Important Questions???

[Irish Pat]

Good morning everyone....So being new to this and reading a lot of posts on this forum I have developed a few questions, some may be stupid but im learning, as I indicated before we really don't have any clue about diabetes because its not in our family, we are still reading up on it but its a learning process. So if you could help me out I would really appreciate it. It appears a lot of people get inconsistent answers from their vets which doesn't really help the unknown. The help you are supplying us, words cant express how much it means to our family. Well here goes, Thank you

1. How much food should a cat consume before a shot is given?

2. What is the goal of insulin? Is it to try to maintain a consistent level of BG, meaning do you want to try to reach a certain BG number and that's where it should be everyday all the time or is that even possible? Like say below 100 or in the 100's, 200's, etc?

3. The vet wanted me to give him 2U of insulin, that appeared to be fine for a 24 hour period but his BG dropped to the lowest its been since he was diagnosed. My question here is, is it ok to keep changing his dosage from day to day? I feel if I did not home test and gave him 2U on the day his AMPS was 67 we may have had an issue that day with his BG dropping to low so we didn't give him any insulin that morning, or would that have been fine to give him 2U because this was prior to him eating?

4. How long does injected insulin stay in the felines body? Is giving insulin every 12 hours being given to maintain a constant level of insulin in the body?

5. Will cats still drink and urinate as much no matter what their BG readings are? Brady is doing a lot better in both, but im just curious if this is something that can happen because of the diagnosis?

6. This is a forum question..Is there actually any vets or vet techs in this group?

7. One other question, what does Dosing Method (SLGS or TR) stand for on the SS?

Lastly, Brady and his family want to thank all of you, it honestly has been the best thing we did joining this forum. The knowledge and support given by this group is priceless. With all that is going on in this world, I hope all of you remain safe and healthy. Thank you again, Brady, Pat and Von

 

[Noah & me (GA)]

that appeared to be fine for a 24 hour period but his BG dropped to the lowest its been since he was diagnosed.

More help is coming but on this one question you do not want his numbers to go really low. How low depends on the exact numbers and the insulin and skipping a dose to avert a HYPO episode was the right thing to do.
There is one vet here, the rest of us figured this out ourselves. Sorry, that's all I'm qualified to say.

 

[Sienne and Gabby (GA)]

I'd need more info to answer your questions. I'm not sure if anyone suggested you add more information to your signature -- when Brady was diagnosed, which insulin you're using, if there are any medical issues, etc. There is information in this post that discusses info for your signature as well as other basics.

1. How much food should a cat consume before a shot is given?

Some insulin requires a good portion of food is on board prior to giving a shot (e.g., Novolin and Vetsulin). These are faster acting insulins. In comparison, with Lantus, you don't have to feed as much since Lantus doesn't begin to work (i.e., onset) for about 2 hours. So, you can feed, shoot, and then give another of the cycle's portion of food over time.

2. What is the goal of insulin? Is it to try to maintain a consistent level of BG, meaning do you want to try to reach a certain BG number and that's where it should be everyday all the time or is that even possible? Like say below 100 or in the 100's, 200's, etc?

The goal of insulin is to get your cat's blood glucose (BG) numbers back into normal range. Diabetes is the result of the pancreas not producing sufficient insulin to transport glucose out of the blood stream and into the cells. When glucose is floating around, it means nutrition isn't getting where it needs to go and over time, it can cause end organ damage. Thus, getting your cat's numbers regulated is important.

3. The vet wanted me to give him 2U of insulin, that appeared to be fine for a 24 hour period but his BG dropped to the lowest its been since he was diagnosed. My question here is, is it ok to keep changing his dosage from day to day? I feel if I did not home test and gave him 2U on the day his AMPS was 67 we may have had an issue that day with his BG dropping to low so we didn't give him any insulin that morning, or would that have been fine to give him 2U because this was prior to him eating?

Again, this depends on the insulin. The answer is "no" if you are using a depot-type of insulin (i.e., Lantus or Levemir) since dosing is based on the lowest number in the cycle versus the pre-shot number. With shorter acting insulin, you have some flexibility with adjusting the dose since the pre-shot number plays some part in your dosing decisions.

4. How long does injected insulin stay in the felines body? Is giving insulin every 12 hours being given to maintain a constant level of insulin in the body?

Again, it depends on the insulin. Novolin N/Humulin N and Vetsulin/Caninsulin have a shorter duration than Lantus, Levemir, or Prozinc The latter three last around 12 hrs. The other insulins last approx. 8 hours and we sometimes refer to them as "in and out" types of insulin. Frankly, the shorter acting insulin are no longer being recommended for cats in part, due to their shorter duration.

5. Will cats still drink and urinate as much no matter what their BG readings are? Brady is doing a lot better in both, but im just curious if this is something that can happen because of the diagnosis?

As Brady starts to become better regulated and is spending time in better numbers, thirst and urination will decrease. These are both symptoms of diabetes and the better regulated a cat is, the less intense the symptoms.

6. This is a forum question..Is there actually any vets or vet techs in this group?

Yes, although they routinely don't self-identify. Usually vets or vet techs are here because they are unfamiliar with the nuances of managing feline diabetes or have limited experience with the insulin that is currently recommenced for treating FD. I would also point out there have been MDs and lots of medical professionals here. The ability to help someone manage their cat's diabetes is not limited to someone who is a veterinary or medical professional. It's also why we keep all guidance on the message board vs in private messaging. If someone make an error, everyone can see the comments and help to correct or at least discuss the information being provided.

 

[Irish Pat]

I'd need more info to answer your questions. I'm not sure if anyone suggested you add more information to your signature -- when Brady was diagnosed, which insulin you're using, if there are any medical issues, etc. There is information in this post that discusses info for your signature as well as other basics.


Some insulin requires a good portion of food is on board prior to giving a shot (e.g., Novolin and Vetsulin). These are faster acting insulins. In comparison, with Lantus, you don't have to feed as much since Lantus doesn't begin to work (i.e., onset) for about 2 hours. So, you can feed, shoot, and then give another of the cycle's portion of food over time.
The goal of insulin is to get your cat's blood glucose (BG) numbers back into normal range. Diabetes is the result of the pancreas not producing sufficient insulin to transport glucose out of the blood stream and into the cells. When glucose is floating around, it means nutrition isn't getting where it needs to go and over time, it can cause end organ damage. Thus, getting your cat's numbers regulated is important.

Again, this depends on the insulin. The answer is "no" if you are using a depot-type of insulin (i.e., Lantus or Levemir) since dosing is based on the lowest number in the cycle versus the pre-shot number. With shorter acting insulin, you have some flexibility with adjusting the dose since the pre-shot number plays some part in your dosing decisions.

Again, it depends on the insulin. Novolin N/Humulin N and Vetsulin/Caninsulin have a shorter duration than Lantus, Levemir, or Prozinc The latter three last around 12 hrs. The other insulins last approx. 8 hours and we sometimes refer to them as "in and out" types of insulin. Frankly, the shorter acting insulin are no longer being recommended for cats in part, due to their shorter duration.

As Brady starts to become better regulated and is spending time in better numbers, thirst and urination will decrease. These are both symptoms of diabetes and the better regulated a cat is, the less intense the symptoms.

Yes, although they routinely don't self-identify. Usually vets or vet techs are here because they are unfamiliar with the nuances of managing feline diabetes or have limited experience with the insulin that is currently recommenced for treating FD. I would also point out there have been MDs and lots of medical professionals here. The ability to help someone manage their cat's diabetes is not limited to someone who is a veterinary or medical professional. It's also why we keep all guidance on the message board vs in private messaging. If someone make an error, everyone can see the comments and help to correct or at least discuss the information being provided.

Thank you for the information, I do have a SS started with the insulin im using and BG levels since he was diagnosed, is there other things I need to add? If so can you please let me know what I am missing to help better answer my questions?

 

[jt and trouble (GA)]

I'm NO expert but I can welcome you to the best site on the planet to help you help your lil buddy. WELCOME TO FDMB!
These are all good questions and I think answering Sienne's questions you will get even better advice!
You are already ahead of the game with home testing. Stay tuned for more good advice.
One thing to remember this is a marathon not a sprint. You got this!
jeanne

 

[Elizabeth and Bertie]

I do have a SS started with the insulin im using and BG levels since he was diagnosed

Hi,
Well done for getting that SS set up!

A few first thoughts...
For those new to diabetes, or who don't yet have a lot of test data, the 'general guideline' is to not give insulin if the preshot blood glucose is below 200. That is ensure some buffer of safety while you're gathering data and 'learning the ropes'. So, some of your preshot numbers were way too low for insulin...

You're getting some quite erratic numbers too, and that may be due to your kitty's blood glucose dropping too low or too fast (or both) and then 'bouncing'. This means that the body, sensing a threat to its safety, releases stored glycogen from the liver to temporarily raise blood glucose.

Also, Prozinc 'often' works better with consistent dosing. If this were my kitty I'd keep to a low consistent dose for several days if possible (unless the blood glucose drops too low) and see if the numbers settle out a bit.
For reference you may be interested to see our Prozinc dosing protocol here:
http://www.felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/

What are you feeding your kitty at the moment (you can add that info to your SS too)?
And have you changed the diet recently?

Eliz

 

[Irish Pat]

Hi,
Well done for getting that SS set up!

A few first thoughts...
For those new to diabetes, or who don't yet have a lot of test data, the 'general guideline' is to not give insulin if the preshot blood glucose is below 200. That is ensure some buffer of safety while you're gathering data and 'learning the ropes'. So, some of your preshot numbers were way too low for insulin...

You're getting some quite erratic numbers too, and that may be due to your kitty's blood glucose dropping too low or too fast (or both) and then 'bouncing'. This means that the body, sensing a threat to its safety, releases stored glycogen from the liver to temporarily raise blood glucose.

Also, Prozinc 'often' works better with consistent dosing. If this were my kitty I'd keep to a low consistent dose for several days if possible (unless the blood glucose drops too low) and see if the numbers settle out a bit.
For reference you may be interested to see our Prozinc dosing protocol here:
http://www.felinediabetes.com/FDMB/threads/prozinc-dosing-methods.225629/

What are you feeding your kitty at the moment (you can add that info to your SS too)?
And have you changed the diet recently?

Eliz

Updated the SS with additional information you suggested, im glad I asked some questions so I can provide as much info as possible to get the best answers. As far as the prozinc insulin is concerned, my biggest issue is the vet is the one that suggested these amounts and I agree, if his numbers get way low I was feeling anxious on giving him the doses she recommended because I fear more than anything his BG going to low. I am working from home due to this virus going around which has helped but now I feel like im checking on him every 15-30 minutes due to worrying his BG will drop to low. It also has me thinking what is going to happen when I return to work and nobody is here to look in on him. What if the dose given lowers his BG to low and nobody is here...That's where im struggling with the dose amount. Uggghh!!!

 

[Elizabeth and Bertie]

What if the dose given lowers his BG to low and nobody is here...That's where im struggling with the dose amount. Uggghh!!!

As you gather data, and 'see' how your cat responds to insulin, you will get to understand how the insulin is working in your kitty's body. And you will get more confident with giving insulin.
Of course, when giving insulin there is always 'some' risk. But because you are hometesting (and doing a great job at it!) this increases your kitty's safety considerably.
It may well be that your kitty needs less than a unit. And it will be interesting to see how he does on the 0.5 today. But that 0.5 may get a wee bit of a boost from the 1.5 that he had last night. (Prozinc cycles can sometimes be influenced by the dose given in the previous cycle).

Just had a look at your SS and see that your kitty was getting some dry food. At what point did you remove the dry?

 

[Irish Pat]

As you gather data, and 'see' how your cat responds to insulin, you will get to understand how the insulin is working in your kitty's body. And you will get more confident with giving insulin.
Of course, when giving insulin there is always 'some' risk. But because you are hometesting (and doing a great job at it!) this increases your kitty's safety considerably.
It may well be that your kitty needs less than a unit. And it will be interesting to see how he does on the 0.5 today. But that 0.5 may get a wee bit of a boost from the 1.5 that he had last night. (Prozinc cycles can sometimes be influenced by the dose given in the previous cycle).

Just had a look at your SS and see that your kitty was getting some dry food. At what point did you remove the dry?

We removed the dry the day we brought him home after being diagnosed, so I would say March 13th

 

[Irish Pat]

We removed the dry the day we brought him home after being diagnosed, so I would say March 13th

Also I updated his sheet with my tests so far today...What I think im going to do is see what is PMPS level is and possibly try stick with 1U at this point because his +6 hours shows his level is climbing.

 

[Irish Pat]

Honestly, when he was first diagnosed and the vet gave him his first insulin shot his BG went right to 147, she had given us a lot of hope when that happened because she thought that maybe it wasn't diabetes and his high BG was totally associated to his pancreatitis. Im still not sure that isn't the case but he really doesn't show any symptoms of panc. Right now he is a very happy cat, a lot better than the day we took him in. He eats, goes to the bathroom, purrs, plays, alert, naps, bugs us like he always does, lol, actually so close to his old safe that its given us so much hope that he is going to do well on his treatments. He would shed terribly and always had hairballs, his coat is soft and he isn't shedding, hasn't had a hairball since we brought him home. We shall see how it goes. Once again you guys make life a lot easier, if not supply information, just to vent out the frustrations.

 

[Noah & me (GA)]

I'll make this quick as I have nothing to add medically. Your post was written perfectly; to the point and the questions all made sense. The one exception was asking about stupid questions, there are only stupid answers. Some threads get sidetracked by emotions but we know what you're feeling right now, I've been there twice. Never mistake a quick and to-the-point answer as heartless. This is a nice place, just happens to be a line at the door right now.
Safe journey for you and Brady, Dickson.

 

[Deb & Wink]

If you could add some information to your user "signature" that would be attached "magically' by the software behind the scenes to all your posts. Your signature can be updated at any time, and the changes will then appear with all past, current, and future posts.

Signature instructions.

Sure would love you to take 60 seconds and put some helpful information in your User Id profile, including the "Signature" portion.

Go to the top right corner of the screen, click on your user name, a drop down list will appear, select "Signature" from that list. Start typing in the text box that appears and be sure to click on the "Save Changes" button at the end of the text box.

Information like your first name, your cat's name age and sex, DX: (diagnosis date), insulin used, meter used (when you get one), food fed, and then the SS (spreadsheet) link when you get that setup are so, so helpful to those of us responding to members. That signature information will be "magically" attached at the end of all your posts. Signature and other user profile information can be updated as needed.

 

[Irish Pat]

If you could add some information to your user "signature" that would be attached "magically' by the software behind the scenes to all your posts. Your signature can be updated at any time, and the changes will then appear with all past, current, and future posts.

Signature instructions.

Sure would love you to take 60 seconds and put some helpful information in your User Id profile, including the "Signature" portion.

Go to the top right corner of the screen, click on your user name, a drop down list will appear, select "Signature" from that list. Start typing in the text box that appears and be sure to click on the "Save Changes" button at the end of the text box.

Information like your first name, your cat's name age and sex, DX: (diagnosis date), insulin used, meter used (when you get one), food fed, and then the SS (spreadsheet) link when you get that setup are so, so helpful to those of us responding to members. That signature information will be "magically" attached at the end of all your posts. Signature and other user profile information can be updated as needed.

Done!!

 

[Deb & Wink]

Thanks for the signature info!!

As far as the pancreatitis causing the diabetes, it can be a co-morbidity. In other words, when the pancreas is not working well, all sorts of things can happen. The diabetes may have led to the pancreas being inflamed. The pancreas also produces enzymes, to help digest the food. So if there are not enough of those enzymes, your cat can get EPI (Exocrine Pancreatic Insufficiency). It's not common, but grayish stool color is a clue.

Pancreatitis can be acute or chronic. We have this : Pancreatitis: A Primer On Pancreatitis. Not sure if you have seen that thread yet. From the Health Links/FAQS forum, in the Sticky at the top labeled Index.
Sticky INDEX: Health Links/FAQs

 

[Sienne and Gabby (GA)]

Thanks for updating everything!

This link to the Prozinc forum will also be helpful. There are instructions -- both basic and more advanced-- to help you figure out dosing. The information is in the sticky notes at the top of the forum.

One point. We are attempting to get people to move away from thinking in terms of a "no shot" number. Rather, think of the 200 that Elizabeth mentioned as a, "post and ask for help" number. Ideally, you begin to shoot progressively lower numbers as your kitty's BG gets back into better numbers.

 

[Deb & Wink]

She is already posting over in the Prozinc forum and has been pointed to the stickies there. Not sure if she has read them yet. The dosing protocol "Sticky" is a very good one. Recently revised in February 2020. I've got a printed copy with a ton of notes on it, that I've made already.

Once you have a "Signature" setup and your spreadsheet up and running and have a bit of test data, it's a good idea to move to the insulin specific group forum.

Pat, would you please move over to the Prozinc ISG, and continue any new posts and threads over there? Thanks.

p.s. He joined on a day where I was helping someone with a hypo situation. I had asked him to post here instead, for other "eyes" to help him.

 

[Irish Pat]

She is already posting over in the Prozinc forum and has been pointed to the stickies there. Not sure if she has read them yet. The dosing protocol "Sticky" is a very good one. Recently revised in February 2020. I've got a printed copy with a ton of notes on it, that I've made already.

Once you have a "Signature" setup and your spreadsheet up and running and have a bit of test data, it's a good idea to move to the insulin specific group forum.

Pat, would you please move over to the Prozinc ISG, and continue any new posts and threads over there? Thanks.

p.s. She joined on a day where I was helping someone with a hypo situation. I had asked her to post here instead, for other "eyes" to help her.

Hey Deb not sure if you are using the "she" for me because im a "he", lol

 

[Deb & Wink]

Hey Deb not sure if you are using the "she" for me because im a "he", lol

OOPS! Sorry, my apologies, my mistake. Pat can be a nickname for a man's or a women's name. Patrick or Patricia.

 

[Irish Pat]

OOPS! Sorry, my apologies, my mistake. Pat can be a nickname for a man's or a women's name. Patrick or Patricia.

Not a problem...And yes I have been reading a lot of the things everyone is pointing me to...Its a lot to consume in such a short time but im trying to get all soaked into this old head of mine. That's why I keep asking questions, its all helping me with trying to understand what is going on with our buddy.