Introducing Sergei, diagnosed 14 September 2020

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Sergei

Member Since 2020
Greetings to everyone. My name is Scott. I'm a new member, very newly caring for our beautiful eight-year-old cat, Sergei, who has diabetes. We just received the diagnosis late on Monday and my partner and I are in complete agreement about trying to manage the diabetes in every way we can, but we are both terribly worried because Sergei seems so sick at the moment. We've not yet been able to start with his consistent insulin regime, which is scheduled to begin with his feeding this evening.

My main immediate concern is that Sergei is in such a rough way. Over the last 48 hours he's gone from being a pretty vigorous cat (though not totally asymptomatic—we took him in as soon as it was clear something was not right) to being crashed out in the same position on the sofa, which is really unusual for him. He ate well this morning and I did see him take some water. He is using the litter box too, so that is a good sign. The vet assured us that he is not in ketoacidocis, but I've never seen him in such a sad state (and similarly he's never seen me in such a sad state).

My partner and I are totally inexpert and inexperienced at this, so for the moment we have agreed to follow the vet's recommendations through the early stages and then to adjust our interventions once we have learned enough and have had a chance to see how Sergei tolerates insulin, etc. Can anyone advise us on on how long it will take after starting insulin before we might expect to see some improvement? I feel ill about all of this myself but I'm trying to stay strong for Sergei. Thanks for "listening" and for any thoughts.
 
Welcome to FDMB Scott and Sergei We are glad you found us and YES we can help Sergei. You have landed in a safe place for Sergei!

I think maybe you should start here:
New? How You Can Help Us Help You!

We are dedicated to helping any and all that find these pages.
Can you tell me what type of insulin was superscribed to Serge? We can go from there.

We are a community of cat lovers with one thing in common feline diabetes. Theres a wealth of information here available at your fingertips WITH many people ready willing and able to help you navigate it all.

WELCOME TO OUR FAMILY:bighug:
jeanne
 
Hi Scott
First of all, take a deep breath and relax... You’ve already taken a very big step towards making things better by finding this site - there are people here all over the world with vast experience of managing FD, and we will support you in whatever way you need.

As well as reading the document that Jeanne’s linked above, I suggest having a little look around the site to familiarise yourself with some of the different sub-forums - this is the main health forum and there are others for specific insulins, as well as other topics.

Can you tell us a bit more about yourself? Where in the world are you? What insulin has Sergei been put on, and what dose? Do you know how to test his blood glucose at home so you can check how the insulin is working? What are you feeding him?

That’s probably enough questions for now, sorry about that but it will help us to build up a picture of you and Sergei and how we can best help.

Good luck!
 
Many thanks for those reassuring words and for the link. We are in the Netherlands, so I'm not sure if all of the various brands will be the same. We are starting with the Caninsulin 40IE/ml using the vet pen delivery system. It is supposed to come in today so I don't yet have it on hand (another source of anxiety at the moment and I may have to take Sergei in to the vet this evening for insulin if the pen does not arrive this afternoon). We are starting him at a dose of 2.5, twice a day, 12 hours apart (9:30 / 21:30), 30 minutes after 1/2 can of wet food (Hills Diabetes Care m/d).
 
How much does Sergei weigh? I have not used Caninsulin/Vetsulin personally, but I believe 2.5U is a large starting dose. I don't know that I'd want to be giving that dose without having some way to monitor what it was doing.

Most of us here home-test blood glucose. It's a great way to not only keep your cat safe and safely adjust dosage, but also it is a tremendous relief to be able to have some way to assess the situation. I think we've all been there, looking at our cat who is obviously feeling poorly, and wishing we knew what was wrong and what we could do to help!

Does home-testing sound like something you would be willing to do?
 
Hi Nan, thanks so much, right, so Sergei is 5.5 kilos or 12.13 pounds. The vet said she was dosing him based on his current weight. Strangely I looked at the guidelines and they specify only a max starting dose of 2 (ugh). We gave him that dose yesterday at the vet's office at noon, and he seemed to do fine through the day and into the night. He's had a mixture of moderate carb food and low carb food today. Now I'm starting to see the value of home testing.

I am open to doing home BG testing and I was just watching the link about it. I feel a bit in the difficult position of knowing Sergei needs insulin soon and not having the right supplies for testing just yet. We know we absolutely have to feed him half an hour in advance of giving the insulin and then to monitor him closely, especially from hours 4 to 5 after administration, when he is at most risk of becoming hypoglycaemic. She said BG was off the charts so he was unlikely to go into hypoglycaemia immediately but that we absolutely had to watch him carefully and have food and grape sugar syr
 
Nan & Amber (GA) said:
How much does Sergei weigh? I have not used Caninsulin/Vetsulin personally, but I believe 2.5U is a large starting dose. I don't know that I'd want to be giving that dose without having some way to monitor what it was doing.

Most of us here home-test blood glucose. It's a great way to not only keep your cat safe and safely adjust dosage, but also it is a tremendous relief to be able to have some way to assess the situation. I think we've all been there, looking at our cat who is obviously feeling poorly, and wishing we knew what was wrong and what we could do to help!

Does home-testing sound like something you would be willing to do?[/QUOTE
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Nan’s right, 2.5u is a high starting dose. The manufacturer of Caninsulin says start with 0.25u - 0.5u per kilo of bodyweight, so that’s how most vets work out a starting dose. Many cats’ bg is indeed “off the scale” on diagnosis so vets don’t usually consider hypo as an option.

We usually suggest starting at a dose of 1u - mainly because insulin is a very powerful substance and you don’t want to be risking an overdose. It’s better to monitor blood glucose and see what effect the 1u has, and increase gradually if needed.

It sounds as if the vet has told you the basics of what to do if you spot symptoms of hypo, but ideally of course you want to avoid it in the first place. To be safe, lower the dose and get a blood glucose monitor as soon as possible. Yes, Sergei does need insulin but we have a saying here - better to be too high for a day than too low for a minute.

Many people come here worried about going against their vet’s advice but there is a wealth of experience here than can’t be under-estimated.
 
Hmmm... Most of us use "human" meters to test blood glucose. I am not sure about the situation in the Netherlands, but usually that means you can buy supplies over-the-counter at your neighborhood pharmacy or even a lot of supermarkets and "big box" stores (eg Wal-mart). So you might be able to just pop out and get yourself set up quickly.

The main things you want in a meter are: takes a relatively small droplet of blood and (most important) strips are cheap and easily-available. You will go through more strips than you think, and it really adds up!

Also on your shopping list:

1) lancets to do the poke. Start with the larger size lancets, 26 or 28 gauge (smaller number = larger size).
2) some kind of antibiotic ointment (not cream) to put on the ear afterwards. I usually only did this once at the end of the day's poking, relying on using pressure to stop bleeding and bruising otherwise.

Whoops, gotta run (at work), more later but that should get you started!
 
Serge said:
I believe you Jt. Should I be concerned about hypoglycaemia over 24 hours since his last insulin?
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No you should be fine.
Caninsulin has what’s called a ‘fast onset’ - gets to work quickly, in the first couple of hours; an ‘early nadir’ - ie the lowest bg is often seen earlier than is ideal; and a ‘short duration’, eg it typically peters out before the next shot is due.
Basically, Caninsulin was formulated for dogs (the clue is in the name - Canin-sulin) who have a different metabolism from cats and for this reason it doesn’t suit all felines. Only time will tell!
 
jt and trouble (GA) said:
Thanks Diana
Scott,
I cannot give dosing advice. I havent had a diabetic kitty in 10 years. Things have changed since back then. I can help you find things and people to come help though. I'll keep tabs on you ;):coffee:
just in case
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Yes Scott you will find that you get replies from various different people here, offering what they can according to their own experience and learning. I think you’ll be absolutely fine - once you’ve got your head around the basics of how it all works, it’s a matter of putting it into practice to your best ability. You will probably always have questions and that’s fine, that’s what this place is all about :)
 
Hi Scott and welcome. Be assured that all of us can relate to the panic you feel in the beginning, which means we are all eager to help. It DOES become easier with time. And Sergei will start to feel better when his blood sugars come down.

My girl started on 1 unit of Caninsulin (Canada) - because that is what the vet was used to. We did switch to Lantus, a much better insulin for cats, then later Levemir due to some other issues she had going on. Both Lantus and Levemir should be available near you. They are insulins available at human pharmacies so easier to get your hands on. But we inject with syringes, not pens. If your vet said Caninsulin to start, no harm in at least trying how it goes. It does help some cats.

What food is Sergei eating now?
 
Diana&Tom said:
Don’t want to scare you Scott but it’s worth reading this document, even if you aren’t testing yet:


https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/
Click to expand...

This was very persuasive and helpful. I will be a much less stressed person once we get up and running with home testing. I feel like I'm driving blind at the moment. Sergei took his insulin at 21:45 tonight, so I'm going to be right here with him until after its known peak which should be between 1:45 and 2:45 this morning. I doubt I will sleep much after that worrying that somehow hypo can still happen. It would be very helpful to understand the operation of this particular insulin and dose on his particular system, and I know that's where home testing comes in. The vet said we would be beginning that soon. I printed the info in the link in case of any hypo symptoms and have a large supply of grape sugar on hand and ready to go. It was intended as both a symbolic and practical gesture that we stopped by the health food store to buy grape sugar before we went to pick up the insulin prescription.
 
Wendy&Neko said:
Hi Scott and welcome. Be assured that all of us can relate to the panic you feel in the beginning, which means we are all eager to help. It DOES become easier with time. And Sergei will start to feel better when his blood sugars come down.

My girl started on 1 unit of Caninsulin (Canada) - because that is what the vet was used to. We did switch to Lantus, a much better insulin for cats, then later Levemir due to some other issues she had going on. Both Lantus and Levemir should be available near you. They are insulins available at human pharmacies so easier to get your hands on. But we inject with syringes, not pens. If your vet said Caninsulin to start, no harm in at least trying how it goes. It does help some cats.

What food is Sergei eating now?
Click to expand...

Thanks so much Wendy. Your (and everyone's) encouragement is very heartening and much appreciated. We got Sergei through his first unsupervised insulin injection. It was a learning experience and my poor partner stuck himself with the back of the needle when removing it from the pen. We will have already refined our process by the next injection tomorrow morning. I really appreciate everyone's help and encouragement. I know my vet uses other systems to manage FD and the vet said its not a one size fits all situation. If we find this is not working then we can find another alternative. I am already developing reservations about the pen and we will probably switch over the longer haul. They seem to use the pen here as a way get people who would otherwise be intimidated or uncomfortable with the syringes to adhere to a routine.

Regarding food: at the moment we are transitioning Sergei from Hill's I/D (stomach issues) to Hill's Diabetes Care m/d. He also gets a very small amount (20g) of Hill's diabetic m/d dry kibble. Feeding is a difficult issue because he has a sensitive tummy and often vomits, especially if he eats too quickly. So we have to feed him in stages. And there is the panic about whether he has eaten enough to do insulin.
 
;)
I dont know where you are located but IF you should have any trouble you can come here. We have folks all over the worls so hours are many. If its an emergency add a 911 to your title. That will alert people to come help.
 
I've heard that you can practice giving shots on an orange. Easier than hurting you! I did find syringes quite easy to use, and actually used syringes when my girl was on Caninsulin. It's easier to give partial doses with syringes too.

M/D isn't particularly diabetic food, just maybe lower carb (though not low carb) than i/d.
 
Also do you see the light gray printing at the bottom of everyones posts? Its called your signature. You will need one for yourself here are the instructions on how to set that up:
First you want to go to the dark blue banner at the top of the page all the way to the left your name appears click that and a drop down appears click signature than add your info
  • On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
    • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
    • Add any other text, such as
    • Caregiver & kitty's name (optional)
    • DX: Date
    • Name of Insulin
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.
 
Hi Scott - I'm new here myself (since Friday, I think!) and just wanted to welcome you, and assure you that you're not alone in feeling overwhelmed at first. I used to be a vet tech but in specialty practice, so I have no prior experience in dealing with a FD kitty. For me, when I started reading all the info here and other reputable places, I was very much "OMG this is so much to digest", but after a couple more days, things are starting to settle in my mind and I'm getting a better understanding of where we are today and what will be happening in the next few weeks.

Hang in there!
 
Jane and Ragnar said:
Hi Scott - I'm new here myself (since Friday, I think!) and just wanted to welcome you, and assure you that you're not alone in feeling overwhelmed at first. I used to be a vet tech but in specialty practice, so I have no prior experience in dealing with a FD kitty. For me, when I started reading all the info here and other reputable places, I was very much "OMG this is so much to digest", but after a couple more days, things are starting to settle in my mind and I'm getting a better understanding of where we are today and what will be happening in the next few weeks.

Hang in there!
Click to expand...
Thanks Jane. These last three days have been a real challenge, from the initial diagnosis which came back at about 5pm on Monday until now, 2:35 am sitting with Sergei making sure he makes it through five hours post insulin, which is happening right now. I've had to just let myself go through the emotions and to try to muster the confidence, reminding myself that I need to keep it together to help Sergei. Tying to gather and process as much information as I can and as quickly as possible is a colossal undertaking. Are you doing testing at home or are the values on your spreadsheet from the vet? I need to get the testing sorted quickly.
 
Deep breath, hold, release, deep breath, hold, release, deep breath, hold, release. Mindfulness breathing can help to reduce the stress of learning to treat your diabetic cat. It certainly helps me to relax a bit.

You can't learn everything about feline diabetes in one or two days, but you sure are trying hard to do that! Kudos to you for all the effort you are putting in to help Sergei.

We'll help you as much as we can. There are a lot of good folks already helping you. @Diana&Tom are even in Europe, but one hour behind your time zone, and in a different country. Perhaps she can suggest some higher carb foods, that are available in the UK and maybe you can find some of these in the Netherlands. I have no idea what higher carb foods may be available over in Europe.

This link takes you to the list of low carb foods, <10% carbs, that can be found in much of Europe. European Cat Food List.
 
Deb & Wink said:
Deep breath, hold, release, deep breath, hold, release, deep breath, hold, release. Mindfulness breathing can help to reduce the stress of learning to treat your diabetic cat. It certainly helps me to relax a bit.

You can't learn everything about feline diabetes in one or two days, but you sure are trying hard to do that! Kudos to you for all the effort you are putting in to help Sergei.

We'll help you as much as we can. There are a lot of good folks already helping you. @Diana&Tom are even in Europe, but one hour behind your time zone, and in a different country. Perhaps she can suggest some higher carb foods, that are available in the UK and maybe you can find some of these in the Netherlands. I have no idea what higher carb foods may be available over in Europe.

This link takes you to the list of low carb foods, <10% carbs, that can be found in much of Europe. European Cat Food List.
Click to expand...

Thanks Deb, the European list will be useful reading for Scott.

Scott, many of us buy food (and other pet supplies) from Zooplus - www.zooplus.com

I don’t recall any other members from the Netherlands at present but our real food expert this side of the pond is my fellow UKer @Elizabeth and Bertie who may be able to give you more info.
 
Hi Scott - Wellcome to the forum! I just wanted to give you a newbie perspective. Hercules was diagnosed in July, and like you I was told here is the insulin, follow protocol and come back in a month. oh and by the way, he might have a hypo, which is when you run into A&E.... Of course that was very stresful, as I wasn't even sure if I could recognize the symptoms... Searching for symptoms I found this wonderful forum and I am now a "pro" tester and Hercules comes to his spot to get his blood taken (as in his picture) many times a day.

We have had a few brushes with very low bg, so i second having some honey in the cupboard! ;)

Sergei said:
Feeding is a difficult issue because he has a sensitive tummy and often vomits, especially if he eats too quickly.
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I switched Hercs to Feringa wet food since learning loads from this board. They are german made, and I am pretty sure you might be able to get in the netherlands.
Here is the list of food available in the UK: https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml#
Some of it will hopefully also be available to you
Hercs has not thrown up since moving to wet food. So that was a bonus from the diagnosis and the change in food :)

Last, but not least. It is a wild ride, but much easier with folks here!
 
Nan & Amber (GA) said:
Any updates, @Sergei ?
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Thanks and sorry for not posting -- the last 48 hours have been challenging. From insulin fails to missed insulin for vomiting and the rocky road of trying to settle on a strategy, my partner and I are feeling despair. Sergei is alive, so that is a good starting place. He is nowhere near stable. Not even close to a road to stable. I have no numbers to offer except that we lowered him to 1.5 Caninsulin last night because he seemed to be drinking a little less water and seemed more alert. That made me fear that dosing him at 2,5 would lead to a hypo. I think that may have been a mistake. So far the effect of that seems far worse than the 2.5 he was prescribed. With the 2,5 he seemed to show improved alertness and function yesterday. He was a bit floppy but affectionate and communicative. He vomited this morning so we had to skip his insulin which he will next get at 20:30. Today he has retreated, seems wobbly, glassy eyed and slow. I really am trying to keep it together but seeing him in this state has been a lot to try to process. I know Sergei is carrying the burden of this so my emotional ups and downs seem utterly selfish or indulgent. I just don't understand how he's gone downhill so quickly. From diagnosis late Monday to today he is a totally different animal.
 
Hold on, it is tough to start with.... but it should get better. How is Sergei as a cat, is he very food motivated? Is there something that you can bribe him with to get him more settled for test?
I know my cat is thankfully very accepting of all the prodding, but folks here have a lot of experience with different cats. What is happening during shots? Perhaps someone has encountered the problem and can help?
You can also ask to have a libre monitor placed by the vet? People here don't love it, but it might be the best to start monitoring the situation with one less stress?
 
So, how many doses has he gotten? Was it:

Thursday morning: 2.5U
Thursday evening: 1.5U
Friday morning: no shot

or did you start Wednesday night and give him two 2.5U shots before reducing to 1.5U? [edit: just found the reference in the thread, looks like you did shoot Wednesday evening]

Has he eaten normally today after the vomiting this morning?

I, too, worry about ketones, based on his symptoms today. If you can pick up some urine testing strips (you should be able to pick them up from a human pharmacy, with the other diabetic supplies) and get a quick test today, that would be great. It's not something you want to let get out of hand.

Tips to catch and test a urine sample

That said, there might be another explanation for Sergei's feeling so poorly today. Some possibilities:

1) the 2.5 dose brought him down to normal numbers (that's why he looked alert, stopped drinking so much, etc.). But once the insulin wore off, he zoomed back up. Human diabetics report that those kinds of rapid swings in blood glucose can leave them feeling awful, and some of our kitties have the same reaction.

2) Some cats just don't feel well in general on Caninsulin-- whatever their BG numbers are, it just doesn't seem to "agree with" them. Not sure if this is the more likely explanation, since he seemed to be feeling a little better after the first dose.
 
Hercule's mum said:
Hold on, it is tough to start with.... but it should get better. How is Sergei as a cat, is he very food motivated? Is there something that you can bribe him with to get him more settled for test?
I know my cat is thankfully very accepting of all the prodding, but folks here have a lot of experience with different cats. What is happening during shots? Perhaps someone has encountered the problem and can help?
You can also ask to have a libre monitor placed by the vet? People here don't love it, but it might be the best to start monitoring the situation with one less stress?
Click to expand...
Sergei is a very smart, affectionate, communicative, and emotional cat. In seven years, I've only ever seen him hiss once and that was at a vet who gave him what they said would be a painful injection of nausea medicine. Apparently they were correct because never a growl or hiss otherwise. I have however seen him pout plenty of times. He's a total sweetheart. So when it comes to insulin and testing, I'm hoping we can keep him that way.

I've been giving him two or three tiny pure meat jerky treats from my specialty pet food store just after insulin. He loves them but he's starting to associate the appearance of them with the injection. He's also starting to avoid my partner, who has been the one giving the injections because I had two consecutive major fails at in the morning yesterday resulting in having to insert twice. The second stick I pulled the pen syringe out a little too quickly as you need three to five seconds for the full dose to be delivered. We decided that my partner would do the insulin for the time being. I think we need to try to introduce Sergei to the pen, to try to condition him to know that it is connected to a set of rituals we follow so that he does not come to avoid my partner or worry it's going to happen at random times.

I tried to extract blood from Sergei's ear yesterday (no training at all but the Vet's office loaned me the equipment after I showed up and expressed concern about all of this) but he cried and looked at me as if I had really hurt him. I may have because he pawed at his ear quite a bit afterwards. I decided I was not going to do that without some training. If I screw it up severely now, I may never get him to cooperate. The vet assures me that we will be doing it soon enough but has asked us to be patient while we deal with this very acute situation.

They have been very supportive but I told them doing this without BG values feels like driving blind. Partner and I are both monitoring Sergei *very* closely day and night. Just after onset Sergei gets very sleepy. I'm perpetually waking him up and making him walk if he seems at all out of it. I don't think we are anywhere near hypo territory, though, because he also gets up and asks for water and wants food. We keep some out just to be safe and if I'm concerned I'll give him 5 to 10g of wet food with some carb content. We take him in on Monday for a first BG test. Right now that's what I'm going to have to settle with because neither of us wants to stress Sergei anymore than he already is at the moment. I'm going to take a big breath and try to relax so that we can just get a routine started. We really are trying. It's just a lot to try to grasp.
 
jt and trouble (GA) said:
Have you been able to check for Keytones in Sergei's urine?
Click to expand...
Not yet. I will talk to the vet's office about it. They checked Tuesday and said that he was not in Ketoacidosis. Not sure how long it takes for it to develop in an animal with uncontrolled high glucose (possibly for months). We have adjusted the diet significantly this week. Sergei almost at target weight already. Just 500g over though I think he's dropped a little this week. We've cut off any treats with high carb content and changed to a lower carb kibble. His main meals are lower carb wet food (Hill's m/d - Diabetes/Weight Management) Do the food changes usually help significantly in real terms over time?
 
Sergei said:
Not yet. I will talk to the vet's office about it. They checked Tuesday and said that he was not in Ketoacidosis. Not sure how long it takes for it to develop in an animal with uncontrolled high glucose (possibly for months). We have adjusted the diet significantly this week. Sergei almost at target weight already. Just 500g over though I think he's dropped a little this week. We've cut off any treats with high carb content and changed to a lower carb kibble. Does that usually help in real terms over time?
Click to expand...
Keytones can develop over night. This can be serious so you might want to run out to a pharmacy and ask for Urine testing strips in the diabetic section
 
Sergei said:
This was very persuasive and helpful. I will be a much less stressed person once we get up and running with home testing. I feel like I'm driving blind at the moment. Sergei took his insulin at 21:45 tonight, so I'm going to be right here with him until after its known peak which should be between 1:45 and 2:45 this morning. I doubt I will sleep much after that worrying that somehow hypo can still happen. It would be very helpful to understand the operation of this particular insulin and dose on his particular system, and I know that's where home testing comes in. The vet said we would be beginning that soon. I printed the info in the link in case of any hypo symptoms and have a large supply of grape sugar on hand and ready to go. It was intended as both a symbolic and practical gesture that we stopped by the health food store to buy grape sugar before we went to pick up the insulin prescription.
Click to expand...
@Wendy&Neko
I agree with @Wendy&Neko,

Not sure if you are reconsidering to change the caninsulin to either Lantus or Levemir. Caninsulin is actually for dogs, (Canine), not for cat (Feline). The only problem- Lantus & Levemir are both very expensive.
But- if Caninsulin works with Sergei --- that is totally fine. According to the research and studies, most cats get remission in those 2 brands. But each cat is different.

Thanks,

Len & Momo
 
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