Hi! Our Story + LOTS of questions! : )

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Doombuggy may be right, it may be time for a new vet. many of us have had similar problems. Remember, the vet works for you! Final decisions are yours. Here is a link to a vet finder Just type in your zip code.

Call around and ask questions.
  • --Do they have diabetic cat patients?
    --What is their usual treatment plan?
    --How do they feel about home testing?
    --Client involvement in the treatment?
    --Nutrition?
Some where on this site there is a list of question to ask your vet. I'll try to find it.

I like my current vet (the one who dx Tess only lasted the weekend he gave me so much wrong info on diabetes and that long because he was closed all weekend), but it does bother me to walk in and see the stacks of Hills food. It really isn't a good choice!

We didn't want to scare you about the dose. WE were just trying to warn you about switching to wet food from dry when Sushi is on that much insulin. The dose in combination to the change to a low carb food that can be tricky.
 
Sushi ended up eating 1/2c of his usual Hills m/d dry food throughout the night. He ate another 1/4c (if that) around 8:30am and I gave him 6u at 9am.

I am giving my vet 1 more hour to get it together and then I'm going to make an appointment with another vet. If I went to pick up a paper script, I'd likely just spend a ton of time waiting in the lobby (I do that anyway...)--it seems that the vet is too busy to call in the script. I've gathered from the receptionists that he's hesitant to authorize a refill because I haven't brought him in in a while. (that's the short story--I'll elaborate below)*

I haven't switched to canned food yet. I'm going to get the hang of testing, do a curve, and take it from there. It's in the plan; I'm just trying to take it one step at a time.



*I mentioned some of this in my first post, but here's more of the story: I'm new to the little city I live in so I don't have a clue about who is a good vet, etc. I found a recommendation for my current vet on Kudzu. I truly like him, but he just hasn't been good to me or Sushi at all. The final straw happened in April (that's explained in my 1st post), and I decided to switch vets. I also decided in April to start looking for another job would allow me to move back home to Baton Rouge, LA (my job was the reason I moved to my current city in the first place). I have a wonderful vet in Baton Rouge, so I was thinking we would move and pick up with him. However, it's taken me longer than expected to find another job, and everything has just been in flux since then. I figured we'd just truck along without any vet visits until we got moved back to Baton Rouge. I was excited to find such a vast amount of information and support on hometesting here; I was thinking I could start implementing some of this in the interim. I'm unhappy with my vet here, but don't know how to find a new one (I've since made some progress, and you've provided some great resources as well!). And it's a lot to go through if I'm going to move to a city with a great vet next week, you know? I've just felt stuck and pulled in a million directions at once, time has gotten away from me, and (don't want to admit this!) I suppose Sushi fell through the cracks? It's all such a mess!
 
:YMHUG: :YMHUG: :YMHUG: Sorry you are having such a hard time of it. How long has it been since Sushi saw the vet? We usually get refills for a year at a time and checkup about every 6 months. Quite frankly my vet has admitted I know more about FD than she does. That has been the experience of many here, since we can focus on just the one disease. Then there are other vets who feel they have to be superior to mere pets owners in everything.

Getting home testing down is the first step. I think you have a good plan of action, however if you end up unable to get a refill and will be w/ out insulin it would be a great time to try to switch to LC food. Has he ever eaten canned food? Some cats are so used to dry that they don't recognize real food when they see it.

I can't figure out where I got the Vet Questions list, but I had down loaded it and here is a copy.
 

Attachments

Any luck w/ the Rx? My DH brought up a good point just now. If Sushi is getting 6 units of "old" insulin the potency may be way down and if you get a fresh vial and use the same dose it could act like a big increase. How long have you been using that vial? How did you get to the 6unit dosage? Vet recommendation or gradually upping the dose? And if so in what increments?
 
I did FINALLY get the Rx and supplies!! Hoorayyyyyyyy!! Sushi's been in rough shape over the past 36 hours or so, so at this point my main concern is getting him to eat. I'm going to attempt to test his urine for ketones, but we're not going to do any glucose testing just yet. I feel like it's important to get back to the "normal" we were at originally first.

HELP!! I fed him around 5:30pm. He didn't eat much at all (maybe 1/8-1/16c?) and I gave him 5u of fresh insulin right away*. I didn't realize how little he ate until after I gave him the medicine. So I started freaking out. He didn't/wouldn't eat any more, so I resorted to pouring a little (maybe a Tablespoon?) chicken baby food onto his food. Is that okay?** This worked like a charm--he ate about 1/4c. All of this before about 6:20. He's been sleeping since then. Do you think he's in trouble for hypo? What are the symptoms I need to be looking for?

-->Another question: I typically feed him -- let him eat and lounge for about 30 minutes -- give him his medicine -- he eats a bit more. So it's like I give him his medicine while he's eating. This is what my vet recommended; what do you think?

Ann & Tess said:
My DH brought up a good point just now. If Sushi is getting 6 units of "old" insulin the potency may be way down and if you get a fresh vial and use the same dose it could act like a big increase.
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Yes, true! Thanks DH! ; )
I'll answer your other ?s in a bit.


*I know I gave him his morning dose at 9am, only 8.5 hours between doses, but it was a dose from a bottle that was totally pooped out and Sushi was REALLY worrying me.
**A few years ago, my other cat was on medication I had to shoot down her throat. She's very feisty and it was NOT going well. Plus it felt very inhumane! I researched online and found an idea to mix it with some chicken baby food. It worked like a charm!
What do you think about baby food as a treat or snack or last resort to help your cat eat? How bad is it for a diabetic cat on a scale of 1-10?
 
As for the insulin, if it really was pooped out there should be no problem, but there is no way to know for sure. Keep a close eye on him tonight. Did you get a meter? I really wish you were home testing . Giving an early shot is like giving an increase. You are adding more insulin before the last dose has finished it's work. But if the old insulin was no good it wouldn't make a difference, but we don't really know.

Lots of us use baby food for cats that won't eat, Just make sure that it is meat only, NO ONIONS.

Also lots of us shoot while the cat is actually eating, they barely notice the shot. Onset for Lantus is usually 2 to 3 hours so we have more leeway in getting them to eat. Some other insulins are very fast acting and you have to get food in right away.

Other things to try are the water from canned tuna, crushed freeze dried chicken or salmon or shrimp treats, bonito flakes, parmesan cheese or Fortiflora (a probiotic that has the same flavoring sprayed on dry food to make it palatable) just a little sprinkled on. We also use the freeze dried treats as a low carb reward for tests. You can get them at Petsmart, the chicken is cheaper in the dog treat aisle.
 
Ann & Tess said:
:YMHUG: :YMHUG: :YMHUG: Sorry you are having such a hard time of it.
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Aww Ann! Thank you so much for this and all of your answers.

Ann & Tess said:
...if you end up unable to get a refill and will be w/ out insulin it would be a great time to try to switch to LC food.
Click to expand...
I had the same thought. But Sushi was worrying me so much that I decided to go ahead and get him on some fresh insulin instead.

Ann & Tess said:
How long have you been using that vial? How did you get to the 6unit dosage? Vet recommendation or gradually upping the dose? And if so in what increments?
Click to expand...
I got that vial in early May. I got the 6u dosage by gradually upping the dose, in 1/2 increments, using (don't kill me!) Sushi's water intake and urination as my guide. They have continued to increase as the insulin has aged, but I have not increased his dosage beyond 6u.

Ann & Tess said:
Giving an early shot is like giving an increase. You are adding more insulin before the last dose has finished it's work.
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YIKES! Didn't know that!!!!!!

Again, thanks for all of the other wonderful info!!!
>>Parmesan cheese--the sprinkle kind or fresh?

Tested for ketones--I'm SHOCKED!! It was between negative and "Trace" (5 mg/dL)! What a relief!! I was sure we were in trouble there!



Here's some other info:
Tonight's insulin/feeding scenario was different than normal in that Sushi didn't eat as much as he normally does. He barely ate anything and I have him his usual huge 5u dose. I understand that insulin + not enough food = hypo. I thought that I might be able to predict whether he was in danger of hypo by evaluating how much he ate tonight .vs. how much he normally eats .vs. his insulin dose. In other words, I thought I might be able to assess whether he was in danger by a description of how tonight's feeding/insulin schedule differed from the norm.
>>One big question I have: how much should kitty eat before you give insulin? What is the minimum amount a cat can eat before receiving insulin without becoming hypo?

To recap on our schedule:
Normal Schedule -
[AM] 6:30am: Feed 1/2c Hills dry m/d food | 6:45-7ish: Give 5-6u of Lantus
[PM] 5:00pm*: Feed 1/2c Hills dry m/d food | 5:30: Give 5-6u of Lantus
He ususally eats 1/8-1/4c intially and then grazes on the rest until the next feeding.
Yesterday -
[AM] 6:30am: Fed 1/2c Hills dry m/d food | 6:45ish: Gave 6u of pooped out Lantus
[PM] 6:30pm: Fed 1/2c Hills dry m/d food but wouldn't eat; skipped evening dose
Today -
[AM] 8:30am: Ate ~1/4c Hills dry m/d food | 9am: Gave 6u of pooped out Lantus
[PM] 5:30pm: Ate ~1/8-1/16c Hills dry m/d food & 5u of fresh Lantus

Sushi still hasn't eaten since 6pm-ish; he usually grazes throughout the evening. Should I push him to eat more or just let him be?
He does seem to be doing better and better! Wahoo!!





*I was not aware that Lantus was a 12 hour insulin. I have a strange schedule; this schedule with 10.5 hours between doses was what my vet and I agreed on. This is an issue I would like to discuss; I'll bring it up once the dust settles.
 
OKAY! I DID IT!
Sushi was much more tolerant of it than I expected and didn't flench or yelp at all. Here's what happened:
The lancing device allows you to adjust the depth of puncture. I set it on the shallowest setting, assuming it was a cat ear so it wouldn't need a lot of depth. I tried, nothing happened.
So I moved it to the middle setting. I got a teeny tiny drop of blood. I tried massaging Sushi's ear, but I wasn't getting anything. I tried putting the tiny drop onto the test strip. The users manual says "If there is not enough blood, 'E-7' or 'Lo' will be displayed." It didn't display either of those, so I don't think there was enough blood to register. Am I right or wrong?
So I tried it on the deepest setting and bam we got something! But the manual also says "Do not add blood on top of the test strip, as you may receive an inaccurate result." Do you think it's inaccurate? Should I try again?


Our #? 215, 5.25 hours after insulin. What does that mean? :-|


I just took a look at Sushi's ear and he has a little bruise or blood blister! :sad: What do I do?!?
 
Whooo Hoooooo! Congratulations! Testing accomplished! What meter did you get?

Usually you need to start w/ a fresh strip after a test like that, but if it gave you a reading it might be OK. Some do allow you to add if the drop is too small, but it sounds like yours says not to. You might want to try again in an hour or two. Next time after the test, pinch his ear w/ a tissue to stop the bleeding and prevent bruising. Many peeps treat w. Neosporin _w/pain Relief, not every time though. Maybe once a day.

We always test just before shooting so that we know our kitty is not too low to shoot. A mid cycle test is also valuable. We need to find the nadir to know how to dose. I usually test one or two hours before as well so that I know if the number is rising or falling.

215 at +5.25 is not bad for a start, especially after an early shot.. Lantus is dosed based on nadir, the lowest point in the cycle. It is often around 6 hours after the shot, but it isn't always always the same. A typical Lantus curve looks like this:
Example of a typical curve:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.
Click to expand...

At shot time it is usually test, feed shoot. We try to avoid food before the preshot test so we get a test free of food influence. You don't need to worry about that so much for other tests. If you are going to test and feed , test then feed.

On the shooting schedule, I know there are others that have life interfere and they work things out. I don't think I'm qualified to advise on that. Please come over to the Lantus group and ask there.
 
I totaly get how you feel about moving to another city and having to rely on someone else or instinct on finding the right vet. My best friend lived here (outside Orlando) when I moved here in 2004. In fact, Midora and I lived with her for 3 weeks while I waited for my stuff to come from Philly. I went to her vet, which was in the transition of being sold to another doctor. I always saw the old owner, who was still working there part time. I feel (as hind sight is 20/20) that if I saw Dr. Josh (the new owner) sooner, Midora's kidney issues would have been diagnosed sooner and maybe something could be done. When I fianly got to see the new owner that Wednesday morning, he took x-rays of them and one was shrunken the other enlarged. She died early the next morning and I beat myself up for months.

If you can, I would still try to find an new vet, even though you have hopes to move again. Good luck and sending some pixie dust your way!
 
Hi!
I wanted to post this real quick...
I'm working on a spreadsheet right now. Here are #'s I've collected today:
6:40am (before feeding or insulin): 279
6:45-7am: ate ~1/8c dry Hills m/d food - 5u Lantus
7-8am: ate ~1/4c dry Hills m/d food
1:10pm (6 hours after insulin): 235
I haven't had time to read/research what all of this means!! This stuff has kicked my butt--I'm SO TIRED and can't shake it! Can you help me interpret? How is he doing?

Thanks again!
Ashley
 
OK, i replied to the other thread too. Start a new thread (condo) for today as I explained in your other post. When you do I'll bring this thread over in a link.
 
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