Friend from work has new diabetic kitty and I need some inpu

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catthom

Member Since 2010
She doesn't yet know the insulin (vet was going to call her to come pick it up), doesn't know how high the BGs were; but her cat had been losing weight, acting starving, drinking a lot and peeing a lo. Why she took him in. He is an altered male- maybe around 5-6 (could be older, he adopted her last year).Sound familiar?! What is known is that the vet wants her to start at 2 units, twice a day on a 12 hour schedule. She did some reading and started using more wet food (FF pate), but was still using about half the diet dry food. Vet wanted her to get the prescription diet but she said no as money is an issue. Kitty loves it, and has had a little diarrhea so obviously she can't move too rapidly. Now, the problems- she work around 30 hours a week on campus, and she is a concert violinist and works away at least 3 or more evenings since she is paid so poorly at the uni. She is willing to learn to test and he is a sweetheart- so shouldnt be a problem. She can be home and shoot around 8 am (works at 10am) back home at 4pm, then takes off to Orlando where she mostly works- then back home by midnight. I think you see the problem- she doesn't have anywhere near a 12 schedule that she could maintain. She has a neighbor who can fill in, but at this point she doesn't know how often the neighbor can help. She will have several days off together in a row in over a week- so could start then, but.......
So, my question is- and this is hypothetical until I get more info- should she start insulin at all until she can handle the closer to 12 hour schedule (with neighbors help) just to establish? Should she just do on dose a day in the am (like, just 1 unit) when she can stick around and observe? Someone else told her to do 2 units a midnight, then 1 at 8 am, that just sounds too risky to me for a newby. Even weekends are problematic, she takes every job that comes her way all over Tampa Bay and Orlando, weddings, special events and cool things like playing with the Transsiberian orchestra (she's on regular call to Disney, probably drives there at least twice a week). I can help out some here and there, but I'm not very flexible due to my hours. She is game on changing the diet to all wet, high protein, and I really hope with some short term decent regulation, her boy can do the happy dance someday soon. She said he has gone even more downhill over the past few days, so I don't know if waiting is really an option. I promised to help her with testing, so we'll have to set that up but it won't happen for at least a couple of days. I have referred her to FDMB- but she doesn't have a computer or internet at home right now, she can access it at work, but her office is very busy and folks constantly come in and out. She's going to try to find out what the BGs or fructosamine was and what type of insulin by tonight, so I'll update when I hear from her.
I'm copying from another place, here's some updates.
BG was 568, they want to start him with versulin. Any input would help.
Cat
Cat
 
Re: Friend from work has new diabetic kitty and I need some

Not Vetsulin! Developed on dogs which have a slower metabolism..

Because of the erratic schedule, I'd suggest ProZinc or PZI. With an Rx, ProZinc may be purchased from Veterinary suppliers such as Fosters and Smith.

If she changes completely to low carb canned food, he may be able to get off insulin.

As an FYI: there are very few low carb dry foods
- Evo Cat and Kitten
- Stella and Chewey's freeze dried
- Young Again 0 Carb (5% as we calculate it)

She may want to recruit several trustworthy folks to teach how to test and shoot - perhaps some students interested in the veterinary field.
 
Re: Friend from work has new diabetic kitty and I need some

I second BJ's opinion of ProZinc or PZI....I don't think a depot insulin would work well with her erratic schedule. It sure WOULD be nice if she could find a vet student...

THANK YOU for helping her!
 
Re: Friend from work has new diabetic kitty and I need some

Three keys to helping our diabetic cats get better.

1. A good insulin. Of the 3 good insulin choices for cats, Prozinc or PZI sounds like the best insulin for your friends schedule. Lantus and Levimir need more consistent dosing whereas the Prozinc/PZI has more flexibility in dosing times.

2. Low carb food. Either wet or dry. Wet foods like Fancy Feast classic pates or Friskies pates or Wellness grain free eithe (many flavors and choices available) or there are a handful of low carb dry foods.

3. Home testing. To see how well the insulin dose is helping the cat.

You're a good friend to be posting for your friend. Hope we can help you and her to get her kitty better.
 
Re: Friend from work has new diabetic kitty and I need some

Was that 528 the actual BG or the fructosamine result? If it was the fructosamine result, that doesn't mean the BG was in the 500s; the range for fructosamine does not correspond to BGs and there should be a conversion grid on the fructosamine test results which give a range (i.e. on some tests, 190-365 is considered "non-diabetic range."). In addition, the fructosamine is an average over 14 days, most of which the cat was eating high carb, dry.

I agree with others that the vetsulin is not a good choice. With the young age and dry food, there's a very good chance that a switch to low carb food is all that is required.
 
Re: Friend from work has new diabetic kitty and I need some

Hi all, original poster, but posting from a different computer and couldn't remember my password (autofill dependency). First, I need to reintroduce myself- I am Cat, aka catthom, many oldies will remember me from back then. I joined FDMB back in 2001, this place saved my baby Max, and my sanity. He died in 2008 after finally coming OTJ a few years before. I'm not new to feline diabetes, but the last insulin I used was U, which was gentle, and had a slow peak and longer duration. Miss that stuff. Shooting, testing- I'm fine. My main question is until she can dedicate a few days together to get into the swing of things, get her neighbor on board etc, should she even start insulin? Or, if so- will once a day be safe? Have any use? Because of her schedule- this will not be for a few days, probably more like next week. PZI sounds like a good choice, but her vet is already being snippy about her turning down that crappy Hills. I want to get her to my vet (who thanks to me, this board and Dr. Lisa is totally UTD on treatment)- but it's a much longer drive and the poor thing just about lives out of her car as is. As far as the BG result- I'll have to call her and see if she's out of practice. But, she texted that the BG was 568, and so I am assuming it is not the fructosamine (I asked for both). I'm pushing her to up his wet food intake, he loves wet food, has had a little diarrhea for the past couple days but if he's not on insulin- I think it's best to just get rid of the dry as quickly as possible. I'll take her some Blue Buffalo I have, so she can use that if necessary. There's a delay anyway- the vet didn't get the insulin in today. Also, getting myself up to snuff- what kind of glucometers are folks using now? I have an old clunky one, but could pick one up quickly. Oh, and the vet said there was no sign of ketones in the urine. I'm just thankful she wants to learn to test and understands how important it is.
 
Re: Friend from work has new diabetic kitty and I need some

Hi Cat!

My main question is until she can dedicate a few days together to get into the swing of things, get her neighbor on board etc, should she even start insulin?
I think it would be fine if she held off on starting insulin for a few days or up to a week. With the change to a low carb food, that's a great first step and could make a big difference. Plus, with the ketones negative for now, there is no rush to start the insulin.

Or, if so- will once a day be safe? Have any use?
Don't know of any insulin that is good for once a day shooting. None of them last long enough. Some vets do start their clients out with SID and then change to BID. Long term, I don't think the once a day of insulin will help enough, leaving her kitty in high numbers too much of the time.

what kind of glucometers are folks using now?
Lot's of us use the Relion Confirm or Micro due to low test strip cost and small blood drop required. Or the Relion Prime needs a slightly larger blood drop. Available at Wal-Mart but if you don't like/have a Walmart, then the Arkray Glucocard 01 is the unbranded version, same manufacturer and interchangeable strips. Available from our shopping partner American Diabetes Wholesale.
 
Re: Friend from work has new diabetic kitty and I need some

Deb, thanks. I'll see if I can pick up a glucometer tomorrow, won't hurt for her to get used to testing before shooting, even if it's in reverse order of what most folks do. My gut instinct was no insulin until she can really set up a better schedule, but nowadays- I am just out of the loop. This gives her time to do that while feeding him high protein stuff. Right now, I told her to feed him small amounts more frequently (she was doing 3 x a day) and she really needs to feed him more as she is reducing the dry food.
 
Re: Friend from work has new diabetic kitty and I need some

With a slower changeover from dry food to wet, there is less chance of digestive upset too. Good plan for lots of mini-meals every day.

I think it's a great idea to try to get the testing started now. It can take time for both the caregiver and the cat to get used to the process. Better to start now, when it's not so critical to get a BG number, than to leave it for later once the insulin is started.

Let us know how things progress.
 
Re: Friend from work has new diabetic kitty and I need some

Someone else has suggested a TID dose if she does PZI- any ideas? It would work with her schedule (barely) but that way she will be the one in charge all of the time.
 
Re: Friend from work has new diabetic kitty and I need some

That is an option. Basically, you start with a small dose, roughly every 8 hours.

Some of us use a conversion chart with ProZinc, so that we can use U-100 syringes and dose in amounts as low as 0.2 units.
 
Re: Friend from work has new diabetic kitty and I need some

Sounds doable. The am and late pm doses would occur when she will be around for a while, so this may be the solution. And, if I can get her comfortable with testing before she starts shooting, then all the better. Thanks everyone- sorry it's been so long, but I am so glad this resource is here. Saved my Max- and countless other kitties.
Cat
P.S. sorry for all of the typos in the first post- I was typing on a cell phone and although I have a qwerty keyboard, in my haste I made many mistakes.
 
Re: Friend from work has new diabetic kitty and I need some

She may want to get one of those 5 compartment feeders for her crazy schedule to make sure there is food available throughout the day.
 
Re: Friend from work has new diabetic kitty and I need some

A couple of years ago because of work I was on an 8/16 hour schedule on the weekends. Not optimum but it worked.
 
Crap, crap, crap

The vet convinced her to start- and to start with 2 units TID on the days she is home 3 times or 2 BID when she has more time and can follow a BID dosage (this really riles me up)- depending on her schedule. She has the complicated schedule for the foreseeable future 4 days a week. So today- she's already given him 4 units (am sometime and 8pm), and she was going to dose him again at 11:30pm. She wasn't comfortable with skipping the 3rd dose entirely- but I convinced her to give him less than one, with food and try and get up and give him more food middle of the night. Tomorrow, I think I have her convinced to go down to 1 unit BID. I'm keeping my phone by me tonight and tomorrow in case anything happens. She has honey and dry food, so she has that in case he hypos. Yikes!!!! Stupid, sorry- inexperienced vet!!!!! We had already planned for her to start testing tomorrow, and I thought she was going to hold off until then. Crapola.
 
Re: Friend from work has new diabetic kitty and I need some

Wow! That is scary dosing advice. We suggest that all cats start with twice daily ProZinc dosing and get data before ever considering TID. And to do TID, you divide the dose into thirds, not give the same dose 3 X day.

Glad she is watching him carefully. I hope you can convince her to restart at one unit BID. She can increase by .25/.5 after three cycles if he is too high.
 
Re: Friend from work has new diabetic kitty and I need some

Dry food is not good to use in the case of a hypo as it takes too long to affect the numbers and too long to wear off. Medium or high carb gravy foods work well or some honey, Karo, or another simple syrup mixed with some regular low carb food work much better at bringing numbers up quickly and not resulting in a prolonged increase in BGs.
 
Re: Friend from work has new diabetic kitty and I need some

I wish it was PZI- but the vet insisted on Vetsulin- thus my profound worries.
 
Re: Friend from work has new diabetic kitty and I need some

What she gave him before his last dose is wet food, and the middle of the night- wet food. The honey and dry are for if he shows any sign of hypo. Plus, I told her to give him wet food after any incident. The dry food she has now is Blue Mountain, so not as carb laden as most. Just send good vibes- with her schedule, it makes it very difficult. Hope her neighbor can come through so she can just do BID dosing.
 
Re: Friend from work has new diabetic kitty and I need some

Tell her to either find a new vet who is up-to-date on feline diabetes (per the AAHA Guidelines from 2010; vetsulin is not recommended for cats) or educate their current vet.

For a hypo incident, dry food will not work well to increase BGs appropriately or in a timely manner. It takes too long for it to hit the system to do anything more than elevate BGs artificially for the next cycle or two.

Even if the dry food is considered to be lower in carbs than most, it's usually still too high in carbs, including the Blue Mountain. There are really only two dry foods that I would ever recommend for cats: Evo cat and kitten (around 8-11% carbs) and Young Again 0 Carb (around 5%); all other dry food is either too high in carbs or does not willingly provide upfront "as fed" values for their food (regardless of whether or not they're under the 10% threshold that we recommend for diabetics). On top of that, there is the whole issue of water-depletion caused by dry food to deal with.
 
Re: Friend from work has new diabetic kitty and I need some

Sorry, I misunderstood. They are, however, dosed somewhat similarly, as they are both non shed insulin. PZI is just milder and lasts longer. Both can be dosed TID and Vetsulin often requires it if the cat is one who doesn't get a longer cycle. But I'm with you. i wouldn't start out with TID. I'd get some data first and start low, go slow.
 
Re: Friend from work has new diabetic kitty and I need some

Made it through the night OK, I'm going over to start on the testing setup. However she doses her cat- whatever insulin, I'll feel better if she is testing at least twice a day.
 
Re: Friend from work has new diabetic kitty and I need some

Update- well, testing went fairly well. Boy, these new meters are soooooo much better than the old ones. I got her a Relion Micro- the strips are on sell on line 50 for 9.99 right now. He is a pretty cooperative cat, she last dosed him at noon (planning on second dose at midnight) and his first test came back 135 at 3:30. A second one half hour later-115. It will take her a while to adjust- but she is determined. Seems like promising results to me. Now, since I am not up to date- I told her I would get back to her- since she will be testing I thought it would be sensible for her to have a plan. Not so much sliding scale, but when NOT to shoot. My feeling is, based on what I did, was not to shoot at all if he is in normal range (remember, he is transitioning to all wet, no more diarrhea and now getting no dry). If he pukes his food right before the shoot- no insulin until/unless he can hold food down. But, if he is between say 200-170, should she shoot a normal dose or a half dose?
Any input welcomed. I will likely start a new thread soon.
BTW, on honey/syrup- then dry, then wet- it's a 1-2-3 whammy. Very fast acting, moderately fast acting then long acting. May not work for some- but worked for me.
 
Re: Friend from work has new diabetic kitty and I need some

The most useful data will be the nadir and then the rise. If he is going to do okay on Vetsulin, we'd like to see a nadir in the 5-7 range and no big jump up afterwards. Maybe she'll get lucky.

I think the tricky part is if he drops nice and low, but then bounces high, you have to try to juggle getting low numbers on a dose with a high number at the end (which can be either a short cycle or a bounce or both.......)

Maybe when we see a full curve, it'll give us an idea about future doses.
 
Re: Friend from work has new diabetic kitty and I need some

Full curve?! Hold onto your horses- she just started shooting yesterday, testing today- full curve? Thanks so much for your help. Any concrete ideas here? Right now, even if she got a computer, I am not sure I would send her here for advice. I am glad folks are watching and commenting, but this was a lot less than helpful. I asked a shoot or not shoot question, based on a newby- surely someone out there can hazard an opinion based on experience. Oh, and folks- please notice I was here since 2002, old slow clunky meters, untrained vets, not much data, frequently confusing information- it was a lot harder, but we did work together. Did all of you do a curve in your first week? Doubt it, so quit acting like that is the only way you can postulate a possible answer. It almost doesn't matter what the insulin is- this is pretty basic first timer help info. I came here because I have never dealt with this insulin. Guess she is stuck with my out-dated experience. BTW, she won't change vets right now for a multitude of reasons and I can't and won't force her.
 
Re: Friend from work has new diabetic kitty and I need some

Whoa, sorry. I assumed she was testing a lot today since she had already gotten several numbers. Bad assumption.

Very few people here use her insulin. Just trying to help, but I'll let others do the advising.
 
Re: Friend from work has new diabetic kitty and I need some

Testing a lot in her first day, on the second day of shooting would not constitute a curve. A curve is after you have settled into a dose (usually BID) and settled into testing. It is possible to do a curve in your first week, but I am not sure I would consider that indicative of any real information except how the initial dose trial is going. She is barely into transitioning food. That is why I asked for help with the shoot don't shoot scenario.
 
Re: Friend from work has new diabetic kitty and I need some

A safe rule of thumb for her would be "when in doubt, don't shoot" with the premise of "better too high for a day, than too low for a moment."

That said, you might print out my signature link Secondary Monitoring Tools for some supplemental assessments she may find helpful. In particular, the urine ketone testing is strongly recommended while she is still working out the insulin dosage and may skip due to low pre-shots, vomiting, etc. You'll recall that ketones are a by-product of fat breakdown for calories and too many may indicate diabetic ketoacidosis (DKA), a potentially fatal, expensive to treat, complication of diabetes.
 
Re: Friend from work has new diabetic kitty and I need some

Here is a Vetsulin Primer that might give you some more ideas of how it works. It goes into some great information on how necessary food and feeding times are when using this insulin because of how fast it acts in cats and how quickly it wears off. It does require a bit more monitoring because of this and you want to make sure food is on-board well before you give the shot.

What dose has she settled on giving currently? At the very least, I would say don't shoot if under 200. If over 200 but below 300, then maybe give a reduced dose (say .5u). If over 300, then possibly the full dose (I.e. 1u). She's going to have to tinker with it to find out what dose brings the numbers low enough when they're really high and what dose does not drop the numbers too low if the BGs are lower. As BJ said, it's better to err on the side of caution and start out with too low of a dose and increase from there as necessary than it is to go full speed ahead with too high a dose. Once you give the insulin, you can't take it back out again.
 
Re: Friend from work has new diabetic kitty and I need some

Thank you Kpassa and BJM, this is what I was thinking (but feeling unsure of myself)- and I told her when in doubt give less or none at all. She did settle on a 1 unit BID dose, but testing did not go well after I left. She couldn't get enough blood last night nor this am, and Koda (her kitty) became less and less cooperative, even with treats. I told her that this was what happened to me and that it would get easier with time. She will keep trying, and I encouraged her to use the rice sock. One problem is Koda has one ear that was damaged and is very gnarly and hard to manipulate. I'm trying to talk her into changing her schedule at work- to come in earlier and then get permission to go home for lunch time- then she could reliably do BID. We'll see- she doesn't even have lunch, just a 15 minute break and works from 10a- 4pm. Then home- then off to a rehearsal usually in Orlando (she's in Tampa) 4 days a week. A very tough schedule. Thanks for the link- I'll share all of this with her. So, one last question- if she can't get permission to leave, and settles on shooting at say 9am, then again when she gets home at 11 or midnight- Should she shoot a lower dose at midnight because of the overlap in the am? I'll read the whole link, it may help make that decision, but your input is always appreciated.
Thanks, Cat
 
Re: Friend from work has new diabetic kitty and I need some

It is possible to shoot a slightly lower dose at night, once you have some test data to know how its going to work in the specific cat. This kind of situation can work better with a non-depot insulin.

Here's a thought - there are bound to be some nearby high schools with a few students interested in veterinary sciences (vet tech, veterinarian). She could contact the guidance counselors there to let them know she is looking for such a person who would like to learn more about feline diabetes by helping her monitor her diabetic cat. Or, there may be a college or two nearby where she could recruit a trustworthy person, especially if it is a school of veterinary technology. A student might even be able to get some field experience credit for doing this, in addition to perhaps, doing a paper on feline diabetes.

Maybe try:
St. Petersburg College
Veterinary Technology Program
Box 13489
St. Petersburg, FL 33733
727-341-3652
(Richard Flora, DVM Director)

On-Campus Program
Associate in Science
Initial Accreditation-April, 1978;Next Evaluation: 2018
FULL ACCREDITATION
Voluntary Program Profile

Distance Learning Program
Associate in Science
Bachelor of Science
Initial Accreditation-November, 1995;Next Evaluation:2018
FULL ACCREDITATION
Voluntary Program Profile
 
Re: Friend from work has new diabetic kitty and I need some

Right now, with her very irregular schedule and her cat not always being co-operative with testing, at the peak (or nadir) of his insulin dosage he drops to a lovely 100-120. But, by the time he hits 10 hours, he is inching up to 300 or slightly above. I wish, given how fast this insulin peaks, she could do TID, but that is just not going to happen. He is now on strictly wet food ( FF classic) so I am thinking- given that some days she has to shoot at 9-10 hours at one period vs every 12 hours, she should up her dose but give a smaller dose when she has a closer overlap. For example, when she can actually do every 12 hours, up her current dose (1 unit) to 1.5. When she has a short overlap, then 1 unit- then 1.5 for the longer period. Not optimal, but this is her reality. Her neighbor comes in to feed at the half way point when she is gone. Wish she could do a better insulin, but we deal with what we have, and not what we wish. She is hoping to do a curve in the next week. That will help.
 
Re: Friend from work has new diabetic kitty and I need some

To update- his last 3 BG tests have been at 120 or below, so she didn't give him insulin. He is now on week 3 of only wet food, so I am hoping this trend continues (fingers crossed, anti-jinx). Thanks for your help, I will update when I can.
 
Re: Friend from work has new diabetic kitty and I need some

That is great to hear! It sounds like he's on his way Off The Juice! 14 days of no insulin with numbers the majority of the time between 40-120 means the kitty is in remission. I look forward to hearing how these next couple of weeks go. :mrgreen:
 
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