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Simke

Member Since 2013
My ten year old cat was diagnosed on Friday. The vet recommended a Frutosamine test which we will hopefully hear back about Monday. At the vet his levels were 24.7, last night it was 29.9. (with a home test kit)We have switched him to a low carbohydrate wet foot diet ( he prefers wet anyway). He is eating well but is unbalanced, cannot walk well and sleeps by the water bowl. Does it make sense to try him on the low carbohydrate diet for a week before starting insulin or should that be started immediately?

Is there a conversion chart to switch the low numbers to the hundreds as far as BG testing that is referred to in this forum?

Thank you for your help?
 
Hello and welcome!

If your cat is not yet on insulin then this is the perfect time to transition him to a low carb wet diet. :smile: (It's a bit more complicated once a cat is on insulin as the switch to lower carb food needs careful blood-glucose monitoring during the transition (because the blood glucose levels can drop quite a bit in some cats)).

You may see the effects of the food change in just a day or so, but in some cats it can take a bit longer. But, since you are hometesting (yay! well done!) you will be able to monitor his blood glucose levels and reduce the insulin if necessary, so that's good.

Whereabouts are you? And what exactly are you feeding your kitty at the moment?
Oh, and what is your name, and your cat's name?

Eliz
 
[s]Simke[/s] Simone said:
...He is eating well but is unbalanced, cannot walk well and sleeps by the water bowl...
Click to expand...

You may find that this will resolve with both the low carb diet and insulin. You may give it a boost, however by using methylcobalamin supplementation. This is a specific form of Vitamin B-12. One product is XZobaline for cats. You can check on mazon, our shopping partner, to find some versions of it.
 
Thank you very much for your help. My name is Simone, my cats name is Simke. He seems a bit better today, his appetite is good, he is still quite uncoordinated and sleeping/ resting a lot. Today we fed him fancy feast mariners catch and Purina DM. Is Purina DM a good choice? What about Purina DM dry food? We also give him temptations cat treats? Are there any better treats for him. We are supposed to hear back from the vet tomorrow about his Frutosamine test. If it suggests the high BG levels like I suspect, should we start on insulin or wait to see the effect of the new diet. Tonight his BG was 20.4 so 9.5 lower than yesterday.

Thanks for your help

Simone and Simke
 
Most dry cat foods have very high calories for carbohydrates, with the exception of Evo Cat & Kitten, Wellness Core Original, and Young Again 0 Carb.

Additionally cats evolved eating prey of about 70% water content, which dry food obviously doesn't have. Over time, this state of chronic mild dehydration (cats won't drink enough to compensate) puts a strain on the kidneys and may contribute to renal disease.

For further information on diet and a printable food list, go to Cat Info and read what Dr Pierson, DVM writes about feline nutrition.
 
This vet can explain about wet/dry food much better than I can: http://www.catinfo.org. Purina DM wet is lower carb but is liver based and most cats tire of the taste. It is also much more expensive than pet store brands and does not have better ingredients.

Temptations are higher carb. My cats like Bonito flakes and PureBites, both low carb.

His numbers are pretty high. I think I would go ahead with the insulin after a few days of the wet diet, if you don't see a big change downward. If you decide to wait a few days, be sure to test for ketones.
 
How do you test for ketones? Where do you get test strips from? Before using insulin what would be the best times to blood test. This morning he is more active and less dis coordinated, but not normal yet.
 
Here's some info on Ketones:

http://www.felinediabetes.com/ketones.htm

You buy the same strips that humans use, from the drug store. Some people are lucky enough to be able to put the strip or a ladle into their cat's urine stream. Oliver would not let anyone watch him in the litter box. So we put aquarium gravel in a clean box and left him alone with it. He couldn't stand not christening the new box; it wasn't absorbed by the gravel; we got our sample!
 
Hi Simone and Simke,

Do you see the little bits of information at the end of people's posts? We do that by putting some information in our user control panel, profile. It will appear at the end of each post you do.

Think of it as a quick way for someone to know a little bit about you and your cat that will help us to help you better. I know your name because I scrolled up in the post and found it. Someone not familiar with your post might not have know it was there.

Here is how to do this:

At the top of the screen, click on user control panel, then the Profile tab, then edit signature A box will pop up where you can put your name, your cats name, what meter you are using for testing, what insulin you are on. Things like that. That is also the place you will add the link to your google docs spreadsheet. You will need to submit the changes for them to take effect.

While you are there, if you click on edit profile and enter some information in the Location field like add your country and maybe the city name of where you live. That will help us to find people in the country where you live that may be able to help you.

Only add this information for these items if you are comfortable sharing this information with us.
 
BJM said:
Simke said:
...He is eating well but is unbalanced, cannot walk well and sleeps by the water bowl...
Click to expand...

You may find that this will resolve with both the low carb diet and insulin. You may give it a boost, however by using methylcobalamin supplementation. This is a specific form of Vitamin B-12. One product is Xobaline for cats, from LifeLink.
Click to expand...

I just wanted to point out that the one for cats is Zobaline with the Z, the X one is for people.
 
Cats can get sick of the purina DM canned so many people here feed fancy feast classic pâtés, friskies pâtés or wellness grain free. Dried food is not a good choice and exacerbates the diabetes. So no dry treats either, many people here feed the freeze dried chicken as treats.

Let us know how the fructosamine test went, we have more tips and suggestions to help.

Wendy
 
Not having a great night, I thought I was doing well with him. Last night he was down to 20.4, but tonight he is back up to 28.2 :(. I though I may be able to change it with diet alone. He does however, look better ( part of the reason I was surprised it was so high again)

Frustrated with the vet clinic, They said I would have results Sat or Monday. I called the receptionist she said they didn't have results yet. I told her I wanted to speak with the vet anyway. She promised she would call me back. I called again at 5pm, she assured me the vet would call me back tonight as she had just started working. I called again at 8pm, answering machine said clinic closed at 7pm.

I bought him freeze dried treats, he said no thanks, he really likes temptations :(

bought ketone strips and fish gravel, but need to buy another litter box.

Any suggestions for a vet who is up to date with diabetes care in cats in Ottawa On?
 
Maybe stop the temptations treats and give it a few more days to see what happens.. Some cats are very sensitive to carbs and a few treats too many can be too much. My cats like the freeze dried chicken but not the liver.
Any infections? How are his teeth?
 
Oh, Simone! Sending you lots of hugs and feel better vines. This sugardance is tough to learn and the steps keep changing all the time.

What do you need help with most?

p.s. Kitty's get treats for testing and shot time. Be sure to buy yourself some treats too. I think chocolate is always good ;-)
 
Simke said:
...Any suggestions for a vet who is up to date with diabetes care in cats in Ottawa On?
Click to expand...

You may need to call around those near you and interview them with the Vet Interview Topics in my signature link.
 
What insulin did they recommend? I am hoping lantus levemir or prozinc since those are best for cats.

What meter are you using?
 
Still no call from the vet. Simke seems better but his blood was 24.7 tonight. He didn't have ketones in his urine though. Tonight's question, he is quite thin can I feed him more? And if so when? He is eating 3/4 a can at 7 and 5. He seems full with that amount but would live to eat at noon or ten pm :)

Thanks
 
Yes, you can feed him more. Small meals spread out over the day help to smooth out the blood glucose levels.

I feed my cats 4 times a day, spreading out the days food evenly over those 4 periods. Wink when he was unregulated, was eating up to 11-12 ounces of food a day (basically 2 5.5 ounce cans) and looking for more sometimes. He lost almost two pounds (a kilo) fairly quickly and I'm still trying to fatten him back up. Feeding 8 ounces or so now. About 1.5 of those Friskies 5.5 ounce size cans.

Unregulated diabetic kitties are not able to properly process the food they are eating. Up to 50% more than a normal non-diabetic cat should be fine to feed.
 
Tonight did not go well, poor kitty has lots of ear holes, but I was unable to test his blood. :( Finally heard back from the vet. The frutosamine test confirmed he had diabetes. He is however looking much better. He is more active and acting much more normal. He isn't bouncing around but he isn't staggering at all. I am going to try to test him tomorrow and if he is still high I'll look for a vet who has experience with diabetic cats. Today he had no treats but I fed him four times instead of two. He is quite skinny now :(

Thank you for your help

Simone
 
What was the issue? No blood or not enough blood? You might need to warm the ear more, or have something behind the ear to press a against. What size lancet you using?

Wendy
 
While you are working on the blood glucose testing, take a look at the Secondary Monitoring Tools in my signature link. These provide additional assessments of how your cat is doing.
 
Ok, you did not get enough blood. Some common problems:

Are you warming the ear sufficiently?
Dabbing on some vaseline or triple antibiotic ointment gel with pain relief to get the blood to bead up?
Lancet gauge size is too fine. Try the lancets labeled for 'alternate site testin' especially when you are first starting out.

Here are a couple of links on home testing with lots and lots of tips that you may find helpful.

This first one is the "how to's" https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

This second one is "how to make your cat comfortable with the process" written by member Kpassa. https://sites.google.com/site/michelangeloprofilefdmb/feline-diabetes/ear-testing-psychology

If after reviewing these you have any questions, please ask.
 
Thank you everyone for being so helpful. I received the Frutosamine results today. It was 693 umol/L. It says greater than 540 is poor :(. Today when I tested him. He was 24.4. He looks better, but I noticed his grooming was very poor. He was limping as he had litter stuck in his paws. I have a veterinary appointment for him on Saturday as I a coming to the conclusion he needs insulin. When cats are on insulin, do you have to test their blood before every shot?

Simone
 
Yes, when a cat is on insulin you will want to test before every shot, as well as catching a few spot checks between the shots...With my insulin dependent girl I test at the very least 4 times a day, before each shot, once around the halfway point or as we call it +6 and then right before I go to bed at night.

Mel, Maxwell, Autumn & The Fur Gang
 
Until the excessive urination is under control, you may want to use non-clumping litter.

To get the clumped litter off his feet, get a moderately large pan, fill it with warm-ish water, set it in the tub, lay towels all over the floor, bring the cat in the bathroom, shut the door, and hold the cat standing in the tray for as long as you can. If possible, massage each foot to loosen the clumps. Then remove cat from foot bath, dry all feet. Avoid dumping the dissolved clumping litter down the drain as it may clog it.
 
I have a veterinary appointment for him on Saturday as I a coming to the conclusion he needs insulin. When cats are on insulin, do you have to test their blood before every shot?
Click to expand...

Yes, please blood test before every shot. If the number is below 11.1 (200 for us US folks) then post on this board if you would.

Glad to see you have a vet appointment for your cat on Saturday. He does need some insulin at this point. When you tested him on Thursday 4/25, you got a 24.4 (439 in US numbers) and that is still pretty high.

A conservative starting dose for Lantus would be the cats ideal weight (or current weight if cat is underweight) in kilos * 0.25Units, rounded down to the nearest quarter unit. So a 8 pound cat would weigh 3.63 kilos. 3.63 *.25 = 0.9 units 0.9 units rounded down to the nearest quarter unit = 0.75 Units insulin.We usually round down for safety, not giving too high an initial dose. We don't want you to have a hypo event your first day. :oops: :oops:

Please don't let your vet prescribe too high a dose of insulin to start. We have seen too many cats hypo on high initial starting doses. If you have supplies on hand, we can walk you through a hypo event. You will get the crash course in blood testing every 20-30 minutes. Nerve wracking to say the least and not how we like members to start off. The only other option to treating a hypo at home is to take your cat to a 24 hour
emergency vet for treatment.

I'm not trying to scare you, but I would like you to be prepared. Here is the link on how to treat hypos: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887 It's always good to have a hard copy on hand for easy reference.
 
If you collect blood from your cat that often do they still come near you? Really not enjoying that process. Do you need to do that for the rest of their lives?
Today he tested negative for ketones but BG was 31.4 :(
Vet appt tomorrow at 11.30

Thank you for the support
 
Simke said:
If you collect blood from your cat that often do they still come near you? Really not enjoying that process. Do you need to do that for the rest of their lives? ...
Click to expand...

Yes, until he is off insulin, you test to keep him safe - safe to shoot, not too low, not too high. You can do it with a minimum of fuss and bother, always reward with a low carb treat, and the cat will come join you when it is time for pre-shot tests. My baby always did.
 
If you collect blood from your cat that often do they still come near you?
Click to expand...
Yes, they do. You need to be welcoming to your cat, talk with a smile in your voice, and let the cat know they are loved and you are doing this testing because you love them so much. :smile:

It's very, very hard to get to that calm state before you test your cat. We realize that this is a very stressful situation for you and your cat. But if you talk to your cat in a rough tone, they are going to run away. So speak softly, gently, in a loving tone and they should come to you.

We also use bribes. :shock: :shock: Food bribes of freeze dried protein treats like chicken, brushing bribes for those cats that love to be brushed, petting and stroking bribes for the cat who loves to be touched. Once you start feeding your cat that freeze dried protein treat, shake the bag to attract their attention and say 'test and treat', they will learn this is something good about to happen and will come running to be tested. :o

It can take a couple of weeks to become good at doing the ear prick to get a blood drop for home testing. I encourage you to keep trying.

Really not enjoying that process. Do you need to do that for the rest of their lives?
Click to expand...

Maybe, but maybe not.

We have a high remission rate following the Tight Regulation protocol with having a cat on Lantus or Levimir and a low carb canned food diet. I believe it is running around 80% right now with new members on this board. Some cats, with the right insulin and dietary support, can get to the point where they are diet controlled and no longer need insulin. You will still need to test some, maybe once a week when that happens.

Some cats, for whatever reason, never reach that point of being able to no longer need insulin. Some cats, come out of remission, and need to go back on insulin. There is no way to predict what will happen for your cat because ECID which means 'every cat is different'.

While your cat is still on insulin, home testing more is beneficial. There are plenty of people that do not want to home test and simply take the cat to the vet every 2 weeks or so to get a curve done or have frequent Fructosamine tests done. It's more expensive that way. For example, my vet changes about $100 to keep my cat for the day and do 6 blood glucose tests. I can do those same tests at home and for the cost of 6 test strips for the Walmart Relion Confirm, that will cost me $2.16. A major cost savings if you are willing to learn to home test.

A cat can also vary from day to day as to what their BG number is. Even with the exact same food, insulin dose, play time, everthing the same but each day is different. Because of this, we encourage people to test at least before every shot of insulin is given, the pre-shot tests. This is to make sure the BG number is high enough to give the full dose of insulin.

Since you live in Canada, you can go to the pharmacy and pick up insulin without a prescription. There may be someone close to you that could help you learn to home test if you are interested.
 
Initially, your kitty won't like being tested - its a new experience for both of you.
You probably won't be very good at it to start with ;-) and he won't like being restrained.

But, you will get better and learn to relax and he will learn that he gets a favourite treat just for keeping still for a minute or two.
Its a win-win!

My cat has been in remission since February - I still test her once or twice per week and she gets so exited when I shake the box with test strips as she knows the treat will follow!
In fact, testing and managing her diabeties brought us closer together. She's always been a bit distant and not as needy as my other two. Now, she follows me around, sits next to me every evening on the sofa and loves being petted.
There can be pluses from this ilness... :-D
 
Dont worry, Simke will get used to it - and so will you. Ideally he gets into remission and you wont have to do this long! But if not, he will get used it - just remember the treats. Many cats here get excited at test time because they get the treats. It doesnt hurt them, what they are usually objecting to is being restrained and having their ears touched and mummy being stressed at them. Cats are used to getting their own way. Once they realize that this is just normal and will happen regularly they get over it. And if you had a child with diabetes you wouldnt think twice about testing before the shot to keep them safe.

The way I think about it is that my cats are totally spoiled. They dont work. They get fed when they want and dont worry if/when their next meal is . They are always safe and cozy at home. They play and spend half their days sleeping. Unlike us they dont worry about money or their future or getting fat or all the millions of stressors we have every day! There is usually no stress in their lives at all. Unlike us!! So the least they can do is get over it and tolerate ear pokes twice a day.

But lets work towards remission. The more you do now the better chance he has - a low carb food, no high carb treats either, test at home, set up a spreadsheet, start a good insulin like lantus or levemir. Then move onto relaxed or in my preference the tight regulation forum and let them advise you on dosing. IMHO Thats his best chance of going OTJ.

Good luck at the vet and let us know.
 
So vet meeting went well, he is starting on Lantus 1 unit twice per day. And he wants three days if blood curves. I am choosing to do them at home so wish me luck. He is very lathargic today. Starting Lantus tomorrow am
 
It's better if they stay inside. Then they are available for testing and shooting and no unsuspecting neighbor feels sorry for them and gives them some dry food. Once you get a routine settled, and if he will come back at the times he needs a shot, you might be able to let him out again. Maybe with a Diabetic disk on his collar.
 
Simke said:
So vet meeting went well, he is starting on Lantus 1 unit twice per day. And he wants three days if blood curves. I am choosing to do them at home so wish me luck. He is very lathargic today. Starting Lantus tomorrow am
Click to expand...

Yeah! So glad to hear the vet meeting went well. Good luck on your testing tomorrow.

I don't see a spreadsheet set up in your signature link yet. Since you will want to post numbers, so we can see them, please use this format right in the post for now. You would replace the 999 with your actual test number. Each + number is counted from the time of your pre-shot test. For example, if your pre-shot test was at 7 am in your timezone, the +2 test would be at 9 am. We all live in different time zones around the world so we use this format to be time zone neutral.

AMPS 999
+2 999
+4 999
+6
+8

PMPS
+2
+4
+6
+8

You said he is lethargic. Is he still eating ok?
 
Good evening,

Yes, he is still eating well. I tried to set up the graph for his shots. I was able to open it but not use it. Is it possible to do it on an ipad? Starting insulin tomorrow at 7am,and doing 12 hours of BG monitoring. Don't quite understand units per ml. The insulin I have is 100 u/ml so I am supposed to give him one unit which would be 1/100th of an ml?

I did manage to get all the litter out of his paws. He is actually very patient and easy to work with. I just get stressed when I have to poke his ear often to get blood. He honestly doesn't seem to care but I get stressed as my incompetance is hurting him.

Have a good night,

Simone
 
You should be using U-100 insulin syringes.

They should be clearly marked in whole units at a minimum, and hopefully with half unit markings too.

Most of us use 3/10 cc (also known as mL) syringes, in a 30 to 31 gauge. Folks vary in their preference for short vs long needle. I always used the short needle.

The spreadsheet is uploaded to a Google Docs account.
That means you must set up the account on Google first.
Use your browser to get to http://www.google.com
In the upper right is a login prompt; you will need to register if you do not already have an account.
Then log in to the account.
Use the file upload feature to get the spreadsheet into Google Docs.
Once you have done that, you use your browser to access the file and edit it.
 
Just tried to work with chart again, was able to enter data, I checked off publish to web, is it linked now?
 
The needles are so hard to read, they are 1cc syringes but he needs only 1 unit so 1/100 of a cc. There must be easier syringes out there. These ones are hard to tell the difference between 1 and 2 units?? In the box it says 1ml/cc
8mm
30g
Ultra fine 11
For u-100 insulin
 
Simke said:
The needles are so hard to read, they are 1cc syringes but he needs only 1 unit so 1/100 of a cc. There must be easier syringes out there. These ones are hard to tell the difference between 1 and 2 units?? In the box it says 1ml/cc
8mm, 30g, Ultra fine 11, For u-100 insulin
Click to expand...

What brand? Did you get them with half unit markings?

Yes, for those of us with vision issues, they can be more difficult to read. Always be consistent with where you line up the bottom of the plunger to the same edge of the line.

And magnifiers help a lot! Here are a variety.

- Syringe magnifiers

- visor magnifiers

- clip on magnifiers

- stand magnifiers
 
You do not want the 1 cc syringes because they only have 2unit markings. I used those at the beginning because it is what the shelter gave me for my foster cat Wink. Almost impossible to get a consistent amount of a tiny dose of insulin in that big syringe. It may work great for people that need large amounts of insulin but not for our sugar kitties. You want consistent dosing with these tiny amounts of insulin we give to our cats.

You want 3/10cc syringes with at least 1 unit markings, preferably 1/2 unit markings. They make these for children so it is easier to dose small amounts of insulin. The needle length is up to you, some people like the short 5/16" needle, others prefer the 1/2" needle.

Higher number gauge = smaller, thinner needle. 30-31 gauge is fine with the short needle. 29 gauge works well also.. Kpassa warned about being careful with the 31 gauge needle in 1/2 length. Easier to bend, easier to break off in your cats skin.
 
Went down to 17.8 three hours after shot now back up to 24.7 seven hours after shot,
I was able to graph it,just haven't figured out how to add graph to my signature yet.

Thanks again for our help,

Simone
 
Simone

The glucose will fall and rise again between the shots. This is normal.

You want the glucose to stay above 50 for a human glucometer, 80 for an AlphaTrak.
Below that is considered a possible hypo event.
Between 50-130 is great for a diabetic cat.
The renal threshold is 240 mg/dL. That is when glucose starts spilling into the urine.

Any cat that has ever had ketones or is unregulated should be monitored for these either by blood tests (pricey meters and strips) or urine ketone testing (tips in my signature link Secondary Monitoring Tools)
 
He tested over 33.3. The meter just said warning over 33.3 m/mmol. Still struggling with the syringes, bought the 0.3ml syringes. The amount is so small it is hard to judge. I can't imagine trying to give .25 more. Just gave him 1 unit do I need to do anything else?
 
Can you test the urine for ketones? If you do not have ketone testing strips, smell his breath. If it smells like nail polish remover or fruity and sickly sweet that is an indication of ketones.

Yes, high numbers are scary but not immediately dangerous. It's the low numbers that are scary and need immediate attention. The high numbers will do organ damage over time so they are not something you want to see long term. The low numbers can mean a hypo for your cat which can kill.

One of our mottos is "Better high for a day, than low for a minute."
 
Simke said:
...The amount is so small it is hard to judge. I can't imagine trying to give .25 more.
Click to expand...
Magnifiers really, really, really help with that. I was dosing before I had my cataracts out, plus I was severly nearsighted (-15 diopters, plus bad astigmatism). I added Carson Clip 'n' Flip 2X magnifiers on my glasses and was able to see much, much better. I wouldn't have managed without them.

P.s. See page 2 of this thread
 
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