Diagnosis for Shamus

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Hi Sherri,

By the time you read this I hope you will have managed to get some much-needed rest. :bighug:

I think that it's better for Shamus to have intensive veterinary support at the moment. Whereas it is normal for a diabetic cat to be lethargic when blood sugar is unregulated, the inappetence is a worry - doubly so in a cat that has just been throwing ketones.

Fingers and paws crossed that the vets will be able to get Shamus eating regularly over the weekend.


Mogs
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Thank you Mogs...just got up from a nap, but still feeling drained. I really feel it was the best place too. The vet felt better keeping him as well and was just really great at helping me understand everything is still manageable. You and all the others have been wonderful. I can't wait for the day I can say he's back to his old self. It's so tough to see them feeling so down. :(
 
Hello all...my sweet Shamus had a good day of eating the first night of his return to hospital and it would be anticipated I could take him home today. I received a call from the Doc this morning and unfortunately he is back to not eating and down and out again. They are putting him on fluids and running the blood tests to check his liver again, blood cell counts, etc. and also notified me that Diabetic kitties can develop Pancraetitis. :( I will know the results tomorrow morning. Prayers please...xo
 
Poor Shamus! :( Prayers on their way, Sherri, plus a link to the IDEXX treatment guidelines for pancreatitis.

Saoirse has chronic pancreatitis and she had a very bad flare not long after she was diagnosed last year. I'm assuming your vet will have ordered a Spec fPL test. If it does come back positive, getting nausea under control is key. Both Saoirse and a number of other kitties on this board have benefitted greatly from ondansetron (see my earlier post for info on this med and also the IDEXX guidelines). Appetite stimulants help as well (e.g. cyproheptadine). If it's a severe flare, buprenorphine can help with pain management. Vitamin B12 injections can help enormously. The IDEXX guidelines contain lots of information on appropriate meds and supplementation.

FWIW, Saoirse was very, very poorly for a while during her bad flare but once the meds and supplements started to work and she started eating again she improved greatly.

Fingers and paws crossed that Shamus will feel better soon.
:bighug::bighug:



Mogs
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Hello All!!!

I am happy to report that Shamus came home today...no pancreatitis! Phew! He has eaten the most I've seen him eat since this battle began and I was able to give him a successful dose of insulin this evening. He is looking great and appears so much more himself today--I really think the IV fluids helped. He is also on an antibiotic to help with any infection that may involve his liver. My hands are together that we are on the road to managing our diagnosis. THANK YOU SO MUCH TO EACH AND EVERY ONE OF YOU! What an incredible group this is! I am still pretty run down from this roller coaster of a week so Shamus and I are going to snuggle and hit the hay! I just wanted to pop by and let you know he's home. His brother Oscar is not happy with Shamus' return since he smells "funny" so I hope he gets the chip off of his shoulder soon! lol ;) Take care and sweet dreams to you and all of your sugar kitties! <3
 
Great news, Sherri! I'm delighted for you both. And hearty congratulations on successfully giving Shamus his insulin. :D


Mogs
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Hello all! :)

Just wanted to touch base and let you know my Shamus has been eating like a champ without appy stims and nausea meds since he's been home and we are doing well (both of us) with insulin injections. You would never even know he had went through the time he did getting to this point. Today he was playing with his "Naughty Knot" cat nip toy and he is alert and back to himself. I am able to sneak the lantus in while he eats and he is none the wiser. THANK YOU ALL!

Tomorrow he returns to the vet for his first sugar curve since it has been about a week since he has been receiving the 2 units of lantus twice daily. I have purchased my strips for the Contour Next that I got free at Shoppers Drug Mart as well. He is currently eating the w/d (it was important in this period of time just to get him eating). One vet says this is what she normally has her diabetic cats on and when I mentioned it was so high in carbs she did say they are complex carbs so that is different. I don't want to mess with a good thing as we have been on the right track to his wellness, but I wondered if I should be changing to the Friskie's Pates? I also know there is a possibility his diet will be changed after the results of the sugar curve. I know you are never to change the diet without monitoring closely as changes in insulin may be required. Any thoughts here?

Also Shamus is 14 lbs. How many cans of food should he be eating?

And then there's Oscar (also currently eating the w/d and Performatrin Ultra Grain Free Adult) who has no medical conditions and I don't want him to get any larger than the 11 lbs he already is. I feel like it's important for him to have the dry food for his teeth but really what is best when I'm feeding two kitties. How much should I be feeding him? Could they both just be on the Friskie's Pates? Should I keep up with the dry food for Oscar?

Thanks a bunch everyone! Your love and support here makes all the difference!

PS - I read a lot about the sugar testing happening with treats. Is it okay to give a treat randomly throughout the day when checking or is that going to affect the sugar levels adversely because it is not given at feeding time with insulin? Just curious.
 
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Treats any time you check is great, as long as it is a low carb treat. Orijen Freeze Dried treats have been a great choice for Shiloh.

I switched both my cats, who had eaten only dry for years, to Friskies. No dry in the house, out of fear that Shiloh would get a hold of it.
 
It would be great if cats needed complex carbs, but cats are obligate carnivores and do fine without them exceeding 10% of the calories.
Take a look at Cat Info and give your vet the link, too.
You must be home testing before changing the food! Its a safety thing.
 
Are the Orijen Freeze Dried treats available in Canada?

Also, I have read lots on the Cat Info page regarding canned food and I want to make the switch for both of them, to the Friskies Pates (WITHOUT gravy of course!). Tomorrow is the first sugar testing Shamus will have had after the week on insulin. I have a feeling my vet will push something else or be okay with the switch to the Friskies but how will I know if this is okay as far as insulin dosages go??? I know home testing will be required, but I'm afraid the vet is going to say go ahead and switch him and keep the insulin dosages the same (although we have started very low at 2 iu's per day 12 hours apart).
 
When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback.

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Add any other text, such as
your name | cat's name | date of Dx (diagnosis) | insulin | meter
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Good Morning All (in Southern Ontario)!..so surprise, surprise. Guess who's sugars were much lower when I brought him in for his first sugar curve? Shamus surprised myself AND the doc with a reading of 3.6. Shamus is staying for some time today so they can watch spikes and dips of his sugars closely and we will be lowering his insulin levels for sure. He is still on the w/d food for this period of time although the goal is to get him on a low carb/high protein diet. It surprised us both because he is 15.4 lbs. and Doc thought with weight and previous readings of 27, 23 and mid-teens we "didn't have to worry about going low" with the current dosage of 2 iu lantus twice per day. So this is concerning to me, yet should I be somewhat glad that he is not as high as he had been?Does this mean it is possible that he is a kitty who could be controlled with diet alone eventually? I know it might be too soon to say. My biggest concern is not that he go low. Is this a normal situation during our first week of regulating?
 
Surprise!
This is why we home test - you just can't tell by looking if it is safe to give insulin, or lower the dietary carbohydrate, etc.
And it is looking good for getting well controlled with insulin. Beyond that remains to be seen.
Have a look at the sticky posts at the top of the Lantus/Levemir forum and see what you think about the info there, then read some of the posts to get a feel for what happens in the forum.
 
Sherri said:
Are the Orijen Freeze Dried treats available in Canada?
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Hi Sherri, Yes the Orijen treats are available here in Canada but I believe the only large retailer is Global pets. Smaller specialty pet shops might carry them.

So glad to hear Shamus is doing so well now. Whether he can be controlled on diet alone is an unknown until you try. We have a saying here that every cat is different (ECID). Just be sure to keep Shamus on a canned diet below 10% carbs and keep him out of any of Oscar's kibble if it's still available. But make any diet changes slowly so you don't create any digestive upset.

Changing his diet could mean he'll need less insulin so it's vital to be testing Shamus before every shot and at least once more through each 12 hour period to make sure you know where he is at. Lantus dosing is base on the lowest reading in a cycle which often is between 5 and 8 hours after the shot. But if you can get a test in even 2 or 3 hours after his shot, you'll be able to see if he is dropping quickly or nice and gently.

BJM provided some instructions earlier for setting up a spreadsheet and attaching that to your signature so it's visible to everyone here. That way if you need help with Shamus' dosing, there will be information available for your helpers to look at and provide the best support.

Here's hoping that Shamus will soon join the OTJ (off the juice) kitties!:D
 
Thanks everyone. As Shamus was monitored for a few more hours after that, his BG went up to 7.3 at the clinic (5.6 on my Contour Next for comparison). What exactly is considered the normal range? I am to call if any of his home readings are in the 3's.

We are home again now with a new and lower dosage of 1.5 iu of Lantus twice daily. I will be sure to change that in my signature. The goal is to start introducing the Friskies Pate food slowly beginning Friday at 25% with a full switch beginning a week from Monday. A week from Saturday a full 12 hour curve is to be done which I can do from home so I am praying that I master the home testing over the next few days--not only to keep myself in the know for safety purposes, Shamus feeling less stressed (he did NOT want to get into the carrier today), but also to help minimize the costs that have been adding up.

I was able to find some freeze dried chicken breast cat treats at Walmart (Pure Snacks) to help me with the at home testing.

The Doc did say he is not currently in remission, but I'm hopeful that Shamus will soon join the OTJ kitties too someday. It would be wonderful to manage with just diet. This is precisely why I am taking his non-diabetic brother, Oscar, off of all dry kibble and transitioning him to the Friskie's Pates as well.
 
See my signature link Glocometer Notes for feline-specific glucose reference ranges.
 
So, I just attempted to try a test a good amount of time before having to test before feeding time and a lot of freeze dried treats but no cooperation from Shamus. They all say how good he is at the vet but that is because he's so scared he just bears down and tries to hide, but if his claws hadn't recently been trimmed, I'd have a good few scratched up hands. :( He is so ravenously hungry that he is trying to swipe, eat, root, around for the treat that he even goes for the lancet to chomp on. He's a grabber too. He starts to moan at me and swat when I touch his ears :(. I didn't struggle with him. I started first with just the lancet. Lots of praise. Then, when that proved to be unsuccessful, I put it in the pen and clicked that lots around his ears and rewarded him with the treats but I finally had to stop. I read the info on the catinfo.com on how/what to do as far as home testing goes and I know it's not something that starts out easy, but he can be a bit vicious when he does get comfortable. I sure hope things turn around. Maybe I can do it while he's actually eating from behind since his focus will be longer with the amount of food he'll be taking in. I was all excited too! Made up some books with all of the info I collected and to keep track of the data--labels and all--cleaned space in the cupboard for everything and have the hypo kit organized as well. I'll keep intending for better results but what happens if your cat is too vicious to home test? :( It's one thing to prick his ear, and then still another to try and squeeze the blood out enough and THEN get the sample on the glucometer. :S I wish I were an octopus...lol...but even still he's a stinker!
 
I would snuggle Spitzer on my lap, holding him with my left arm and positioning his head with my left hand. With the right hand, I'd put the strip halfway in the meter, and grab the lancet and prick. Then, I might snag the droplet on a left hand fingernail if Spitzer was being squirmy, and fold over the tissue to blot the remaining blood. I'd push in the test strip with my right hand, get the meter up to the ear, sip up the droplet from the fingernail, and wait on the test result.
 
Sounds like youhad it down to a science. :) My boy gets way fiesty even on my lap. We made some small progress as I managed to finally get the ear pricked (after once going straight through and managing to get myself good--hope there's no contamination when this happens???) but even though the blood droplet was good I couldn't get enough of it...with him swatting...even though I got a small amount on my fingernail--it just wasn't enough. I'm worried as I am back to work tomorrow (I'm a teacher and had been thankfully off during all of this so far) and was supposed to test before I gave his injection tomorrow morning and not give it if it was in the 3s. I won't be home to even monitor.
 
I was able to get an in home visit with a vet tech who recently started her own home pet sitting business who has experience with diabetes to help with the BG tests. She was working a mobile vet before starting her own business. I was unsuccessful with the BG test so I gave him his insulin with his meal knowing she would be over within the hour to check BG then (I would have rather not given the insulin not knowing what his BG level was but we had been on this schedule for a week and the insulin dosage was now adjusted to lower). Now I am feeling just awful and thinking how riduculous that sounds because he was showing a level of 2.8! I am trying SO hard to manage him well and just when I feel like we're doing well, there's another roller coaster ride and I'm trying to do it all right. After that reading he got a couple temptation treats and ate another half can of w/d and she came back to check him--2 hours later he was 2.7. He would only eat some treats, but no food (she tried the Purina DM, friskies and some gravy food). He has already ate 2 cans of w/d food today so he's probably not at all hungry. He is alert and not showing any symptoms but this is all very concerning to me. I am not happy with the idea of him being on this w/d! I also think his insulin dosages are too much! I have been reporting the numbers to my vet and my home tech is coming in an hour again to check.

Another question...it has been my understanding that it is okay to give the insulin WHILE the cat is eating (this makes it manageable for us). I usually wait until he has eaten half the can. IS THIS OKAY? (And I do understand that a BG test should be done before--we've just been struggling with him allowing me to). What is the general rule of thumb for WHEN to give the insulin when feeding???

I hope to hear from someone who can help soon! Thanks in advance all! <3
 
That's fine. It works well to test, feed, and shoot within about 15 minutes or so for insulins like Lantus, Levemir, ProZinc, and PZI.
While you work on blood glucose testing, see my signature link Secondary Monitoring Tools for some other helpful assessments.
 
Sherri,

If Shamus' levels are not rising as much as they should and he's full from eating the w/d and temptations, you may need to try to get him to take a bit (maybe a teaspoon) of karo (corn) syryup or maple syrup. If he won't take it on food or from a spoon, rub some on his gums. That will bring his numbers up quickly for a short time and give some of the food he's taken in time to get into his system. 2.7 is really low so I'd try a little syrup now to keep him safe.
Those pre-shot tests are so important is situations like this. I hope you can get Shamus to co-operate real soon!
 
Sherri, when you have a second, please let me know what Shamus' next reading is. I just want to be sure you two are OK. Some cats don't show any sign of hypoglycemia until they get really low and it sounds like Shamus could fall in that category so you are going to have to keep a close eye on him for this whole cycle. Even when his numbers come up, there is a possibility he could dip again so don't let your guard down. That's one of the few drawbacks of long acting insulin!
 
Thank you. We couldn't get another reading but I am on my way home to meet up with my friend and get another. He received a few treats as active and alert but I know they don't always show signs. Vet says no insulin tonight at all or tomorrow morning. Tomorrow morning only if 10 or above and only 1 iu if that's the case. I will be in touch. Thank you so much!
 
Thanks Sherri. I'll check back a little later then. If Shamus keeps dropping or isn't rising, I'd suggest you start a new thread up on the Health Board and use the 911 in the dropdown box on the left hand side of the title area to get more eyes on your situation and more help to keep Shamus safe:bighug:.
 
Came home to an alarming reading of 1.9. Applied corn syrup and straight to vet. At the vet last check was 6.5. Crisis averted, but not without lots of emotions from me. :( Was given options to hospitalize again to monitor until midnight, or put on IV dextrose slip overnight, or take home and get him to eat and monitor every two hours. The prices are soaring very high. I am struggling with the home testing but have opted for that. I need to be able to do this independently if I'm going to manage this properly. Please pray that Shamus learns to tolerate home testing soon and we start to get things regulated. My new angel friend is willing to help tonight if I need it. She is a God send.

As it stands now, Shamus came home and ate a can of w/d. He is not interested in Friskies pates or purina DM.

The vet did mention that usually they are not dealing with lows this soon, as generally it is harder to get the high numbers down and that Shamus is sensitive to the insulin especially considering he is 15 lbs or that there is a possibility that he could eventually require 1 iu for a 24 hour period of time or that there is even a chance he could be in early remission? Lots of possibilities now, but honestly I'd rather his sugars too high than too low at this stage.

Send good vibes and encouragement our way for the rest of the evening's monitoring. I just can't keep running back to the clinic. :(
 
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Shiloh & Rhonda said:
Sherri, sending good vibes and many :bighug::bighug::bighug::bighug::bighug::bighug::bighug: your way!

And did you mean corn syrup rather than corn starch?
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Yes I did...oi...I will try and fix that. I'm about to try and test myself and my aunt is going to come and hang out with me for the evening. I'll try and keep you posted. Thank you for the hugs. I need them and appreciate them so much!
 
Oh Sherri! Thanks for the update. I was concerned poor Shamus might keep dropping so I am so glad to hear that you caught the problem on time.:D

While it might be unusual for a cat to be heading to remission so soon, it's not unheard of. The tough part is that the route to remission can be a little bumpy as you now well know. :nailbiting:

I take it you will not be giving Shamus any insulin tonight and only if you get a decent pre-shot number tomorrow and even then at a very reduced dose. A hypo can make the cat even more sensitive to the insulin for a bit.

You will get the hang of testing Shamus. We've all been where you are and know how frustrating it can be at the beginning. Here is a link to a video(thanks to @pevsfreedom ) that might help a bit.

If there is anything we can help you with, start a new thread with the specifics and put a question mark from the dropdown box in the title.

There are a number of threads about testing so if you have time to do a search, you might find some helpful tips that will help you. But if you have questions, just post because Shamus is in a hurry to get to remission and researching takes more time!:bighug:
 
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FYI: No insulin lasts 24 hours in the cat, so once a day dosing isn't likely until he's almost off the stuff.
 
BJM said:
FYI: No insulin lasts 24 hours in the cat, so once a day dosing isn't likely until he's almost off the stuff.
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Yes I understand thank you. It was just a conversation the vet had with MANY case scenerios for the future, whenever that may be.
 
MrWorfMen's Mom said:
I take it you will not be giving Shamus any insulin tonight and only if you get a decent pre-shot number tomorrow and even then at a very reduced dose. A hypo can make the cat even more sensitive to the insulin for a bit.
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Yes, you're correct. No insulin for Shamus tonight or tomorrow morning unless the numbers are 10+ and even then only 1 iu instead of 1.5 which is what I was told. Thank you for all of the positivity and suggestions. :)

Oh and I couldn't get the link?
 
Sorry about the link. Not sure what went wrong so if you do a search for "pevsfreedom" user name and go to any thread you'll find the link in his signature. I'll see if I can figure out what I did wrong.

I am by no means experienced enough to be giving out dosing advice, but my gut tells me I'd be uneasy giving Shamus a full 1u even if his reading is over 10 tomorrow. I'd be more inclined to give him 0.5u till you see what he's doing and can home test him given Lantus is a depot insulin. @BJM any thoughts?
 
Are you using syringes with half unit marks? And we have some folks here that use calipers to measure consistent small doses that fall between the lines, or when the syringes are badly marked and start in inconsistent positions.
 
BJM said:
Are you using syringes with half unit marks? And we have some folks here that use calipers to measure consistent small doses that fall between the lines, or when the syringes are badly marked and start in inconsistent positions.
Click to expand...
Syringes have half marks and are clearly marked from the clinic. I only got to do the half dose twice since it was new yesterday.
 
So over the course of the night we've had 5.1 upon returning from vet, food, 4.6, food, now 3.9. Time for more food if he'll eat or corn syrup or treats? Help please!
 
Hi Sherri,

I'm hoping you put a note up on the Health forum with 911 but in case not, give Shamus corn syrup and get another reading if you can assuming your last one was about 50 minutes ago.
 
Hi Sherri ( nice name BTW )
I only read your first post and skipped all the other post
I just wanted to tell that I joined this group back in 2007 when my cat Dusty first was DX. I followed everything i learned here and actually got Dusty into remission. He has since went to rainbow bridge
Sadly I just found out a few weeks ago that one of my other feline fur babies has developed diabetes. I feel so so so bad because of my past experience with this and my back ground in the animal field. Skittles has had diabetes for a while and I didnt notice! he didnt show the "signs" that dusty did.
He started walking funny but I thought it was because of the brand of cat litter I had switched to, the litter was sticking to the bottom of their feet ( I have 3 cats) so thats why I thought he was walking like that AND I thought I must had made his feet sore when I pulled of all the liter. I should have known better! The week before I took him in, he had started getting in the shower and drinking water....but he has always liked his water cold so I thought that was why he was doing it. I put ice cubes in their water. He would actually try to get in the freezer whenever we got ice ( my freeze is on the bottom of my frig instead of the top
I am having a hard time getting his under control. :(
 
Hi Sherri! :)

I'm so sorry I haven't responded to your post. I haven't been active on here in a while--mostly the Facebook page. How are things going with your sugar baby? Have you managed to get things under control? I hope so. My boy went into remission 9 days after being on Lantus--it has been almost 3 months OTJ. Luckily I was home testing--the hypo incident let me know his pancreas had kicked in again! I'm so grateful. Especially for the help I've received here! Your picture is just beautiful! Is this your sugar kitty? Let me know how things are going.
 
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