So just got the diagnosis of diabetes yesterday. I was actually pretty relieved because I feared it was kidney failure. She's on 1 unit twice daily. I'm prepared and ready to take on diabetes. I just had my first at home insulin shot. The vet tech advised me the best time to give the shot is when she's eating. I did that but it sort of traumatized her and she stopped eating. I panicked and switched her to fancy feast instead of the canine royal stuff, she ate more of that but still not as much as I liked. I caved in and added a few kibbles in and she ate more after that. I figured I'd rather her numbers be too high than too low at this point since she did get the insulin. Will she be ok? I think a lot of the issue is that she got so much to eat the night before. Another question is, can I instead shoot her right after she's done eating? I feel like this would go over better.
Welcome to FDMB. There's a lot of information to absorb at the beginning of your cat's diabetes journey. First, when you give a shot depends, in part, on which insulin you're giving your cat. For example, with Vetsulin which is a harsh, fast-acting insulin, you need to feed your cat and give a shot about 30 min. after your cat has eaten. However, with Lantus (glargine), you can give a shot while your cat is eating since the insulin doesn't kick in for roughly 2 hours after an injection. Given that yesterday was the first time you gave a shot, I'm not surprised that you startled your kitty. And yes, you can give a shot after your cat eats. Your cat's reaction may also be due to the gauge of the needle. Are you dispensing insulin directly from a pen or are you using a syringe? We recommend a syringe for a lot of reasons. You have greater choices as to the gauge of the needle. You want a 30 or 31 (or higher) number gauge needle. The higher the number, the thinner the needle. The thinner the needle, the less your cat is likely to notice. The pens only dispense insulin in 1.0u amounts. We recommend adjusting doses in much smaller increments so you don't end up missing what could be a good dose for your cat. It sounds like you're aware that what you feed your cat is important. What your vet likely doesn't know is that Royal Canin food is high in carbohydrates -- even the canned food. All of the "prescription" diabetic dry food is very high in carbs. Fancy Feast in the pate style are generally low in carbs. This is a chart that contains nutritional information on most of the canned foods available in the US. You have lots of choices for low carb food. We consider low carb as under 10% although most members feed their cat a variety that's around 5% carb. We also suggest that you not limit your cat to eating only twice a day. Many of the members here spread out their cat's food over a few hours around shot time. This is particularly helpful if your cat was used to grazing before being diagnosed with diabetes. In addition, spreading the food out keeps numbers propped up during the time when the insulin is most active. Another big item for us is home testing. This is the best, if not the only way, to keep your cat safe. Without knowing what your cat's blood glucose level is you don't know if her numbers in a safe range to give an injection and you don't know how low the insulin is dropping your cat's numbers. Not home testing leaves your kitty incredibly vulnerable to a hypoglycemic episode. A very large number of people here use the Walmart Relion glucose monitor. The strips for their glucometer are the least expensive around. I can't encourage you enough to home test. And finally, this is a post on helping us to help you. It provides instructions on what to put in your signature so we don't pester you by asking the same questions repeatedly. There are also instructions on how to set up your spreadsheet. The spreadsheet will allow you to track your cat's progress and it will allow us to provide feedback and answer questions based on how your cat is doing. The members here are very generous with their time and knowledge. Please let us know how we can help.
Thank you SO much for your thorough response. You've given me a lot of helpful information and I am so glad I have this community. After I gave her insulin I got her to eat some more, so she was fine. I guess I'm just curious if there's a recommended oz portion or calories that should be eaten with the insulin. I just picked up the relion monitor at walmart with test strips and lancers, and will do that tonight before I feed her to see where we're at. Kind of dreading it as I can't imagine she's going to take to being poked well, but I'm determined and she'll get used to it. She's only had two insulin shots but is doing so much better. No more drunken walking, and the restless behavior has really diminished. She's played a bit and I woke up twice to her curled around me which she hasn't done for awhile. She was sticking to one spot by the water. Very happy with everything!! Her name is Snits, btw, like my username. To answer questions, I'm using Lantus and will continue to do so as the tech stressed that if a cat is going to go into remission it will be with this insulin. She's scheduled for a glucose curve next month at the vet. Thank you about the information on the royal canine stuff. I found it a bit suspect that it was chunks in gravy. Just picked up some fancy feast and frisky pates, so she's set. I am a bit worried about her being picky and not wanting to eat them since she's primarily been a dry food gal her whole life, but again, she'll get used to it. I can give her some chicken too, she seems to like that. Girl loves pumpkin as well. I need to be careful because she seems to get constipated easily. Do you think that will change as her numbers get stable? Again, thank you so much! Happy to be a part of this community.
Okay, to follow up, just did a glucose reading. She came out at 346 on the relion. She actually did so well, I was impressed. So I've done some research and it looks like anything over 150, give insulin, anything under, skip. Is this correct?
Good job with the testing! One thing I didn't mention was treats. Every time you test Snits, no matter whether you're successful, your kitty gets a treat. You want to provide a positive reinforcement for testing so Snits begins to associate testing with treats. There are low carb treats available. Most people here use a freeze dried protein (e.g., freeze dried chicken) but if your some members will use chicken breast that they cook at home. We had one member who has a very "special" cat whose treats were cooked shrimp. Likewise, it doesn't have to be a food treat. One member's cat thought brushing was a treat. Whatever works! I'm going to tag one of our members who is great at helping with spreadsheets. (@Bandit's Mom) Bhooma will be online later and can lend a hand if you need it. Also, if you are home testing, you will likely not need to get a curve at the vet's office. You will have a ton more data than the vet will be able to get. Also, cat's numbers are often artificially inflated when a vet does the curve. Most cats get rather stressed out by a car ride and spending time at the vet's office. Stress causes a rise in blood glucose numbers. Basing a dose on numbers at the vet's office could potentially cause the vet to suggest more insulin than what your cat needs. There are options besides skipping a shot. However, given how new you are to this, skipping is fine. One big positive is that your vet started Snits on Lantus. It's a great insulin for feline diabetes. This is a link to the Lantus board. I'd encourage ou to read the sticky notes at the top of the board. There's a lot of information there so don't expect to be able to digest it all immediately. It's good place to start so you understand more about the insulin, dosing, etc. If Snits has a tendency to get constipated, make sure you add some water to her food. That may help. Keep an eye on her litter box behavior, though so you know what's going on. Some cats need something to help them keep their bowels moving! One plus with canned food is that moisture level is very much greater than with dry food so the problem may self-correct. Just be aware that if you make an abrupt shift from dry to canned food it may cause a temporary GI upset.
Hi again! I did another successful glucose test again today. I tried one in the morning but wasn't getting enough blood and figured she had been poked enough. This evening she read at 345. Is it normal for her numbers to stay the same in these early days? Thanks so much!
Lantus blood sugar numbers, in an ideal cycle, will have a gentle downward movement to around the middle of the cycle to the low point or nadir, then go back up again. Depending on when you test during the cycle, you may get different numbers in the middle of the day or night rather than at shot time. Lantus is also a depot style insulin, meaning it can take several days worth of shots for you to really see what is going to happen on a particular insulin dose. When you first start, we suggest holding the dose 5-7 days. It may take a few days after you start to start seeing more downward action.
Thank so much! You've covered so much for me beautifully. I'll be sure to be back if I have questions or need help. The amount of support and help here is amazing.
Hi back again. She ran to the bathroom and vomitted. She was very drunken in her walking but that’s somewhat normal and was probably worse due to stress. The vomit was mostly water but was food colored with chunks. I made sure she was finished vomiting and quickly took a reading. It was at 82 so think she okay. I gave her some food which she scarfed down she seems happy and is cleaning herself now. I gave her insulin at 4pm so it’s been 5 hours. She was 345 before. Does 82 5 hours later seem ok? To remind, she’s on 1 unit twice daily. should I check her again in a few hours to make sure she doesn’t get dangerously low?
Good catch on that 82, and giving her some food. I would test in an hour or two to make sure she's still OK. Keep the Royal Canin stuff around (which type?) as I suspect it's higher carb food which you can give her if she gets too low. When kitties are getting some dry food, we don't like them being on a dose that gets them below 90. Do you have syringes with half unit markings for the injections? If so, I'd recommend lowering her dose to 0.75 units - you eyeball the difference if you've got the half unit markings. Regardless of type of syringes, her dose needs to go down some, possibly even to 1/2 unit. It's also a little worrying with having just started insulin for her to get that low so soon given the depot isn't build yet. Which is another reason her dose needs to go down.
The royal canin stuff is glycobalance. I also have some other higher carb stuff i'll keep around in case. She's currently on no dry food atm, but friskies pate. I don't have the half unit syringes yet - waiting for the pharmacy to get enough in. The vet sent me home with some 6mm 100 unit syringes. They admitted that these were not ideal needles at all. They said that's all they had at the time, so I had them call in some at the local pharmacy. It's a rural area so hopefully get them soon. I'll test her again in the morning to make sure she's back up, and then lower her dose from there. Thank you!
Oh wow, thank you! I was just going to order off of Chewy after I run out from the pharmacy, but ADW seems considerably better. I still don't have the syringes from the pharmacy yet, but am ok for now as I have enough to last me for awhile. Oh wow, thanks so much for linking me to the exact ones I need. I was on my mobile when I saw this and the the link wouldn't load. So just for an update, I lowered her to .75 as per wendy & aneko's guidance. She seems to be doing a lot better, hasn't puked since and seems more at ease. Her BG was 386 this morning. We had a bit of a hassle getting enough blood, and I felt pretty defeated, but I feel ok now. Not testing her before shooting is not an option for me. I'm not sleeping as much because I want to be present if she needs me. On the second day testing I wasted a bunch of strips getting ER04 not realizing I didn't have enough blood, and now I feel like I'm poking her too much and getting too much, but I'll get the hang of it. I plan on doing a curve after a week of her being on the .75 unit to see what it's doing to her BG throughout the day. Another thing I've noticed is her neuropathy seems to greatly improve towards the later part of the 12 hours is up. At peak she seems wobbly. Is this possibly because her body isn't used to being at a normal/low BG so she's just not as coordinated? I've taken BG tests when I was concerned but she was always at a safe reading. I'm planning on getting her some b12 methyl to sprinkle in her food. Her neuropathy isn't horrible, she has a wide gait and her legs aren't always completely straight. She is using them to scratch and flings them up to clean now, and doesn't seem to have any hesitance to get up and walk like she did, so those are all good signs. Overall, she seems a lot better. She's wandering again, jumping up on furniture and will play. Her morning BG readings are still high, but I imagine it's too soon to see too drastic of a difference. I will try and set up a spreadsheet when I have time! I am making notes on a notepad, so I can take from there.
Have you had a chance to get your spreadsheet set up? We can be of considerably more help if we can see what Snits' numbers look like. If what you've been seeing is neuropathy, it takes time for that to resolve. Snits would need to be in good numbers for at minimum a month -- probably more. It may be that your kitty has a touch of arthritis.
Okay, I've been looking on the forum. Seems like i have three options when it's under 200. Do nothing, stall her food then test again, or give 10-25% of what she normally would get. I think my best option for now is to do nothing, as I've already fed her and am hesitant to give her any insulin not knowing what may happen. I'll check her numbers in the morning and see how she did with no insulin so i'll have a better idea of what to do when this happens. I'll work on my spreadsheet tomorrow and make it a priority.
