GuMung’s diabetes 3/17/22

[Dkshin89]

Hello, everyone. I have been reading a lot of posts and informations in this forum. It is been overwhelming week since I found this forum a week ago.

Gumung has been diagnosed with diabetes on 1/25/22 when he had signs of drinking lots of water, lethargic, and hiccups. He did x rays, nothing found, but BG was 650.
From that day vet prescribe Vetsulin with 2 unit twice a day. And sent home to bring him back to vet in 3 week.
In 3 week (precious time passing by), his signs did not improve. He was drinking, wanted to eat more food even though he is not gaining any weight, still has hiccup or burp after drink and eat.

So I seek another vet near me. From 2/9/22 with new vet suggested lantus (vet described vetsulin does not give high chances of remission). So from the evening of that day, I gave lantus 2 unit twice a day. I did home testing few times , showed desperate numbers around 4~500 and sometimes 600 too. When I called vet one week later, he suggested to bring him in two week and be on 2 unit by then.

3/1 another vet visit, another blood test of Ketone, no sign. Fructosamin, 577.
He shook his head and said “cats should not be this hard to manage their diabetes”
He also suggested To put on Freestyle Libre 2 so I can monitor him without doing home test.

So from last Saturday 3/12 he suggested to do 3 unit and see how it works. And if this doesn’t work ( he keep saying that he can not allow more than 3 unit , but in this forum some do more that 3 ?)

I haven’t done amps or pmps and do frequent tests throughout day, I did some and here is the note.


Sat 3/12 (before summer time change) ( stared 3 unit pm)

6:00pm Food

7:00pm Lantus 3 unit

7:11 pm BG level 577

9:00pm (+2)Libre 377

9:30pm (+2.5)Libre 367

10:30pm (+3.5) Libre 326

11:00pm (+4) AlphaTrak 353



Sun 3/13 (Summer time change)

6:40am excercise

7:00am Food

7:46am Libre showed HI

7:57am Libre HI

8:00am Lantus 3 unit

Libre showed HI


7:00pm Food

7:04pm AlphaTrak 533

8:00pm Lantus 3 unit

10:00pm (+2)AlphaTrak 396

11:59pm (+4)AlphaTrak 374



Mon 3/14

2:00am (+6)AlphaTrak 513

4:00am (+8)AlphaTrak 427

7:00am Food

8:00am Lantus 3 Unit

9:00am (+1) AlphaTrak 502

10:30am (+2.5) Libre 400

12:58pm (+5) AlphaTrak 479


7:00pm Food

8:00pm Lantus 3 Unit


Ears were too red, couldn’t check with AlphaTrak. Libre showed all HI rest of the day.


Tues 3/15

7:00am Food

8:00am Lantus 3 Unit

Libre showed all HI

3:50pm (+8)AlphaTrak 409

Libre showed all HI rest of the day


7:00pm Food

8:00pm Lantus 3 Unit

11:00pm (+3)AlphaTrak 484


Weds 3/16

7:00am Food

8:00am Lantus 3 Unit

Libre showed all HI

1:40pm (+6)AlphaTrak 585


7:00pm Food

8:00am Lantus 3 Unit

Libre showed all HI

11:30pm (+3.5)AlphaTrak 481




I am not sure if I am doing right. I also went to vet to show him how I am doing with injecting insulin since he thought I was not injecting insulin properly. He is now referring me to internal medicine..
I am just really desperate and worry sick that the longer his BG stays in that high range, he might get another issues such as pancreatitis..


ps, i am trying to type all in to spreadsheet like others do. And also I will be doing amps and pmps and do several test throughout day as much as I can do. Does cats ear get red from pricked ear? Or am I so bad so bad at it that my boy is suffering?

sorry for lots of questions and info for my cat, but I feel like I have no one to trust right now, now not even my vet..

 

[Chris and Checkers]

Hi and welcome to the site. Here is some information I getting your spreadsheet set up and getting started on the site.

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

I am glad to hear you at testing Gumung's blood sugar yourself and using the Libre. Testing is hard at first but it does get easier and their ears grow more capillaries so it is easier to get blood from them. Here is a link with some tips and advice that might help.

https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

What type of food are you feeding him?

 

[Dkshin89]

Hi and welcome to the site. Here is some information I getting your spreadsheet set up and getting started on the site.

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

I am glad to hear you at testing Gumung's blood sugar yourself and using the Libre. Testing is hard at first but it does get easier and their ears grow more capillaries so it is easier to get blood from them. Here is a link with some tips and advice that might help.

https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

What type of food are you feeding him?

Thank you, Right now I am feeding him fancy feast classic pate ocean white fish and tuna feast & weruva paw licking chicken since Monday. I did also purchase ziwi to see if he likes it.

Before that, I was suggested to give him M/D dry and wet and Royal canin glycobalance and once I found out any dry is not going to be good for him, I bought DM but he got sick from eating. He does not look thirstier than before, but he is constantly begging for food.. I give him two meals 12 hour apart.

 

[La-La Leo (GA)]

Welcome! I'm still learning! It's a lot in the beginning. I understand your angst with the high BG numbers. This forum is the BEST for helping/guiding/teaching us how to manage feline diabetes. ♡

I just expressed the other day about my kitty's ears; Bandit's Mom shared with me this:

From Marje and Gracie's Testing and Shooting Tips

Ear Care
Since our kitties must endure so many tests, what are some ways to take care of the ears?

• Hold a wet, cool baby washcloth on the poke site immediately after the test to prevent bruising.

• Put Emla cream on the test sites after each test. It only takes a tiny dab and you can wipe it off before the next test. Emla cream requires a prescription from your vet. Neosporin with has been found to contain a toxin to cats, polymixin and should be avoided.

• You can purchase Ledum 30C homeopathic remedy at any health food store. Dissolve one tablet in a small bottle of pure water and then apply one or two drops to each ear every day. Ledum is great for puncture wounds.

I'm using the Ledum 30C remedy and it works!

Lots of great advice and help here.
It will only get better for your kitty and you.

 

[Chris and Checkers]

Be careful when you switch to a low carb diet it will drop his BG.

https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Most cats don't like the DM. It is actually better to feed several smaller meals throughout the day rather than 2 meals 12 hours apart (that is only for Vetsulin).

Yes, some cats here get more than 3 units of insulin, but we increase slowly, 0.25units at a time. Here is some information on the dosing protocols we use. You will need syringes with half unit markings.

https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

 

[Bandit's Mom]

Hello and welcome to FDMB!

I can help set up your spreadsheet and signature. Will send you a PM with the details I need. Look for it in the Inbox at the top right corner of this page.

An unregulated diabetic cat eats huge amounts of food because they're unable to process the food they consume. Think of insulin like it's a key and on every cell in the body there's a lock. Without the keys, no matter how much food they eat (which breaks down into glucose which is what the cells need to survive), the cells starve. The glucose stays in the bloodstream (which is why the blood glucose is high). You want to feed more than twice a day. Feeding twice a day is old school and more suited to in-and-out insulins like Vetsulin. Lantus is a much better insulin for cats and you can feed mutliple small meals through the day and night. Not only will it keep your cat happy, it is also easier on the pancreas. Many folks use an auto-feeder like the PetSafe5 or CatMate 5 that you can program to open whenever you want to offer a fresh meal while you're not at home or at night when you're asleep.

The vast majority of dry food is extremely high in carbohydrate, and should be the first thing you get rid of. However, like @Chris and Checkers pointed out, removal of carbs can drop his numbers really low when he is already on insulin and you want to monitor him closely. Without enough tests, too much insulin can also look like too little insulin. What happens when the dose is too high is the cat's body fights to stay alive. The insulin may be trying to drive the blood glucose down too low and the pancreas will release stored hormones and sugars to bring it back up fast so too much insulin can actually look like it's not enough!

We have all been where you are so do not hesitate to ask as many questions as you want. You have come to the best place you never wanted to be. There is a ton of experience here on feline diabetes and we are all here to help you.

 

[Dkshin89]

Welcome! I'm still learning! It's a lot in the beginning. I understand your angst with the high BG numbers. This forum is the BEST for helping/guiding/teaching us how to manage feline diabetes. ♡

I just expressed the other day about my kitty's ears; Bandit's Mom shared with me this:

From Marje and Gracie's Testing and Shooting Tips

Ear Care
Since our kitties must endure so many tests, what are some ways to take care of the ears?

• Hold a wet, cool baby washcloth on the poke site immediately after the test to prevent bruising.

• Put Emla cream on the test sites after each test. It only takes a tiny dab and you can wipe it off before the next test. Emla cream requires a prescription from your vet. Neosporin with has been found to contain a toxin to cats, polymixin and should be avoided.

• You can purchase Ledum 30C homeopathic remedy at any health food store. Dissolve one tablet in a small bottle of pure water and then apply one or two drops to each ear every day. Ledum is great for puncture wounds.

I'm using the Ledum 30C remedy and it works!

Lots of great advice and help here.
It will only get better for your kitty and you.

Thank you so much! I just ordered Ledum 30C homeopathic For my baby. Hopefully this brings down some of the redness on his ear.

 

[Dkshin89]

Be careful when you switch to a low carb diet it will drop his BG.

https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

Most cats don't like the DM. It is actually better to feed several smaller meals throughout the day rather than 2 meals 12 hours apart (that is only for Vetsulin).

Yes, some cats here get more than 3 units of insulin, but we increase slowly, 0.25units at a time. Here is some information on the dosing protocols we use. You will need syringes with half unit markings.

https://www.felinediabetes.com/FDMB...-low-go-slow-slgs-tight-regulation-tr.210110/

I see. No wonder he just vomited white bile. He must been very hungry. I will try to adjust his feeding schedule to three small portion according to his weight.

I would like to see what happens to his BG on raising his insulin. I am just fearful because my vet is so strict on using insulin. He believes that if he prescribe more than 3 unit is going to kill the cat.

 

[Bandit's Mom]

I see. No wonder he just vomited white bile. He must been very hungry. I will try to adjust his feeding schedule to three small portion according to his weight

The puking bile/foamy vomit is on account of acid build-up due to long gaps between meals. Frequent small meals through the day and night will help with that.

He believes that if he prescribe more than 3 unit is going to kill the cat.

A cat needs as much insulin as it needs. No absolute dose is too much or too little. The best way to determine what is a good dose for your cat is to test and see how low the insulin is taking your cat's blood sugar. Lantus is dosed based on nadirs and not on preshots. We increase in multiples of 0.25U here so that we do not bypass a good dose.

If you will input the test data you have for the last few days into the spreadsheet, we will be better equipped to help you with dosing since we are very data driven here

 

[Dkshin89]

The puking bile/foamy vomit is on account of acid build-up due to long gaps between meals. Frequent small meals through the day and night will help with that.


A cat needs as much insulin as it needs. No absolute dose is too much or too little. The best way to determine what is a good dose for your cat is to test and see how low the insulin is taking your cat's blood sugar. Lantus is dosed based on nadirs and not on preshots. We increase in multiples of 0.25U here so that we do not bypass a good dose.

If you will input the test data you have for the last few days into the spreadsheet, we will be better equipped to help you with dosing since we are very data driven here

Thank you, everyone here have extensive knowledges!
I will keep update on his spreadsheet to get more advices. I will try to test more frequently for 2~3 days to see if this 3 unit is enough or too much or too little for him.

After vet saw the blood analysis, he did not mention one weird number that could cause him this bazaar reaction (not much of reaction) to lantus. He is now suggesting me to go see internal medicine specialist to do ultrasonic. I am not sure now if I should seek for another better vet (third) or go see specialist to do ultrasonic.

Hopefully I get more educated from knowledgeable people here at the forum and make a right decision.

 

[Hendrick Cuddleclaw]

Hi Erin and GoMung, welcome to the club. I am new to this whole thing as well, hang in there it gets better. My boy Hendrick is on Lantus, 2.75u (probably increase to 3 very soon) and we are following the Tight Regulation dosing method. It takes a lot of work but I am trying my best. I think Lantus and the people here will help you tremendously and GoMung will improve soon -- I have seen Hendrick's coat get smooth and shiny again, his energy levels return, he is happy and snuggly and wants to cuddle, full of purrs. It took a few weeks on Lantus, slowly increasing the dose, before we saw major results, so be patient. The people here are super smart and will help you so much, they are like angels.

Glad you made it here, I'll see you around the forums.

 

[Bandit's Mom]

I will keep update on his spreadsheet to get more advices. I will try to test more frequently for 2~3 days to see if this 3 unit is enough or too much or too little for him.

It does look like 3U may not be enough for Gumung. Unless he went low on the night of 3/14 and is bouncing from there.

("Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).")

I would suggest you get a test or two in both the AM and PM cycles today and unless you see a number below 200, you can take his dose up to 3.5U tomorrow. Do you have syringes so that you can increase doses in fractions of a unit or are you using a pen to give insulin?

You might also want to start posting on the Lantus / Levemir / Biosimilars forum where you will get inputs from more Lantus users.

@tiffmaxee

 

[Dkshin89]

Hi Erin and GoMung, welcome to the club. I am new to this whole thing as well, hang in there it gets better. My boy Hendrick is on Lantus, 2.75u (probably increase to 3 very soon) and we are following the Tight Regulation dosing method. It takes a lot of work but I am trying my best. I think Lantus and the people here will help you tremendously and GoMung will improve soon -- I have seen Hendrick's coat get smooth and shiny again, his energy levels return, he is happy and snuggly and wants to cuddle, full of purrs. It took a few weeks on Lantus, slowly increasing the dose, before we saw major results, so be patient. The people here are super smart and will help you so much, they are like angels.

Glad you made it here, I'll see you around the forums.

Thank you Henrick’s mom and dad for leaving me a cheerful comment!
I am using AlphaTrack2
From your spreadsheet, I can see you have switched to human meter. May I ask you what was the reason to change? Is it more accurate? Did it read better BG?

Also what is the brand of syringe do you use? I am using relion full unit 100 syringe

Thank you again,
Erin

 

[tiffmaxee]

Welcome, Erin. I agree with everything Bhooma has told you. Will you be able to test at least 2 times every cycle?
Most here use human meters. That is because our methods were based upon them, before pet meters were available for home use. They read a little lower than pet meters but at the high and low end of the bg range are close. The test strips are much less expensive and you will use a lot of them. Some choose to use pet meters because their vets insist. My internist had never used a human meter but was fine with me using one.

 

[Hendrick Cuddleclaw]

Thank you Henrick’s mom and dad for leaving me a cheerful comment!
I am using AlphaTrack2
From your spreadsheet, I can see you have switched to human meter. May I ask you what was the reason to change? Is it more accurate? Did it read better BG?

Also what is the brand of syringe do you use? I am using relion full unit 100 syringe

Thank you again,
Erin

I switched because the experts here asked if we would be open to switching to a human meter as the dosing methods are based on human meter numbers and I was getting help here with dosing and following Tight Regulation. The cost of the strips for the AlphaTrak 2 was not an issue for me and I liked how it could use a very small droplet of blood, but the human meter works fine and it is nice that the strips are cheaper, I will admit.

I tried many different brands of syringes over the past couple months, finally deciding that Sure Comfort 31g 8mm syringes were what I liked best. I get them from ADW diabetes: https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct

 

[Diane Tyler's Mom GA]

Welcome Erin, the date you have up top should be the date you posted not the date Gumung was diagnosed

You can edit your title by looking to the right where it say Thread Tools tap on that then tap on Edit Title and correct it

 

[La-La Leo (GA)]

I like this page for several reasons,
but like how it shows what a new cat getting regulated looks like---crazy numbers. Helped me see what to expect.

During Phase Two, "Fluctuations are very common in this phase before BGs start to stabilize under consistent dosing: a typical curve of cat over the first 1.5 months on Lantus can be seen here."​

 

[Dkshin89]

Welcome Erin, the date you have up top should be the date you posted not the date Gumung was diagnosed

You can edit your title by looking to the right where it say Thread Tools tap on that then tap on Edit Title and correct it

Thank you for your comment Diane Tyler’s mom, I just edited the title and will follow the rules in this forum from now on so I don’t confuse anyone with dates.

 

[Dkshin89]

I like this page for several reasons,
but like how it shows what a new cat getting regulated looks like---crazy numbers. Helped me see what to expect.

During Phase Two, "Fluctuations are very common in this phase before BGs start to stabilize under consistent dosing: a typical curve of cat over the first 1.5 months on Lantus can be seen here."​

Thank you for the link, I will try to read though it.

 

[Dkshin89]

Welcome, Erin. I agree with everything Bhooma has told you. Will you be able to test at least 2 times every cycle?
Most here use human meters. That is because our methods were based upon them, before pet meters were available for home use. They read a little lower than pet meters but at the high and low end of the bg range are close. The test strips are much less expensive and you will use a lot of them. Some choose to use pet meters because their vets insist. My internist had never used a human meter but was fine with me using one.

Thank you for the reply, I will try to see what kind of human meter is best for us. I really thought I must (without doubt ) use pet glucometer for my cat. I will be able to test as much I can but I was so scared from red ear of my cat. But I understand now, it has be done and more test is done is better for him to figure out the best unit number.
Do you suggest any kind of human meter?

 

[Dkshin89]

I switched because the experts here asked if we would be open to switching to a human meter as the dosing methods are based on human meter numbers and I was getting help here with dosing and following Tight Regulation. The cost of the strips for the AlphaTrak 2 was not an issue for me and I liked how it could use a very small droplet of blood, but the human meter works fine and it is nice that the strips are cheaper, I will admit.

I tried many different brands of syringes over the past couple months, finally deciding that Sure Comfort 31g 8mm syringes were what I liked best. I get them from ADW diabetes: https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct

Thank you Hemdrick’s mom and dad, I will try to go into that link to purchase that 1/2 unit syringes. Do you recommend any human meter?

 

[Chris and Checkers]

Most human meters that you get from pharmacy should be good enough. If you live in the US you can get a Relion meter with strips at Walmart for a really affordable price.

 

[Bandit's Mom]

Walmart's ReliOn Premier is $9 with strips at $17.88 for 100. Most people switch to human meters because they test a lot and the strips are much cheaper. Human meters were what were used before pet meters. There is no issue with accuracy.

Walmart also has U-100 syringes under the ReliOn brand. You want the 30 unit (0.3 ml) capacity syringes. They come with half unit markings. $12,58 for a box of 100.

When testing him, are you using the lancing device or poking freehand with the lancet? If you poke the marginal vein, that would cause more bleeding and bruising. If you are using the lancing device, try reducing the depth of the poke and see if that helps reduce the redness. Testing gets easier with time and practice and their ears also "learn" to bleed.

I think you can go to 3.5U tomorrow morning.