Don't know where to start!!

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NadjaAndSam

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HI everyone my dear Sam has been diagnosed with diabetes. We have an appointment next week and the doctor will teach us how to inject insulin.
I've been reading catinfo.org and I am looking into buying an in-home blood meter but do I do it everyday? how do I know what levels are normal? How do I know that I need to give less insuline? The Dr. also mentioned she will prescribe a diabetes diet for him but according to catinfo.org prescribed diabetes food isn't good. What do I feed Sam?
I'm so confused!! I've been trying to feed him wellness and Nature's variety, he is a very picky eater, he is not eating much either :(

Thank you!!
 
First, breathe. We were all overwhelmed at first. The more you learn (and you are already well on your way) the easier it gets and the more relaxed you become.

I would suggest starting with hometesting. This will give you a good idea of your cat's blood glucose levels without insulin and you'll be ready to test him to keep him safe once he is on insulin. Here are some links about how to hometest, where to poke, etc.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=287

You can start today by getting him used to the process. Decide where you want to test - maybe on a blanket or towel, on a bed or couch, or maybe between your legs. Put him there and start messing with his ears. You can use a prescription bottle filled with hot water to get him used to having his ears heated. When you are finished, be sure to reward him with a treat. An easy low carb one is just a plain piece of chicken boiled with no spices and cut into treat sized cubes.

When you get your meter and lancets, you can add that part.

The other things - how much, when, when to increase or decrease - are all dependent on the insulin you will be using. The favorites here are all mild and long lasting- Lantus, Levemir and ProZinc.
 
First off, there's nothing difficult about taking care of your diabetic cat at home.

For diet, you do NOT need any special fancy expensive vet rx food; just stick to any of the wet low carb foods under 10% carbs in Binky's list. Many people just feed fancy feast or friskies pate flavors, not any with gravies or grilled, and for sure no dry food or snacks.

Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition


For home testing, it's really no diff than for a human. You test blood sugar before giving shots, testing before the am shot and before the pm shot.
Go to the pharmacy and get any blood glucose meter, lancets and test strips for that meter.
Lots of people in the US use the Relion meters as they are good and the strips are the most econimical.
Others use oen of the Bayer meters or even OneTouch or Aviva. they work just fine and you don't need to get the expensive meter from the vet.
Also pick up some KETOSTIX to test urine for ketones...

Good insulins are Lantus or Levemir with PZI from the vet also good but not as long lasting.

You are going to be just fine, and your cat is going to be even finer once you get settled.
 
Hi and welcome to FDMB.

A diagnosis of feline diabetes is very scary and overwhelming when you receive it. But let me you assure you that it is very manageable and it will not take you very long to learn a routine.

I am glad to see that you want to test at home. That is the best way to manage FD. You can use any brand, including store brand, human glucose meter to hometest. Many of us use the Walmart Relion brand meters. You want to look for a meter that only needs a small amount of blood, such as .3 sample size. If you do get a Relion meter, both the Confirm and Micro, use this amount. You will test every time you need to give insulin, so at least twice a day. For newbies, we recommend not giving insulin if the reading is below 200. After a while you know how your cat generally responds to his dose, so you may be able to use a different number as your "don't shoot" number.

Do you know what insulin you will be using yet? Hopefully your vet will prescribe either Lantus, Levemir, PZI or Prozinc. Cats respond well to these insulins. Lantus & Levemir are human insulins you will get from any pharmacy. If your vet prescribes these, ask for the prescription for the pens instead of vial. The initial cost is more, but they last much longer than a vial. Depending on your dose, you may be able to get almost a full year's amount of insulin with one package of pens. The vials have a limited shelf life and usually quit working long before you use all of it. Also, look in the Supply Closet on this site. There are links to discounts for the Lantus and Levemir.

For food, we recommend a low carb/high protein canned or raw food diet. For canned foods, you do not need prescription foods. Many of us feed our cats either Fancy Feast, Friskies or Walmart Special Kitty canned foods. You want to look for pate flavors and limit all foods with "gravy" in the name. You do not need a prescription diet.

I suggest you begin reading through the information we have on this site. Start with hometesting, diet and hypoglycemia articles first. You will probably have lots of questions. Feel free to ask us all of them. We have all been where you are now and we are here to help you.

Caring for a sugar kitty is not difficult and will make your bond stronger. With the proper care, you still can have many more years to spend with Sam.
 
Welcome! Just wanted to say I'm a relative newbie also and yes, it's overwhelming at first! Just breathe and start learning all you can. It's probably good that you don't start insulin until later this week. It's the perfect time to change his diet before you give insulin. It's possible you won't even have to give insulin! A lot of kitties are diet-controlled as long as they are getting canned, low carb foods. My sugar cat and his furry friends eat my local grocery stores' store brand which is the exact same ingredients as the low carb Special Kitty from Wal-mart and even cheaper. If you make the diet change now that would be easiest. It's so much harder and more nerve racking when you've already started insulin. If you do go to Wal-mart to get the Special Kitty or Little Friskies, check out their Relion Micro meter and testing strips. They are about the cheapest out there and seem to work very well. I'm happy with it and a lot of others on this board also use it. You could also click on the free home testing kit icon at the top of the board index page. I got my kit in the mail from Rebecca and it was great for me not to have to go buy everything and figure it out myself. Everything I needed to home test just showed up in my mail box. This takes some of the stress out of it.

Take care and good luck. Everyone on this board have been super friendly and helpful to me as I've tried to regulate my sugar kitty.

Heidi and Frodo
 
Re meters - DO NOT BUY the freestyle lite meter, many users having problems with it reading low at higher BG readings - it has now been nicknamed the heartbreaker. Do not buy a meter that requires more than 0.6ul of blood or you may have trouble getting enough blood to test.

Re testing - I don't know about PZI but with lantus or levemir you're also going to want to get mid cycle checks as dosing changes are based on the nadir (lowest BG level in the cycle).

Re dosing changes - don't worry about that just yet you will be able to get advice here from the experts as you need it.

Re starting dose - if I were you I would check in here first before you start giving whatever dose the vet tells you to give, some vets start cats on doses that are way too high. Also if you are still feeding any dry or HC food changing over to low carb wet can have a massive impact on BG numbers.

Re food - don't be sucked into thinking you need the prescription food. Vets don't feel comfortable or can't really recommend anything that's not prescription but you will save yourself a fortune (and probably make Sam much happier - not many cats are keen on that prescription food) if you stick to the low carb options on Binky's List and definitely no dry food even prescription dry food.

You don't mention how Tom was diagnosed - has he had a fructosamine blood test or just a urine test? Do you know what his BG numbers were? Has he had any other recent health problems? What were you feeding him pre diagnosis?
 
On the topic of meters... I use the Nova Max Plus. It cost $20 at CVS and the test strips were $36 for a pack of 100 online. The advantage of the Nova Plus is you can test ketones with blood rather than with urine (disadvantage is the ketone test strips are way expensive, but with a shy litter box user it's the only way I can test ketones.) Also, the test strips only require a small amount of blood and they sip it up into the strip so it's easy to get it off the ear.

It took me a week to get the technique down but now Scout sits quietly for her tests as she knows she gets a treat before and after. I'd recommend testing your own blood first to get the hang of how the lancet and meter work.

Also to echo what everyone says here, if you switch to low carb wet food there's a good chance your kitty will not end up needing insulin. :)

Good luck and check in and let us know how its going!

Lori
 
Thank you everyone!
Sam had blood and urine tests, from the blood test his glucose level was 400.
I recently purchased relion and my vet told me to get one appropriate for pets but I will cancel the order since everyone uses the one for humans.
Sam was eating wet food only about 1 month prior to being diagnosed.
He doesn't have many teeth left in his mouth due to gum disease so eating dry food was just hard for him but it turned out to be good since I'm learning dry food isn't good anyways!
I have posted another topic viewtopic.php?f=28&t=63784

thank you everyone!
 
Here's another food list you can use: Pet Food Nutritional Analysis It lists a lof of the higher end foods which may not be on Binky's chart.

If you are outside the US, there's non-US food list: http://binkyspage.tripod.com/nonusfd.html

.
melancia said:
I am looking into buying an in-home blood meter but do I do it everyday?

Yes, you will need to test every single day before giving the insulin injection. No different from a Human diabetic. You need to know what your cat's blood glucose level is before you give insulin. This can prevent hypoglycemia from happening a couple hours later.

how do I know what levels are normal? How do I know that I need to give less insuline?

Normal non-diabetic levels are roughly 60 to 150 mg/dl (3 to 11 mmol). You want to get your diabetic cat to stay in this normal range for as much of the time as possible with insulin and diet. This will take time to achieve so don't be discouraged if your cat's blood glucose levels seem to be stuck at a high level.

Once you start testing blood glucose levels at home and keep track of the numbers, you can see any trends and, after showing the vet the numbers and discussing them, adjust the dose. If your cat constantly hypos, then a lower dose is obviously needed. Most people here use a spreadsheet on Google and email their vet the link to the spreadsheet. Instructions on how to create one is here: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=50130 If you live outside the US, choose the World/US template download.
 
squeem 3 thank you for the info.
I've been trying to home test him with relion but I'm having a hard time figuring out the right spot on his year.
I wanted to figure out how to bloodtest first before giving insulin but my vet said we urgently needed to start on insulin today so I gave him his first shot this morning and have to give a second one in a couple hrs but I get nervous to do it without testing him. Should I stop with the insulin (since I just gave him one) until I'm able to test him? I poke him several times a day and rub his years too but I"m having a hard time!
 
Rubbing is often not enough to heat the ear. Try a prescription bottle filled with hot water, hold it next to his ear for a minute or so. You can leave the bottle behind his ear so you have something to poke against.

You can poke twice in the same spot to make the hole a little bigger.
 
You can also try a rice sock to heat the ear. Just put some uncooked rice in a sock and microwave. Whichever method you use make sure you test on the inside of you wrist before applying to Sam's ear so you know it's not too hot. The place you're trying to lance is the very edge of the ear. If you use a torch you should be able to see there is a vein that runs up the edge of the ear. Ideally you want to lance between the vein and the edge of the ear. If you need to you can lance the vein but be prepared for a fair amount of blood which Sam may shake off so don't have him sitting on your favourite couch when you do it! You can lance from either side, i.e. inside or outside of the ear.

If you are using a lancing device you may need to turn it up to a higher level.

Some people have trouble using prescription bottles as the backing for the ear because of the curved shape. I just use my finger. It is important you have something behind the ear because you won't get blood if the lance doesn't go into the ear properly.

Which insulin are you using and how many units?
 
Thank you!
I'm giving him prozinc 1 unit 2 x a day. I starte yesterday but I didn't give himinsulin at night because I was having a hard time with the meter. I think I might be using it wrong. I was adding the blood to the strip and then to the meter but I guess the meter has to be on first with the strip..!
too many things to learn!
 
Hello and welcome!

I remember how overwhelming it all was at first... I promise that within a couple weeks, you'll be amazed at how routine everything has become! One thing you'll definitely want to get is a low-carb treat... many of us use Purebites that can be found online or at Petco. The freeze-dried chicken are a huge hit in our house, as are dried tuna/bonito flakes. If you give a treat with every poke of the ear (whether successful or not), it's very likely that your dear Sam will be a much more willing participant in no time!

You'll find the community here to be wonderfully helpful in getting you started. You're definitely in good hands!!
 
There is a lot to learn and you are quite correct the strip needs to be in the meter before the blood is applied. As you go along you will iron out all your errors. The important thing is that you are learning, no one started out doing it all perfectly. So keep posting with any questions or problems that you have and you will keep getting better and better at it.

I don't use prozinc so I can't comment on whether or not it is safe to give without testing at his BG levels. I use lantus and on one unit of lantus with those sort of high BG levels and no change in diet necessary it would be safe to give at this stage of the game while testing was still being worked on. You may want to post a question about that on the insulin support board for prozinc users.

It is important that he starts getting his insulin because that high a level of BG can lead to ketones which can lead to diabetic ketoacidosis (DKA) which can be fatal and if not fatal will still lead to a very sick kitty and a massive vet bill. You need to get some ketodiastix (available at the pharmacy) to start checking his urine for ketones. Make sure you read the instructions because you need to time the test correctly for accurate results.

If Sam's not shy about peeing one of the easiest ways to get the urine sample is to stick a spoon under him when he's going. To my great surprise I found that this method works with Vyktor. Other people replace the litter with something non-absorbent like clean acquarium gravel, pieces of cut up plastic shopping bags or even lentils (make sure they don't end up back in the food cupboard!) to get the sample. If he uses the same spot in the litter tray everytime you may be able to put a little container or make a well out of plastic wrap in that spot to get it. I haven't used that method myself but have heard others talk about doing that. If you have trouble getting a sample post a new thread or go back and edit the subject line in your original post in this thread with a query about how to get a urine sample in the subject line. People are very inventive when it comes to these things!

I can't stess how important it is that you do this, you do not want Sam getting DKA and if he is starting to get ketones you want to know ASAP.
 
GOOD NEWS!!! I was finally able to test Sam! I was doing it all wrong. His result was 362 though :/ if the human meter isn't that accurate do you think it is 50 over or 50 less than 362? I know at the vet's office he tested 400.

That is good you used the lancet without the pen. I also find it very helpful!

I'm soo happy :]
Thanks for your valuable suggestions!!
 
You don't have to adjust the readings that you get on your meter at home...It isn't uncommon for BGs to drop when the kitty is at home and relaxed since almost all cats are stressed at the vet's and stress raises those readings..

Mel, Maxwell, Musette & The Fur Gang
 
melancia said:
GOOD NEWS!!! I was finally able to test Sam! I was doing it all wrong. His result was 362 though :/ if the human meter isn't that accurate do you think it is 50 over or 50 less than 362? I know at the vet's office he tested 400.


Yay this is great news :-D well done you :-D

The human meter is accurate (to within a 20% variance as required by law) it just reads differently to one that is calibrated specifically for cats. In Australia a lot of vets use human meters I don't know about where you are. Most people on the board also use human meters and the protocols followed here are also based on human meter readings.

Sam's BG will change all the time depending on stress, when he's eaten, the time of day, if he's well and the mystery changes, as well as changes caused by insulin action of course. This is why it is so important to test before every shot.
 
thank you!
I'm in Utah,my vet really wanted me to use one for pets but it's too expensive!!
so should I test him before he eats? I tested him last night after he ate and before giving insulin.
 
melancia said:
thank you!
I'm in Utah,my vet really wanted me to use one for pets but it's too expensive!!
so should I test him before he eats? I tested him last night after he ate and before giving insulin.

For testing, a general guideline is to remove food, no feeding for 2hrs prior to the shot time.
Food affects the BG numbers so if he eats, his number may be higher at shot time, then you give shot and he drops low when the food wears off in a few hrs later.
So see if you can get a true number that is not food influenced.

Most important tests will be just before each shot so that you know he has a high enough number to give a shot. Hopefully, he will get better and his pancreas will heal with your helping by giving shots, and then he may be off insulin. You will know that by testing.

Food will take a bit to show up in his numbers, and the insulin will take a couple hours to start showing in his numbers as well.
Just test before his shot, then feed him and give his shot. You can test when you like, and by doing a curve at home, maybe testing every 2 or 3 hrs for a 12hr cycle, and you will see how food affects his numbers and also how well the insulin is working. Many people are away at work during the week and can test only before shots and maybe a couple times after they get home, so don't worry about needing to test all the time. If you are home, it's good to get a test or two during the cycle, and you will learn how he's doing.

Lots of info, and lots of questions. Ask all you want, and someone will have an answer for you.
 
gotcha! last night when he got 362 it was right after he ate.
I just tested him right now on an empty stomach and the result was 135mg.I was wodnering if this was wrong since he got 362 last night but it was right after he ate.
He just ate now and I"m debating if I should give his insulin since it was bellow 200.
I'm planning on doing the curve today, to test him every 2 to 3 hrs. I'm counting on the help of this forum since I don't think i will know rats on what to do with this info, if I should lower his insulin intake or what!!
 
Hi Nadja

You can also post prozinc dose questions on the PZI insulin support board if you like, I use lantus so I don't post there but I just had a peek and there's been plenty of traffic through there today. I assume they do the same as the lantus board and you post your numbers there everyday if you want to so that the experts there get to know you and Sam and can help with your specific circumstances in mind. Here is fine too of course. Tip for you though, it is best if you start a new thread when you have a new query with your question in the subject line eg Prozinc Dose Question that way your new question won't get missed.

You're off to a great start

Serryn
 
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