Jerry - newly diabetic health concerns

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HappyCat

HappyCat

Member Since 2013
Hello there my handsome happy fellow Jerry was officially diagnosed August 6 2013 and started his insulin August 9. Thanks to the fine folks here an overdose was prevented, from a vet recommendation of 3 units 2x daily to 1 unit 2x daily. I do however have a couple of diabetic/general health concerns that I'm hoping someone may be able to help with.
I do make it a point to clean my cat's ears but admittedly Jerry's got a bit neglected as I scrambled to try to save him the last couple months. It dawned on me when doing a testing one day when I noticed how filthy they are. So on the 19th I attempted to clean them. It seems he has quite the buildup that either really bothers him or he doesn't care for ear cleanings as he tries to itch his ear as I do it, one more than the other and I don't know if it itches or if he's trying to knock out the qtip. I have this stuff that's supposed to help break things up to clean up the ears but I guess I'm afraid of it making it worse. One ear has a lot of buildup while the other I got a chunk literally about the size of a lancet cover out. Any suggestions for him, or possibly for my husbands cat whose ears are so small qtips can't even fit?
My next question is about eye health. On the 11th he had his record high and low readings, the 20th was the next closest to highs and lows. The next day he had horrendous eye boogers as I call them, especially today, green and a big glob. His eye lids look a little puffy and not red put pinkish. Research indicated that could be a sign of health problems which obviously he has the diabetes, wasn't sure if that's common or a matter of him hitting those extreme highs and lows. Everything behavior wise and functioning is normal I just can't think of anything he'd have hurt his eye on. He doesn't romp around play fighting anyone or do much of anything so wondering if I should be concerned.
Also there's been a variety of information on when to feed him. I was told by my vet to feed with this shot but my vet hasn't used Lantus. I've read comments on other forums to feed around the nadir. I've been feeding with the shots so I'm wondering if that's where some of his extreme highs and lows are coming from too. Sometimes he gets the nadir feedings put it is primarily with his shots so if this is wrong please someone speak up.
Any input on one or all concerns would be much appreciated. Thank you!!!
 
Hello.
On the ear issue, I would ask the vet to look in and see what all is in there.... It's easy to injure something so I'd be careful sticking a qtip too far.
It's very normal for them to do the scratching along with you, most cats do have very itchy ears and they just can't itch them themselves very effectively.
I'm also guessing it's an outdoor cat if you are finding that large of debris.

On the eye issue, sometimes an eye infection can flourish along with the diabetes and even boost their numbers. There used to be someone here whose cat would often have eye goop flares and the cat would spike in bg numbers.
You probably want to get that seem about too.... green and puffy needs medication.....


And feedings, I myself feed my cat smaller portions ( like 1/4 of a 3 oz can every 4-5 hours ) . My cat is now in remission and smaller, more frequent meals are easier on the pancreas.
Most here, test, feed and shoot all within a few minutes..... and some "steer" bg numbers with food .... You will learn that is what we do when numbers drop too low.
When I was shooting, I fed mine at shot time, and again at +3 or +4.... and then again around +7.... and then waited until shot time .....
The most important time to abstain is at least 2 hours before shot time.... but even better if the time gap is a little larger. I chose +7 because my own cat seems to handle no larger of a gap than 5 hours between meals.

I also make food available in the night cycle too... sometimes a slightly larger gap if she eats it all up.
 
He's strictly an indoor cat. His left ear is a filmy wax that he seems itchy about. His right had the chunk up top but not the filmy wax. Just something I had noticed.
As to the eye goop and pink I had wondered if that was an issue or a side effect. We'll definitely have to check that out.
Hes on a strictly pate diet and he loves it maybe too much. His main feedings are with the shot with a snack about 5 hours in. Overnight he gets a bit extra but he eats it all up pretty quickly. The eye issues may be a good indication of spiking numbers as sometimes he's where he should be and sometimes off the chart. He's been looking and acting healthier overall besides this recent development.
Thank you for the help! :smile:
 
Safe cleaning approach:

Take a cotton ball.
Saturate with pet safe ear cleaner.
Place inside ear.
Massage outside of ear with cotton ball inside; this gets the cleanser well into the ear.
Remove cotton ball.
Use dry cotton ball or tissue to wipe up moisture and debris.
Repeat as needed.
Severe buildup may take repeated applications.

Yeast infections have a somewhat sour smell and the debris may be blackish.
If the ear is very reddened, check with the vet. An ear solution with a small amount of anti-inflammatory steroid may be helpful.
 
Eye goop may be feline herpes which can respond to 500 mg of the amino acid (protein building block) l-lysine. It comes powdered, in tablets and capsules and as vet chews. My cats thought Vetri-lysine was wonderfully tasty!

Glucose control may help, however do check with the vet if it is reddening in addition to being weepy. A secondary bacterial infection can ocurr on top of feline herpes.
 
Dakota, one of my 2 diabetics, has leaky eyes too - the higher his BG is, the more they leak and the stickier the liquid. When I can get him to stay down in at least the low 200's, they don't leak nearly as much.

BIG HUGS!!!!
 
Hey there

I am looking at your SS and there are a lot of pinks and reds. He might need a dose change but without some more mid cycle tests (5-7 hours after shot) or a before bed test (2-3 hours after evening shot) its hard to tell how low he could be going. Can you get more tests this weekend?

Also are you testing his urine for ketones?

Wendy
 
I actually just increased him last night since he's been on the same dose consistently for I think 10 days and never lands where he should he's been close once when he was getting too much and once lately just hasn't quite gotten there. Most of the time he's just consistently in the 3 and 400's though especially the last 2 or so days. Not too good at .25 increments so he's at about 1.5 starting last night. Everything is going great besides trying to pinpoint his dose. Urine is good just high numbers went from a drastic 6 bowls of water a day to less than 1. Is 1.5 from 1 ideal or should I guesstimate .25? Thank you.
 
In order to avoid missing the optimal dose, we eyeball 0.25 unit increments between marked half and whole units when raising and lowering doses.
 
Can you update your SS so we can see?

Remember that you want to base dose changes on the nadir ( low point) not the preshot tests. Because the way Lantus works is that the cat starts high at pre shot, drops low around 5-7 hours after the shot and goes back high as it wears off. He could be dropping low all day and you wouldnt know and by increasing a dose without checking midday for a few days (or at night) you could be forcing him too low. And you need the data over a few days to account for any bounces (reactions from lows).


Wendy
 
First lets hold the 1.25 dose for 3-5 days unless you see him drop under 50 which is an immediate decrease. It takes that long for a dose to settle in his system since Lantus is a depot insulin that builds up over time, or drains over time (if you are decreasing dose).

Lets see how the dose does over the next few days. Question though - does he have an ear infection? I am wondering about this ear cleaning mentioned on your sheet?

Wendy
 
I don't think he has an ear infection I sure hope not. His left ear gets filmy ear wax and the right gets chunks of wax more solid than his other ear. Doesn't bother him he just gets satellite ears when I do it moves them around a bit when I'm done.
 
Btw I had wanted to confirm from my meter I was hoping my husband got dyslexic with numbers hoping it was a 454 reading but the meter confirms his am reading was 544!!! Never been in the black before even before treatment. Is it the lower they hit the higher they hit or something? He sure knows how to make his mom worry so I'd appreciate any information on drastic spikes like this and why they occur. Thank you.
 
We haven't found a good dose of the Lantus insulin for Jerry yet. I know you are holding this 1.25U dose for a few more cycles, but it looks to me like Jerry will need more insulin.

Until that happens, the numbers will be high and we don't really know the reasons. Could be too much food, too little insulin. Could be a bounce. Could be another health issue keeping numbers high. Could be you need a lower carb food than the Friskies pates. Could be lots of things.

Which specific Friskies pates are you feeding Jerry?

You did mention those "eye boogers" a few days ago, so that may be an infection or inflammation somewhere that is contributing to keeping the numbers high.

Wendy suggested holding this 1.25U dose for 3-5 days. I think if you don't see Jerry out of those reds (400's) and pinks (300's) by tomorrow night, you should increase the dose to 1.5U. Let's not change ahything for now. Keep the same food and dose and lets see how the next few cycles go.

Would you please update the SS for today, 8/24 so we can see today's numbers? When you get a chance. Sure would appreciate it. Thanks.
 
Hi guys.
Current food is the friskes pates, I've been getting the combo packs of mixed grill and turkey and giblets. Maybe once a week he'll get a seafood one.
Spreadsheet updated for Saturday but not yet Sunday as we're still smoothing things out and unsure how to format.
Yesterday's AM reading - 544. Today's AM reading - 170. Has not yet received his shot as I never know what to do when he's low he's always just high high HIGH. Consulted with his guardian angel who suggested I test again shortly and see what he's up to. Would appreciate any advice on the lowest you guys shoot and if you stay at the same dose. I've never shot below high 200's.
Thanks for your help on behalf of the predictably unpredictable happy cat.
 
You might want to make a note in the remarks column of your SS about which flavor of the Friskies pate you fed. Mixed Grill is 11% carbs, Turkey and Giblets is 8% and the Salmon in the variety pack is 7% carbs. Some cats are more carb sensitive than others. I had to stop giving Wink the Mixed Grill because it would raise his numbers 30-40 points.
 
As a newbie we dont advise shooting under 200. However if you can get a +2 or +3 and are ready with strips and honey then you can shoot as low as 150 for now. The logic is over time, with data, you slowly reduce the no shot number.Shooting low is something you need to learn to do to keep your cat in normal numbers. The mantra is shoot low to stay low.

I regularly shoot as low as 50 but I know my cats behaviour very well and know how to handle it if they do go low.You arent there yet.

Heres a primer on shooting low http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

What you can also do is, wait and see .. so say you get a number below 150. Dont shoot Dont feed. Wait 30 minutes to see what he is doing and see if he goes up enough to shoot. Remember to not shoot for 2 hours before your shot time so that the preshot number isnt infuenced by food.

Wendy
 
Oh wow. I had wondered what the "mix" of mixed grill was didn't realize it was so high. You guys are so helpful! :razz:
As of yet I've been too nervous to shot below 200. I've been concerned on what dose to use. Today I was able to shoot at 297 just took awhile. Hoping to know what to expect from him sometime but he likes to keep me guessing.
Thank you for the input on food and the link. I appreciate the help!
 
Things are going pretty well thank you for asking. :razz:
He managed to be within his target range a couple times. The other day I got a reading in the 70's and was ready to save him if needed but he made his way back into the 100's. I can't tell yet if higher days are from the mixed grill or from still working with the .25 increment. He seems more successful when I'm closer to 1.5 than 1 unit but I just eyeball the best I can and go from there. Everything's updated for the moment and we would appreciate any input.
Thank you! :razz:
 
I agree with what what most of the others have said about cleaning his ears. NEVER use q tips. If you can suddenly twists or lunges, you could puncture his ear drum. I use baby wipes wrapped round my finger. If there is buildup further down that where your finger will reach then use some hydrogen peroxide to help break it up and bring it to the surface. Because it bubbles, it can be a bit disconcerting to the cat, but it is not harmful or painful.
 
Hmm what is interesting is that when he got the 77 it took him almost 24 hours to hit that red. Makes me wonder if those other reds are triggered by greens... and how low those greens are that the red hits so quick.

So guess what I am going to suggest? You are right! More tests! You need to fill in some of those blanks that are missing data especially in the PM ie +3 and +9.

Don't assume the nadir is +6.. They vary... And you even saw that with the 77 which was +5. If you hadn't tested +5 and just got the +6 you would only have seen the 128 and never known about the 77!

Maybe a starting point is to get a Pmps +2 every night and if its dropping set the alarm for a later test.. At varying times. And maybe spend a weekend (soon) getting tests every couple of hours, and even more frequent if he hits blue.

Wendy
 
From what I can tell his "peak" so to say for the Lantus is probably around 3-5 hours maybe 4-6 rather than 5-7. Our Friday progress is logged but not Saturday yet as we've got to see what else we can fit in this evening for testing. Currently he's only hit the green once with that 77, he hangs out in the blues a lot sometimes closer and sometimes farther than his range. How often would you recommend testing for blues? I've already found things can drastically change in an hour. Thank you. :mrgreen:
 
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