Introduction

[Divehead]

Greetings and mmmmrow!
I'm Jay and my 11 year old neutered male orange tabby Blaze was just diagnosed with
Diabetes. His initial BG level was 400. My vet advised me that
Blaze needs 2 Lantus injections per day. I am currently phasing in Royal Canin diabetic cat
Food into his diet.I am bringing Blaze back
To the vet on Tuesday for his 1st BG curve. I was initially expecting
To pay $200 per 10ml vial of Lantus. I saw online that Lantus pens are available. I intend
To do more research on this topic. My questions at this point are: can I buy Lantus at low cost from a reputable company?;
Are there quality low-cost home feline BG test kits?; can I buy diabetic cat food without going thru a vet?
My primary goal is helping my sweet Blaze enjoy his life.
Blaze and I thank you for your support.

 

[Sandy and Black Kitty]

Hi Jay and Blaze and Welcome!

You came to the right place for learning everything you need to know about Feline Diabetes, Lantus and treating Blaze.

Fasten your seat-belt - tons of information will soon be coming your way here today. . . answers to all your questions and more

 

[BJM]

Welcome Jay and Blaze!

His initial BG level was 400.

Vet stress may elevate the glucose from 100 to 180 mg/dL. Home testing, which we strongly encourage, may show much lower levels.

My vet advised me that Blaze needs 2 Lantus injections per day.

Lantus is best given every 12 hours with the same dose each time. The initial dose should be based on the lower of the cat's current weight or ideal weight, in kilograms (pounds divided by 2.0), multiplied by 0.25, then rounded down to the nearest quarter unit.

I am currently phasing in Royal Canin diabetic cat Food into his diet.

We generally feed our diabetics low carb canned or raw food available over the counter. Many prescription diabetic diets are actually too high in carbs to do much good, are expensive, and come in one flavor which often ends up with the cat refusing to eat. Cat Info discusses why to feed this way and has a printable food chart with nutrition info for many common US brands. (I feed Friskies pates to my pride of 15, including 1 diabetic.)

I am bringing Blaze back To the vet on Tuesday for his 1st BG curve.

If you test at home, you can do the curve yourself, eliminating the effects of vet stress, and getting much more accurate numbers. Plus, it will cost much less!

I was initially expectingTo pay $200 per 10ml vial of Lantus. I saw online that Lantus pens are available.

We recommend the pens. Although a 5 pack may have a considerable upfront cost, it is actually more cost effective as you can use the entire contents of a pen before its effectiveness wanes. Also, while human labeling states it expires in 28 days, we have found that storing it on a stationary shelf in the refrigerator extends its use up to about 6 months. Sometimes, you can get a pharmacy to sell a single pen, More tips on reducing costs are here.

MAre there quality low-cost home feline BG test kits?

Many of us use the WalMart ReliOn Confirm or Confirm Micro, or the Prime.
And if you despise WaLMart, The Arkray Glucocard 01 or 01 mini is identical and sold through American Diabetes Wholesale.

 

[julie & punkin (ga)]

welcome Jay! hi Blaze! cat_pet_icon

You just hit the jackpot! the folks on this site know diabetic cats inside and out - we'll give you a hand on learning what you need to know to take care of Blaze and get him regulated.

My sweet Punkin is gone, but I used a Relion Confirm (bought at the unmentionable Walmart, only cuz i had no other option) with the generic Arkray strips bought through American Diabetes Wholesale online. You can register first at mrrebates and you'll get a rebate on each purchase you make at ADW. it's worth doing.

The link BJ gave you isn't active. you want http://www.catinfo.org to look up the carb content of any food you're going to give Blaze. You want everything under 10%, most of us feed around 5% carbs. There are many Fancy Feast classics and Friskies that are low-cost and low-carb. Blaze shouldn't eat any more dry food ever again. poor guy! Dr. Lisa, who has that site, is a vet with a passion for helping cat owners learn how to keep their cats healthy. it's a good site with a lot of information.

When you get a chance, please start a spreadsheet and write a profile. Directions for these are here: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=50130 and http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=79123

Those 2 things are primary tools that people helping you will refer to over and over and over again.

And not to completely overwhelm you, but if you're still good for more info, take a look at the yellow starred sticky posts hereLantus & Lev Tight Regulation. If you are on info overload (which we get cuz there is a ton to learn!) don't worry about it. Just start with the spreadsheet and profile, and then it would be good if you looked at the yellow starred sticky on the top of the Tight Reg forum on "Lantus & Lev: info, proper handling and storage" before you use your Lantus for the first time. You want to care for it so it lasts til the last drop. I did a video that's on there for how to draw up a dose. It's so expensive you don't want to accidentally contaminate it when you start.

So . . . ask us questions and we'll help you get where you need to be!

Glad to meet you! julie

 

[julie & punkin (ga)]

almost forgot - these particular syringes are great. http://www.americandiabeteswholesale.com/product/terumo-thinpro-insulin-syringe_5891_112.htm you'll do dose adjustments by as little as 0.25u (a quarter of one unit) and these have half-unit markings that make that infinitely easier. They're also one of the less expensive syringes you can find, and in our comparisons on this site we've found them to be one of the most accurate. they have a lubricant in the barrel so the plunger moves smoothly.

anyway, you can use any u-100 syringe with 0.5u markings, i'm just passing this along before you've bought a bunch because many people here prefer these.

when you've got a meter and strips, holler and we'll coach you on hometesting tricks. don't be discouraged when you begin because a cat's ears will be hard to get blood from the first couple of weeks. as you poke his ears will grow capillaries, and after a couple of weeks you'll get blood every time.

edited to add:

You might also want this Lantus Savings Card: http://www.lantus.com/sign-up/offers.aspx It'll save you significantly on the Lantus. You have to register him as over 18 and a human! And some people have glitches to work out on it, but hopefully it will go smoothly for you. Some pharmacies will break up a box of pens and then you're paying no more than $25 on each pen - which is a huge savings. You have to call around to find one that will break up boxes - there's no rhyme or reason to it. But some pharmacy will, so keep looking. Here's Tina's suggestions on making it work:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=113322

 

[Deb & Wink]

Hi Jay and sugardude Blaze and welcome to the message board.

You've already gotten a ton of information from other folks on some of the basics, so I'll let you absorb some of that info and just wanted to welcome you.

Hang in there because it does get easier and we have your back here.

Deep breath, hold, release, deep breath, hold, release, deep breath, hold, release, deep breath, hold, release...................................

 

[Divehead]

Thank you for such a warm reply to my introduction!

Julie - so sorry about Punkin.

I am in the process of absorbing the initial information I received.

Blaze is about to encounter several big changes in his life: Lantus injections, BG testing and new food. My biggest concern is that these changes will have a detrimental effect on his quality of life, by overwhelming him and/or causing him to fear me. How do I bring these changes on board without frightening Blaze?

 

[Deb & Wink]

How do I bring these changes on board without frightening Blaze?

One step at a time.

The food change is a good start, as that step alone can make a big difference in the BG levels, especially if you have been feeding a high carb food and switch to a low carb food.

Just keep loving on Blaze all that you can. Talk to him about these new changes you are doing and why you are doing them, to make him feel better. I think our cats do understand that with all these changes we are trying to make them feel better. Talking about it can not only reassure Blaze, but you too.

Give him some loving attention, weather that is some brushing, petting him, ear scritchies, hugs, some pure protein treats or whatever makes him really happy.

Remember to treat yourself too! That can be a piece of chocolate or a cookie, it can be reading a good book or taking a short walk, or going outside to look at the stars at night or treating yourself to a nice hot soak in the tub. This can be a very stressful time for the bean as well as your beloved kitty Blaze, so remember to take some "me" time and pamper yourself.

Keep asking questions here. We'll keep giving you suggestions on how to make this all work and come up with alternatives when needed. If you don't understand something, please ask again for us to explain and we'll try to explain a bit differently and tell you the "whys" and how these changes can make a difference.

{{{{{Hugs}}}}}

 

[Divehead]

Deb-
Thanks for your kind words and encouragement.
I read Dr. Lisa's paper on CatInfo, and was
appalled at at the purposeful neglect that some pet food companies
exhibit in formulating food for our pets.
I noticed in your sig block that you use Fancy Feasts pâté. I assume
this food contains liver. I am feeding Blaze 1/4 C of
of 1/2 Hill's i/d, 1/2 Royal Canin diabetic, 2x daily. Both foods
are on Dr. Lisa's bad list.
I have another cat, Blaze's sister Star. She is a black, grey and tan
tabby. She has IBD, the reason for the Hill's i/d. I wonder how she would
tolerate a change to canned food....
What is your recommendation for phasing canned food into Blaze's diet?

 

[Deb & Wink]

What is your recommendation for phasing canned food into Blaze's diet?

A good way to phase in the canned food, is slowly over about a weeks time to cut down on digestive upset issues. Slowly,cut back on the amount of dry and substitute more of the wet each day. You may notice a bit of diarrhea with the initial switch to canned food or the poops will be a bit smellier for a couple of weeks.

Some cats really love the canned food and are easy to switch over,taking to the canned food immediately. Those caregivers are very lucky to have such easily persuaded kitties. :lol:

Some cats, like my Wink, do not recognize the canned food as edible. ohmygod_smile It took me about 6 weeks to transition him from dry to wet food. I used almost all of these tips and tricks from this article Transitioning Feline Dry Food Addicts to Canned Food. These tips were a godsend to me. Once Wink was eating all the low carb canned food, his numbers dropped quickly and he went OTJ (off-the-juice, insulin being the juice) or what is known as diet remission.

I feed the Fancy Feast classic pates because that is what I can afford, it's readily available in many stores, comes in many-flavors and Wink likes it! The Turkey and Giblet flavor has always been his absolute favorite. ;-) I also feed some of the Friskies pate style foods to my 2 civies (non-diabetic cats) and some to Wink.

Some of the Fancy Feast foods do have liver in them, but not usually as the main ingredient.

I'm not sure what to tell you about the food situation for your IBD kitty Star. Maybe someone else will have some ideas for you to try.

 

[julie & punkin (ga)]

i have a 5 yr old civvie (non-diabetic) anya, who had something causing diarrhea from the time we got her as a 4 month old kitten. We tried a number of meds and fortiflora to help the diarrhea and nothing helped. We were feeding her and punkin both the Hills easy-on-your-bladder dry food because punkin had chronic bladder infections.

When he was diagnosed with diabetes, at first we gave him the prescription m/d, i think. whatever Hills canned and dry food both that the vet sold us for diabetic cats. Anya continued to have diarrhea during these foods. The vet told me that the gut could become so irritated if they had diarrhea as kittens that it would just continue. so we didn't have a diagnosis of IBD, but the symptoms seemed to be the same.

After a couple of months giving insulin we found this board and transitioned both cats to Fancy Feast canned low carb food. Punkin didn't have another bladder infection and anya stopped having diarrhea. i added a little water to the food, but other than that it was straight from the can. That was 4 years ago and anya hasn't had any diarrhea episodes since that time, after several months of non-stop.

So . . . i hope you have the same experience. I wouldn't hesitate to try giving it to Star and seeing how she does.

Unless you buy liver flavor, it's not the main ingredient in FF.

 

[BJM]

Some notes on the IBD:
- some cats with IBD may do better on a raw diet
- a friend who does rescue, says slippery elm has been very useful in controlling diarrhea - info on using it may be found at Feline CRF (lots of kitties with CRF get GI upsets)

And there is a Yahoo group on feline IBD here. You'll need a Yahoo account first, then you request to join the group.

 

[Divehead]

Hi Julie-
Thank you for sharing your experiences with me. I'm glad
that Anya benefitted from the FF. I am going to transition FF into
Blaze & Star's diet.

Next question: what's the scoop on Lantus vs. Levemir for diabetic cats?
Thanks again.

 

[BJM]

Both are depot insulins where the effect builds up over several doses.
More of our users use Lantus, however Levemir may be used a similar way using the same protocol.
Both are insulins often prescribed for humans; the use is off label in cats, and can be quite successful in getting good control and sometimes off of insulin if you follow the tight regulation protocol.

 

[julie & punkin (ga)]

i agree with BJ - they are both great insulins for cats. we have people here using both who would be able to help you learn to use either one. Lev is slightly newer, but enough cats have been on it for us to "know" it - not as many vets do.

There are a couple of differences. take a peek at this Lantus vs Lev link.

from a practical standpoint, Lantus is made in an acidic base and for higher dose cats that can sting. however it doesn't bother all cats - mine had a high dose condition and got up to 15.5u doses and never reacted to the insulin. Lantus' low point in most cats, is generally between 3-6ish hours after the shot.

Lev's low point is a little later, maybe 8-12 hrs after the shot.

cats react differently and that can even vary from day to day, so it's not possible to say definitely what you'll experience. But the difference can matter when it comes to monitoring because you'll want to know what that low point is in order to decide on dosing. both of these insulins require dosing decisions to be made based upon that low point. so if your schedule is tight, that might make a difference to you.

There's some good information here that might be helpful as well: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=151

they cost about the same, the protocol we follow is the same for both insulins, and people here can help you with either one.

 

[Divehead]

Wow!
I brought home some FF Classic Chicken Feast to try. I placed 1/2 tsp in each of their food cups.
Blaze almost knocked his food cup out of my hand, and proceeded
to Hoover every morsel down! Star ran over to her cup, and cleaned it better than
I ever could! I'm going to watch them for a little while, and verify that they
don't have any digestive issues. I think I'll give them a little more if they are ok.

Questions:
I consulted Dr. Lisa's food chart. There are 2 carb columns for each food type.
Do I add the 2 carb values to get the total carbs per serving?

How much FF wet food should Blaze eat? The directions on the can say 1 can
per 3.5lbs body weight.

 

[Deb & Wink]

I consulted Dr. Lisa's food chart. There are 2 carb columns for each food type.
Do I add the 2 carb values to get the total carbs per serving?

Nope the 2 different sets of columns do not get added together. One set of columns is protein, fat, carbs, phosphorus on a Percent of calories basis. The other set of columns is protein, fat, carbs, phosphorus on a % dry matter basis. I usually use the first set of columns, calorie basis, in picking foods for my cats.

How much FF wet food should Blaze eat? The directions on the can say 1 can
per 3.5lbs body weight.

Well, ECID. Every Cat is Different. I feed my 3 cats a bit more than 0.5 ounce per pound of body weight for them to maintain their weight. Other people here feed their cats up to 1 ounce per pound of body weight. So, you will need to experiment a bit to find out home much to feed your cats. Kind of depends how well the BG's are under control for Blaze. Also depends on if your cats need to lose or gain weight or are at their ideal weights.


To give you some idea, my sugardude Wink is very well regulated, in fact diet controlled, and weighs 10.5 pounds. He gets 6-7 ounces of the Fancy Feast a day and maintains his weight fairly well. At the beginning, he was eating 10-12 ounces of food a day and still losing weight rapidly.

 

[julie & punkin (ga)]

the best guide is to feed enough to hold their weight stable. i have 2 11 month old kittens that each eat 2.5 cans of FF per day - they weigh around 10lbs each. my almost 5 year old girl who weighs a little less, maybe 8 pounds, eats 2 cans per day.

unregulated diabetic cats aren't getting the value of the food they eat - the high blood sugar means that the energy from the food is floating in their blood stream instead of getting into the cells. so unregulated diabetic cats are often starving. if that's what you're experiencing, you want to feed Blaze more to compensate for the fact that he's not really getting all the value from what he's eating. it's tricky though, because his appetite center isn't reliable, so you don't want him to eat endlessly as much as he wants, just enough to hold his weight where it ought to be.

Here's a good link on that: Feed Kitty as Much as They Want?

When you go to the vet tomorrow (i assume you're still having a curve done there as scheduled) you'll want to ask for a prescription specifically for the pens. The vial or the pens require different prescriptions. You'll also need to make a dozen phone calls to find a pharmacy that will sell you the one pen. They come in a box of 5 - which some people buy but if you don't have to, it costs less up front.

Blaze will get used to the routine, Jay. You don't have to worry about ruining his quality of life. I told myself i knew better than Punkin, and I knew that he absolutely had to have the testing and the shots in order to survive, and just like with my kids, i made him do it. I think being convinced of that helped me get through starting testing him when he didn't want anything to do with it. For 2 weeks I had to drag him out from behind and under furniture to test him, then wrap him tightly in a beach towel in a "kitty burrito" so i could immobilize him while i tested him. At 2 weeks - he gave up. from that point on it was fine. A treat after each poke made it more tolerable for him.

 

[Divehead]

Good evening-
Please explain to me the reasoning behind using the
cat's pinna for obtaining blood for BG checking.
Thanks!

 

[Divehead]

Julie-
I had to cancel Blaze's 1st BG curve tmw, cuz I don't
have the insulin, and Banfield requires me to supply the insulin.
I'll pickup a Lantus pen scrip tmw, & reschedule when I have the Lantus pens.

 

[BJM]

Good evening-Please explain to me the reasoning behind using the cat's pinna for obtaining blood for BG checking.
Thanks!

There aren't as many nerve endings in the cat's ear, plus the capillaries bleed easily without requiring significant restraint or an invasive venipuncture.

 

[julie & punkin (ga)]

plus ears are very easy to poke and most cats really don't mind once they are used to it.

i thought maybe you had to do the curve with your vet, but if your vet isn't requiring it, you can do a curve at home. that's practically free and you'll have a more accurate numbers because there won't be vet stress.

Both Lev and Lantus are depot-type of insulins, so it takes a few days to see what a dose will do. the dose is usually begun using a weight-based formula and then the cat is monitored frequently for several days to see what the dose will do. do you have a suggested start dose from your vet? there isn't any point at all in having someone do a curve on him until he's been on it a while.

Using a weight based formula for determining a starting dose of Lantus or Levemir when following the Tight Regulation Protocol:
the formula is 0.25 unit per kg of the cat's ideal weight
if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight
if the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration

Online Calculator for Converting Pounds to Kilograms

It's not difficult to get the hang of hometesting. Once you get started, i think you'll think it's not so bad.