Gandi update - beginning treatment

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Kathryn Elizabeth

Kathryn Elizabeth

Member Since 2023
Hi everybody, I wasn't sure if it best to begin a new thread - if not please let me know and i will take this one down. Just cross posting new last few messages on the other thread, not sure if they are being seen. Maybe i am just being impatient, sorry!

Here is the other thread https://www.felinediabetes.com/FDMB/threads/june-21st-2023-new-member.278770/

So the owners have decided to treat Gandi, the cat i am looking after here in New Zealand while owners are away in Europe til September. I am taking him to the clinic for the day on Wednesday to have his first injection and blood glucose curve.

I want to embark on the home testing also, and think i have just abut got my head around it.


If it was my cat i would be super keen to get home monitoring onboard ongoingly from the start, in fact i think that this is what Jane(owener) is also considering, but at this stage beginning the process with the vet experience seems like a good way to go, especially since the owner is on the other side of the world and doesn't have great internet access or capacity to be researching everything, and I also have limited resources in terms of energy management (and my own cat with chronic health management requirements). Thankfully i feel pretty relaxed about administering injections!

I will do my best to ensure the vet is not using the Caninsulin/Vetsulin that everyone here is non-recommending, although i presume because i am not the owner that to some extent they will need to follow their standard procedure unless owner states otherwise. Ironically, my usual vet who i have a great relationship with, is also away overseas on holiday! But will definitely switch over to her when she returns in a few weeks. I think she will be more open and trusting of my competency! But we'll see how it goes on Wednesday with this other vet

I have read a bit on the AAHA guidelines to get a bit more up to speed on the finer details. Ultimately i am not going to be able to avoid the need to learn all the ins and outs of it myself, as it is another 7 weeks til owners return. So, time to buckle myself in!!

I realise that doing BG tests at home gives better monitoring in the long run but feel like this middle ground of at least getting him started on insluin with the vet clinic observing it all, is a good place to be.

And can't wait to see how this affects his behaviour and constant miaowing/food demands.

Thanks for all the moral support and all the information shared on this forum.


To everyone when they started out did they start in this way with a BGC at the vets, or go Straight to home monitoring and all very D.I.Y.?
I realise that the stress hyperglycaemia is very real, though I am sure the vet clinic take that into account when they are looking at the figures. And because i don't really have a relationship with this particular vet, it feels a bit more awkward to question things and offer information that might be alternate to their standard procedure - especially since i am not the owner, so everything would need to come from the owner if there was a decision to deviate from what the vet would recommend. Very tricky!

PS. i am also reading through the message board newbies FAQs which is really helping, thank you.


Do you guys think that this would be a suitable glucometer?

https://www.kiwichemist.co.nz/produ...64760&pr_ref_pid=7006769447064&pr_seq=uniform

strips:
https://www.kiwichemist.co.nz/produ...47064&pr_ref_pid=6919508164760&pr_seq=uniform

The manufacturer also sells a Dual one which tests for ketones but i presume that wouldn't work for the cat?
 
I am SO GLAD Gandi is going to be treated. Well done for your part in achieving this!!!
Yes that glucose meter is good. Others inNZ have used it. And yes the blood ketones glucose meter does work for cats.
There are a few people whose cats spend the day at the vet doing a curve but most just go home and give the dose and test. I think the vet does that because most people don’t home test. The curve is not really all that useful I don’t think because the cat is usually stressed and the BGs will be higher than normal. And depending on the insulin prescribed, it doesn’t keep the BG the same every day. It changes daily in the beginning.
If Gandi is eating a low carb canned diet the starting dose should be 0.5 Unit. If he is eating ant dry, the starting dose is 1 unit.
I am going to ask @Bandit's Mom to help
You set up the spreadsheet. She will contact you. Keep asking lots of question. I am excited for Gandi he is going to start treatment.
 
Bron and Sheba (GA) said:
I am SO GLAD Gandi is going to be treated. Well done for your part in achieving this!!!
Yes that glucose meter is good. Others inNZ have used it. And yes the blood ketones glucose meter does work for cats.
There are a few people whose cats spend the day at the vet doing a curve but most just go home and give the dose and test. I think the vet does that because most people don’t home test. The curve is not really all that useful I don’t think because the cat is usually stressed and the BGs will be higher than normal. And depending on the insulin prescribed, it doesn’t keep the BG the same every day. It changes daily in the beginning.
If Gandi is eating a low carb canned diet the starting dose should be 0.5 Unit. If he is eating ant dry, the starting dose is 1 unit.
I am going to ask @Bandit's Mom to help
You set up the spreadsheet. She will contact you. Keep asking lots of question. I am excited for Gandi he is going to start treatment.
Click to expand...


Thanks!
Ah yes, the (dreaded) spreadsheet. thanks, i will definitely need help with that.

I think if it were my cat and i was dealing with my own vet (who trusts my competence), i would prob go straight away to the home testing without the vet cliniccurve. But then i would've done that 4 weeks ago when we first knew his BG was so high!

So gonna just go with this 'curve on Wednesday' plan so at least i can get in there and get some good conversations in with the vet, otherwise this could get delayed even further because of the time lag between messages going back and forth from vet to owner with owner having intermittent internet on opposite time zones and vet not being particularly comprehensive with email responses.

I totally agree though, about the stress at the vet affecting the reading. it's a compromise for now i guess.

Oh so would it be better for me to get the dual meter that also reads for ketones? I think i will go ahead and order it tonight and should be here by Friday.

What i am feeding him currently i believe is low carb. definitely lower than he was previously on. it's a whiskas canned jellymeat. no biscuits. the company said "The carbohydrate content for the WHISKAS is between 1.5-2.5%" but i am guessing that is as fed rather than dry matter, and i haven't had the brain power to do the calculations yet. Anyway i appreciate your recommendation about the dosage and shall discuss that with the vet on Wednesday morning, the nurse said on the phone today that they take things cautiously at the start so that's a good sign!
 
I have ordered the dual meter, the glucose testing strips and the lancets :) will get ahold of ketone blood strips later (not available on same website i was ordering the other bits)
 
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Bron and Sheba (GA) said:
I should have mentioned that the lancets you need are size 26 or 28. Did they give you a choice?
Click to expand...
Hello, i had watched Janet's video so i knew to find those, it was hard to find in NZ actually (the meter comes with 10 30's as standard but i found a bought of 100 28's.) Thanks for pointing this out though! ..

however, plans have changed.... more info in comment below.
 
New Update.
I took Gandi in to the vet clinic this morning for his first shot and BGC. Dropped him off and they called back 30 minutes later saying they Only have Caninsulin, and also that they now do not want to proceed with any treatment until the owner has had a telephone conversation with the vet (so far she has only been doing it via email) to make sure she understands everything that is involved. I guess there was some hesitancy as to whether she really does, based on the latest email she sent to the vet.
So I had to bring Gandi home with no treatment, and it is not really my call to begin doing it.
I haven't been able to speak to the vet myself, only the vet nurse, who is very understanding. I explained about the vet association guidelines Not recommending Caninsulin but they said NZ guidelines still recommend Caninsulin for cats.....
She even agreed that Lantus is much better for cats and produces a gentler curve.
But the problem is that the decision needs to be made by the owner, so the vet clinic is going to see if they can get Lantus.
I presume i could find it, but my resources are super low and to some extent it's out of my hands now until the owner managed to connect on the phone with the vet, and/or the owner decides Exactly how they want to go ahead.
If they want to do it using Lantus and vet BCGs i am def gonna be nervous about him going hypo without me realising... but we will just see what they decide....
What a situation huh!!
 
Oh dear! What an unfortunate situation. I really can't see why they couldn't go ahead. Are they trying to talk the owners into euthanasia?
If and when they do go ahead, and I really hope they do, you can still test at home. They will not know.
Please keep us posted.:bighug:
 
Bron and Sheba (GA) said:
Oh dear! What an unfortunate situation. I really can't see why they couldn't go ahead. Are they trying to talk the owners into euthanasia?
If and when they do go ahead, and I really hope they do, you can still test at home. They will not know.
Please keep us posted.:bighug:
Click to expand...

No, i don't think so, i think they just are unsure that the owner comprehends the task and they don't want to go ahead until they feel that she does. Informed consent i guess...
 
Bandit's Mom said:
Hi Kathyrn, I can set up a spreadsheet for you. Just want to confirm that you're getting a human meter that reads in mmol/L?
Click to expand...
Hi, thank you so much, slightly unsure whether we will be doing the testing (i hope so) but the meter i am looking at, yes "Measurement Range 1.1-33.3 mmol/L"

Also wonder your opinion on whether i should get a Dual meter than also reads for ketones in blood (though the test strips for the ketone testing are about $3 per strip!)
 
Bron and Sheba (GA) said:
I am SO GLAD Gandi is going to be treated. Well done for your part in achieving this!!!
Yes that glucose meter is good. Others inNZ have used it. And yes the blood ketones glucose meter does work for cats.
There are a few people whose cats spend the day at the vet doing a curve but most just go home and give the dose and test. I think the vet does that because most people don’t home test. The curve is not really all that useful I don’t think because the cat is usually stressed and the BGs will be higher than normal. And depending on the insulin prescribed, it doesn’t keep the BG the same every day. It changes daily in the beginning.
If Gandi is eating a low carb canned diet the starting dose should be 0.5 Unit. If he is eating ant dry, the starting dose is 1 unit.
I am going to ask @Bandit's Mom to help
You set up the spreadsheet. She will contact you. Keep asking lots of question. I am excited for Gandi he is going to start treatment.
Click to expand...
Hiya i put a pause on the meter order before they shipped it, which was a good job as i have got mixed up between which test strips for which meter.
I wonder your opinion on whether i should get a Dual meter that also reads for ketones in blood - the test strips for the ketone testing are about $3 per strip so wouldn't be doing that every day! (the strips for the blood glucose for that meter are similarly priced to the ones for the non ketone meter at least). But testing his urine for ketones is a LOt of hassle as he is an outdoor cat and collecting a urine sample took two nights of locking him inside, plus no idea how fresh the urine was by the morning. The good thing to note is that his recent urine sample a week or two ago showed no ketones. But i realise that can change at any time too.
 
It is up to you if you want to buy a dual meter. I was always able to test the urine easily.
For ease of use it may be worth getting for you. Unless ketones appear, you won’t have to test all that often.
The longer one leaves a cat without insulin when he needs it, the more likely the cat is to get ketones. There is no doubt some cats are more prone to ketones than others though.
The test strips for ketones are definitely more expensive than the normal strips for glucose, what ever dual meter you buy.
I used to get my strips online at eBay which was pretty reliable. They are cheaper that way. Once you have bought them once from a pharmacy and know the ones to buy, you should be able to get them on eBay quite easily.
Make sure Gandi is eating well as that will help keep ketones away.
 
Bron and Sheba (GA) said:
It is up to you if you want to buy a dual meter. I was always able to test the urine easily.
For ease of use it may be worth getting for you. Unless ketones appear, you won’t have to test all that often.
The longer one leaves a cat without insulin when he needs it, the more likely the cat is to get ketones. There is no doubt some cats are more prone to ketones than others though.
The test strips for ketones are definitely more expensive than the normal strips for glucose, what ever dual meter you buy.
I used to get my strips online at eBay which was pretty reliable. They are cheaper that way. Once you have bought them once from a pharmacy and know the ones to buy, you should be able to get them on eBay quite easily.
Make sure Gandi is eating well as that will help keep ketones away.
Click to expand...
Thanks, that's great. Ohhh he is eating well!!! He is demanding food constantly!
 
Hi all, latest weird twist on things is Gandi's owner says the vet has emailed them and is now recommending putting Gandi on oral medication instead of insulin. Totally baffled and very emotional, wish i coud just treat him (can't get insulin without prescription here and it's not my decision to make). Anyone got opinions on this? The vet at first said this would Not be suitable for him so I have no idea why she is saying this now, I need to try to talk to her myself really. It feels like such a giant mess and it's now 4 weeks since his diagnosis with no treatment. Thank goodness he so far shows no signs of deterioration....
 
The oral treatment is definitely not the way to go. Please try and talk them out of doing that.
As far as I am aware it can only be given for limited and specific conditions. It is possible it can be hard on the pancreas as well.
it has only been in the market for a short time and they have been doing trials with it.
 
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Is it possible you could recommend to me a good schedule for blood glucose testing? This would be based on no insulin injections, just practicing with the meter and gathering data, while the vet and owner faff around in their communications and decision making :(
I am guessing that something like a pre food test and then one hour after food. Currently feeding him 4 or 5 times a day. My brain is too tired and stressed to figure out from looking at spreadsheets what might be the best to experiment at this stage. (hopefully meter will arrive on Saturday).
 
I would test before feeding and then get a test in 3 hours after the main meal. That will tell you if the pancreas is working at all. If it is, the food will stimulate the pancreas to produce some insulin and the BG will go down.
You don't have to do that every day but I would get the test in before the food. Other days you could either not test or get a test in sometime during the day. The snacks you give during the day wont effect anything so don't worry about trying to work around the snacks.
 
Bron and Sheba (GA) said:
I would test before feeding and then get a test in 3 hours after the main meal. That will tell you if the pancreas is working at all. If it is, the food will stimulate the pancreas to produce some insulin and the BG will go down.
You don't have to do that every day but I would get the test in before the food. Other days you could either not test or get a test in sometime during the day. The snacks you give during the day wont effect anything so don't worry about trying to work around the snacks.
Click to expand...
Ok, what about.. well, i am giving him the same amount of food, four times a day, just dividing his daily amount out into relatively similar portions.
 
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