Introduction and seeking Support/Help for our newly diagnosed cat

Hi, my wife and I are hoping to find some help here because we are starting to feel very defeated with trying to get our newly diagnosed sugar cat, Dyson (15), regulated.

Some backstory to his situation:
3/25 we took him to the vet because we noticed he was losing weight and drinking large amounts and peeing large amounts. At the vet blood work and urine work was done.

3/27 we contact the vet because we still hadn’t gotten results and vet tells us they just came in and he’s DKA and needing to go to the ER.

We bring him to the ER where he stays until 3/29 , and did seemingly very well there. They were very happy with how he had no trouble with eating and they were able to start flushing the ketones out and treating him with insulin etc as they do.

We were sent home with him on 3/29 and instructed to give him 1 unit of Vetsulin (this is what was prescribed and also what our other diabetic cat is also on at the moment) 2x daily at his meal times and to wait a few days before trying to take a curve (we know how and are able to home test).

His tests were consistently coming back “HI” which indicates the meter(an Alpha Track 2) doesn’t go up to whatever amount his glucose is at, as I’m sure you know. We even bought a new reader (an Advocate Pettest) as we were about to be out of strips for the Alpha anyways, and it had been discontinued. The next day, when the new reader arrived, he still registered HI on that one too.

We contacted the vet and they said we could try increasing his dose to 1.5u. So we did that and a few times were actually able to get readings from the meter, albeit they were over 400 every time.

During all of this he is never losing his appetite at all, but still drinking more than he should probably be and urinating larger amounts than is normal.

We took him in for his follow up appointment on 4/8 and he had gained a bit of weight back , which was good, and his belly felt better to the vet than it did on the initial visit, but he still was registering HI. We told the vet but she wanted to still keep him at the 1.5 and told us to take a curve again over the weekend (which was this past weekend), and then give her the results and we’d go from there.

Saturday we did the curve and his numbers were still almost all at the HI level. With only a few of them falling lower than that. And whenever he gets a HI reading, we can always tell by noticing he is visually more sad looking than when his numbers drop down at least into the 400s it is a noticeable change in him.

We called the vet and they said we could go ahead and do 2u, so a this last saturday's evening meal, he got 2u, which was at 10pm. He was checked before he ate and he was at HI then. He was checked again 2.5 hours later and he was at 355 which seemed great, as it was the lowest he had registered since this whole thing began.

By morning he was 594 before his insulin (9am) and then 531 on a check I did at around noon that day, a few hours after his insulin. The rest of that day anytime I checked again it was back to registering HI and he seemed sad most of the day afternoon and evening Sunday.

This morning before his shot he was still at HI , and 3.5 hours later he was again still HI.

We have made an appointment for him to have an Ultrasound tomorrow, to check for possible pancreatitis. While he was in the ER they asked if we wanted to get him an ultrasound. We asked if, in their professional opinion, they felt it was medically necessary/important for him to have at that time. They stated that they did not think so, so we replied that if at any point they felt it was medically necessary, they should perform the ultrasound without even having to contact us about it first. No ultrasound was performed, so we felt confident their stance had not changed. If they had explained to us specifically why the ultrasound was an important test, we wouldn’t have hesitated, but we didn’t want to just do a test that they said wasn’t necessary. The ER visit was already costly AND stressful for Dyson, and if there was no need to add more to both of those things, then why do so?

All that said, does anyone have any similar situation experience or any advice based on his story? We will obviously know more after the ultrasound, but we are just very frustrated not being able to help him after all this time going by already.

Some info about what he eats:
Wet food is Fancy Feast Classic pâté with freeze dried pure beef liver sprinkles on top.
Treats are only freeze dried beef and freeze dried chicken.

We try to limit dry as much as possible but we have a regulated sugar cat who really won’t eat much wet food and another non sugar cat who flat out refuses wet food. Dyson has had small amounts of the dry food here and there but we don’t leave large quantities out so that it is limited as best as possible. The dry is the Dr Elsy’s chicken.

Thanks in advance if you made it through this whole post. It’s been a struggle and any help or encouragement is much appreciated!

 

Hi you are in the right place Dyson is just precious, I am not a pro at this, but I can tell you the since his Glucose has been so high I would avoid any carbs and I mean any carbs, I had several monitors that either read as yours HI, or the Libre2 with Sensors that read all wrong, until I was advised here that the best monitor to use, which most of us do is the ReliOn Classic with the strips, always the correct reading with numbers, no guessing I myself test my Corky every 2 hours sometimes if he's glucose is low before shot, I test every hour, your choice.
I myself, the Vet opened a hole in my pocket that ran as far as I could see, and I am on a very tight budget, after Corky left the hospital after 8 days since June 2, 2023, I am yet to take him to another Vet, but that's me and Corky, I have been able to monitor, get true advise, increase/reduce ( correctly ) foods to feed , right calories; with experts on Diabetes, in this forum along with the spreadsheet ( Click below Corky's Spreadsheet in blue) we all have; and I have not been more certain on how Corky is REALLY doing, even in an emergency glucose low, of course he has no other ailments, I personally have had bad experience with my cats own Vet from babies, so is up to you to get another opinion if you are not sure or ask this forum for help. Dyson is just adorable. Best to you and Dyson from Corky and Coco

 

I am only a rookie, but it seems like this all happened within a recent time frame. And, I don't want to say the wrong thing because my cat is on a different insulin. I can't see the spreadsheet. Perhaps another member who has a better experience can see it? Watching because I am pulling for Dyson.

 

No doubt I was just saying hello there will be other members expert member that will see your post and post you back, and telling you about Corky, me and his diabetes I don’t know if you are a member or registers here perhaps that’s why you can’t see the SS, I know we all can see each other SS by clicking after the members post at the end of the actual post tells us all about our cat and the SS wait a bit, I just happen to open my laptop and saw your post

 

I can't see it either ,says access denied

 

@kthondragon
We can't see your spreadsheet

We cannot see your spredsheet
To set spreadsheet sharing permission:
* At the top right of the spreadsheet screen click on Share.

* In the pop-up dialog box click on the Get Link section.

* Change link access from 'Restricted' to 'Anyone with the link' and make sure that the permission on the right hand side is set to 'Viewer'.

* Click Done to save the changes.

Dyson is precious

 

Tagging a few member that are familiar with Vetsulin
@Suzanne & Darcy
@Wendy&Neko

 

Hi and welcome to the forum.
I can’t see the spreadsheet either. Have you ticked the share button? Once we can see the SS we will be able to help a lot more.
it is not unusual for cats to take months to become regulated so your case is not unusual but with DKA in the very recent past we want to get those BGs down to more normal numbers. It could just be a matter of him needing more insulin.
Are you testing for ketones in the urine after the DKA? If not, I would strongly recommend you do as it is important to ensure that ketones do not reappear. To check you will need a bottle of Ketostix from Walmart or a pharmacy, collect a sample of urine from Dyson and read the result exactly 15 seconds later. You need to be testing for ketones every day at the moment.
You also need to be feeding Dyson 1 and 1/2 times as much food as he normally eats. So apart from the two main meals he needs lots of snacks during the day and evening.

 

I *think* I have fixed the spreadsheet issue, so hopefully you can see it now.

we have definitely increased his food intake. We upped his meals from a half can to a full can of his wet food and also feed him freeze dried chicken or beef off and on throughout the day. We also gave him a quarter can of wet food as a snack when he was hungry earlier today as well.

we can definitely pick up some Ketostix and will attempt to test for ketones. Can we just “dip” it into his pee in the litter box after he goes?

and thank you everyone for the hello and welcome

 

Now you can see everyone's Spreadsheets, you are in the right place and hands!! I told you all the right members would read/answer your posts right away!

 

You need to give the insulin every 12 hours. On your spreadsheet I cannot see anything in the Units column for how much insulin was given in the evening cycle. Maybe you just have not filled that part in yet? Other than the two preshot tests, try to also test at +2 and +4 for each cycle if you can. We have very limited data at this point, but it may be that he is starting to get an occasional lower number that he is not used to and then bouncing up higher as a result. If we can catch him when he’s hitting one of those low numbers it would be very helpful.

 

Thank you… somehow I had forgotten to put the dose in the evening cycle. We will get the +2 and +4 readings whenever we can and I will add them to the spreadsheet as we go.

 

@kthondragon
Hi now that we can see your spreadsheet can you please set up what we call our signature, it's information we need to see Dyson
Here is the link
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help


You can look at Tyler's information after my posts in gray letters
On your SS can you just add the year up top where you have March 27
Thank you Erika

 

From what I have read here, that's not the best way
Here is a link for you to read
https://docs.google.com/document/d/1quta5WLEjdO0Y_t2dAYSwN84h-LNZWxOdtVsJDKZ16A/pub

 

OK, I've added the year to the spreadsheet, and I think I've added the info to the signature (I'll find out as soon as I click post, I guess!).
And thank you for the link... I'll read through that. We'll be picking up some keto-sticks today when we bring him in for an ultrasound (hoping to rule out, or, I guess, diagnose with, pancreatitis.)

 

In the morning since my Corky's AMPS is at 6:00AM I have a pen along with the supplies or pc of paper write it down and the when I wake up I put the numbers on the SS

 

Everything looks great. Good luck with the ultrasound .
Keep us posted
@kthondragon

 

We are still waiting on the ultrasound results, and I will update once I get those. They also wanted to test his liver, since while the internist was performing the ultrasound they recommended the vet do so.
In between the ultrasound and letting him get relaxed when we got back home, we didn't get a lot of blood glucose readings yesterday. We were, however, able to get a ketone strip reading, and it looks like there are no more ketones in his urine, which i think is definitely a good thing.
Soon as I have more info I will update.

 

OK! Got the results from the ultrasound...
The internist mentioned liver discoloration and nodules. Also some stuff about the bilial tracks and gall bladder. Recommended he be put on ursodiol for his biliary tract... but my quick research tells me that giving that to someone with pancreatitis, which it turns out he has a minor case of... is not recommended. The vet is going to double check with the internist on that.
So right now, we are going to wait to hear what the internist says, while also increasing the vetsulin from 2u to 3u. We will see how that does over the next 10 days and then, if his sugar is still not controlled but his behavior is still normal, switch to glargine.

 

We usually don't increase by whole units , let me tag a few experienced members for you
@Bron and Sheba (GA)
@Suzanne & Darcy
@Wendy&Neko
@Marje and Gracie

 

The vet also said she wouldn’t normally increase by a whole unit either, but thinks it is both worth a try and worth the risk at this time since his blood glucose levels have barely even gotten to the high 300s at the lowest.

 

Hi Mike let's see what the experienced members say that I tagged ok

 

I’ll wait to hear what people say. We weren’t planning on increasing it until the morning anyways so my wife could monitor him closely after the increase.

 

My only concern with going up one unit to 3 units is not knowing what happened the night of the 16th after +2. He dropped a lot from High (over 600) to 362 in the space of two hours. If he kept on going at that speed down to nadir, he might have seen some reasonable numbers. Or not, we just don't know. Many cats go lower at night. We determine how to change the dose based on nadirs or low points. A 0.5 unit increase might be safer.

 

I hate that I am posting this, because I don't want to seem as if I don't appreciate all of the advice here.. I do, greatly. But we decided to give the 3 this morning since my wife is home all day and can monitor him closely. If his numbers drop more than we anticipate, we will adjust to 2.5u at his nightly dose (maybe we should do that anyways just to play it safer?) We *do* recognize the danger, and we are keeping a close eye on him with a rescue kit ready and available.

I want to stress that we *really* appreciate all the advice and help we are getting here. It's just hard to balance what the vet is telling us and what we learning here.

 

I understand the desire to balance, you are balancing recent DKA and high numbers too. Do try to get a test later than +2 at night, say a +4, if you can, after the jump in dose. For safety's sake.

 

We will definitely make sure to test him at +2 and +4 tonight. Thank you for being understanding.

 

Updated spreadsheet.... not as much as a fall as we might have hoped for. Going to keep at this dose and hope his body just needs to adjust. The "curve" is just a bit weird...as his numbers went up at +4 last night. We will see how it goes today as well.

One weird thing, at least to me, is that we took his blood glucose reading at +4(yesterday morning)... and it read mid-200s. Which was surprising, so we took it a couple more times immediately after in order to confirm the reading, and both those times it was in the 400s again. That's a bit worrisome. He's looking great tho... awake, aware, active... and eating.

 

He was just high and flat last night - mostly within meter variance. Good to see some downward movement today.

With some meters, if you don't get a big enough blood drop, they'll register a lower number. Good thing you retested. Any chance you have another brand of meter around as backup? It's always good to have a backup anyway, the same or different type, in case something happens to the first one.

 

The only other meter we have is the ReliOn from Walmart... which I think uses a different spreadsheet. But we are starting to run low on the pet meter strips anyways, so are planning to switch at some point.
Is there any kind of conversion formula or is just different in general?

 

No conversion formula. The pet meter is typically higher than the human meter, but they are much closer in lower numbers. Our dosing methods were written for human meters - written back in the good old days when there were no pet meters. We have people who can help with the spreadsheet conversion when you want to switch, let us know. You can continue to use the same spreadsheet, just have a breakpoint where the switch happens.

 

Today he was tested at 8am, and came in at HI…so we gave him 3u vetsulin as usual and tested at +2 and he’s still HI. Tested with a human meter at +3 and it read 541(which would be another HI reading on a cat meter.). I’m at such a loss… just when something seems to be helping, there’s a weird day.

 

Fast drops in numbers can cause bounces, where their bodies dumps sugars to protect themselves. He might have done that last night. A little later test might have told more. He probably saw at least the 400's last night.

 

Hello again
His numbers seem better over the weekend, at least. It's hard to mentally adjust from the pet meter to the human meter, but the curve definitely looks better, I think.
I wouldn't mind some help in converting the spreadsheet over to the human meter, as right now I just split it with a big purple line... and obviously the fill colors are wrong.

 

Tagging @Bandit's Mom for help with spreadsheet switch from AT to human meter.

 

Was wondering if someone could look at the current spreadsheet.... his numbers are all over the place and we are very confused. He seems to be bouncing up and down even during a single day. Is that normal to happen for almost a week after a dose increase? As soon as it looks like his numbers are trending better, they spike back up and stay there. Are we just not being patient enough? Hate seeing the poor boy going through this

 

With bounces, as Wendy explained, Dyson's liver and pancreas have essentially forgotten what a normal blood glucose is all about. As a result, if numbers drop out of the range his body has become accustomed to, a stored form of glucose along with counterregulatory horomones are released which causes the numbers to spike. Sometimes the spike is more dramatic, other times it's less dramatic. The bounce can last up to several days.

A couple of suggestions. You may want to read over our guide to Vetsulin. If you've not already looked it over, it will provide some background on the insulin you're using. One of the bigger issues with Vetsulin is that it does not have a long duration due to a cat's fast metabolism. So what you're also seeing is that the insulin doesn't last 12 hours. The peak or nadir is often at around +4 or +4.5 which means it's likely wearing off by around +8 or +9. Because of its relatively short duration in cats, it's no longer recommended by the American Animal Hospital Assn for treating feline diabetes. The insulins that are recommended are Lantus (or the generic, glargine) or Prozinc. Many vets like to prescribe Vetsulin because it means they can stock one insulin for both dogs and cats. However, Vetsulin - which is also called Caninsulin outside of the US -- was developed for dogs and they have a slower metabolism than cats. Bottom line, there are better insulins for treating feline diabetes. If Dyson isn't responding well to Vetsulin, it may be worth discussing other options with your vet.