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sashaspecialkitty

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Hello. My cat, Sasha is 7 yrs old. She was diagnosed about 6wks ago with diabetes. I am having a very hard time with this. I am a nurse so I feel very comfortable with dosing, and injecting. Our instrutions from the vet were humulin-N 1 unit in am, 1 unit in pm, titrate dosing per her water intake, and do not exceed 3units twice daily. Well not once has her water intake decreased. She drinks approx 1quart of water daily. I have her on vet prescription feline DM. Since she got down to such a low weight(4lbs), vet said she can eat as much as she can to get weight back on. She did gain some, but it seems over past two week she is loosing it again. Her day is now almost spent entirely on the kitchen floor laying by her food and water. Some days her eyes tell me she is not doing so well, other days she seems ok. She has gone through a period of urinating on the floor right in front of us. That has stopped, but she just seems so unhappy. What an amazing kitty she used to be. Best hunter I ever came across. From squirrels to bats, our kitty caught it all! She even took on a fiesty golden retriever once, and won! Now I am asking myself the question every pet owner dreds: is she suffering? My husband thinks we should relieve her of her misery, I am not opposed, however if we can bring her back to a high functioning kitty again, of course I will do whatever is within our means to help her.
What do we do? Please help?
 
Are you home testing her blood glucose levels? It's important to test her in order to figure out where she is and how much insulin she needs. If you start testing then you can fill out a spreadsheet like all of us have and add it to your signature. It will give everyone here an idea of what's going on with her numbers.
Also - have you posted in the Humulin support forum? I've never used this insulin so I can't give dosing advice.
Has Sasha had a full physical with urinalysis, visual check of her teeth, and blood panel to make sure she doesn't have anything else going on? Sometimes they can have an underlying UTI or other issues. This can raise their blood glucose levels and make them not feel well. I'm just wondering if she has other health issues since she urinated on the floor for a while.
 
Okay first take a big breath and let it out slowly. :-D

You are already ahead of the game by being a nurse, so at least you aren't going to pass out at the sight of blood or needles... :lol:

Now that you are breathing again..there are 3 major keys to getting Sasha back to her sassy self again.

1) Diet--Which DM are you feeding her the dry or the canned...if its the dry, you are going to want to take it back and get a refund on it. Almost all dry is too high in carbs for a diabetic. The canned DM isn't bad, but it is pretty average to below average ingredients with a way too expensicve price tag and most cats tire of it quickly. Most of us here feed Friskies pate style, Fancy Feast Classics, on the lower price scale and things like Merrick, Wellness and Evo on the pricier range. Basically anything off this list that is under 10% carbs Binky's Lists that Sasha likes and fits the budget.

2) Insulin--NPH is not a great insulin for cats, it is a very harsh insulin in that it hits hard and wears off way too quickly. Normal duration in a cats body is about 4-6 hours. so they drop really early, and then zoom right back up again long before their next shot. Tha 3 best insulins for use in cats are Lantus, Levemir, & PZI, all three of these are long lasting gentle insulins. Is there any chance you can talk to your vet about changing her insulin?

3) Home Testing--Here's where being a nurse is going to come in handy. :-D We test our cats just like a human diabetic would test their own. We use human glucometers that take a very small sample of blood and uses strips that sip the blood. But instead of pricking a finger we simply prick the edge of their ear and test the blood from there. You will find lots of tips, tricks and videos here Home Testing.

For now read everything you can here and ask lots of questions someone will be around to give you an answer. The only silly question is the one that goes unasked. Everyone that will be responding to you here either has or has had a Sugarcat (our name for our diabetics) that we have been successfully treating at home.

Welcome to the FDMB Family!

Mel, Maxwell, Musette & The Fur Gang
 
Welcome to the boards, you are in the right place to help your kitty.

First step is to learn home testing if you are not doing that already. Without home testing you can't know how well your kitty is reacting to the insulin, you could be giving too much, too little. You just can't know without testing. We test every preshot, and then try to test at least a time or two between shots to see where the BGs go.

Once you are hometesting you can see how well your insulin in working. Humulin N in not a very the best insulin for cats. It is a fast acting, short lasting insulin so the kitty is usually on a roller coaster of a quick drop that doesn't last long enough so it wears off and the kitty rises back up into high numbers by the next shot to be pulled back down again by another dose. You may want to talk to your vet about getting a newer insulin like Lantus (glargine), Levimir (detemir), PCI, or Prozinc.

You can start by getting a meter. You can go out and buy a human glucose meter, that's what most of us use. Many use the ReliOn meter from Walmart because it is relatively cheap to use. Try to stay away from any of the Freestyle meters, there is some question on their reliability. I use an Accu-chek Aviva myself and like it. The strips are terribly expensive unless you buy them on eBay or sometimes Amazon though. You can also request a starter kit from the FDMB site via the link above.

Also read the FAQs on the site viewtopic.php?f=28&t=2501. It will give you a lot of great advice on insulins, testing, and proper diet.
 
Welcome -

I chose the ReliOn meter at Walmart because of the reviews on this board and the cost of the test strips. Most others are about $1 each... I buy 100 for $36. There's another generic name for them and you can get them online, but most Walmart stores carry the ReliOn meters and test strips. I am a little OCD about testing - which means I've gone through A LOT of them since early January.

I changed food before I started the insulin, which seemed to have helped considerably (although SOMEONE managed to sneak some from his brothers & sisters until he got busted!). I use Fancy Feast Classics, but would use anything w/ 4 or less carbs on Binky's list. FF comes in boxes - both assortments and single variety, which is much easier than juggling 25 cans in the grocery store!

It's sometimes challenging to successfully get blood from their ears. I call Grayson "my little turnip" - but after a while, the capillaries in their ears do much better for you. If you warm them, w/ either a rice bag from the microwave, or a pill bottle w/ warm water, that seems to help. This was the biggest challenge I faced. Everything else is pretty easy.

And don't forget to test for ketones. I had a scare last week, and fortunately caught it before it blew up into DKA - only because I was testing at least once daily.

You've already been instructed to breathe - now just work with your kitty, tell him what you're going to be doing, and in no time, he'll come running for his tests (especially if there's a freeze-dried chicken treat afterward!), cuz he realizes how much better he feels!

Good luck and we'll look for you around the board.

Lu-Ann
 
Hi,
I'm sorry Sasha is having such a hard time. Here are some important links about Lantus (glargine) and Levemir (detemir) insulin. You need to get her on one of those. Some cats do OK on N, but since these longer acting insulins came along last decade, they are the best options. The documentation is available to convince any vet, if they won't prescribe, then find a new vet.

http://www.diabeteshealth.com/read/2007/07/17/5316/lantus-and-levemir--whats-the-difference/

http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf

http://www.tillydiabetes.net/en_6_protocol2.htm

https://www.ideals.illinois.edu/bitstream/handle/2142/16049/1_Gilor_Chen.pdf?sequence=3

Also, please get some ketone test strips and test her urine. The behavior and weight loss you describe is concerning. We can help you figure out how to get urine to test.

Sorry so short, getting ready for work. This is the best place to learn about feline diabetes.
 
Thank you everyone for all of this helpful information. To answer about her complete physical, no blood work done. I think that will be in her best interest, vet suggested may be a waste of money as her BS on day of dx was 497. He felt confident diabetes was her only issue. I am a bit puzzled about the insulin. My vet has 30+yrs under his belt and assured us if we followed his insructions we would in no time have our happy healthy kitty back. I did question his choice of insulin,wondering what his rationale was, again he pulled out his experience card, so I listened. I will be most happy to print off the links provided and drive them right up to the vet today, and request a change in insulin. I think it may be time to find a new vet anyway, I took Sasha to him back in Sept telling him I believed she had DM or another process going on due to significant weight loss, his reply was"she looks like a perfect healthy cat to me", uugghhhhh this is very frustrating and a bit overwhelming. cat(2)_steam
The food: it sounds like most of you feed a wet food? So if I went and bought fancy feast cans, how many will she need in a day? I think she will like this, she does seem tired of her "rolex" brand cat food. ($54.00 for 5lbs.)
Glucometer and chem 10 testing strips? I really can analyze her urine as I would one of my patients? Is this a daily thing too, or more based on her symptoms? This ought to be interesting retrieving a sample from her!
Glucometer; just buy one at the store? As easy as that? Is there another area on the body I can obtain her blood sample? I do not see how Sasha will cooperate with the warming and "fussing" with her ears. I think if she could she would give me the finger on that one! She knows where I keep the TB syringes, and twice a day, she will perch and wait for her shot, it makes her feel better for a couple of hrs anyway.
I am so happy to have found this resource. Thank you all again for your help, I am sure I will have a ton more questions after I gather these necessary supplies. Happy monday, hope everyone has a blessed day!- Jennifer, Sasha's "mom"
 
Yep it is that easy just go to the store and buy a human glucometer, I personally have two diabetic cats that I adopted as diabetics, and they each have their own meters. Maxwell has been in remission for over a year and off insulins so I only test him a couple times a month, so for him I use the Relion Micro from Walmart as they have the cheapest strips but also let me purchase the smallest amount at a time.

With Musette I use the Bayer Contour and really like it a lot but the strips are a little bit more pricey, but you can usually find some good deals on them online at places like EBay.

As far as the ketostixs go, you are going to want to test more often when her numbers are high or she isn't eating well. in the beginning I tried to get a ketone test on Musette as often as possible.

As far as how much she needs to be eating, right now while she is unregulated she will need to eat as much as she can since she isn't using her food properly. Once you get her more regulated she will naturally slow down to her normal level of consumption. But on average a 10lb cat needs about 6 oz of canned food, or about 20-30 calories per pound of ideal weight for the cat.

Mel, Maxwell, Musette & The Fur Gang
 
Here's a shopping list for hometesting:


A human glucometer. Any one that sips and takes a tiny sample is fine. The meters are often free at drug stores; it’s the strips that are expensive. You can, however, buy them on ebay at less than half the price of stores. Lots of people here also like the ReliOn from Walmart. It is an inexpensive meter and its strips are the cheapest around. Try the meter out on yourself or someone else before you try it on your cat. You want to be familiar with it before you poke the cat.

Lancets and a lancet device. Usually, until the ears “learn” to bleed, a 26-28 gauge is good. Any brand will work as long as the lancets match your device.

Ketone strips. (Ketostix) Just like human diabetics use. You will sometimes need to test urine if the numbers are high.

Rice sack. Make this out of thinnish sock, filled with raw rice or oatmeal and then knotted. You heat this in the microwave until very warm but not hot. Then heat the ears before poking.

Also nice to have. Flashlight: so you can look at the ears and find the little capillaries that come off the vein running down the ear. Vaseline: Put a tiny smear where you want to poke. It will help the blood bead up.

And some lo carb treats to give your kitty, successful test or not Lo carb treats

If you decide you need another vet, you can start a new thread with your city/state and see if someone has one near you.
 
Welcome! Please ask us all your questions. There is a lot of good advice to be had here. You are definitely ahead of the curve with being in the nursing profession. I started out ahead of the curve because of my experience with human diabetes. Turns out there's not a whole lot of difference between DM in humans and cats. Here are some of the differences I've found:

Many cats become diet controlled from low carb wet food (like my Scout). Getting them regulated with insulin and a low carb diet can take time, but if you get them in good numbers then their pancreases often get working again enough to bring them down to normal numbers after meals on their own, then they can be weaned off the insulin. (I wish the ADA would look into the efficacy of this for treatment of Type II humans, but they only grudgingly accept low carb as a means to weight loss, for no more than one year, for diabetics.)

The blood sugar ranges are different for cats than for humans but not by a lot. The good news is, cats tolerate hyperglycemia way better than dogs and humans, so going high for a few days won't do as much damage to a cat. The main dangers, as with humans, are DKA and hypos, and you can read up here on how to recognize the symptoms, but cats are so good at hiding illness that testing Sasha's BG regularly is your best line of defense.

Scout and I currently share a Nova Plus glucometer. It also tests ketones with blood, but the strips for ketones are very pricy. The strips for glucose testing are much cheaper. I used to use Accu-check, which was fine for me but not good for cats because it was a pad-type testing strip. The sipping type are definitely better as you only need a little blood. I use an alternate site lancing device as it has a clear tip which makes it easier to see where I'm poking her. Some people poke freestyle with the lancet until they can reliably get blood. Warming the ear is key!!!

Some people test on the cat's paws but most folks here do ears. Scout hissed at me the first few times but I have thoroughly bribed her with treats and cuddles and pets and now she comes for her treat, doesn't fight me while I do the test (though I have to hold her still to stop her from hopping down before we're done), then has another treat.

Good luck and let us know how you're progressing! Once you get the right dose of insulin, I bet you'll have your Sasha back in no time!

Lori
 
Hi guys and welcome from us! I'm so glad you are on board with beginning to home test .. You'll find that it gives you so much information about how sasha is doing .. I really hope you can get your vet to switch insulin for you as well .. Mocha was on lantus and tolerated it very well .. in fact, so well that in just a few short days, we'll be celebrating one full year OFF THE JUICE :-D She is completely diet controlled (wal marts, special kitty turkey and giblets @ .47 a can and 3 or 4% carbs) I hope you guys stick around and get sasha back to feeling like a new girl :-D
 
sashaspecialkitty said:
The food: it sounds like most of you feed a wet food? So if I went and bought fancy feast cans, how many will she need in a day? I think she will like this, she does seem tired of her "rolex" brand cat food. ($54.00 for 5lbs.)
Click to expand...

Yes canned (or raw) food for diabetic cats :smile: The right diet is important for a diabetic cat, just like it is for Human diabetic.

Make sure to feed only the low carb varieties of Fancy Feast. Here is a list of low carb/gluten free Fancy Feast: http://www.felinediabetes.com/glutenfree.htm The rest of the Fancy Feast varieties are on on this chart: http://binkyspage.tripod.com/CanFoodOld.html Look for the ones that have a number 10 or less in the carb column. Gravy based foods are too high in carbs for a diabetic (think ice cream with chocolate syrup and whipped cream and cady toppings for a Human diabetic) so don't feed these. But do keep a few cans in your kitchen to use if your cat becomes hypoglycemic. The high carbs will raise blood glucose levels.

The food chart lists many other suitable foods you can feed. Again, look at the column for carbs and choose foods that have a number 10 or less. Here's the newer Binky's chart http://binkyspage.tripod.com/CanFoodNew.html and the Pet Food Nutritional Vales chart.

Feed your diabetic cat whatever low carb food he likes and you can afford and can find in the local stores.


Glucometer and chem 10 testing strips? I really can analyze her urine as I would one of my patients? Is this a daily thing too, or more based on her symptoms? This ought to be interesting retrieving a sample from her!
Glucometer; just buy one at the store?
Click to expand...

Any Human blood glucose meter/glucometer will work. If you have a Wal Mart nearby, the Relion brand is good. Otherwise, just pop into your local pharmacy and buy one of the big name brands like AccuChek, OneTouch, and Bayer. The AccuChek Aviva is cat-friendly and reliable but test strips are pricey.

Is there another area on the body I can obtain her blood sample? I do not see how Sasha will cooperate with the warming and "fussing" with her ears. I think if she could she would give me the finger on that one!
Click to expand...

There are people her who have fractious cats and can test their cat's blood glucose levels using the ear. So give the ear a try for a week or two. Reward with treats after you're done with the ear. An alternative test site is a paw pad but most cats don't like thier paws being fussed with.


She knows where I keep the TB syringes, and twice a day, she will perch and wait for her shot, it makes her feel better for a couple of hrs anyway. [/quute]

Are you using TB syringes to measure insulin? It is not recommended to use TB or other types of syringes to measure insulin. Here is a response from BD about that: http://www.felinediabetes.com/phorum5/read.php?8,1839069

Only use insulin syringes to measure and give insulin. Humulin N is a U100 insulin so you will need to get U100 insulin syringes. The 3/10 cc ones are best, preferably with half unit markings.
Click to expand...
 
I also recommend the Bayer Contour meter. The strips are only 24.50 at Hocks.com and they sip the small amount of blood. I like the Freestyle lite pen lancet with its own lancets though it will take any. It never fails to draw blood & is very adjustable. You can also get that online from American Diabetes.com or amazon.com for only 6.99. The syringes I use are Walgreens under 30 units, 3cc 3/16, 8mm 5/16, with 1/2" lines and 31 guage, shorts. They hurt the least and you need 1/2 lines when adjusting dose. Other brands have them too, I just prefer this brand. I second the Insulin choice as well. Lantus and Levemir & Prozinc are the longlasting insulins being used on cats with the most success. I like Lantus.

Your cat will feel much better when on a proper diet with the proper insulin and when regulated. You'll see the constant hunger, the rivers in the kitty liver, etc all turn more normal.

Melanie & Racci
 
Hi Girl and welcome!
My kitty has been getting injections since December and Im still in "shock & awe" that I can test her ear. She was a feral cat when I found her and she NEVER wanted to be touched. She is somewhere between 12-14 years old and until December she had never even been picked up! Belive it or not - diabetes brought us close together. Not only does she now let me pick her up she also plays and purrs while Im testing her ear and sometimes when Im really lucky while her test is going on she looks up and me and bumps my nose with hers! I think we have a special bond because of the diabetes. Anyway the one thing I wanted to tell you is I found a way to test for ketones that is super easy!! I purchased a "Breeze" litter box. It has a tray in the bottom that you use a liner with. When the liner is full of pee you just toss it and replace with a new one. When I want to test kitty for ketones I leave out the liner and collect the pee in the tray. When Im done with the ketone test I just pour the left over pee in the tolit, wash, dry and put a new liner in! Its so easy to get a sample like that and I really like the Breeze box. So easy to clean!
T bcatrun_gif
 
Just a note on the vet - they have to know about many different species and it can be difficult to stay up to date on everything. If you think he is 'teachable', this Convert A Vet post has some information about home testing that you may share.

Also, we have veterinary articles that you can print out and share to help him get up to date, like this one:

Lantus/Levemir testing & dosing protocol Roomp & Rand
 
Hi and welcome

You have gotten great advice from people in the know. I will add one thing ....call around and find a vet who will support your home testing and get your kitty on another insulin..pronto! Mine guy is on Lantus, a good one, but your kitty may do better on Levemir...go with that. But get to another vet..please.

Then it will take some patience and read, read, read all the links to find out about how this disease affects cats.

Best of luck. Everyone here will hold your hand as you go. As you can see you are far from being alone.
 
hi jennifer!

i answered your questions about lantus nadir, spreadsheet and condo where you asked them, but i wanted to check in with you.

we've seen many, many cats with that high of blood glucose - and we've seen them thrive. we've seen cats that have developed neuropathy recover when their blood glucose got back under control and they got the right supplements. Sasha is young and we can help you get her back healthy again.

you've been given an old-school insulin. cats have an extremely fast metabolism and they do very well with Lantus, Levemir or ProZinc. Our experience is with Lantus but i know a lot about Lev as well. Prozinc is fine too, although i think the L's have done slightly better at helping cats go off of insulin than the prozinc. but it can be fine.

being a nurse you are one step ahead in the game. i think you'll find that sasha will get used to the ear testing and do just fine with it. when i started i posted here about how horrible it was and people told me their cats would come when they called them, or they would shake the test strip container and the cat would come. i was pulling punkin out from under the furniture and hoping i didn't dislocate his little arms! but now, i kid you not, he comes when i call and he hops up on the sofa where we test. it's amazing. i had to wrap him in a beach towel at first like a little kitty burrito to hold him still, but within 2 weeks he accepted it and we stopped having to do that. it only gets easier.

you've been given lots of great information about home-testing. you need a longer duration insulin. yes, sasha needs a low carb canned food - BUT - since she's already getting insulin please don't change the food until you've mastered home testing. if you dramatically reduce the number of carbs she's eating and the insulin dose doesn't adjust with it, she could be over-dosed. so let us teach you to hometest first and transition the food gradually over a few days.

you do want to check for ketones asap so we know it's not that making her sick. i would add Neosporin OINTMENT with pain relief to the shopping list that Sue gave you. you can put it on sasha's ears and it helps tremendously with the pain. i tried it on myself! :lol:

that's probably enough for now - we try not to overwhelm new people because it's already overwhelming. but we will help you every step of the way and you'll see sasha doing better in no time.! we all have diabetic cats. we understand it. we understand how overwhelming it is, and we know how to help sasha get better.

welcome to the best place you never wanted to be. :YMHUG:
 
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