Jersey and I Need Advice......

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Shelly & Jersey (GA)

Shelly & Jersey (GA)

Member Since 2014
I have been lurking around the message boards for a few weeks now and decided it was time to ask for help. I apologize in advance for my long story.

Twelve years ago, I lost Bugsy, the cat, to diabetes. We had his blood glucose under control, boarded him at the vet’s office for a weekend so we could attend a conference, and came home to find out he had died. Although the vet never admitted it, I am confident my precious boy had a hypoglycemic episode while being boarded.

In November 2013, my heart broke when I found out my 6-year-old girl, Jersey, had diabetes. At that time, the vet recommended trying diabetic food to control her diabetes. I was ecstatic – that was never an option given to me the first go-round. We switched Jersey from Meow Mix (dry) to Hill’s w/d (dry). We did a few follow-up visits, her glucose was still high, and we were told to give her 2 units of Humulin-N once a day. The news brought me to tears. That’s when I finally pulled my head out of my hiney and started doing some research (which led me to this board).

I switched Jersey to low-carb Wellness Core canned food on January 12th, which she still eats today. She also occasionally eats Fancy Feast classics.

We also started testing her at home, although we have had extreme trouble with ear testing. We finally had to switch to paw testing, which I know is not the preferred method. I’ve tried testing on my own but have found that I really need my husband’s help to get enough blood from her. As a result, we haven’t been able to test as often as we would like. (We have varied work schedules.)

When we first started testing, my husband panicked at a reading of 338 and insisted it was time to start giving her insulin. We wanted to err on the side of caution and only gave her 1 unit instead of the 2 units specified by the vet. We did that for 3 days and were finally able to get a blood glucose reading at +2. (Our previous attempts had failed miserably.) The bg of 63 freaked me out (due to my past experience), and I resisted giving her any more insulin until the vet could see what was going on. I was worried that we may not have actually tested her at nadir. Without that data, I just felt it was too risky to continue with insulin.

We took Jersey back to the vet on Friday, 1/31/14, for a check-up. Her bg at home that morning was 167. At the vet’s office, it was 316. When asked whether the increase could be due to vet stress, the vet said he didn’t believe it was. My cat, according to him, didn’t seem stressed out. (I disagreed with that greatly.) When he asked why I had switched her to Wellness, I told him it was because I had read that low-carb canned food was the best for diabetic cats. He stated that w/d was designed for that same purpose and was also low carb. After basically saying nothing about the numbers I had collected over the past 10 days, the vet told me to give Jersey 1 unit of Humulin-N once a day.

At this point, I feel like I can no longer use this vet’s services for Jersey’s care. He is apparently unaware of the nutritional information for the products he sells; he did not test Jersey’s bg using my home meter (which I had requested he do so that we could compare numbers); etc.

Here’s my concern at the moment: I know Jersey is still struggling with glucose regulation, and I want to help her. However, I am scared that she may go hypo on the Humulin, especially since her numbers seem to be dropping quite a bit this week (or at least at times). I also know that Humulin isn’t recommended because of how harsh it is. At this point, we’re out of money. The food, insulin, vet visits, home-testing supplies, etc. have drained us. We should be able to take her to a new vet next week, though. In the meantime, are there any recommendations you might have for us? I know we’ve done several things wrong with her care, but we’re really trying to get it right this time around.

Any guidance would be greatly appreciated!
Shelly
 
Welcome! Sorry you and Jersey have had a hard time. If she were mine, yes, I would find a new vet who understands diet and will prescribe a better insulin. That should solve many of your problems. If you want to post your city and state, maybe someone knows a good FD vet near you. If not, I would call around and ask questions before going in - How many FD cats have you treated? With what kind of success? What kind of food do you recommend? Do your patients home test their cats? If you can get a yes to those questions, you have a good one.

Insulin is the most expensive part of this dance, once you are home testing. But I think it is worth it to get a good insulin. It gives Jersey a much better chance of regulation or even remission. All of the three preferred insulins are in the $100 range except for BCPPZI. It is a compounded PZI that is presently being used by several members on the PZI forum with success. Your vet has to call the compounding pharmacy but it does tend to run in the $50 range. If money is a problem, it might be a consideration. If you want to try Lantus, there are ways to get it cheaper. Someone will be along to give you the thread.
 
Hi bean Shelly and sugarprincess Jersey and welcome to the message board.

From the DCIN (Diabetic Cats in Need) website is this article on How do I get Lantus Insulin Less Expensively?

The Hill's W/d dry is somewhere around 37% carbs versus 5-8% for most of the Wellness Core wet foods. The Wellness Core Indoor (12% carbs)and Salmon/Whitefish/Herring (13% carbs) are too high in carbs for a diabetic cat. All the Fancy Feast classic pate style foods are 1-5% carbs and excellent choices. We use this food chart to select foods <10% carbs, 3rd column of numbers, to feed our diabetic kitties.

For now, you work with the insulin you have. I think the food change has made a dramatic difference in Jersey's BG levels. She may not need insulin. Unfortunately, the only way to know that is to test a bit more. We suggest a test in the AM, 2 hours before any food is fed. Another one in the PM, again, no food for 2 hours before the PM test.

You've made an excellent change in the food and that is certainly helping your Jersey girl.

Do you have any other BG (blood glucose) readings to share with us?

Would you like some testing tips?

p.s. We like a good story, to give us a feel for what is going on with your cat. Otherwise, we have to ask a whole lot of questions. ;-)
 
Hi Shelly and extra sweet Jersey! Welcome to FDMB!

You've already gotten excellent advice from excellent people. So I just wanted to say hi!

Let us know if you'd like some home testing help. It's really the best way to keep your baby safe. Where do you live? Someone might be able to come help you get home testing down if you're near any of us.
 
It is possible to use Humulin or Novolin N successfully with a diabetic cat, even if not the most optimal by today's standards. N type insulins are U-100, that is, they have 100 units per mL. You want to use syringes with half unit markings so you can be more accurate in dosing.

Here is a primer on it, to help you understand how best to work with it.

One very important tip is to test, feed, WAIT 30-60 minutes, then shoot. This is because you need the food on board before the insulin starts hitting as N insulins hit fast, drop fast, and wear off fast.

For safety, home blood glucose testing is key. The lowest point between shots is roughly 3 to 4 hours after the shot. That is the 2nd most important time to test, to see how low the glucose is going. With a new cat, start with a low dose, such as 0.5 units, until you see how Jersey does.

Sometimes, optimal control requires shooting smaller amounts 3 times a day.
 
Thank you all for your replies. They are greatly appreciated. I'll try to provide additional information that was mentioned in your replies to my original post.

For those who asked, I added my location to my signature - Batesville, Arkansas.

I would welcome all testing tips and dosing suggestions any of you have for me. I've read through a lot of the discussions about testing, tried them, and still found that we were all in tears (cat, husband, and myself) until we moved to paw testing. We're certainly willing to keep trying to improve our techniques (whether on the ear or the paw).

Unfortunately, the only bg numbers we have right now are listed on the spreadsheet. We are testing before any food is given, and she hasn't usually eaten for at least 4 hours before the test. We're also trying to readjust our work schedules right now so we can test more often. I've only managed to get a ketone reading once at home, but I am diligently watching the cat and the litter box for my next opportunity. :)

We're only feeding Jersey the low-carb Wellness Core, along with the occasional Fancy Feast classic (low-carb) varieties. I took the food chart with me when I went shopping for new food on the 12th; it was an absolute Godsend!

I hope I have included all necessary information in my signature and profile, as well as my spreadsheet. If there is any additional information I need to add, please let me know. Like I said, we really want to get it right this time around, and I truly believe this site is going to help us do that.

In the meantime, do any of you have any suggestions on our current insulin? I know our bg testing is limited right now. Would you recommend that we hold off on insulin altogther until we can do more home testing and/or visit with a new vet? Do we need to start her on a low dose right now? I definitely don't want to continue to keep her off of needed insulin any longer than we have to/already have.

Our veterinary choices are relatively limited here; there are only a handful of vets (one of which handled my first diabetic cat). We hope the vet we go to next week will be more open to what I have learned in my research on feline diabetes.

Again, thank you all for your words of comfort, your advice, and your time.
Shelly
 
The spreadsheet is really interesting. I wonder why the am numbers are lower than the pm ones. How does food/activity play into the picture?

Generally we consider a cat regulated if they range from mid 200s at preshot to double digits at nadir on insulin. But not below 40, which is hypo territory. We consider a cat in remission if they range from 40-120 off insulin for two weeks. We suggest new diabetics not shoot a preshot under 200 but wait 20 minutes, without feeding, and retest. Your objective is to make sure the number is rising, not falling, and 200 or above.

So your am preshots are generally too low to shoot while the pm preshots are often in the range to dose.

How long since the diet change? No high carb treats or food at all? If you changed on the 12th of January, you are probably seeing the benefit you are going to. If she is above 200, you could try giving a tiny dose and see what it does. Be sure it is a time you can monitor and raise the number with food if she would drop too low.

If you are only going to be giving a small dose if she goes above your target number, Lantus and Levemir may not help. They are shed insulins so you need to shoot every 12 hours. I don't think you could shot even a drop twice daily at these numbers. I think I'd try the N and see what happens. If she becomes generally higher overall, then it might be worth a trip to a vet out of your immediate area for a better insulin. You don't have to visit them very often. If you are hometesting, you can fax your numbers.

That's what I can think of. Maybe others will have other ideas.
 
Thanks for your reply, Sue and Oliver. Hopefully I've answered your questions below.

Sue and Oliver (GA) said:
How does food/activity play into the picture?
Click to expand...

Jersey is fed three times a day. She eats at 6:00 a.m., 2:00 p.m., and 8:00 p.m. (Testing is done prior to meals.) Portion sizes remain constant from one meal to the next. We do play in the evenings - but that's after her evening meal. I do sometimes catch her hanging off of window valances at around midnight, and I hear her little claws scratching the wood floors as she tears through the house at night. Since I'm gone during the day, I'm not quite sure what she's up to. However, I'm guessing she is probably most active at night and sleeps more during the day.

Sue and Oliver (GA) said:
How long since the diet change? No high carb treats or food at all?
Click to expand...

I did permanently switch her to her new low-carb food on January 12th. She is given no treats at all and no human food, although I have given her an extra snack of low-carb canned cat food when she has seemed especially hungry. That has happened once or twice over the past couple of weeks.

I figured, based on what I had read here, that most of her numbers were too low to shoot (especially with limited bg testing at this time). I do have 3/10 mL syringes with .5 markings, so I could eyeball .25 units if/when the time comes for small dosing.

We are working on getting more testing in during the day. I would like to vary some of the test times so I know how her bg is fluctuating throughout the day. (At this point, we haven't had a full day available to do an actual curve sans insulin.) If I do get some late morning/early afternoon bg numbers, do I place those in the +2, +3, etc. columns even though we haven't given her insulin?

I completely agree that it may be well worth it to find a vet located outside of our immediate area. I have my fingers crossed that it won't have to come to that, though - I'm hoping to get a positive "vibe" from another vet in town. :-D

Again, thanks so much for sharing your thoughts on Jersey's case!
Shelly
 
Yes, just put a number in the +2 column if it is +2 hours after her morning test. You might put somewhere on the spreadsheet that you're not giving insulin yet so people understand what is going on.

The only variable I see is that she eats during the day and doesn't eat at night. One test you might do is to take a test, feed her and test 30 minutes later. If her number has gone down, it usually is a signal that her pancreas is working. (because in a diabetic cat with a non functioning pancreas, food will cause levels to go up, not down) it is generally thought that small frequent meals help support the pancreas and help it heal.
 
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