First Post - New to Feline Diabetes

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dodgingwrenches

dodgingwrenches

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Hi all,

This is my first post here. I've done a lot of reading, but I still feel as if I know nothing and don't know what I should be doing with my newly diagnosed diabetic cat. I done a lot of reading from the FAQ and sticky links - finding a lot of broken links though :(. Here's my situation:

Cat: "Heart", a 6 y.o. neutered male, long-haired orange handsome fellow. Always been a thin boy, but a big boy (part main coon somewhere). Normal weight around 15 pounds. He has a "brother" and a "sister" (three cat household) but is the boss.

Three weeks ago I took him to the vet. He wasn't himself. Sleeping under the bed, not exerting himself as alpha male, and was getting skinny (could feel every bone in his spine when I pet him - but he was always thin, so I didn't think much of it at first). I had in the two months prior switched my food to Science Diet "Light" since my other two cats have weight issues (dry food household). Figured Heart would just eat more of the light food. Then thought he wasn't, hence the weight loss, so I'd start giving him his favourite wet food to supplement.

Anyway, at the vet, he was diagnosed with diabetes.Weight was down to 13.9 pounds. Blood panel showed everything was normal, except his sugar which was at 23 (we're in Canada). Started him on insulin (Novolin) twice a day, 3 units each time. I asked my vet if he had cat specific insulin instead of human, he shrugged it off saying this was just fine in his experience. After a few days on the insulin, Heart started doing better. Started eating again, drinking less, peeing less, becoming the "boss" again.

Around day 12, I noticed he was drinking a lot again. Day 14 we were back at the vet's office. His blood glucose was at 29 (he gets his shots 8am and 8pm, vet visit was 4pm). His weight had gone up slightly from 13.9 pounds to 14 pounds. Vet increased the dose to 5 units twice a day and told me to come back in two weeks. This was this past Tuesday. Theory for the sudden drinking bonanza again - the weekend before the vets visit, my husband had started giving the injections instead of me. We were using 27 gauge, 1/2 inch needles (vet said we can re-use up to four times each needle - not sure how I feel about that). Vet thinks maybe my husband wasn't injecting properly? Husband isn't sure. He says as soon as he felt pierced skin, he injected, so it could be true. He was afraid of hitting muscle or bone. I did in the meantime order 30 gauge, short needles thinking this would be more comfortable, but now I worry the needles are too short. Another difference between my husband and my injections is that I'd try different parts of his body (read there was less blood circulation in the scruff of his neck) whereas my husband stuck to the scruff. Either way, since Tuesday, I've been giving the injections again, and varying sites. Tried one with the short needle as well (stuck it all the way in though).He still is drinking a lot though. I'm now also giving everyone wet food (vet had given me Purina DM after the first visit to give to Heart) since I want them to be healthy. I was under the misconception that dry food was healthier for them (teeth, etc) so had switched everyone to dry food.

What should I do next? I thought of buying a blood glucose monitor, but there is too much information and I just don't know which one to get. Then I read about the "peak" values and +2, +4, etc. What does this all mean? When should I be measuring his BG? How often? Which monitor should I buy? Then how do I "regulate' his dosage? I feel lost :( I just want the insulin to work and Heart to get better. He is the best cat I ever had, and I'd hate to lose him so young.

Sophia
 

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Hi there

you may want to cross post this thread into the Health forum - lots of traffic there....

Im not too familiar with novolin, but I need to correct your vet - human insulins work quite well in kitties. lots of members here use human insulins.

cross post in health ok? this forum does not get a lot of traffic
 
Hello there, welcome,

Odie and I are in Ottawa too... if you need help learning to hometest or something, let me know.

I don't know much about Novolin (we use Lantus - a human insulin), but 3 units seems kind of high to get started.

You really should start to hometest, so that you can figure out what's going on with his blood sugar levels. Stress from the car ride and being at the vet's office can raise numbers a lot. You need to know how he's doing at home, at different times of the day, to figure out how much insulin he needs. In Ottawa, the cheapest glucometer and strips I found are at Costco. The True Track meter is free when you buy strips (a box of 100 strips is $43). This is what I am using now. I initially had a OneTouch Ultra Mini, which quite frankly I prefer, but the cheapest strips I could find are $73... so for that big a difference in price, I'm using the True Track for now.

It's a steep learning curve, there's so much to learn and it's like a whole new language. Read, ask questions, breathe. Within a few weeks, it'll just be routine and so much easier to handle.

As for + 2, +4. When hometesting, you always test before each shot - AMPS = morning pre-shot and PMPS = evening pre-shot. Then each hour after the shot is indicated with a +1, +2, +4, etc. For example if you gave his shot at 8am, his test value right then would be his AMPS and then if you tested at 2pm (6 hours later), that would be at +6.

Insulin doesn't instantly work, it takes a bit of time to get into the system. For most insulin, the point where it's most in the system is somewhere between +5 to +7 (but can be different, that's why you test to figure it out). This is called the "nadir". It is where the cat's blood glucose level will be lowest in the cycle. When you're testing, you want to make sure that at no point the numbers gets dangerously low.

Keep asking questions... and remember I'm in Ottawa.

Odiesmom
 
the other thing I wanted to mention is that you should consider switching to low-carb wet food (this will be good for everyone and does not need to be expensive, nor does it need to be "vet" food - vet food is often high-carb).

There is a chart here that lists the nutritional values for a bunch of different foods:
http://binkyspage.tripod.com/CanFoodNew.html

You want to try and stick to under 10% carbs. Lots of people here feed Fancy Feast varieties that are on the list with success... of course you have to find something that your cats will eat. Once on low-carb food, Heart's insulin needs will go down considerably. Some cats are able to be diet-controlled only (no need for insulin), but others still need some small amount of insulin. In any case, if you do switch, be aware that 3 units of insulin will likely be too much at this point, so you should be testing to find out and probably reduce the dose of insulin.

Odiesmom

PS - Heart is gorgeous!
 
Thanks odiesmom for the reply. Your cat looks a lot like mine (mine is a long-haired orange tabby, but he got a hair cut so looks like a short hair now).

I'll see if I can get my mom to take me to Costco (she has a membership) and try to pick up one of those True Track monitors. So how often should I measure his BG at first to learn how he reacts to the insulin? It will be interesting learning how to do that...

You think 3 units is high - he's curently on 5! Vet bumped it up since his BG was even higher second time around (29). This does worry me...
 
I found that food chart a few days ago and printed it for my husband to take to Wal-Mart. He picked up a bunch of Special Kitty varieties off of it. I'm really hoping that mine is one of those that goes in remission, being a young fellow and all.
 
Please very careful if you plan to switch to a low carb wet food diet while still on a higher dose....this link will explain how to slowly transition your kitty to a wet food diet...home testing is a must - especially at this dose and during the transition.
Not sure about Ottawa, but here in Toronto's Costco, you dont need a membership to purchase pharmacy items/prescriptions, but since u have access to one, thats ok too!

How To Transition From Dry Food to Wet

Good luck to you and remember to visit the Health forum, as I mentioned before - lots of eyes there if u need immediate assistance!
 
I'm guessing you've also found the post with all of the hometesting tips?

viewtopic.php?f=14&t=287


As for how often to test, well definitely before each shot, to make sure it is safe to give him insulin.
Then you'll want to get some mid-cycle tests done to learn how his body is reacting. At least get 1 or 2 tests done in the +4 to +7 range. Basically in these early days, the more data you can collect the better. Now that has to be balanced with the rest of your life and not raising your and Heart's stress levels up too much :smile:

I don't know enough about Novolin to give real dosage advice. With Lantus, this would be a huge starting dose (unless there's some other health issue going on that warrants it). When they get too much insulin, there's a risk of the blood glucose going too low which is dangerous, but there's also a risk of their body sort of going into defensive mode and you end up seeing high numbers instead. That's why most people start at a low dose, let that settle in for a few days, see how the numbers are looking, and then increase by a tiny bit (like 0.25, 0.5, 1 unit) at a time.

Did the vet test for something called "ketones"? This is something that can sometimes happen when they have high blood glucose numbers. It's important to take care of that quickly because those can be dangerous.

If you want advice from more people, post in the general "Health" rather than the Novolin one... more people check there frequently.

Odiesmom
 
They definitely have no problems switching to wet food. They all, with their previous owners, lived off of it. I'm the mean owner that switched them to dry food :shock: It's funny seeing all three kitties trying to stuff their faces into the same food bowl.

Going to costco today to pick up the BG monitor. I guess I'll take a few measurements for a few days just before the needle then at +4 and +8 and then at +12(before the next one) since the shots are twelve hours apart. I'll let you know of the results.

The vet did tell me the signs to look for for hypoglycemia, but so far, Heart has been fine after every shot. If I can get his BG levels down, I'll gladly reduce the dose...
 
I got the meter and did my first reading. It didn't come with glucose testing solution, so I tested it on myself to see if it was within a healthy range (5.6 sounds good to me ;-) )

Heart's insulin was at 31.8 though :( (multiplied by 18, that is 572). This is at +11. His shot is due in an hour (vet's prescribed 5 units).
 
Good job on getting testing done!! :RAHCAT

Yeah that first one is quite high. Hopefully with the switch to wet food, they'll start to come down. The +3 number was heading in the right direction. Tomorrow, if you could get something like +4 and +6 readings along with his pre-shot numbers, that would give a good idea of where the nadir is and how low he goes.

With numbers that high though, I think you have to watch for ketones. You get test strips for that at the pharmacy too (they're much cheaper than the glucometer strips). You somehow have to dip them in his pee - either by sticking it under the stream while he's peeing, or catching some pee with a ladle, or somehow getting a puddle of pee to dip in. I have not tried this (Odie's numbers were luckily not that high initially)... but you really want to catch ketones early because they can be deadly if not caught early enough.

Congratulations again on successful testing though! You're well on your way to mastering this :smile:

Odiesmom
 
Looks like your thread got moved over - if anyone's wondering what Im talking about :lol:

keep us posted on your kitty Heart (cute name) Sophia!
 
Posting below a condensed version of N insulin. Never basea dose on a reading at the vet clinic........it usually will spike from stress........glad to know you now have a meter and can test at home.


Using N??? Please Read!!! Some good info for newbies using other insulins included...
Posted by: Kimber & Bunny (IP Logged)
Date: January 26, 2008 03:35PM

HUMULIN 101


NOTE: Although this was originally written as a primer for N insulin, much of this is a GENERAL HUMULIN PRIMER with advice and experience that pertains to any of the ‘human’ insulins, including Lantus which I have found works very much like Humulin U.

Novolin is the same as Humulin N, just a different manufacturer.



In cats, N tends to be the faster acting, often with rapid onset and little duration.
N is not the easiest insulin to regulate on. However, there are several cats on this board who have been regulated on it. Bunny was regulated on Humulin N for just short of 5 years. Bunny, unlike most cats, got 12 hours duration out of the N.



Every Cat is Different, and not every cat will react the same to any given protocol or dosage. It is VITAL that all changes be discussed with your veterinarian who can talk about these options with you so that TOGETHER you can find what is best for your cat.

There are some very important issues/points to remember when using N, most of these are pertinent for the other insulins as well.

1. FOOD. Always make sure kitty eats about an hour before his/her shot. This will insure that kitty has food on her stomach to counteract the typical fast drop of the bg's caused by N (some cats do not drop fast on it, which is, again, why hometesting is so important!).
Feeding an hour ahead also leaves you relatively sure the cat is going to keep the food down. Warning: We are dealing with cats here, which means nothing is guaranteed. Bunny vomited at peak, while we were asleep, and that is how we had our first hypo in over 5 years of treating diabetes.
NOTE: Bunny free fed and seemed to know when he needed to eat, so we did not have to worry about his eating before hand. However, kitties getting timed feedings should be fed as stated.

2. DO A CURVE/HOMETEST. This is a must with all insulins, but can really save you from hypo on N. You need to know when the insulin peaks because you need to know just how low the bg's are dropping. N, in my experience, can peak at anywhere from 2 to 6 hours. Before Bunny got sick, his peak was at around 5 (depending on exercise and food consumption) and after his cancer dx and subsequent hypo, we dropped down to two hours after shot. Needless to say, we have switched insulins.

The importance of your peak/nadir/low number is two fold: A) You do not want to hypo your cat. High blood glucose @#$%& slow, low blood glucose KILLS FAST. B ) You cannot adjust a dosage on preshot alone. Preshot numbers can be deceiving in that if you are going too low at peak, you will have high numbers at preshot. It is kitty's body's way of saving it from overdose. Consistently high preshots without knowledge of your nadir number could mean rebound, at which point you don't need to increase your dosage you need to DECREASE.

HORROR STORY: When we were newbies and our vet was learning this right along with us, we kept increasing Bunny's dose based on high preshots and vet visit readings. He was up to FIFTEEN UNITS OF N BID!!! Makes my stomach flip flop thinking about it now! Posted on this board that I was at my whit’s end because I could not get nice preshots. The posts I received back said, "That is WAY too much N! Start over and check your peak numbers!" He was going down to 26 at peak! YIKES! If not for the fact that Bunny free feeds, and can thus bring his numbers back up by eating, he would have died. ALWAYS FIND OUT WHEN YOUR PEAK IS AND CHECK THOSE NUMBERS BEFORE ANY INCREASE!

When curving on N for the *first time*, in my opinion, it is good to check bg's at +2, +3, +4, +5 and again at +6. This will tell you exactly where your peak is. After the numbers start to rise, you can go back to every two hour checks. This is not the only way to do a curve; it is just my opinion on how to do your first with a new insulin, especially one as fast acting as N.
Until you have a chance to curve, I do not recommend giving the shot at bg’s under 300 simply because you do not know yet how much of a drop you are going to get. I have sat up all night on hypo watch with several folks who were new and thus had not curved yet, only to find out their cat dropped 200 on a single unit…not good when preshots was 250.


3. SETTLE TIME/ONE CHANGE AT A TIME. Speaking of increases, just like any other insulin, allow at least two weeks between changes/increases for the change to settle/body to adjust. This includes food changes. If kitty is starting a low carb diet, do not increase insulin until the cat's body can adjust to the change. Too many changes too close together will leave you wondering which change you made gave you the result you wanted. The only exception to this rule is a decrease in dosage. If kitty is going too low (I don't like Bunny to be anywhere under 100 and I, personally, do not “shoot” under 250), definitely decrease your dose.

4. LOOK AT THE WHOLE CAT. Many folks on this board have lovely regulation numbers that are consistently between 100-200. Some cats will not regulate that way. Bunny was mid 300's preshot (never any ketones) and low/mid 200's at peak when he was regulated. Any other change took him too low (lowest I could take him without a rebound was 180ish). He was flat on his hocks with neuropathy at dx. Once we regulated him, he started walking normal, decreased water intake and peeing and started to put some weight back on. The vet said that even though his numbers were higher than the ideal, it was obviously what worked for him. His annual FULL blood work ups, until the cancer, always showed normal.

5. GET A FULL BLOOD WORKUP AT LEAST ONCE PER YEAR. This is all insulin’s. Because diabetes affects so many other organs, it is very important to know the kidney, liver etc are functioning properly. This test lets you and your vet get a better picture of what is going on with kitty. It also helps catch other diseases when they may still be in their early stages and thus easier to treat.

6. SYRUP. This is just too important! If kitty is catatonic, non-responsive or having seizures, IMMEDIATELY give karo syrup, maple syrup or honey. You can rub it on their gums or the inside of their cheek. Never syringe syrup.....you could aspirate the kitty.
Even if you are on your way to the ER, the sugar spike could save your cat's life or some of the organs that are damaged during such an episode. Do not worry about getting syrup everywhere, it will wash up later. Do not worry about taking kitty's bg's too high--high sugar @#$%& slow, low sugar @#$%& fast. If possible, have someone drive while you continue to apply the syrup on the way to the doctor. It could save your cat's life!
High carb foods such as dry food or the semi-moists like Tender Vittles are good to keep on hand as well. Why? Because if kitty is conscious/with it enough to eat, then the this will help Keep the Bg’s up longer. Syrup is a temp fix and does not maintain the needed rise.

7. SEMI-MOIST FOOD/TREATS. Tender Vittles and other semi-moist foods/treats, milk and carrots can also cause a major spike in the bg numbers, because they all contain SUGAR. I am not saying kitty can never have these again. Quality of life is very important. Bunny has always been allowed one or two a couple times a week. I am just saying to abstain from these treats until you achieve regulation.

8. KNOW YOUR CAT. There may come a time when kitty does not want to eat what s/he is supposed to. It is important to know what foods you can give to entice eating, as it is crucial for the cat to eat while on insulin! Also, if you are curving and kitty’s numbers start dropping too low before and/or during peak, it is lifesaving to know what to give in order to start increasing numbers. Things that have worked for myself and others: vanilla ice cream, gravy, white bread, Catsip (the milk that is made for cats, not the stuff you put on hotdogs), donuts, popcorn, dry cat food or dry cat food with tuna water dumped on it, semi-moist cat treats. You will want to know beforehand what high carb foods your cat loves, and will readily eat, so that should you find yourself in a situation where your kitty's numbers are going too low, you already have a supply on hand, and won't waste precious moments experimenting with different foods.


9. START LOW GO SLOW. If you start too high, you could “miss” your ideal dosage. Many people have found that ½ a unit BID or 1 unit BID ends up being the perfect dosage to keep kitty in the 100-300 range.

10. BID (TWICE PER DAY) dosing: In all the years of being on and off the FD Boards (since 10/97) I have not come across a cat that got any more than 12 hours duration on N. It is NOT a single dose per day insulin by any stretch. Increasing dosage does not make the insulin last longer, it only makes the cat’s number see-saw more, dropping them lower which causes their glucose to go higher. If your vet wants SID (one dose per day) please explain this to him/her and if they refuse to listen, PLEASE INSIST that you do twice per day dosing.
Even on slower acting insulins like L and U, MOST cats need insulin twice per day.

11. EVEN AFTER YOU REACH REGULATION IT IS A GOOD IDEA TO PS TEST AND/OR DO PERIODIC CURVES. Insulin needs change. Throughout the six years I treated Bunny his insulin had to be adjusted. Just because 2 units BID worked for the past 6 months, you are treating a CAT, and cats change their minds all the time! His dosage varied from 7 to 5 units over the first 5 years because his body’s needs changed. Without periodic curves, I wouldn’t have known to adjust his dosage and could have easily hypo’d him.


:O)
Copyright © 2003-2007
Kimber, Bunny (Grey Angel) & Dee(Guardian Angel) & Riley
(with much appreciated contributions from Debra & Care Bear; Hope, (((Patches)))GA, (((Baby)))GA, Hope & Mishka)

PS…since the subject has been brought up several times on the FDMB…Humulin insulins in the United States are ALWAYS U-100, and therefore should be used with “U-100” needles.
 
You've gotten great advice so far.

I wanted to suggest that since you have a walmart nearby - they sell the relion brand meter - It's actually one of the least expensive meter and strips around. I started off with a true track and you can see by my spreadsheet (Maui) that I had lots of problems with it - mainly inconsistent numbers.

So, I returned it and use the one touch ultra and mini.

I know many people here use the Relion and like I said, it's reasonably priced.

Regarding ketones - you can pick up ketostix or ketodiastix at Walmart too - just look in the diabetes section (or ask the pharmacist). You want to use them just to make sure he doesn't have ketones.

If you want to change insulins and your vet is resistant or refusing to allow you to do that - then you may need to get a new vet. And since Oldiesmom is close by - maybe she can recommend her vet for you.
 
odiesmom said:
Good job on getting testing done!! :RAHCAT

Yeah that first one is quite high. Hopefully with the switch to wet food, they'll start to come down. The +3 number was heading in the right direction. Tomorrow, if you could get something like +4 and +6 readings along with his pre-shot numbers, that would give a good idea of where the nadir is and how low he goes.
Click to expand...

This morning, before I gave him his shot, the reading was "Hi" (>33, or >600). nailbite_smile Should I (without my vet) try increasing his insulin? I can take various measurements throughout the day, but tomorrow I'm back at work, so it'll be harder to do. Not to mention that he doesn't really like my taking blood since I'm not doing it well. I watched the Mike & Buddy video, but I still have to stick him a few times before I can get a decent drop. Either there is not enough blood coming out, or he moves and ruins the drop I do get. He's not a happy kitty right now... Oh yeah, he's been getting wet food for a few weeks now. DM for two weeks, and now Special Kitty for almost a week. I'm losing hope on that one... At least he's still eating though!!

Yes, I picked up Ketonix at Costco as well yesterday. I'll see if I can catch him going to the litter box...
 
I would not increase the insulin.

It takes several days for some insulins to start working well.

Never increase the dose based on one reading.

You need a curve to to that...your homework assignment for next weekend.
 
Welcome fellow Canadian!!
We are here in Montreal.

You have received excellent advice so far. I am not familiar with N, my Max was on
Lantus (Glargine) and has been off insulin since April 3.
If Heart is not loving the special kitty, you can try the Fancy Feast, classic flavours and some Friskies too.
Here is the link for the food list.
Food List

With regards to Hilary's suggestion about the meter, yes the Relion is terrific and inexpensive strips but it is not available here in Canada. That is the meter that I used but I had easy access to getting it from the states.
 
Just to clarify, there are no problems with him eating wet food we picked off of the chart. He's been on wet food, and on insulin, for two and a half weeks now, so should have adapted somewhat by now :(
 
Hillary & Maui said:
If you want to change insulins and your vet is resistant or refusing to allow you to do that - then you may need to get a new vet. And since Oldiesmom is close by - maybe she can recommend her vet for you.
Click to expand...

If you want to talk vets, let me know. I'm not sure whether to mention individual vets here, but I can sent you a Private Message.

btw - like Randi said, we can't get the Relion in Canada... I tried

How many days has he been on Novolin? 3 units, then 5 units?
Anyone with Novolin - with numbers this high even after that long, is that a hint that she should change insulin?

Odiesmom
 
wondering if the starting of wet food and continuing with 5U , he is bouncing???
need a curve or at least some spot checks at +4/6
 
You cannot adjust a dosage on preshot alone. Preshot numbers can be deceiving in that if you are going too low at peak, you will have high numbers at preshot. It is kitty's body's way of saving it from overdose. Consistently high preshots without knowledge of your nadir number could mean rebound, at which point you don't need to increase your dosage you need to DECREASE

You need to get a good curve in before increasing that dose. N is fast acting with a short duration in most cats so he may actually be going very low at nadir(peak) and then sky rocketing back up to a high number. Increasing, especially with N, is really not going to give you longer duration but it may very well HYPO your kitty. I think you will find from testing and doing a curve or two that N is not going to work well and you will need to get another insulin like Lantus which has a high rate of remission in newly dx'd cats.
 
Welcome, Sophia and Heart! Wow, you are really getting your feet wet with testing right away and all. Good for you!

Here is my main concern: this insulin is very similar to vetsulin (caninsulin in Canada) that both my boys were on to begin with. 3u is way too much to start out on. 1u (or a half unit) should be the starting dose. That should be held for 5 days and be raised - if the numbers show it needs to be raised - in no more than half unit amounts.

I am afraid your vet is treating Heart like a small dog and setting his insulin dose based on weight - which you can't do with cats. And raising his dose by 2u without knowing how he is responding to insulin is, frankly, poor vetting.

Be aware that a lot of cats show no signs of a hypo until they are very low. Beau could drop to the low 30s (less than 2, Canadian) and have no symptoms. The most reliable way to determine a too low BG is with the meter. And you will want to be testing at +1 and +2 and +3 with this insulin. It works very fast, and the lowest point could be well before +4 especially with a too high dose. Then it wears off rapidly and the BG climbs back up, but if it drops too low it will soar ever higher because the body releases stored sugars to save itself from a hypo situation. This is called rebound. And the numbers in the 500s and 600s really sound like rebound numbers to me.

I think the fastest way to get him back on track is to ditch the dry food entirely and drop his dose to 1u every 12 hours - basically starting over. FYI - many of us have diabetics from "light" versions of dry food. Beau was on Iams weight management before diagnosis (and for a while after - sigh). Please test for ketones while you are starting over.

It will take up to 3 days for the rebound response and hormones to leave his system, so stay with the 1u - don't panic and shoot a higher dose if you see a higher number. On day 2 or 3, try to get a spot check in at about +3 or +4 - maybe before bedtime? You need to be testing for ketones (should be anyway with a newly diagnosed cat) because he may be in high numbers for a few days - but it looks like he is anyway right now.

There may be a good chance that with the early diagnosis, a diet change to low carb wet food (for the other two cats as well), and a short course of insulin Heart can go into remission. But if he doesn't you may want to think about switching him to a better insulin for cats - namely either levemir (detemir) or lantus (glargine). They are both longer acting insulins which work very well with a cats very fast metabolism.
 
That you Sheila very much for your reply.

To answer some other questions, he was on 3 units for the first two weeks (twice daily) and has been on 5 units since last Tuesday night. And yes, the vet calculated 3 units based on his weight.

I took some blood again at +3 today, and he was down to 20.2 (363). Last night at +3 he was also around the 20 mark. I'll do another in another hour or so. Does this still sound like rebound?

My spreadsheet is updated here:

https://spreadsheets.google.com/ccc?key ... 2RUE&hl=en

I'm finding it very difficult pricking him for blood though. His ears are starting to look like pincushions and I'm feeling terrible because he really doens't like it and it takes several pricks to get one with enough blood. I know the problem is my inexperience, but I'd like to let his ears heal before pricking them more. I found various videos on youtube, and in one, someone uses the paw. Is this a recommended practice here or are there reasons to avoid using the paw? Someone else, with the same monitor as me, used the lanset device that came with it (I've been using separate lancets). Maybe I should use this to get a better prick? I couldn't see it well in the video, but I think she pricked from the back (furry) side of the ear, towards the edge. The lancet device has numbers 1-5 though for depth, and I'm not sure which one she used.
 
dodgingwrenches said:
That you Sheila very much for your reply.

I'm finding it very difficult pricking him for blood though. His ears are starting to look like pincushions and I'm feeling terrible because he really doens't like it and it takes several pricks to get one with enough blood. I know the problem is my inexperience, but I'd like to let his ears heal before pricking them more. I found various videos on youtube, and in one, someone uses the paw. Is this a recommended practice here or are there reasons to avoid using the paw? Someone else, with the same monitor as me, used the lanset device that came with it (I've been using separate lancets). Maybe I should use this to get a better prick? I couldn't see it well in the video, but I think she pricked from the back (furry) side of the ear, towards the edge. The lancet device has numbers 1-5 though for depth, and I'm not sure which one she used.
Click to expand...


Can you describe how you are doing it now? Perhaps we can suggest things to change/try differently.

I have not tried using the paw. I think the usual concerns are that
- cats are usually even less likely to let you prick their paw
- they walk on their paws, so bruising there is more likely to bother them
- they scratch in the litter box and walk everywhere, so tiny pricks have a possibility of getting infected

My offer still stands if you want in-person help.

(I can't remember if I've said this in your thread before, sorry if I have)

- I do prick on the furry side, with a very thin layer of vaseline on the ear first to make the blood from a nice round drop rather than spread in the fur.
- I also use a flashlight - rest the ear against the flashlight, then it gives something hard to press against for pricking and lets you see exactly where the vein is to prick.
- A warm rice sock against the ear for a few seconds before can help make the ear bleed more. Take a thin sock, add 1/2 cup of uncooked rice, knot the sock, put in microwave until it's quite warm (but not hot enough to burn), hold against the ear for like 30 seconds, then prick.
- Pricking lower down along the side of the ear usually bleeds more than towards the tip
- A small dab of Polysporin Complete can help with healing/pain afterwards (look for the one with pain relief)
- I also wrap Odie in a towel first to hold him still

Odiesmom
 
I tried it this time with the lancet device, and a rice sock, and that was a disaster too. He squirmed less with the lancet device, but I never got enough blood. Three test strips wasted, an annoyed cat, and yelling with my husband later we gave up. Half an hour later, tried again. I started pricking with the lancet myself again, not with the device. It hurts him more, but gets more blood. His +5 now is 23.7 (426), so on the way up again. I put some polysporin on his ear, since both edges of both ears aren't looking to good right now... Heart is now also upset with me and hiding under the bed... When he does that, I know I'm in trouble!

I don't even know what to do at this point. His blood sugar is too high, it's not going down to anything normal. He's eating again though, eating well, but I'm giving him a lot of insulin. Today he's not drinking like crazy (wasn't yesterday either), but the BG is so high. I feel terrible, and what makes me feel worse is knowing that his diabetes is all my fault from giving him the "Light" food.
 
Hmm just realized the last reading I got could have been higher because I gave him a few of his favourite treats to compensate for pricking his ear a million times. Don't know how fast acting those Temptations with regards to raising BG levels
 
dodgingwrenches said:
Hmm just realized the last reading I got could have been higher because I gave him a few of his favourite treats to compensate for pricking his ear a million times. Don't know how fast acting those Temptations with regards to raising BG levels
Click to expand...



I'm giving you a link to fav low carb kitty treats...up here in Canada you can find both Halo freeze dried treats, PureBites and PureSnacks, all 100% pure meat and very low carb and yummy.

The tempations are a wee bit on the high side plus have extra additives and stings.

Next time you're at a Walmart or Zellers, check out PureBites and PureSnacks, you may also use the doggy ones too - exactly the same thing, just has a dog pic on it. Doggy ones are a little bigger, just break them down to small bits for kitties.
Halo treats you'll find in pet stores. A little pricey but just as good.

Low Carb Kitty Treats
 
Hi,

it's possible kitty is in rebound. The large insulin dose dropped his bg, his body panicked and dumped glucagon into his bloodstream (natural liofe saving redponse) and result-high bg again. Constant high bg, vet increases dose and thus the viscious cycle continues....

However,(this is a bit of a hobby horse of mine) as I think Ronnie mentioned-you MUST be checking for keytones before reducing dose right back to 1u.Yes, ethos of this board is start low, go slow, but twice in the time I've been a member, people have advised to cut a dose right back and it has resulted in keytones, one was serious and needed hospitalisation.

Important to remember you can see your cat, we can't. He isn't just a number.
In the first instance, I would consider cutting back to 2.5u and monitor for keytones. This will mean stalking the litter box. Make note of how much he poops and pees and eats. Is he lively, playful, preening?

If his numbers actually look like they are dropping then you would consider reducing dose a little more.

With Novolin being a fast acting insulin, you want to try and get +1,2 and +4-approximately the lowest number in the cycle when this insulin is working it's hardest on the bg.

You have to be careful with newbies that we don't overload-but there are some cats who need high levels of insulin, but it's only thorugh testing and gradually increasing dose that we work this out (later down line bean may then be advised to get specific tests-your not anywhere near this at the moment)

If your swapping to lower carb food-do this gradually. so say 5ozs is a normal meal, give 4ozs usual food, 1oz new low carb. Next time
3ozs usual food, 2 ozs wet and so on.(I just plucked those numbers out of the air-but hopefully you get what I mean :-D )
 
Dodgingwrenches,

I sent you a reply to your PM... but it's sitting in my "outbox" rather than "sent mail" and I can't figure out why.
Let me know if you didn't get it.

Odiesmom
 
You've gotten some good advice so far. Dropping the dose to 1U and home testing and switching to low carb wet food are probably your main defenses at this time. Also, please get the ketone test strips to test his urine with. If you need help figuring out how to get a urine test, ask and members will offer suggestions from what has worked for them. Covering the litter box with plastic wrap is one method.

If you're concerned about his ears, there is one very important thing to do after each successful stick - press on the spot for several seconds with 2 fingers, using a cotton ball or tissue to stop the blood and prevent bruising. The bruising is what can make their ear sore, not necessarily infection. I have been testing Gandalf for over 5 years now and you could never tell it. Also switch ears and locations on the ears each time.

Have you seen this picture: http://i106.photobucket.com/albums/m267/chupie_2006/testingear/sweetspot.jpg That's the area you want to stick for best results. But anywhere around the ear between the vein and outer edge of ear is fine, it just takes a while to teach it to bleed.

Once you get a handle on these things, I suggest looking in to one of the longer acting insulins either Lantus or Levemir. If the current vet will not consider even ProZinc insulin, you may have an uphill battle as those are human insulins but they work very well for cats, it's just that the clinical data on their use in cats is slim so very few vets are familiar with them and prefer to stick with what's been approved for cats, at least here in the States anyway. It may be different in Canada. So if you feel you need a different vet, please consider it.

Your cat stands a better chance going in to remission on either Lantus or Levemir than Novolin.
 
I think PMs sit in the OUTBOX until the recipient reads it -- it is then in your SENT box and their IN box.

Novolin is like Humulin N.

Many vets treat cats like small dogs. Dogs are dosed by weight. Cats should NOT be dosed by weight. Cats should start at 1 unit BID and after 5-7 days, determine if an increase is needed or not.

Every cat is different -- and for some cats, even 1 unit BID is too much. Right now, I have two diabetic cats (adopted here through this board after my first diabetic, Norton, passed away). One gets 0.5u BID and the other gets 0.25 BID.

By starting off at 3 units, you may have missed the best dose. Most vets do not have much training in diabetes - in 8 years of study, they may spend a couple of hours on diabetes in all animal species. Most spend even less time studying proper nutrition. I have gotten better information here than from my vet. I still like and respect my vet, but I've learned that she doesn't know everything and doesn't have the time to study the newest trends and recommendations.

I would suggest that you change to Lantus or Levemir -- both are available in Canadian pharmacies without a prescription. Get the 5-pack of pen cartridges. Please go to the Insulin Support group and read the sticky posts. There has been a study that showed cats given Lantus have the best chance at remission or becoming diet controlled. Levemir is a newer insulin very similar to Lantus -- I'm using it for my cats. There are quite a few people here using Levemir for their cats -- there just has not been a published study, so some vets may be reluctant to prescribe it. (in the US, we have to have a prescription to get Lantus or Levemir)

Start over at 1 unit with the new insulin.

ALSO.... since you are changing the diet to Low Carb canned food -- REDUCE INSULIN DOSE!!!!

The dry food diet has made the high dose of 3u and now 5u necessary. When you change the diet, LESS insulin is needed.

SO .... keep on testing
 
Hi all, new here, just kind of reading up on all the posts, and seeing if anyone here in Ottawa, Ontario Canada is using Levemir for diabetes treatment in Felines? Please let me know, thanks. Everything I have read up on it, seems to be the best way to go.
 
Hi, you have posted on the bottom of a very old thread. I will copy your post and start a new one for you. Look for Newbie aaznangelottawa on the top of the page. We have lots of Canadian members who can help you out.
 
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