Is it normal to be this hard in the beginning?

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Cedar

Cedar

Member Since 2016
Our 14 year old, Cedar, was diagnosed with diabetes 3 weeks ago. She started on 1 unit of Lantus for her first week. On week 2 the vet increased her dosage to 2 units. A few days later we could barely get her to eat anything. She was withdrawn and very weak. We took her back to the vet and she kept her there for 2 nights to make sure she was eating. The vet also gave her an antibiotic in case of a possible infection and a medication for nausea. We were told the water intake and urination was still high (which is why we took her in initially), and her blood sugar was at 500, but should level out within a week and ahe was fine to come home. I just brought her home this afternoon, and I don't feel like her appetite or energy has increased much. I feel like I am torturing my poor kitty instead of helping her. Any advice would be much appreciated.
 
Welcome to the FDMB! The best place you never wanted to be!! (we'd love to know your name too!)

What are you feeding Cedar? It's important to limit the amount of carbs a diabetic eats, so we recommend low carb canned or raw foods that are less than 10% carbs. The water from canned or raw is also important to help protect the kidneys, so we really don't recommend dry of any kinds unless your cat just refuses to eat canned/raw. This FOOD CHART lists many of the foods that are available pretty much anywhere and the percentage of carbs (Column C). Lowering the amount of carbs a cat eats can drop their blood glucose up to 200 points! It doesn't have to cost a fortune either....Many of us feed Fancy Feast Classics, Friskies pates or 9-Lives ground cat foods
(Do not do a diet change quickly!! If you're not home testing and drop the carbs, you could put your kitty into hypoglycemia!)

Are you home testing yet? If you aren't, it's important that you start. By home testing you not only save money by not having to take frequent trips to the vet, but you will also know exactly how Cedar is doing and can keep her safe. I know it sounds daunting, but we have lots of tips on home testing that even the most difficult cat can learn to at least put up with it...and most will learn to actually come when you get the supplies out!! A human meter like the Relion Confirm or Micro (available at WalMart) are two of the favorite meters around here.

Going from 1 unit to 2 units is too fast...We do dose increases in .25 unit increments because even 1 drop too much can cause a cat to have a hypoglycemic crisis....and by going up in whole units, you could bypass what might be a "perfect dose" for Cedar. We have an established protocol here for Lantus that's been published in a veterinary journal....You'll find it in this Lantus Tight Regulation Protocol thread

We also have a great spreadsheet we use here that's every bit an important a tool as a good insulin and a low carb diet is for your diabetes "toolbox". Here are the Instructions on getting the FDMB spreadsheet for when you're ready

I don't want to overwhelm you (too late, I know!) but I do want you to know that this disease IS treatable and it's not a death sentence!! Our cats here are happy, healthier and hopefully living many years after diagnosis....and in some lucky kitties, just the diet change is enough to keep them diet-controlled!!
 
Thank you so much for your reply. We have been terribly worried that we aren't doing the right things for her. We have purchased Fancy Feast Classics because we read those were good low carb choices. The vet prescribed Hills wet and dry. Currently, we are feeding whatever she will eat (mostly boiled chicken) because she doesn't have much of an appetite. I have been reading for a couple hours here and am learning so much. I am so thankful to have found this site.
Nicole
 
You can take the Hills back to your vet and get your money back..it's got a 100% guarantee so you can just tell them your cat refuses to eat it....use the money you get back to buy a blood glucose meter and some replacement strips!!
 
Cedar said:
She started on 1 unit of Lantus for her first week. On week 2 the vet increased her dosage to 2 units. A few days later we could barely get her to eat anything. She was withdrawn and very weak...her blood sugar was at 500.
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I agree with Chris, the vet raised her dose too much too quickly, so it's possible she's getting too much insulin right now, especially if she's not eating much (and eating mostly low carb foods like Fancy Feast or chicken when she does eat). I would strongly encourage you to start home testing her blood glucose as soon as you are able, because that is the only thing that will tell you accurately if she's dropping too low. Cats have inflated BG at the vet, so you can't really trust that 500 as being representative of what her BG is like at home.

I would VERY strongly encourage you to pick up a bottle of Ketostix asap and test her for ketones. Diabetic Ketoacidosis is a deadly complication that can arise when a cat has high BG, an infection, and stops eating. Because you've mentioned several of these issues, you'll want to be vigilant for ketones. Catching them early can prevent a very expensive and not always successful emergency treatment. For the ketostix, all you need to do is catch a small urine sample and dip it in.
 
That makes sense. I will pick up a home test kit ASAP. Where do I find Ketostix?
 
Are you in the US? Pretty much any grocery/department store with a pharmacy (Wegmans, Walmart, Target, etc.) would have them, or a drug store like CVS or Rite Aid. They're in with the diabetic testing supplies, or if none of those are an option there's a gazillion options on Amazon.

If you're outside the US, hopefully one of our international members can help you out!

(Just an aside...any ketone test strips will do--they don't have to be Ketostix! They're just the ones I usually get, but any brand will do.)
 
OK, just to clarify, I need a testing monitor, straps and lancets? I ordered a Relion Micro and testing straps from Amazon to be delivered tomorrow. I didn't realize I needed the lancets when I placed the ordered. I will pick those and ketone straps from the drugstore. I just want to make sure my shopping list is complete.
 
Cedar said:
OK, just to clarify, I need a testing monitor, straps and lancets? I ordered a Relion Micro and testing straps from Amazon to be delivered tomorrow. I didn't realize I needed the lancets when I placed the ordered. I will pick those and ketone straps from the drugstore. I just want to make sure my shopping list is complete.
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Yup! Your Relion Micro meter may come with a lancet device and a small number of lancets, but usually the lancets that are included are too small to work with cats. I know the Relion Micro I bought came with the lancet device and about 10 (too small) lancets, but that was 7 years ago! Look for 26g or 28g lancets from the drug store (they may say "Thin" on them). The lancet device is optional...I prefer to use it, but many members here just free-hand. What you prefer is completely up to you! I've found the simple Relion device from Walmart is my favorite (the same one that may come with your meter), but any simple lancet device you find (avoid the ones that load multiple lancets, like the multiclix) will work if you want to try one.
 
The monitor will probably come with about 10 lancets to use if you get a device with it. Remember that at first Cedar will not bleed well- or will bleed too well if you get the vein. Somewhere there is a picture chart of an ear but I don't know where to find it on the new site (old person here- LOL) remember to rub the ears to get them warm or to warm them on a rice sock. Slow/no bleed will be because the capillaries are not trained yet to bleed- that will come in time.

For the test- get a strip out but do not put it in the meter since the Micro will need the blood on the strip very quickly (4 years ago it was 10-15 seconds) and if Cedar doesn't cooperate (they rarely do at first) you might not get the blood on the strip before the time runs out. I scoop up the blood on my thumbnail and then place the strip in and let the strip sip it up once it is ready.

As for the lancet device- I went free hand for quite a while since Sneakers did not like the snap sound. Near the end we got used to the device and I did like it because free-hand you cannot gauge the depth all the time and can go through the ear.
 
I can put the strip into our micro meter and the little blood drop icon continues flashing for over 2 minutes so you have more time than 10-15 seconds! It takes about 7 seconds from the time you put the strip into the meter before the little blood drop icon comes on saying it's ready

The strips will "wick up" the blood so it takes very little....a blood drop the size of a pin head is really more than enough!!

Here's the "Sweet spot" we usually aim for...and there are very few pain receptors
sweet spot diagram.jpg
sweet spot.jpg


Here's something I wrote up for others that needed help with testing...maybe it'll help you too! (substitute "her" for "him"...LOL)

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well.

When you're first starting, it's also important to use a lower gauge lancet, like 25-28 gauge. Most of the "lancet devices" come with 33 gauge lancets and they are just too tiny to start with. The bigger lancets (that are lower numbers) make a bigger "hole". As you poke more and more, the ears will grow new capillaries and will be easier and easier to get blood from...we call it "learning to bleed"

Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!
 
There are some tips on urine ketone/glucose testing in my signature link Secondary Monitoring Tools which you may find helpful.
 
Hi and welcome..... and yes the beginning is overwhelming....
You will do just fine!!
Tons of great advice here and more to come, your kitty will be feeling better before you know it:cat:
:bighug::bighug::bighug:
 
I purchased the Relion Micro monitor and struggled the first few times to get enough blood to work, when I finally got enough it gave me an error message, so I tested my blood to make sure the strips were good. They were. Yesterday morning I tested Cedar before her morning breakfast and shot and received a HI reading. She received her dinner and pm insulin, but I did not get her blood sugar reading. Again this morning before her breakfast I received a HI reading. I tested her 4 hours after breakfast and shot and another HI reading. I need to get to a computer to download the spreadsheet. Will this tell me times to be testing her?
 
HI means that BG is greater than 600 which is not good.
What was/is the dose of lantus you are giving Cedar? Is Cedar now eating and acting well?
With those high BGs I would be testing the urine for ketones using a human urine dipstick. You can get those from a human pharmacy. You will likely have to ask the pharmisist.
 
I have been giving her 2-2× a day for 2 weeks. She spent 2 days last week overnight at the vet because she would not eat. Her blood sugar was 500 when they sent her home. Her appetite has been sporadic, but overall good. Friday night she ran around the backyard and ate her cat food and almost an entire poached chicken breast and then Saturday morning she would not eat so I could not give her insulin. She has needed a little coaxing to eat since and has been napping mostly and receiving her shots. They tested for ketones during her stay and found none, but she has not been tested since.
 
Julia & Bandit said:
I agree with Chris, the vet raised her dose too much too quickly, so it's possible she's getting too much insulin right now, especially if she's not eating much (and eating mostly low carb foods like Fancy Feast or chicken when she does eat). I would strongly encourage you to start home testing her blood glucose as soon as you are able, because that is the only thing that will tell you accurately if she's dropping too low. Cats have inflated BG at the vet, so you can't really trust that 500 as being representative of what her BG is like at home.

I would VERY strongly encourage you to pick up a bottle of Ketostix asap and test her for ketones. Diabetic Ketoacidosis is a deadly complication that can arise when a cat has high BG, an infection, and stops eating. Because you've mentioned several of these issues, you'll want to be vigilant for ketones. Catching them early can prevent a very expensive and not always successful emergency treatment. For the ketostix, all you need to do is catch a small urine sample and dip it in.
Click to expand...


Oh my goodness, do you know how hard it is to test a cat's urine? LOL :-) But definitely give it a shot
 
Do you think she could have pancreatitis? It is not uncommon with diabetes (after all, the pancreas releases insulin) Cats with pancreatitis don't want to eat - does she seem to be in pain? meat loafing? lip licking? Here is a good summary of pancreatitis
 
How is this possible? 6:30am she had a BG reading HI prior to her shot, 11:00am HI, 5:30pm I was so excited to get a BG reading of 301 (before her pm shot). The lowest reading we've had since her diagnosis!!! But then at 8:45 (2 hours after her shot) her reading was HI again? :(
 
It will really help if you'll start using our spreadsheet program to record the numbers you get. Here are the "Instructions on getting the FDMB spreadsheet"

We really do depend on seeing each cats spreadsheet before we can give a lot in the way of meaningful advice

That being said, it's possible that you haven't reached a dose that's enough to help Bear yet...It's also possible he's getting too much insulin!! Too much insulin can look like too little! (which is another reason it's so important to test and keep the spreadsheet)
 
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