Midnite from the Midwest

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Klay & Kristy

Klay & Kristy

Member Since 2015
Yesterday, August 4th, we were informed that our cat Midnite is diabetic. She is 13 years old and weighs 12lbs, her BG was 347. Insulin is Prozinc and perscribed 1 unit every 12hours. Since then we've been absorbing all the information we can about her condition. Browsing through the threads here has been very helpful and informative for which we are grateful for.

Currently my questions are in regards to BG meter and food;

Are we ok to keep feeding her Fancy Feast and should we stick with one flavor or is it ok to switch it up? Her favorite is the flaked fish & shrimp feast.

The vet told me it wasn't necessary to monitor her glucose but I don't feel comfortable not knowing before I give her an injection. Considering ReliOn Confirm. Also is a lancing device suggested or should I just prick by hand?


The back story to how we got here:
Last Friday night, July 31st we noticed Midnite didn't finish all of her food as she normally would. Nothing too alarming to raise concerns at the time. Saturday morning filled her food and water bowls as usual, when on about our day and hours later noticed that her bowls were still topped off. Came to find her locked in our son's room so I figured that was why her food had not been touched. Then Sunday when we awoke and found her food bowl mostly full but she had drank most of her water. Thinking perhaps it was something dental and not wanting to crunch on dry food we got her favorite Fancy Feast flavors. When I popped the can she came running and meowing as normal but then only ate 1/4 of a can at most when typically she'd eat all of it and want more. At that point knew something was a miss. Keeping a close eye on her Sunday we noticed her laying in places she normally didn't, wasn't very active at all, and she wanted to jump over the gate to get to her litter box but would sit there like she was trying to figure out how to get over it. Monday morning we take her in to be seen by the vet and they take x-rays and draw blood. On the x-rays everything looks good except that she is constipated so the vet keeps her overnight to remedy that and wait for lab results on blood work. Tuesday morning we get the call and the Doctor informs us she has diabetes.

Midnite comes home:
She didn't eat or drink at all when at the vets so I gave her some food and she ate very little, less than 1/4 can, even after acting excited about it. Gave her a bath and let her relax for a few hours then tried again. Still wasn't interested that much in it so I warmed her food up a tad and sat with her on the floor petting her then she finally ate almost 3/4 of a can and drank a decent amount of water.

My apologies for the lengthy introduction, just hoping we can make it through this seemingly critical week and have a few more years of enjoyment with our beloved fur baby, Midnite.
 
Klay & Kristy said:
Currently my questions are in regards to BG meter and food;
Are we ok to keep feeding her Fancy Feast and should we stick with one flavor or is it ok to switch it up? Her favorite is the flaked fish & shrimp feast.
The vet told me it wasn't necessary to monitor her glucose but I don't feel comfortable not knowing before I give her an injection. Considering ReliOn Confirm. Also is a lancing device suggested or should I just prick by hand?
Click to expand...

Hi there, Klay & Kristy --- & welcome to FDMB! Will keep this brief as it is late and I'm off to bed shortly ...

Yes, you're right to be concerned about vet saying monitoring isn't necessary: You definitely SHOULD test @ home before you inject the insulin! (Otherwise you are "shooting in the dark" - never a good idea.) You don't want your kitty's blood glucose to be below 200 at shot-time when you're new to treating diabetes.
Monitoring your cat is very wise - our usual mantra is "Start Low (on insulin), Go Slow." Our cats don't get diabetes overnight; it is not resolved overnight, either. The protocol is: Test blood glucose/ feed/ shoot (if in safe BG range). A lancing device is not really required; just the lancet. Most of us use 28-gauge, doing the ear-poke by hand.

Have a few questions to start (I may not see your answers until morning, though ...)

Which insulin are you using & at what dose? (Would assume you are dosing twice a day at this point?) Please let us know.
What was the blood glucose # the vet reported to you when he said your cat has diabetes?
Is she an "only" cat?
How often do you feed?
What does she weigh now - & what should she weigh?
What is the total amount of food she gets per day? (24 hrs)
Is someone around to test your cat's blood glucose throughout the day, or does your schedule not permit that? (At what times can you test?)

Many here feed Fancy Feast (most of the Classic pate FF are great low-carb choices), as well as some of the flaked, I believe), but we don't generally recommend you feed fish-based food all of the time (too much mercury). On the Main - Feline Health & FAQ page you will find "stickies" and many links to guide you on food & meter choices, etc.

Once you're ready with your meter, we can get you set up with a spreadsheet so that you can plug in all your data - this way you'll be able to track your cat's progress & accumulate information that will help you make informed decisions about your own unique cat. And there are many great people here to help you!

Must go for now; will look forward to hearing from you! - Robin
 
Klay & Kristy check out the glucometers on Amazon - they have the Alphatrak2 starter kit (meter, 25 strips, lancing device , 30 lancets, contour solution, instructional DVD) priced at $60.00. It's a very easy meter to use and is calibrated specifically for cats and dogs. Know that many vets aren't in favor of home testing for numerous reasons, however, do not let that stop you. I went through the same thing with my first sugar cat (Scooter) and slowly my vet clinic came around. When Pedro was diagnosed recently her first question was what meter did I want to use for home testing! She is a great vet and we are very blessed to have her caring for our Thundering Herd. Stick to your guns.
 
Hi Klay& Kristy! Midnite is gorgeous!! Robin covered alot, so I will just add a few comments, okay?
I am new here myself! We were diagnosed in late June 2015. Very scary and overwhelming. I decided to take things one at a time, and ASK ALOT OF QUESTIONS.
I think you have your priorities straight, glucometer and food. Pretty important.
Your glucometer choice is great! The strips are easy to pick up, and cheap. I use the ReliOn Prime and it works just fine on the tiniest of drops! Walmart is open 24-7 so running out at 3am won't be a huge problem. ( trust me, it's gonna happen) :banghead:. Oh, and keep instruction book handy for first few days!! ((Pro tip))
No matter what the vet says, just be polite and TEST ANYWAY. Wouldn't you have liked to know exactly what her blood glucose was on Sunday, when she wasn't herself? Testing will keep her safe! It is the absolute BEST thing you can do for her.
We have tons of personal home testing tips! Just ask.

http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Most of us use a lancet by hand, rather than a device. Better control. And no weird noisey *click* to acclimate kitty to!

Like Robin said, feeding fish all the time isn't good for the babies! Change it up slowly, to avoid tummy upsets.
Fancy Feast is great, accessible and affordable. There is a food list sticky in Health forum, when you have time.

Sorry you have to be here..but so glad you are!
All the best --Brenda
 
Robin&BB said:
Have a few questions to start (I may not see your answers until morning, though ...)

Which insulin are you using & at what dose? (Would assume you are dosing twice a day at this point?) Please let us know.
What was the blood glucose # the vet reported to you when he said your cat has diabetes?
Is she an "only" cat?
How often do you feed?
What does she weigh now - & what should she weigh?
What is the total amount of food she gets per day? (24 hrs)
Is someone around to test your cat's blood glucose throughout the day, or does your schedule not permit that? (At what times can you test?)
Click to expand...

Hi Robin and thank you for the response, I'll try to keep it short and simple to answer your questions.

Insulin is Prozinc and 1unit every 12hours, her number was 347, she is an only cat but we have 2 dogs, typically feed twice a day 1 can at each feeding, 12lbs is her current weight, and my wife or myself is always around since we work opposite shifts.

Tucker&Me said:
Hi Klay& Kristy! Midnite is gorgeous!! Robin covered alot, so I will just add a few comments, okay?
I am new here myself! We were diagnosed in late June 2015. Very scary and overwhelming. I decided to take things one at a time, and ASK ALOT OF QUESTIONS.
I think you have your priorities straight, glucometer and food. Pretty important.
Your glucometer choice is great! The strips are easy to pick up, and cheap. I use the ReliOn Prime and it works just fine on the tiniest of drops! Walmart is open 24-7 so running out at 3am won't be a huge problem. ( trust me, it's gonna happen) :banghead:. Oh, and keep instruction book handy for first few days!! ((Pro tip))
No matter what the vet says, just be polite and TEST ANYWAY. Wouldn't you have liked to know exactly what her blood glucose was on Sunday, when she wasn't herself? Testing will keep her safe! It is the absolute BEST thing you can do for her.
We have tons of personal home testing tips! Just ask.

http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Most of us use a lancet by hand, rather than a device. Better control. And no weird noisey *click* to acclimate kitty to!

Like Robin said, feeding fish all the time isn't good for the babies! Change it up slowly, to avoid tummy upsets.
Fancy Feast is great, accessible and affordable. There is a food list sticky in Health forum, when you have time.

Sorry you have to be here..but so glad you are!
All the best --Brenda
Click to expand...

Good points and thank you! Wasn't thinking about the noise a lancet device makes. We have a variety of Fancy feast, thinking I need to change to just a few flavors that are close in nutritional value to keep things consistent and stable. May have to wait until payday since the vet just cleaned me out.
 
Klay & Kristy said:
Insulin is Prozinc and 1unit every 12hours, her number was 347, she is an only cat but we have 2 dogs, typically feed twice a day 1 can at each feeding, 12lbs is her current weight, and my wife or myself is always around since we work opposite shifts.
We have a variety of Fancy feast, thinking I need to change to just a few flavors that are close in nutritional value to keep things consistent and stable. May have to wait until payday since the vet just cleaned me out.
Click to expand...
Ugh, don't we all just hate those vet bills??? Yikes! Make sure you click on that food info link that Sue /aka Sue & Oliver (GA) posted to you above; will give you all the carb amts on the various FF varieties. (FDMB recommends less than 10% carbs; I myself stick to 3%-4% carbs in the FF varieties for my cat.)

Thanks for your answers. Is great that you both are available for testing your kitty!

Let us know when you get your meter & how testing goes for you; as mentioned before, you'll want to get your data plugged into a spreadsheet. (If you have trouble with that, there are others who can help you with it; I am, unfortunately, no good with setup of spreadsheets.)
 
Oh ditto on the
May have to wait until payday since the vet just cleaned me out.

Home testing is going to really help because they'll be no need for glucose curves at the vet anymore! Plus, your values won't be reflecting "being at the vet stress" either.

The spreadsheet we use is an invaluable tool. At a glance, the veterans around here can tell so much!! You can email it to your vet too, should the need ever arise.

Be sure to ask for assistance if you need it, so you can have it up and running soon. You'll be glad you did Klay.
 
Quick update:
This morning Midnite ate almost all of her food which is a huge improvement from days past. That was at 10:30am. Went and picked up a glucometer, ReliOn confirm and just now tested before I'm off to work and her BG is at 162 according to the meter. They didn't have 28gage lancets so I got 26 and that seemed to make getting a sample simple. She didn't appreciate getting pricked but allowed me to "sip" the drop without issue.
 
162 is a good number. When in the cycle did you get it (how many hours since the shot?). For general reference, we consider a cat regulated if they are in the mid 200s at preshot and in double digits at nadir - but not below 50, which is approaching hypo territory.
 
Klay n Kristy.... I am also from the Midwest and also new at this "Sugar dance" that we are all doing. Keep up the good work and let me know if I can help at all (not that I really know what the heck I am doing yet. LOL)
 
Welcome to FDMB, the best place you never wanted to be.

There are 4 things you'll need to manage your kitty's diabetes:
- You - without your commitment, the following won't work.
- Home blood glucose monitoring with an inexpensive human glucometer such as the WalMart Relion Confirm or Target Up and Up (the pet ones will break your budget!). This saves you the cost of going to the vet for curves and done regularly, removes the need for a fructosamine test.
- Low carb over the counter canned or raw diet, such as many Friskies pates. See Cat Info for more info. If already on insulin, you must be home testing before changing the diet. Food changes should be gradual to avoid GI upsets - 20-25% different food each day until switched. There are 2 low carb, dry, over the counter foods in the US - Evo Cat and Kitten dry found at pet specialty stores and Young Again 0 Carb found online.
- A long-lasting insulin such as ProZinc, Lantus, BCP PZI, or Levemir. No insulin lasts 24 hours in the cat, so giving it every 12 hours is optimal for control.
 
Sue and Oliver (GA) said:
162 is a good number. When in the cycle did you get it (how many hours since the shot?). For general reference, we consider a cat regulated if they are in the mid 200s at preshot and in double digits at nadir - but not below 50, which is approaching hypo territory.
Click to expand...
It was only 3hrs after her shot, I know this isn't the ideal time to test but being I had to goto work I wanted to start getting used to testing and gaging numbers. For whatever reason Kristy only got 94 last night at 10pm before her shot and food, this morning at 10am I got 233. She tested on the right ear and I tested on the left. I'm sure the meter isn't totally accurate but question how much it is off and confused about her result. Guess I figure this out when we goto the vet and compare their test results.

Kristine said:
Klay n Kristy.... I am also from the Midwest and also new at this "Sugar dance" that we are all doing. Keep up the good work and let me know if I can help at all (not that I really know what the heck I am doing yet. LOL)
Click to expand...
Thank you, I feel in the past few days I'm becoming an expert in feline diet and diabetes!:p What parts do you reside, we are close to STL, MO.

BJM said:
Welcome to FDMB, the best place you never wanted to be.

There are 4 things you'll need to manage your kitty's diabetes:
- You - without your commitment, the following won't work.
- Home blood glucose monitoring with an inexpensive human glucometer such as the WalMart Relion Confirm or Target Up and Up (the pet ones will break your budget!). This saves you the cost of going to the vet for curves and done regularly, removes the need for a fructosamine test.
- Low carb over the counter canned or raw diet, such as many Friskies pates. See Cat Info for more info. If already on insulin, you must be home testing before changing the diet. Food changes should be gradual to avoid GI upsets - 20-25% different food each day until switched. There are 2 low carb, dry, over the counter foods in the US - Evo Cat and Kitten dry found at pet specialty stores and Young Again 0 Carb found online.
- A long-lasting insulin such as ProZinc, Lantus, BCP PZI, or Levemir. No insulin lasts 24 hours in the cat, so giving it every 12 hours is optimal for control.
Click to expand...

I feel we were lucky when it comes to food being we already had her on Fancy Feast, just had to set aside the ones with gravy for the most part. Went and bought all Chicken Feast since that is low carb. My only concerns are the fat content. Figured it's best to keep feeding the same flavor and nutritional value for now.
 
Her numbers are in good ranges. If the 340+ was at the vet, those numbers can be inflated by as much as 100 points because of stress. We suggest new diabetics not get shots under 200. Instead, stall without feeding for 20 minutes and retest. You want to be sure the number is rising, not still falling and that it is above 200 before you give insulin.

If you could get a number in the 5-7 hours after the shot, that will give you an idea of how low the insulin is taking her.
 
Klay & Kristy said:
It was only 3hrs after her shot, I know this isn't the ideal time to test but being I had to goto work I wanted to start getting used to testing and gaging numbers. For whatever reason Kristy only got 94 last night at 10pm before her shot and food, this morning at 10am I got 233. She tested on the right ear and I tested on the left. I'm sure the meter isn't totally accurate but question how much it is off and confused about her result. Guess I figure this out when we goto the vet and compare their test results.
Click to expand...
Ok. Personally, I wouldn't have given Kristy a whole unit on a 94 pre-shot. I might not have given any insulin. Our general advice for newbies is to not give insulin if the pre shot is under 200 until they get more data about how their cat reacts.

Though high glucose (hyperglycemia) is bad, really low glucose (hypoglycemia) can be worse because a cat can die from going really low. Anything under 50 (on a human meter) is considered a "hypo". Here is the link to info about hypos: http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

It's possible that giving her insulin when she was 94 took her low, which resulted in what we call "bounce". When the liver detects too low glucose, it dumps glucagon into bloodstream to raise it. That can show up as a higher than normal bg level at the next test. (BTW, 233 isn't really too bad at the beginning!)

So, you might need to talk to your vet about a do not shoot number.

Sorry about the the jargon and technical info! We call this the sugar dance - it's one foot forward, one foot back. But you will get the hang of it. You even got blood on the first test, which many can't do.
 
Maggies Mom Debby said:
Ok. Personally, I wouldn't have given Kristy a whole unit on a 94 pre-shot. I might not have given any insulin. Our general advice for newbies is to not give insulin if the pre shot is under 200 until they get more data about how their cat reacts.

Though high glucose (hyperglycemia) is bad, really low glucose (hypoglycemia) can be worse because a cat can die from going really low. Anything under 50 (on a human meter) is considered a "hypo". Here is the link to info about hypos: http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

It's possible that giving her insulin when she was 94 took her low, which resulted in what we call "bounce". When the liver detects too low glucose, it dumps glucagon into bloodstream to raise it. That can show up as a higher than normal bg level at the next test. (BTW, 233 isn't really too bad at the beginning!)

So, you might need to talk to your vet about a do not shoot number.

Sorry about the the jargon and technical info! We call this the sugar dance - it's one foot forward, one foot back. But you will get the hang of it. You even got blood on the first test, which many can't do.
Click to expand...

To clarify Kristy is my wife, Midnite our cat. Lol! I'm think since it was Kristy's first time testing Midnight and she was extremely nervous, there was an error somewhere and the reading was false. Do understand your warning about creating a hypo condition. No need to be sorry, your jargon of technical info is much appreciated!

Midnite finally had a bowel movement last night which made me feel a bit better that things seem to be working. My next concern is it doesn't seem like she's drinking that much.
 
If you are feeding all wet low carb, it may be that she is getting moisture from her food. To increase her water intake, you can add a little warm water to the food and make a "gravy".
 
Couldn't get Midnite to eat last night, tested at 298. She ate very little, 1/4 can at most so decided to skip insulin at doctors recommendation. This morning tested 259 and she ate 90% of her food no problem. Still not much in her litter box as far as stool goes which is concerning. On the other hand I'm not sure how long it would take her system to get back on track since she was constipated and the vet gave her an enema last Monday. Just worried we're going to have a repeat of her being "backed up" again.
 
The fact that she was 298 at pmps and 259 12 hours later with no insulin suggests to me that she needs less insulin. If she were mine, I would be cautious and drop the dose to 0.5 if she is over 200 for the preshot test.

Many people here use Miralax daily for kitties that tend to be constipated. Also FortiFlora (a probiotic) is popular.

Can you set up a spreadsheet? It will be very helpful for you, your vet and us when you need dosing advice. It'll show her history of dosing and levels at a glance. The instructions are here:

http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

You also might post on the PZI forum. Everyone there uses or has used your insulin. It is helpful to check out the threads to see how others are doing and to look at their spreadsheets,
 
The spreadsheet looks good. I am not sure what you mean about a time stamp?

Her numbers are confusing to me. Normally, if you skip a shot, the numbers normally would continue to rise over the next 12 hours and be high the next preshot test.

It is ideal if you can shoot twice daily, 12 hours apart, not skip the evening shot. It would be good to get some numbers in the 5-7 hours after the shot to see how low the insulin takes her. Why are you skipping the pm shot? You can shoot a number 200+. If your data shows she drops too low midcycle, then you could lower the dose 0.5 and shoot twice daily.
 
Sue and Oliver (GA) said:
The spreadsheet looks good. I am not sure what you mean about a time stamp?

Her numbers are confusing to me. Normally, if you skip a shot, the numbers normally would continue to rise over the next 12 hours and be high the next preshot test.

It is ideal if you can shoot twice daily, 12 hours apart, not skip the evening shot. It would be good to get some numbers in the 5-7 hours after the shot to see how low the insulin takes her. Why are you skipping the pm shot? You can shoot a number 200+. If your data shows she drops too low midcycle, then you could lower the dose 0.5 and shoot twice daily.
Click to expand...
Time stamp at for what time you gave the shot, for now put that in the comments. We skipped the evening shot because we could not get her to eat much of anything.
 
The +1 is a test you'd get one hour after the shot; the +6 is 6 hours etc. Those designations work better for us since you are posting information to people in every time zone, around the world.

Is she not liking the wet low carb food? What have you tried? This vet has some great ideas on her website: www.catinfo.org. One of the things that worked for us was to add some warm water to the pate types. You can make a gravy. Sometimes, it's the texture of the food they don't like.
 
She loves the food, when she has an appetite she gobbles it down no problem. She's actually been eating Fancy Feast for a few years. All she does is lay around all day, try to get her to play or just walk around even and she wont. There's not much stool in her litter box either. Thinking there's some other issue going on with her, at her age it might just be that time unfortunately. We go to see the doctor this evening.
 
Just got back from the vet and she upped Midnites dosage from 1 to 1.5 units. She didn't seem to concerned about her not having regular bowel movements. Good news is the tester we got is pretty much spot on, ours reading 243, theirs 246.
 
Glad the tester worked. I wonder why he decided to raise the dose, and by a full .5? She has pre shot numbers In very decent ranges and you've only gotten one mid cycle number so you don't really know how low she is going.

FWIW, if you are going to increase, I'd increase to 1.25 and see what that does. It's impossible to tell what is really happening with her numbers yet. I'd feel better if you had more data to base an increase decision on.

And I would be worried about her constipation. Have you tried pumpkin or Miralax?
 
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