Help please Diabetes and kd

[Finney]

Hello everyone I'm new here but I have came to this website before but decided to make my own questions and ask for help please. My cat mr. Grinch had a UTI back in late October and received a steroid shot shortly after that I noticed he was losing weight drinking a lot of water and had puddles of urine. I took him back to the vet early January and they tested his blood and did a urinalysis and said his glucose was high around 450 but they didn't know if it was from the steroid shot so they started him on the Hill's prescription diet DM for diabetic cats (I was doing dry food) and wanted to see him and a couple more weeks. So in late January I took him back and they did another urinalysis and nothing changed his glucose was still around 450 so they decided to start him on novolin n insulin 2 units every 12 hours and to see him in a week. 6 days later after starting the insulin I had to take him back to the vet because he was not eating so I could not give the insulin. They said his glucose was in the 700 range and that his X-ray showed a lot of stool so they begin to give him miralax along with enemas they did more blood work and said his liver and kidneys or a little elevated but not concerning at that time. When he was at the vets he still was not eating so there were force-feeding him what food to help with the constipation they advised me to switch to wet food. After a couple of days of him at the vets I brought him home I was still having to force-feed him giving him the DM wet food and they changed his insulin to one unit every 12 hours I wanted to see him and 7 days. The day before my appointment before I fed him there was a little vomit and he was having trouble walking so I took him to the vet they advised his sugar was so high the meter couldn't read it and he was dehydrated they did more blood work a tech called me that night and said he has Kd and there maybe nothing they can do. So i was thinking I was going to have to put him to sleep but she said the Dr will call me and let me know more. Dr called me the next day and said I will be doing sq injections for it. I just brought him home yesterday they are having me give 100 ml subcutaneously three times a week for the Kd and now three units of insulin every 12 hours and they switched his food to the wet WD hills diet. please advise what food is good for diabetes and Kd and how much food should he eat before insulin? I asked the vet about a home glucose meter and they said I need a specialized pet meter which I think is BS please advise and that they don't like pet owners to test at home. 3 units seemed really high to me and after looking at his chart from the vet it looks like when he was there his sugar just went up and down. He was 13 lb late October he is now 6.8 lb. And how often should I replace the insulin? Sorry for the long post it's been a stressful couple of months and I'll probably have more questions. Thank you for your time.

 

[Kris & Teasel]

Welcome! You've had a very rough time recently. We can help.

Dr called me the next day and said I will be doing sq injections for it. I just brought him home yesterday they are having me give 100 ml subcutaneously three times a week

This seems a reasonable schedule but I'm not an expert. @JanetNJ ?

they switched his food to the wet WD hills diet. please advise what food is good for diabetes and Kd

Wet foods that are low in phosphorus and low in carbs are best for diabetic kitties with kidney issues. This chart is very useful because is lists carb and phosphorus levels. You want carbs to be under 10% and phosphorus under 200 (@JanetNJ ?).

how much food should he eat before insulin?

Novolin insulin has a strong action - ie., it can hit early and hard and drop blood glucose low. Your kitty needs to have a meal on board before you give it and you should wait 20 to 30 minutes after he eats to give the shot. There are other insulins (ProZinc, Lantus) that are more effective for kitties although some do well on Novolin. We can help you learn how your kitty is doing on Novolin.

I asked the vet about a home glucose meter and they said I need a specialized pet meter which I think is BS please advise and that they don't like pet owners to test at home.

Pet meters are good because they give readings much closer to what the vet would get in the clinic. The test strips are very expensive though so most of us use a human meter with cheaper strips. Human meters read lower but we all know how to interpret them here. Some vets don't want owners testing at home because they worry about them changing the insulin dose without vet advice. The problem is many vets aren't very knowledgeable about feline diabetes and start kitties on doses that are too high or they recommend dose changes that are too big. Your kitty, your choice of meter, your choice to test BG at home, your vet bill to pay. End of story.

3 units seemed really high to me and after looking at his chart from the vet it looks like when he was there his sugar just went up and down.

It is higher than the usual recommended starting dose of 1 unit twice a day. BG is often inflated at the vet's because of stress so dosing decisions made there can result in too high a dose being recommended.

And how often should I replace the insulin?

If it's properly stored (middle shelf of fridge, protected from shaking or jostling, etc.) it should be good for many months.

If your kitty's diabetes was steroid induced he might do much better than he has been if you take the bull by the horns and start a good BG testing routine and post here often for help.

Below is something I put together a while ago for new people. There's a lot of info here so take it in small bits and ask a ton of questions.
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It would help us if you set up your signature (light grey text under a post). Here's how:

• click on your name in the upper right corner of this page
• click on "signature" in the men that drops down
• type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.

Another thing that will help us help you now that you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and look at it before offering advice: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
We REALLY need this spreadsheet set up so we can help you quickly and properly.
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Here's the basic testing routine we recommend:

1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
3. do extra tests on days off to fill in the response picture
4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
5. post here for advice whenever you're confused or unsure of what to do.

This is useful: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

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Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high:

1. BG goes low OR lower than usual OR drops too quickly.
2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing. Very important.

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Here are some tips on how to do urine ketone testing (VERY important if BG is high and kitty isn't eating well!):

• put the end of the test strip right in his urine stream as he's peeing
• slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
• put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.

Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.
This is an extra precaution that's simple and can give vital information.

I'm sure you're on overload right now. You've come to the righty place and your gut instincts to try something better for your kitty are bang on.