphatrak 2 meter sold by vets is very expensive and the test strips are very pricey too. The difference between the Alphatrak and a human glucometer is about 30 points at the low numbers, more like 30 percent at the high numbers. It is the cost of the test strips which is the budget killer. That is why so many people here use the human glucometers like the Relion brand ones.

but I guess I expected some better results by now.
This is a marathon, not a sprint. It takes time. Time to learn to home test, time to heal the pancreas, time to monitor, time to get your cat to eat a low carb food <10%.

Please, let us know what specific questions you have or areas where you would like help.
 
Deb - My meter is Relion micro - that's all the book shows. Is that just as good as the two you mentioned?

Sue - Regarding lowering Bob's insulin, is that ok to do since he's showing at 600 - I can tell he doesn't feel good and he's drinking a lot of water. Initally the vet told me it wasn't necessary to test at home but I insisted. Now I just seem to be annoying them. I need to know which numbers are most important and how to decide how much insulin to give. Would you mind giving me step by step instructions, including how much insulin to give based on which numbers? Also, should I wait to change his food until he's regulated or should I try to do that now while we are trying to get him regulated? Sorry, I know it's a lot of questions. It's just nice to chatwith people who have dealt with this before.....
 
Oops, I forgot about the little Micro! ohmygod_smile The Relion Micro is a smaller, more compact version of the Relion Confirm. The test strips for these two meters are interchangeable. Yes, a good meter, good price on the test strips, 36 cents each.
 
Also, should I wait to change his food until he's regulated or should I try to do that now while we are trying to get him regulated?
One more question for you so I can answer your question better. What food are you feeding to your cats now?
 
oh my gosh - Bob just showed some interest in the Fancy Feast tuna. I can't believe it. How do I figure the carbs on the canned food? I read the ingredients and it does contain wheat gluten.
 
Deb - I feed all my cats Purina UR dry. I have one cat who develops crystals and the vet said the food would be fine for all the cats so that's what they've been eating for about 3 years. Before that, it was Blue Buffalo dry. I never knew dry was bad. I just mentioned that Bob actually just ate some fancy feast tuna feast but I see that it has some wheat gluten so I don't know how low carb it is. Normally, he will not touch a canned food. I've tried over the years to give him some....
 
We have a wonderful reference chart for most of the canned/wet foods sold in the US. See here: http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

You want to look in the 3rd column of numbers and look for something with <10% carbs for a diabetic appropriate cat food.

Is that Fancy Feast Tuna one of the pate styles or another type?

ETA: Classic, tender, flaked, chunky styles of Fancy Feast flavors are all < 10% carbs.
 
I'd suggest going with the dose you are on, get some midcycle numbers and see how those numbers look. Get rid of the dry while monitoring. That'll tell you what to do with your dose. General reference: regulated cats are in the mid 250s at preshot, in double digits at midcycle, but not below 40

You also should be getting ketone tests while he is in these high numbers.

There are food charts here:

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

We try to stay in the 8% carb range.
 
Deb - it was the fancy feast tuna flaked. I'm amazed he ate it, but it gives me some hope! Thanks for the chart, I'll use it!

Sue - I will start looking at his mid cycle numbers - so I will test him pre-shot in the morning, 6 hours later, then pre-shot in the evening. Correct? How do I determine the amount of insulin to give?
 
How would you feel about doing 2 units if he is in the 300+? It should be a good starting place and should be safe if his numbers go down with the change to wet food. Get some numbers and if it is too little after a couple cycles you can raise the dose by a little bit. As long as you are testing, you can keep him safe even if he'd drop low.

If you tell me when you will be testing, i'll try to be around to watch for you. (add the time zone)

Glad he liked the Fancy Feast. Try to mix it up and feed fish only a few times a week (mercury)
 
I can def try the 2 units. Am I looking at the number right before I give him his shot? One last question - is it normal for them to shoot up so high? He's just been all over the place and the vet keeps changing the insulin every time. I have one friend whose vet told her to give 6 units twice a day and she has done that no matter what his numbers are and he seems to be doing better than Bob! I just don't understand why it's so high after we have started to give insulin. His number was 428 when he was diagnosed and several time it's been in the 500's and now the 600's. Just don't understand....
 
You want to test before he eats and before you give the shot. Food can change the number so you want it without food on board. So it's test first. Lots of us give the shot while they are eating. If you are worried he won't eat, feed him and then shoot.

My guess is that the dry food is keeping the numbers high and he may be rebounding. (did you read the link on the symogyi effect?)
 
Not yet - I will read now. I usually test him at 7:00am and around 7:00pm. May 15 minutes or so before or after. No more than that. Just tested him now and he's 312 but he got 5 units tonight. I'll test him again at 1:00am and see what it is...thanks for all your help. Im going to load up on canned food tomorrow and see if he will eatanything other than fish! He def didn't like the turkey giblets!
 
7 eastern. I read about he symogi (sp?). So, I would need to see the blood glucose at the 6 hour mark to see if his dosage of insulin is causing his blood sugar to go too low and then in turn go up too high?
 
That's right - you got it.

I am in Colorado so I can't be on line that early. I'll have to check on you later tomorrow am.

Have we talked about ketones? It would be smart to test for them if you reduce the dose.
 
I will do the glucose curve tomorrow. See how it goes. Ketones were mentioned a couple of times. My vet never mentioned that - whatexacty is it and what should I watch for? can I test the urine in litter?
 
To test Akasha's urine, I used a big stainless steel cooking spoon- she is not laid back by any means, but she actually let me put it in behind her while she pottied. I have one finicky cat here out of the 3. He prefers dry food, BUT I finally got them all 3 switched to friskies pate or ff. I have to trick the finicky one once in a while by putting a few drops of fish oil in the wet food and mixing it in. (I only use fish oil made from anchovies, sardines, and mackerel, per vet orders). Don't know if that helps you any, but it worked for me. They are all 3 on wet food now and my obese kitty (the finicky one) has lost weight and my sugar kitty is in remission.... Anyone else used fish oil to get them to eat????
 
You said you are doing a glucose curve on Sunday, May 12th. Since you do not have a spreadsheet set up yet, would you please list the numbers in your post like this, replacing the xxx with your actual BG (Blood Glucose) numbers and putting in the units of insulin:

5/12/13 AMPS xxx units insulin +2 xxx +4 xxx +6 xxx +8 xxx +10 xxx PMPS xxx units insulin

At some point, we like members to have a spreadsheet set up in our standard format. Here is the link with the how to instructions. http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207 Let us know if you need help with this setup. We have people that can do that for you.

Being able to look at a spreadsheet helps us to help you better. We know your life is full so do the spreadsheet when you have some time.
 
Thanks so much for the information! I think I published my spreadsheet. The link is below. I don't think I understand where exactly to enter my numbers tho. I put in his pre-shot number and the number of units he got. I'm not understanding the +2, +4, etc... Is that just every two hours? I copy and pasted the link below Did I do this right?


https://docs.google.com/spreadsheet/pub ... utput=html
 
ok - that's what I thought. I'll fill it out and if you could have time tonight, maybe you could look at it. Obviously, he didn't go very low with the 2 units. 6 hours after his initial shot should be the lowest number, correct? Then he will probably start going up, correct?
 
Somewhere betwen 5 - 7 hours after the shot is usually the lowest point but every cat is different. Getting rid of the dry completely should also change the numbers downward - we just don't know how much yet.

You need to add the url for the spreadsheet to your signature. If you do that, it will come up updated for us to see each time you post. Go back to your original copy of the spreadsheet, choose File/Publish on the left hand side. Copy the url that comes up there. Then go to your signature in the User Control Panel and paste, then submit. If you want it just to say Bob's SS, then do this. Bob's SS before you submit.
 
ok. I think I updated the spreadsheet to how up in my signature. Bob is up to 534 and we still have 3 hours until his shot. I feel sick - the vet told me to give him 5 units when he is in the 500's. I gave him 5 last night and he was 376 this am (I take away his food at midnight). What should I do?
 
I would give 2 units again and check for ketones. And take away all the dry food. You can do this two ways. Go back to a higher dose, take away the food and montior like mad so you catch when when he goes low. Or you can take away the dry, give the 2 units a few more cycles and watch the numbers. If he stays in the pinks, even with a food change, you add a little more insulin.

You were jumping between 600 and 100, right? So the high dose was not working - it was too much if he swung between those levels. It may be that he needs more than 2 units, but the best way to figure that out is to go up gradually. As long as you are testing and he is eating and you are checking for ketones, it is better to be high for a few cycles than low for a minute.

My advice is worth what you are paying for it. :mrgreen: All I have is my experience on this board - no vet degree here. I understand it is scary to trust people on the internet. You have the syringe; he is your cat; you decide.
 
No - I really appreciate all the help. I did call my vet and we talked for quite a while - that's one nice thing about my vet is that they are on call. Anyway, he thinks we should do 4 units twice a day for a few days unless he goes below 200 in the morning. He thinks that since we have been jumping around on the units, it's probably not a good thing. I do understand about the food and I plan to replace his food eventually. I'm way too nervous to do it right now because I work full time and I'm by myself. My vet has had really good results using prozinc and the purina dm. They said a big percentage of their cats have gone into remission with that plan and those people did not even check blood glucose at home. Even tho it's only a short-term solution, I'm happy with it if it means he will eat regularly while getting regulated. Then I can work on switching to canned food for all my kitties. I don't want this to happen to one of the others! I'm going to continue to fill out my spreadsheet and stay in touch, but for now, will do what the vet recommends. I certainly don't want to go rogue and alienate them! :-D Thanks again for all of the advice!!! It's awesome to talk to people who understand.
 
Be aware that the DM food is liver based, and unless your cat is totally gaga over the top in love with liver, he likely won't eat it consistently for more than a few days.


ETA: And... your vet works for YOU...... if you have to worry about 'alienating' them because you didn't buy the particular product they're trying to sell you..... I'm thinking you might need a new vet. Do some research, you will probably find as most of us here have... that stuff isn't very good for them anyway.

My favorite nutrition info here, written by a vet catinfo.org Really good info there.
 
I'm feeding 1/2 regular dry and 1/2 the dm just while I'm trying to get Bob regulated a little. I have read the information you posted on the food and I totally agree - i'd def like to switch to a quality canned food when things are a little less stressful for all of us. I would never make my own food like that person does, although it would be nice just to buy it somewhere like that!! Don't think I could grind my own rabbits - yikes! And I really didn't mean to make it sound like my vet is evil - I just know how frustrating it is for doctors when patients don't follow their advice and then call them in the middle of the night for help when they haven't done what the advised. I would like to give them a try for a while and see what happens. I will keep a very close eye on Bob and continue to educate myself on the food. I'm going to stop by a natural pet food store and see what they have. Will probably post a few of my findings....
 
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