Jackson - Started insulin today

Dyana

Dyana

Member Since 2009
I suspected Jackson might be diabetic as his fur was spikey and his appetite was more ravenous than usual.
I went to Walmart and picked up a new meter and test strips on 12/20. His vet appointment was on 12/22.
My vet wanted me to keep testing him and then talk in a week. She was not available during the holidays because her flight was cancelled to come home, but she called me on New Year's Eve from Canada and said to keep testing him and we'll talk again in a week. Tonight his ketones went up. I sent her an email, but she is off on Wednesdays.
I have Lantus that my friend over nighted to me, and some U100, 29g, 1/2 inch, .5ml syringes and I bought a battery for my digital caliper. I just ordered some U100, 31g, 15/16 inch .3ml syringes from Amazon but they won't be here until Friday.
Tonight, I wrote in my email to my vet that I think he needs to start insulin now, and asked if I can pick up a bag of fluids.

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Dyana said:
I suspected Jackson might be diabetic as his fur was spikey and his appetite was more ravenous than usual.
I went to Walmart and picked up a new meter and test strips on 12/20. His vet appointment was on 12/22.
My vet wanted me to keep testing him and then talk in a week. She was not available during the holidays because her flight was cancelled to come home, but she called me on New Year's Eve from Canada and said to keep testing him and we'll talk again in a week. Tonight his ketones went up. I sent her an email, but she is off on Wednesdays.
I have Lantus that my friend over nighted to me, and some U100, 29g, 1/2 inch, .5ml syringes and I bought a battery for my digital caliper. I just ordered some U100, 31g, 15/16 inch .3ml syringes from Amazon but they won't be here until Friday.
Tonight, I wrote in my email to my vet that I think he needs to start insulin now, and asked if I can pick up a bag of fluids.

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@Wendy&Neko
@squeem3
 
The urine ketone strips show Trace right exactly at 15 seconds but the strip is getting so dark right afterwards. I know the instructions say to ignore it after 15 seconds, but it scares me.
I am picking up a bag of fluids from my vet after work.
Does anyone know how much I should give him?
He is not drinking or peeing much.
 
Your vet might be able to help you with more comprehensive testing, and should be able to offer advice about administering fluids (though there are people here who will have advice about that, and hopefully one of them will chime in - it's outside my experience). I've found the urine strips rather challenging to use/interpret and have been grateful for professional help with ketone testing, though obviously your experience may vary.

I was about to start talking about getting a fructosamine and confirming diagnosis, but then I realized from your signature etc that you're not actually new and you know your stuff, so best of luck with this transition! ❤️
 
Thanks. He had blood work, urinalysis, and fecal for his annual physical on 12/22.
When my vet was stuck in Canada she said I could take him in to another vet there and have him do a urine ketone test, and I said I that would be almost the same as I am doing at home. She agreed that a Fructosamine was probably not necessary as I have been testing with a Relion meter for almost two weeks now, and his numbers are consistently mid 200s to 300s.

I can't wait for the blood ketone test strips to arrive. It's showing arrival between Jan 8th and 12th.
I think the "proper" new syringes should arrive this Friday.
I did talk to my vet about getting a prescription for Lantus and syringes, and starting him on a very small dose, but she wanted me wait to see if the switch to all low carb food and treats would work first. He used to eat some gravy food and a LOT of Temptations type treats. Unfortunately she is off today, so I'll have to wait until tomorrow for her to give me the go ahead. When she does I will try to "eyeball" a drop or two of insulin.

I hope he gets used to the glucose testing soon. It seems to really hurt him. I am using 28g lansets currently. Any suggestions on how to make the BG testing less painful for him?
 
I'd be the wrong person to ask about BG testing, since my cat was so intolerant of it during his original dx that this time around, we went straight to using a Libre (continuous glucose monitor) - I'm hoping to work up to occasional BG testing as confirmation/comparison but we're not there yet.

If your cat doesn't take well to the BG testing, you could consider a Libre with only supplemental BG testing to make it easier on him? Happy to provide resources/info - we have some very thorough stuff here.
 
I'd also be careful about starting fluids unless you know that Jackson doesn't have any cardiac issues. Add water to his food before giving sub-q fluids and keep an eye on ketones. Trace ketones are not worrisome. Chances are if you get his BG levels a bit lower, the ketones will drop. Also, is he eating enough? Is there any chance he has an infection or inflammation of some sort (e.g., how are his teeth?).
 
I have 3 minutes to get back to work.
I had the vet check his teeth and mouth and she said they looked fine. His white blood cells were not elevated on his bloodwork on 12/22.
I talked to the vet at the office this afternoon and he said at almost 15 lbs, that he can get 100 to 150 ml of fluids per day.
My vet said his heart sounded good on 12/22.
His Pro BNP worries me a little.
He was switched to a low carb diet and is eating 1/2 can of Fancy Feast six times a day with twice as much water added as usual.
If he'd pee more, I would get more urine ketone tests in.
Luckily, supposedly, I am getting the "proper" syringes and blood ketone test strips fro
amazon tomorrow.

I have to go.. Thanks so much for responding <3
 
I just returned home from the vet and got a bag of fluids (one half hour drive each way). I am trying to be proactive in case his ketones get higher. I will hold off for now. I thought 100 to 150 a day was a lot. I have been adding about a tablespoon or so of water to each of his six meals today.
I used to feed my two cats 1/2 can of Fancy Feast twice a day, and 1/2 can of Friskies with gravy once every day, and lots of crunchy treats.
I guess I should feed him more... He's always hungry.

I am so tired. I got about 3 hours of sleep total last night. So sorry if I am repeating myself here.

He has been laying around a little "moppy" for the past 3 or 4 weeks, but is otherwise himself, and loving his food and new treats. My two cats went through 9 oz of chicken and 5 oz of salmon freeze dried treats in less than 2 weeks. Luckily another 16 oz of salmon treats arrived tonight because we were out.
After he eats his meals, he always goes to lick Sabrina's bowl nice and clean, and then he usually jumps up on my kitchen counter to hang over the sink to lick the empty cans that I am soaking to get washed for recycling. I asked the vet to check his mouth for any cuts from licking those cans. She said she did not see anything.

I would like to share his bloodwork, but when I download it it is saved as an Adobe Reader file, and the button to add a link says it wants a URL and I don't know how to download it to a URL file. Any help with that?

I will have to set up a new and separate spreadsheet for Jackson, as my current spreadsheet has so much data (from 2008 to 2025) from both J.D. and Ginger and so many sheets in it. I need to start fresh somehow... Any help with setting up a new spreadsheet would be appreciated.

Thanks for all your help, as always <3
 
Dyana said:
Please let me know if this works.
Everytime, I try to view it, my computer tries to save it as Adobe Reader.
Thanks.
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Adobe Reader is the main program for opening and viewing (but not creating) PDFs. :) The file you've shared is a PDF, and I can open and view it just fine. Others (who are more knowledgeable about what's in the file) should be able to as well.
 
Dyana, so sorry you might be dealing with a second diabetic. I can't believe he's already 11! Try starting a PM with @Marje and Gracie to see if she can help you with the spreadsheet. The spreadsheet has a Labs tab and that is the best place to enter blood work and urinalysis data to track changes over time. A couple things I noticed in the labs PDF. First, his phosphorus is trending up. At some point it may be worth seeing if he likes something other that FF with lower phosphorus. I also see the Urine Protein level is getting up there. That is worth watching, and if it stays that high you may want to get a urine protein/creatinine ratio test done. My vet was not worried about one-off high numbers of a particular lab value, but believed in testing again later to see if it resolves.

Regarding the ketones testing, did you try it on your self or other kitty to make sure it's not the test strips? They are new strips?

Walmart's Relion brand U-100 syringes are also half unit marked.

Some tips and videos here on ear testing: Hometesting Links and Tips
 
Dyana

I’m so sorry to hear about Jackson. I’m traveling today but have a layover and will do a SS for you for him if you could please just PM me your Gmail address so I can get it to you.

Tobey’s cardiologist said the ProBNP is a screening tool and if the numbers are outside the normal range, an echo by a cardiologist should be done. Until you can do that, I would hold off on the subq fluids and get as much water in him orally as you can.

You’ll see the SS link in your signature block when I get it done…a couple hours…but again I’ll really need your gmail address so you can enter data.

Hang in there…you know we are here for you.
 
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I PM'd you. Thank you so much <3
I asked my vet for her choices of cardiologists and got a couple names and will look into it more soon, and will hold off on the fluids for now.

I'm so tired. I really need a good nights sleep, but alas I started his insulin today.
He is sleeping and resting comfortably a little more, but otherwise is acting totally normal. AND, he's getting MORE food! :cat:
 
Wendy&Neko said:
Dyana, so sorry you might be dealing with a second diabetic. I can't believe he's already 11! Try starting a PM with @Marje and Gracie to see if she can help you with the spreadsheet. The spreadsheet has a Labs tab and that is the best place to enter blood work and urinalysis data to track changes over time. A couple things I noticed in the labs PDF. First, his phosphorus is trending up. At some point it may be worth seeing if he likes something other that FF with lower phosphorus. I also see the Urine Protein level is getting up there. That is worth watching, and if it stays that high you may want to get a urine protein/creatinine ratio test done. My vet was not worried about one-off high numbers of a particular lab value, but believed in testing again later to see if it resolves.

Regarding the ketones testing, did you try it on your self or other kitty to make sure it's not the test strips? They are new strips?

Walmart's Relion brand U-100 syringes are also half unit marked.

Some tips and videos here on ear testing: Hometesting Links and Tips
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Thanks. Marje is helping me with the spreadsheet.

I just bought eight 30 can cases of Fancy Feast pate that will last my two cats about 30 days. I think he eats everything, including often what I am trying to eat. They switched from the gravy food to all pate and from the Temptations to Freeze Dried no problemo. The two main words my cats know are "Food" and "Treats" I say either of those and they'll wake up from a deep sleep. Haha.
I never did switch Ginger over to a lower phosphorus food because she was so picky picky. She lived a good life and passed from kidney disease and old age at 20 years and 5 months. At the end I was syringing her food with an added phosphorus binder.

I think I will schedule another blood test and urinalysis for Jackson in about 2 months.

I have not tried the urine ketone test strips on myself. They are a new box.
And, this morning I used a metal spoon to catch the sample as opposed to the white plastic spoon I was using (waving it under his butt). The first time I looked at the metal spoon there was nothing there. The second time, I must have waved it a little too deeply and when I looked at the spoon there was a bunch of litter in it too, but I tested it anyway.

I went to Walmart first and they said as usual that they don't have syringes with half unit marks.
 
Jackson's ketones showed small this morning, so I gave him some insulin.
He was 325 at 6:45am. I gave him a little under the zero line of Lantus at 7:45am using the syringes that don't have half unit marks (so just a guess).
At 12:30pm he was 284.
My syringes with half unit marks arrived today, so tonight I will give him 0.5 units and try to stay awake to test at least once mid-cycle.

This sure is exhausting, but I will get by.
 
Dyana said:
I went to Walmart first and they said as usual that they don't have syringes with half unit marks.
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They do. WalMart's Relion brand of syringes have half unit markings but it's not specifically noted on the box.

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An old post says this about WalMart:
If you're going to Walmart, ask for Relion 3/10ml, 31 or 30 gauge insulin syringes. (Don't mention half unit marks because this tends to confuse them and they think you don't know what you want and will try to convince you that you need 1/2ml syringes---you DON'T)

ALL of the 3/10ml Relion syringes at Walmart have half unit marks. Trust me on this. You will want one of these boxes of syringes (the difference is the needle length...blue box are shorter needles than white box but both work fine). As long as the box has the purple stripe, they are the correct syringes.
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WalMart's pharmacy should also sell other brands of insulin syringes like BD / Embecta and Monoject. But you can also buy the half unit marked insulin syringes online. Amazon doesn't require a prescription. Diabetic supply web sites may or may not, depending on what your state laws are.
 
Yeah, I had the same problem over a decade ago. They always said they didn't have them. Good thing to know that all of their Relion syringes have 1/2 unit marks. They and Walgreens both tried to sell me the 0.5ml syringes (with no 1/2 unit marks). I bought them from Amazon and they came today.
 
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