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Tals

Tals

Member Since 2015
Hi everyone, never thought I'd end up here... in 1 day I learned everything there is about feline diabetes. Yet, one thing they don't teach you is how to deal with this...on emotional level. Devastated....I keep looking at Shimi and my heart breaks. The vet won't say how long he has, only that his state is progressive.
Now what? Does Shimi feel pain? Am I being selfish by trying my best to keep him alive? We just increased his dose today...again...I don't know what to think or how to feel or whats appropriate, I'm honestly not looking for someone to tell me its going to be ok, because its not going to be ok...its just getting harder and harder every day. Any advice would be greatly appreciated. Thank you, kindly
Tals.

Shimi tried to catch a fly today, made mommy so happy... I thought he was getting better...
 
Tals, when was Shimi diagnosed? What kind of insulin? What are you seeing as far as symptoms that make you think he is in pain? Are you worried that the shots are causing pain, or testing?
I know they don't teach you how to deal with it emotionally. My breakdown was about 4 weeks in. Shiloh had gone pretty low, and I was up most of the night, then work, and I was just exhausted, then I burned myself making DH's dinner. that was all it took. But I got some sleep, took some get deep breaths and got back to it.
 
Diabetes doesn't seem to hurt cats, although they may develop nerve weakness from the high glucose. This shows up as difficulty standing and walking.
Well cared for, a diabetic cat can live a normal life. This means a low carb diet (there are over the counter options like Fancy Feast Classic Pates), insulin (it is possible to become diet-controlled, and home testing for safety using an inexpensive human glucometer like the Target Up and Up or The WlaMart Confirm or Confirm Micro.
You can do this and we'll coach you as much as you need.
 
wow Thanks for getting back to me so quickly. Shimi was diagnosed fist by me at home about a month ago, then by the vet about 25 days ago. he spent a day at the vets on IV, he almost had a ketoacidosis...I starterted him on 3 units twice a day (glargine), changed his diet from free feed to portion control (w/d cat food) and got a OneTouch machine to test his glucose levels at home. I noticed he was urinating excessively again, plus his sugar was through the roof, so I rushed him to the vet today. we increased the dose to 5 units twice a day. He is constantly starving it seems. sleeps all the time, doesn't play. The vet said its an aggressive form of diabetes...what the heck does it mean? How long does Shimi have? I love him so much...my God.
 
Didn't want you think we abandoned you. I'm not sure about the w/d. Is that canned or dry? I don't know about aggressive diabetes, never heard it described that way. The insulin is Lantus? And how much does he weigh?

Can you give us some of his numbers?
 
VERY IMPORTANT: The Lantus dose is adjusted based on the lowest glucose post-shot.
Also, by changing the food and starting insulin together, you may have started too high, which would explain why he is so hungry - he could be eating his way out of hypoglycemia. Or, he might really be a high dose cat, though the W/D dry is pretty high carb.
 
Hi! Yes for sure...Shimi is 11 years old. he was 11.6 lb when I got him to the vet, he is 12.2 lb today. The Insulin is called Glargine a.k.a Lantus. w/d is a special food for diabetic cats, I give him both wet and dry, its low fat high fiber & protein. I give him exactly as its indicated on the diabetic cat food charts and the package. so he is getting 1.5 cans per day plus 1/4 cup of dry...I mix them together, since I've noticed that only wet food makes him hungry faster. I don't' know whats aggressive means. I researched it, comes up as acute form of diabetes in humans.
 
Hi BJM,
It was the vets decision to give him that dose....he spent more than 24 hours at the vets where they tried to check his glucose levels every few hours. They started him at 2.5 units of course and increased it to 3 units. he seemed to be ok, but about a week ago Shimmi started to drink and pee a lot again, his sugar at the peak of Lantus (6 hours after the shot) was 22... every day I checked his sugar and every day it grew higher until I couldn't wait anymore and rushed to see the vet again. He bumped it to 5 units. Whats your experience with Lantus BJM?
 
The thing is that too much insulin in a cat can also result in high numbers and look like not enough insulin. The normal starting dose is 1 unit per kg of a cats weight or ideal weight if they're a bit chunky. Around here we generally make increases in .25 or sometimes .5 units so that the ideal dose isn't missed. It seems to me that Shimi has gone up way too quickly.

I can't see what basis your vet would have to decide Shimi has some sort of 'aggressive' diabetes at this point. Unfortunately, but not surprisingly since they have so many different species and ailments to deal with, most vets aren't well versed in how feline diabetes should be treated. Luckily the people here are so I'm very glad you found us :)

There's a spreadsheet in the tech forum with instructions on how to set it up. We'll be able to see what's going on with Shimi then and be able to give appropriate advice on dosing. Kudos on getting on to the home testing quickly :) The lantus experts tend to hang around in the lantus/levemir insulin support group forum.

Try not to panic, diabetes isn't a death sentence, in fact 85% of cats who start following the tight regulation protocol (see the sticky in the top of the lantus/levemir forum) using lantus within 6 months of diagnosis will achieve remission and become diet controlled :). Vyktor is a case in point he had diabetic ketoacidosis and I nearly lost him. We found the board, followed the program and three and a half months later he was in remission and over three years later he is still diet controlled.

Up yours to his vet at the time who thought he was too old (he was only 15!) to bother treating!!!
 
I used Lantus and then ProZinc for Spitzer (passed from a blood clot) and was starting to use Levemir for Gracie when she passed (pancreatitis). I also have used Regular and NPH insulins as boosters when needed.

Please look up the W/D food at Cat Info. Cats are obligate carnivores and do not need tons of 'fiber' in their diet. Ditching the dry may greatly reduce the insulin requirement as much as 1-2 units.

Also, your vet may not know, or may have forgotten, that vet stress may greatly increase office tests ... by 100-180 mg/dL in one study.

Before you make any food changes, you must be home testing the blood glucose to keep your cat in safe glucose numbers. Please see my signature link Glucometer Notes for more details.
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you people are truly amazing! Thank you for your support. I'm going to reduce the dose to 4.5 units today check his sugar daily, if its not spiking and in a range of high-normal, I'll go down to 4 units (3 was really not enough for Shimi) I also think 5 units is too much, but I asked the vet 3 times if he is sure to increase so drastically and suddenly. I called another vet this morning and he advised me to reduce the dose. The inconsistency of the information I am getting from the vets is frustrating. Its all a matter of opinion it seems. I'm going to look at your charts and start following your advice. at least one thing is for certain. Everyone here loves their pets and wants them to live long. Thank you again and again.
 
Hi Tals, I'm newly joined here as well - my girl was Dx just last Saturday - and you couldn't have come to a better place. If there is anything I can suggest, and what advice resonated with me, is to remember that insulin is a hormone. It requires patience to see what happens and although you want results as quickly as possible for your kitty, use the spreadsheet to track readings and give Shimi's body time to adjust to every change you make. Every cat is different, for sure, but hormones work in delicate balance in any creature - consider monthly changes in a human woman's hormone levels can sometimes make her a raging lunatic for a week -- or is it just me??? :nailbiting: Anyway, you get the idea!!

My girl is 15 and does not seem to be in any pain - and I've read here that FD is not a death sentence. Hang in there, you are doing fine. While I can't guarantee Shimi will be "okay" you are absolutely in the right place to give him the best chance of having a great quality of life for years to come. You are not selfish at all and fantastic that you are doing so much for him.

One thing you said I'm not sure about though, regarding diet, and that is "high fibre". I think the jury is out on that one but most of my reading indicates that high fibre is more for dogs than cats. Anyone else please pitch in on this?

I have my girl on Fancy Feast - there are certain varieties that are low carb - and her numbers are doing well. I always test her BG before her meal and then a few hours after in the evening - using the spreadsheet on this site is fantastic and gives me a much better picture of how she is handling the diet change and insulin. Her reading at the vet's was 26 and because she is also exhibiting the neuropathy BJM spoke about (weakness in the hindquarters and sort of walking on her hocks) it's likely it's been up that high for some time. I have every hope that she will be regulated with the combination of diet, insulin (for now!), vigilant testing, observation and recording, plus tons of cuddles and love. You can do this!!
 
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Hi Brashworks, Thank you so much for a lovely note. 3 cats 2 dogs and 2 birds? hahahaha you guys are alright! Whats BG? oh!! Blood Glucose... People here use a lot of abbreviations I'm still not familiar with. Where do I find this chart? I looked, but the site is a bit complicated, I keep ending up in wrong places. is there a link to a chart I can download? I see we are using the same machine, One Touch. To your knowledge, are the readings similar to what cat readings would be? My vet said yes...but then he also said a lot of things which another vet contradicted.
The food was also recommended to me by the vet. Shimmi was on Fancy Feast all his life, 11 years, and we had no problems. All of a sudden he started drinking a lot, at first I thought it was the salt content in the food, so I went to a specialty store and got him different kinds of mainly protein cans and treats, then obviously he developed diarrhea and I kept buying new and more expensive food all the time. The drinking only increased and then I smelled the nail polish breath. My heart just sunk :( I knew he has diabetes. Few days later the vet confirmed and we started this process. This is when the new food came in...he wasn't eating much of the protein food and kept loosing weight + all that commotion in his tummy...then he didn't go for 4 days, the vet recommended this food and I have to be honest, Shimmi loves it. I feed him mainly wet stuff anyways. The extra fiber just keeps things moving along for him and at least in that area of his life I have no more concerns.
For 15 days everything was going smoothly, before I found this amazing group, I was doing my own chart. I hate pricking his ears, because I have my own issues...can't stand the site of blood :) but I manage...I cringe, but manage...
date, time, dose, stool, urine, vomit, food, water, blood test, behaviour
That's what my chart looks like.

Day 15 he started drinking a lot again, his sugar was always high...I watched him like that for a week, then took him to the vet who said that his diabetes is aggressive, progressive and that he needs to bump him up to 5 units. I did that twice, last nigh and this morning and to tell you guys the truth, Shimmi didn't talk to me all day. He is usually very vocal, but not today. 7 pm was his last shot...I gave only 4 units...as was suggested by another vet over the phone.

I need your chart guys, and I need to stop giving him different doses all the time. I know 3 is not enough, I know for sure...so should I stick to 4 units?
Thank you everyone for your ongoing support.

God bless,

Tals
 
Can we get you started using our grid to record your glucose tests? It will help us give you better feedback. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.
 
Hi Tals,

I don't have a ton of time to write but note that there are only certain varieties of Fancy Feast that are really low carb - some of them are actually pretty high. Look at labels, don't feed anything with veggies or wheat gluten, wheat, corn, soy, potato, etc. I have three varieties - Classic Chicken Feast in the Pinky/Red can, Tender Liver and Chicken in the goldy coloured can, and Turkey & Giblets in the olive coloured can.

The spreadsheet is located here: http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

Looks daunting but the instructions are excellent and if you're like me ( I noticed your values are in mmol/L not the mg/dL) the World chart is invaluable. Give it a look - you can put your values in from your chart. This way you can share it with the folks on the board, who can decipher it at a glance (unlike me, who has to really think about what I"m looking at)
 
@BJM Thanks a lot. How often should I check his sugar? The reading I get on the OneTouch device is what I enter?
 
Testing:
1) Always test before giving insulin to make sure it is safe.
For now, your no shot level is 200 mg/dL on a human glucometer (230 for pet-specific); this will lower as you collect data around the middle of the cycle to know how low he is going.

2) Mid-cycle tests between shots - whenever possible, test around the nadir (lowest glucose level between shots) for your insulin, to see how low he's going. For Lantus, this often falls between +5 to +7 hours after the shot. Some folks do this on weekends or set a clock for the middle of the night to get this test done as it helps determine dose adjustments. This number should be at or above 50 mg/dL on a human glucometer (68 mg/dL for pet-specific).

3) a before bed test is helpful in determining if you need to break out some higher carb food and steer the glucose level or go to bed with some peace of mind. Steering means giving 1-2 teaspoons of high carb gravy, waiting 30 minutes, and re-testing (repeating as needed) to make sure the glucose stays above 50 mg/dL.

Yes, enter the value you actually get; no conversions needed. If you are not in the US, enter the data on the World page and it will automatically enter the US page via a formula (mmol/L = mg/dL / 18)
 
Tals...at least before every shot. EVERY SHOT! A plus 2 in the evening can be a good indicator of how the night will go. Much lower, need to stay up and test more. About the same, probably a level cycle. If it is higher, may be a good night to get some extra sleep. Plus 5 to plus 7 can help you figure out how low he is going on his dose.
 
@BJM thank you. above 50 mg/dL on a human glucometer (68 mg/dL for pet-specific) ummm...not sure how much is that need to use your formula to convert. I"ll manage. Thanks again.

@Rhonda Thank you. But I have no idea what +2 in the evening means or anything else that followed that sentence o_O so sorry. I thought +2 is the reading 2 hours after the shot as BJM said.?
 
She means getting a pmps +2, ie before bed, as it can be an indicator of diving if it has dropped a lot.
 
Our World version of the spreadsheet has 2 pages - a US page which you leave alone and a World page where you enter mmol/L. The US page updates automatically, at least for the first bunch of rows.
 
Thing submarine - the glucose goes dive, dive, dive! (Obscure reference for old TV show) And you get to break out the high carb syrup and follow the protocol for intervening with low numbers. Test, see low number, give 1-2 teaspoons of high carb gravy or a couple drops of syrup, wait 20-30 minutes, re-test, and repeat as needed until above 50 mg/dL on a human meter, 68 mg/dL on a pet meter, past nadir, steadily rising, and no problems are observed.
 
@Shiloh & Rhonda & @BJM ok so lets see if I get this right...
the chart is easy, I think I'll figure it out.
So I should enter the reading the way it appears on a human device in the World chart here (no cat/human conversion?)
I should check his sugar AMPS and PMPS and maybe sometimes at the peak of Lantus +5 to +7 during the day right?
His sugar is always high btw... hopefully that will change with time.
I should cut out his dry food entirely and keep him on wet only for now.

When do I dive? :) still not sure what that is
I'll start right away.
 
The dive is if his sugar starts dropping really low, fast. That is when you need to break out the high carb food and/or the syrup. You aren't doing the diving, his sugar is.

Everything else, you nailed it!
 
Tals said:
@Brashworks that's just super! You are from Ontario :) So am I. I'm in Toronto...
Click to expand...

I'm just around the corner in London! There are quite a few Canucks around here.

Isn't that funny we got the same meter? Mine came with a lancet pen but I do it freehand. Because of the type of insulin the vet gave me to start, I actually feed Genghis about a half an hour before her scheduled shot. While she is distracted eating, I rub her head and then poke her ear. She has been very patient with my novice and bungled attempts - and I think she actually associates the ear poke with yummy, yummy food. I took the cap off the lancet pen so it's easier to hold than just the lancet, but the pin is exposed. I have a permanent bandaid on my thumb and index finger to protect me (I spent a few days as a pincushion - who knew lancets were so sharp and ears so thin?) - Genghis was having none of a cotton ball or anything else against the inside of her ear. But the bandaids give me courage to make the kind of poke I need to get the sample for the meter. Bravo to you for getting it done with your aversion to blood! :D

And listen, you are getting fabulous advice here. I know your mind must be reeling with all of this but, trust me, I can tell how devoted you are to Shimmi and I know it will all gel into something that truly makes sense. It's early days -- I've looked at some people's spreadsheets (click on mine below labelled Genghis SS) and I am so amazed at how devoted people are to their fur kids. We are among the most wonderful folks here!
 
Shoot, and I meant to answer you about the meter. I am having Genghis' glucose curve done next week and will have the vet take tandem readings with my monitor for comparison. I will let you know when I know!
 
@Brashworks you are so great! Thanks for everything, truly. How much does a glucose curve cost? what do they do exactly? poke his ear every hour?
You made me laugh with your permanent banaid...that was a knee slap actually :)) Because the same happened to me...like exactly, you couldn't have described it better.
I agree with you, people here are amazing. You have no idea how sad I was yesterday after the dose increase and the vet's visit...but folks here pulled me out of my horrible thoughts pretty quickly. When I fist registered, the morbid me, decided to first check the grieving forum o_O I don't recommend...today I feel much better and I got to chat with few more people including you and I feel blessed.

thank you!
 
A glucose curve is serial glucose tests from pre-shot to pre-shot, every 2 hours. An option to save money is to do the tests at home.

Be cautious about changing doses based on a vet curve; those numbers may be from 100-180 mg/dL higher than at home.

You don't dive; sometimes the planets align and the glucose level drops dramatically.
 
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@Tals My vet said doing a glucose curve would be about $120 each time; yours may be different. He was very supportive about home testing but I'd rather have it done once there, at least, if only to find out the variance between his readings and mine.

I'm glad I could make you laugh. I'm thinking I may do all 10 fingers for a Michael Jackson sort of effect :p Could be a look that's all the rage next year, like the FD Newbie badge of honour…

@BJM Thank you, as always, for your advice - always invaluable. I plan on taking my spreadsheet into the vet's next week and would be hesitant at this point to change her dose based on one curve, especially when right now I have not exactly restricted her feeding but her numbers are looking pretty decent.

Not to hijack Tals' condo but first, what are your thoughts on establishing the variance between his readings and mine, should I give him my meter to take readings at the same time? I was checking out the thread in Tech section about variances between pet and human meters and, while I'm not sure I understand all the statistics (no, I'm sure I don't!) is it worth doing to see how much of a difference there is for my particular meter? I have read your Glucometer Notes and don't want to be lulled into thinking her readings are "better" than they actually are. At this point I'm test to see trends and absolutely so I'm not shooting blindly, so I don't need the exact difference but I'd like an idea. Thoughts?
 
You'll only have, at most, 14 paired tests, so there isn't a lot of data there to come up with a function of the relationship between the 2 testers. It won't hurt, but I don't know that it'll particularly help.

It is more useful to give the vet the articles by Dr Rand of the University of Queensland where she provides some reference ranges with interpretations. Check this post for the article links.
 
@BJM @Shiloh & Rhonda @Vyktors Mum @Brashworks guys, I'm sorry to bother you but I think I need your help.
Shimi hit new heights today with his readings. I know I promised a chart, didn't get to it yet, was a stressful day so to speak. AMPS at 6:30 am was 20 or (360 in US measurements)
he ate, I gave him 4 units. He slept for 7 hours, then I did a +7 check 30! (540 in US measurements) This is supposed to be the peak of Lantus...right? its supposed to be lower than in the morning?? I was watching him for the next 5 hours hoping he doesn't go hyperglycemic on me. i gave him a bit of wet food with Argenine...supposedly that stuff reduces glucose as well. Increased the dose to 4.5 units this evening, as I got scared 4 wasn't enough?? Whats going on with my Shimi? Do you guys know? I'm a bit scared.
 
Tals, I'm not experienced enough to give dosing advice, but hopefully someone else will chime in. Those seem like really high numbers to me. What was his PMPS this evening? What is the lowest he has been on the insulin? Just asking so that everybody doesn't have to go through the whole convo to find out. And you might want to post in the Lantus forum with his numbers, just to get some other people looking at it. I will post a link in that forum to this condo and see if we can get you some advice!
 
Hi Rhonda @Shiloh & Rhonda thanks for getting back to me...can you link me? I'm so not tech savvy. yes, those are indeed high numbers. I honestly didn't do a PMPS because I couldn't wait to give him a shot just to reduce this sugar as fast as possible...maybe the first vet was right? Maybe 5 units is what Shimmi needs?
 
Shiloh & Rhonda said:
Tals, I'm not experienced enough to give dosing advice, but hopefully someone else will chime in. Those seem like really high numbers to me. What was his PMPS this evening? What is the lowest he has been on the insulin? Just asking so that everybody doesn't have to go through the whole convo to find out. And you might want to post in the Lantus forum with his numbers, just to get some other people looking at it. I will post a link in that forum to this condo and see if we can get you some advice!
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The lowest he's ever been since he was diagnosed a month ago is 16 (288 in US measurements)
 
Got to do a test be back in a sec with more info but please get onto the spreadsheet ASAP it is really really difficult to give advice without being able to see the picture.
 
Lantus is a depot insulin, you DO NOT dose based on pre-shot levels. Lantus likes consistency. To be able to see what a dose is doing you need to hold that dose for a few days and give it time to settle.

Shimi was started on a very high dose @ 3 units and then to be increased by another 2 units is just nuts, as I mentioned earlier too much insulin can look the same as too little. How high the numbers are does not affect the starting dose of lantus. When we get your spreadsheet happening I'm going to call for some very experienced eyes to come take a look for you.

Can you go ahead and link the spreadsheet into your signature (don't forget to allow sharing) so I can see what's happening and help you fix it up
 
Its says a world spreadsheet, but its not recording the numbers in my units of measure. I'll just use a converter and will convert the numbers myself. hopefully this will work.Doing it right now thank you ladies so much.
 
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