Hamilton the diabetic cat

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Ellen Santangelo

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Meet Hamilton. He is 5.5 yrs. old. I am a cat rescuer, he is my first diabetic. He was returned to me from a rescue that I placed him in. I have been treating him with vet care, dry and wet DM food, and prozinc that keeps going up and up. I am ready to abandon this kind of care and work on him myself with a meter and strips that DCIN sent me. But I need help. I need a starting point. My recent prozinc bottle is already half empty because he is on such a high dose, 7 units. Will I be able to figure out how much insulin to give him? Does it change all the time? How much food should I give him and what kind? I'd like to start him on Fancy Feast or Friskies, something I don't have to go to the vet for. His weight goes up and down because he sneaks food from my other rescues, which I sometimes have to put in the room with him. He's so hungry and I feel bad for him and give him too much I'm sure.
 

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Welcome, and bless you for taking a diabetic kitty!

Yes, you can do this. The learning curve is steep and it can feel really overwhelming at first, but once you get the routine down, you'll be fine!

Starting point:
1. Get a cheap human glucometer from any pharmacy that's near you and convenient. Most folks around here use one of the relion meters from WalMart. I use this one https://www.adwdiabetes.com/product/8195/agamatrix-presto-pro-blood-glucose-meter-kit-and-strips because I can just order online (no WalMart near me) and it's cheap.

2. Food: definitely get him off the DM food. It's too high in carbs for a diabetic. Fancy Feast Classics and Friskies Pate are low carbs and fine for feeding him (and the rest of your kitties). Friskies is the cheaper option. Be careful that you are getting the right varieties (Classics or Pate) because the other versions of those foods are too high in carbs.

Food is one of the most important things in managing diabetes. I really can't emphasize it enough. If he's getting into the other cats' food, or a dog's food, or high carbs treats (even one!), it will make a difference. That's why if there is any way you can switch over the other kitties so that there is absolutely no way he's getting into higher carb food, it will be best. And it really is okay to leave out wet food. My cats free feed on canned or raw cat foods all day long with no problem. I understand that may not be an option depending on your rescue situation, but thought I'd throw it out there in case there is any way you can make it work.

Make sure you get the glucose meter before you make the food switch, as getting him off that high carb food may make a big difference in his insulin needs, so you'll want to be monitoring him before you make the change.

We can definitely help you interpret the numbers you get and figure out dosing. And yes, it does change over time, so daily monitoring is important. Again, that can sound overwhelming at first, but it's really not difficult once you've established the routine.

At the top of the Prozinc forum, there are threads with a yellow "sticky" icon at the beginning. Those are essential reading to learn the overview of how all of this works. Again, it's a lot all at once, but make note of your questions as you read through, and ask as many and as often as you need. We are all here to help!
 
Oh, and as for being hungry all the time - if he's not on enough insulin yet, then his body can't properly absorb nutritents from the food and he is really starving, so feed him as much and as often as he needs for now. If he's on too much insulin (a common problem when the vet has been managing the dosing), he could be hitting some low BG numbers and ravenous as he tries to bring his BG back up again. So again, feed him as much and as often as he needs. Once his BG gets better regulated, his need for food will go way down, but for now, don't withhold food as he really does need to be eating more than normal.
 
Welcome to our forum! Djamila has already given you great info so I just wanted to say hi and we're glad to help! Please ask any questions you have...it's a steep learning curve at first but it gets better!
 
It wasn't easy but I finally got a reading on Hamilton. I tried to get it before I gave him insulin but I could only get a tiny drop that didn't set off the meter. I just tried again, and it was 316. This is about an hour to an hour and 1/2 after his evening dose of 7 units prozinc. I want to set up the spreadsheet so people can access it, but I can't seem to figure that out. One thing at a time I guess. It took days just to figure out the meter, strips, lancet, and his ear. I am surprised I was able to do it, he is not an easy cat, but after he settles down from eating, I think he likes the attention.
 
Ellen, that's great! It is hard to test at first, but it definitely gets easier with time and practice. My kitty was pretty near impossible when I first started, and now, while I wouldn't say he likes it, he does cooperate :cat: And like yours, he loves the attention (and treats) he gets!

I'm going to tag someone who can hopefully help you out with the spreadsheet: @Marje and Gracie
 
Congrats on the test, Ellen! It's tough for sure at first...but Gypsy got to the point where she came running when she heard me shaking the box of lancets. She never LIKED it per se, but she knew tests came with treats and she loved that!
 
Hi, thanks for asking. I've been struggling to get his ear pricked with enough blood to do a reading. Since Feb 5, I got a BG of 316, 367, and this morning, 386. I've been giving him 7 units twice a day. Once I can get consistent readings then maybe something can happen where I can learn how to dose better. I need help setting up the excel spreadsheet.

He is hard to get a reading because, he's a shy, swatty cat to begin with. He will run away when I prick his ear. But I got it figured out, now I put him in a bed on my lap and I have more control.
 
Ellen Santangelo said:
Hi, thanks for asking. I've been struggling to get his ear pricked with enough blood to do a reading. Since Feb 5, I got a BG of 316, 367, and this morning, 386. I've been giving him 7 units twice a day. Once I can get consistent readings then maybe something can happen where I can learn how to dose better. I need help setting up the excel spreadsheet.

He is hard to get a reading because, he's a shy, swatty cat to begin with. He will run away when I prick his ear. But I got it figured out, now I put him in a bed on my lap and I have more control.
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Kudos to you for persisting with the ear pricks! Are you giving a low carb treat before/after every test? I use them liberally with my guy and he's a cooperative cat.

The spreadsheet we use here is an online Google docs sheet, not Excel. There are people here who can help you set it up if needed.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
@Marje and Gracie, can you help with Ellen's spreadsheet?

Ellen- what gauge lancets are you using? The thicker gauge lancets (like a 28) are helpful when a kitty's ear doesn't want to bleed. Then you can go to the 30 or 33 gauge (thinner) when his ear starts bleeding better. Also, are you warming the ear before you poke? If you put a little uncooked rice in a small sock, and then warm it in the microwave for 20 seconds (depending on the microwave) and hold it to his ear it helps to get more blood. Or some folks have used warm water in a pill bottle and held that to the ear. Just something to warm it up first.

Another factor that can make a difference is hydration. Diabetic cats, especially before they are in good numbers, tend to be quite dehydrated. If you mix in at least 2 tablespoons of water to their food, it can help offset that. The better a cat is hydrated, the easier it is to get blood.

Hopefully one of those suggestions will help. Great job persevering with this! It can be challenging at first, but it gets easier with time. :bighug:
 
Yes, I got the warming up trick. I was able to get another reading today! So he was 386 at 7:50 a.m., and now at 10:20 he is 187. Olive oil on the warm ear helps the blood bead up. Good hint about adding water to his food. He does drink water. When I first got him he drank tons of water, that has changed since the insulin.
 
Djamila said:
@Marje and Gracie, can you help with Ellen's spreadsheet?

Ellen- what gauge lancets are you using? The thicker gauge lancets (like a 28) are helpful when a kitty's ear doesn't want to bleed. Then you can go to the 30 or 33 gauge (thinner) when his ear starts bleeding better. Also, are you warming the ear before you poke? If you put a little uncooked rice in a small sock, and then warm it in the microwave for 20 seconds (depending on the microwave) and hold it to his ear it helps to get more blood. Or some folks have used warm water in a pill bottle and held that to the ear. Just something to warm it up first.

Another factor that can make a difference is hydration. Diabetic cats, especially before they are in good numbers, tend to be quite dehydrated. If you mix in at least 2 tablespoons of water to their food, it can help offset that. The better a cat is hydrated, the easier it is to get blood.

Hopefully one of those suggestions will help. Great job persevering with this! It can be challenging at first, but it gets easier with time. :bighug:
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Just seeing this. Yes, I can help.

Ellen.....I’ll send you a private message. Check your “inbox” in the upper right corner.
 
Hi everyone,
Hamilton was adopted, and is going to his new home tomorrow. I am a little sad because, since I have been testing him, I have become so bonded to him. It's best however, that he go to his new home, where he will be one of two cats instead of over 10 in my home! I will point the new owner to this valuable resource. If there was a piece of advice I could send with Hamilton, what would it be? He got placed by a great rescue, and he will have a very good vet. My heart will always be soft towards diabetic cats and with all the rescue I do, I'm sure another will come my way, and it won't be so overwhelming. Would it be feasible, to give the new owner my password and let her log on, or should I just point her to this website and she can introduce herself, and get started on the spreadsheet that was created for him? I will at least point her to FDMB, and she can certainly find Hamilton's posts.
 
I think it would probably be best if the owner starts her own account, and then just links the spreadsheet. She doesn't need to start a new spreadsheet, she can just copy your link into her new signature. However, if you think that might be a barrier to them joining, there is nothing wrong with using your account (maybe just change to their name so we don't call them "Ellen" forever!)

That's exciting that Hamilton was adopted! You're absolutely right that there is something about caring for a cat's diabetes that really bonds us with them.

It's hard to narrow down a piece of advice -- test lots, ask lots of questions - this is complicated, so sometimes even when you think you know what to do, someone else will see a better approach, never ever lapse in food choices, and give lots and lots of kisses and chin scratches! :bighug:

Oh, and one thing for you --- the spreadsheet is still private, so we can't see it. If you go to the top right corner, there is a blue button marked "share" click on that and then select " anyone with the link can view" then we'll be able to see it :).

Good luck with the rest of your fostering! While I hope there won't be any diabetic cats, if you get another one, it'll be fun to see you back here again! :cat:
 
Thank you. I will show this all to new owner, and for now, give her my password to get in. I will suggest she set up her own account later. I will miss Hamilton, he is very special. He has a little dark side, which is so funny. Sometimes he will swat at you if you pet him wrong, but he has Never done that while shooting insulin or testing ear. He is so good.
 
Hi everyone,
Guess What. I got Hamilton back, within a day of adopting him out. He is a cat with an edge, and he got out of his room and hid on the new owner. And, when she tried to get him he scratched her. She got very nervous that he missed two doses of insulin. I went and got him back. Learning lesson, Hamilton will need a more savvy cat person. Anyway, I've been trying to get back in the swing of things with testing and food etc. Tonight is the first night that he reads 102. I tested again 2 minutes later, it was 108. He has been consistently above 300 at suppertime. So not sure if I should give him his 8 unit dose. There was evidence of vomiting overnight. Not sure what is going on.
 
Ellen Santangelo said:
Hi everyone,
Guess What. I got Hamilton back, within a day of adopting him out. He is a cat with an edge, and he got out of his room and hid on the new owner. And, when she tried to get him he scratched her. She got very nervous that he missed two doses of insulin. I went and got him back. Learning lesson, Hamilton will need a more savvy cat person. Anyway, I've been trying to get back in the swing of things with testing and food etc. Tonight is the first night that he reads 102. I tested again 2 minutes later, it was 108. He has been consistently above 300 at suppertime. So not sure if I should give him his 8 unit dose. There was evidence of vomiting overnight. Not sure what is going on.
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Definitely no insulin on those BG numbers. I tried to look at his spreadsheet but I don't have access. I don't recall the details of how he got to an 8 unit dose. That's very high!
 
I can't remember either...that is a very high dose. I'd definitely skip insulin with a preshot of 102.
 
He kept going to the vet, trying to get regulated, and they kept upping the dose. He was going up and down in weight at the time. I will skip tonights dose.
 
I have to figure out how to post to it. Marge set me up one for Hamilton but I don't know how to use it yet. As soon as I figure it out I will post all the readings I have taken for him since Feb 4.
 
I have entered the data from February. It is not perfect, next month will be better. I clicked "share" but there was no where to click "anyone with link can view". I would like anyone interested to be able to view.
 
Ellen Santangelo said:
I have entered the data from February. It is not perfect, next month will be better. I clicked "share" but there was no where to click "anyone with link can view". I would like anyone interested to be able to view.
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Maybe @Djamila can help. She's better than I am at putting up screen shots to show you what to do.
 
First click here (I'm guessing you already did that)
upload_2018-2-28_5-53-6.jpeg


Then wait a few seconds since Google docs are often quite slow, and this window should open up:

upload_2018-2-28_5-53-57.jpeg


It might say "anyone with the link can edit" at first, but if you click on that little triangle where the arrow is pointing, it will give you more options.

Let me know if it still didn't work.
 
Ok everyone, I fixed Hamilton's spreadsheet, and re-entered all the data I had collected so far. It's not consistent because of the learning curve testing his ear, time constraints, etc. I want to know if you can view it and start helping me with dosing. I agree 8 units is too much. His numbers are running a little lower so I have been giving him 5 units the last couple of times. I will be running out of prozinc soon, and that is one of my questions. Should I continue on prozinc, or switch to Lantus? Maybe it's too early to switch. I am currently feeding friskies pate and vet quality diabetic dry because that's what he is used to. Thanks so much for your help so far. I am determined to help this cat!
 
Ellen Santangelo said:
Ok everyone, I fixed Hamilton's spreadsheet, and re-entered all the data I had collected so far. It's not consistent because of the learning curve testing his ear, time constraints, etc. I want to know if you can view it and start helping me with dosing. I agree 8 units is too much. His numbers are running a little lower so I have been giving him 5 units the last couple of times. I will be running out of prozinc soon, and that is one of my questions. Should I continue on prozinc, or switch to Lantus? Maybe it's too early to switch. I am currently feeding friskies pate and vet quality diabetic dry because that's what he is used to. Thanks so much for your help so far. I am determined to help this cat!
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Hurray for getting this up! I think dropping the dose was a good idea and I like that yellow pre shot BG today. I suspect the diabetic dry food is still propping up his BG. If it's something like RC Glycobalance I believe it's very high in carbs - the wet version is 14% carbs so the dry will be higher. Some people here have success with these low carb kibbles: Young Again Zero (available on their website - will send a sample) and Dr. Elsey's Clean Protein (will also send a sample).

Try to get at least one test in between +4 and +7 today. I think it's too early to rule out ProZinc although Lantus is a very good insulin for cats and there are structured guidelines for dosing and a lot of very knowledgeable people on the Lantus forum.
 
Ellen Santangelo said:
Kris and Teasel - Just tested Hamilton at +7 he was 217.
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That's a very decent number for the early stage you're at. :) Stay at 5 u for now. If/when you can eliminate all dry food his numbers might drop and that dose will have to come down. Your goal right now is to get this testing routine up and running to start a reference data base on your spreadsheet.
 
I want to make sure I'm not making a mistake with the needles. I'm using donated needles from a rescue, some are U-100, some are U-40. The U-100 have 30 units on the needle, and the U-40 has 12. I have most recently been using the U-40.
 
Ellen Santangelo said:
I want to make sure I'm not making a mistake with the needles. I'm using donated needles from a rescue, some are U-100, some are U-40. The U-100 have 30 units on the needle, and the U-40 has 12. I have most recently been using the U-40.
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ProZinc is a U40 insulin and that's what those U40s are for. It's possible to dose ProZinc with U100s and a conversion chart:
http://www.felinediabetes.com/insulin-conversions.htm
If you're using the U40s, put the U100s somewhere out of the way where you won't accidentally grab them. Similarly, if you want to try the U100s with the conversion chart HIDE the U40s so you don't make a dangerous mistake. Using U100s allows a bigger range of fractional dose options as you can see on the conversion chart.
 
The carbs on the Hills Prescription Diet M/D glucose management are 18% according to their website - definitely high enough to give higher-than-necessary BG. If you absolutely have to feed dry food, I would go with one of the two that Kris named previously - but if there is any way to get him off of it altogether that would be best.

And definitely put those syringes far away from each other! They both work great, but mixing them up could have devastating effects. When you're out of one kind, then switch to the other - making certain to use the conversion chart with the u100's.

I'm so sorry the adoption didn't work out. Maybe he's just meant to be yours? :cat:
 
He is doing ok as far as I know. Once in awhile I see evidence of vomiting in the room. (He is in his own room.) I will post his numbers every day. Keeping him on 5 units 2x a day, using the U-40 syringes. I am feeding friskies pate 1/2 can twice a day and some Hill M/D dry. I have ordered some Elsy's dry and will switch him to that as soon as I get it, gradually.
 
Try to get a mid cycle test in the daytime and/or a before bed test every day. We need that data to know how a dose is working.
 
CarePoint Vet U-40 Pet Syringe 29G 3/10cc 1/2" w/Half Unit Marks 100ct
by: CarePoint Vet
Shop All: CarePoint Vet Products

Are these ok to use for prozinc, rather than the Ulti-care:

UltiCare U-40 Pet Syringes 29 Gauge, 3/10cc, 1/2" - 100ct

The CarePoint are less $$$....
 
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