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Cindy & T

Cindy & T

Member Since 2013
I am not new to feline diabetes (my cat T was diagnosed in 2007) and I am not new to this board (although it has been a while since I've been here -- so long I don't even have the email account I used to use!). I learned a lot on this board when T first got his diagnosis.

Long story short: T is the most awesome black cat in the world. He is diabetic. I adopted him in 2007. He had been found living on the streets and had been at the shelter for weeks. He was skinny, miserable and cranky. He did not have a diagnosis at the time, and I truly thought he was just old (turns out he was only 5 or 6 at the time). When I got him home and saw the high water/food consumption and urine output, I realized it was hyperthyroidism or diabetes. The vet confirmed diabetes. I have been giving him insulin injections (Lantus) 2x a day since (at varying amounts, but generally he has stayed around 2 -3 units) and have had him on a diet of Fancy Feast Classic flavors, no dry food at all. In 2009, he had to have all of his teeth removed (apparently as a result of a virus he had when he was a kitten). I have been blessed with being able to manage his diabetes easily over the years..he has remained very stable. Until recently.

My current situation is (and please, no lectures -- you would be kicking someone who is really down at this point and you probably wouldn't be telling me anything I don't already say to myself daily): I am broke -- broke beyond broke and I won't go into the details of why. I've been hoping I could get things together in this regard as I know T can and may require extensive care at any time. Unfortunately, that time has come before I could get it together. About a month ago, his appetite went off. Not drastic, but definite. I knew I couldn't afford to get him into the vet (it would cost $260 for the exam and full bloodwork) and I began casting around for solutions. My main concern was: had he developed CRF? There's a free clinic in the area, but they only do basic things. My vet (god bless her) finally came up with an $84 solution to get his blood tested (she does not have a private practice; she did a 'mini-panel' on him via a tech). I didn't pay some utility bills and I took him in. The vet tech drew his blood and also gave me some SubQ fluids to take home (at my request -- he has been dehydrated). On the way home, I got a call. "Do NOT give T insulin tonight -- his blood sugars are 37. Give him anything he wants to eat and if he doesn't eat, give him Karo and bring him to the ER.") Thank god, he ate. A lot.

The vet had me skip 3 injections and suggested I get a glucometer for home testing. Meanwhile, I was to start him back on 1 unit 2x a day.

I had never done home testing but I didn't pay another bill and used the money to get a glucometer. Unfortunately, I can't afford the strips that go with it, but it came with 10. I botched some of them, but managed to get readings on Th/Fri/Sat. His levels on Th were over 600. The vet told me to bump him up to 2 units a day 2x a day (the rest of his bloodwork had come back good). Levels on Friday, 376. Saturday, 449. I've only been able to test him one time a day as I'm trying to conserve the test strips.

And now, today, his appetite has gone off again. I've requested aid and test strips and a glucometer are on their way. In the meantime, I'm baffled by why he won't eat. He has ALWAYS been a hale and hearty eater! Even after having all of his teeth removed, he attacked a plate of Fancy Feast (growling and hitting it because it hurt him :sad: )

Any ideas about what could have caused his appetite to go off so drastically? (I started giving him Pepcid a couple of weeks ago... it seemed to help at first, but not today). I so, so, so want to get him in to the vet for full labs. Until then, I am just doing what I can to keep him comfortable and looking around for options.

Thanks for reading.

PS -- I tested his urine for ketones today. Negative.
PSS -- Can a lancet be reused if I boil it and douse it in rubbing alcohol? I only have one left (and no money to buy more).
 
Welcome back T The Awesome!

First

If the lancet has plastic on it - do not attempt to boil it for re-use. Plastic melts. Instead scrub it well first on the stick needle part with soap, and then rub it with alcohol booze. Why scrubbing it extra on the needle part is because, all body tissue is protein but what we call egg white cells. And with a stick in tissue, the tissues microscopic egg white sticks to the needle. As long as s a m e Cat, no problem to stick again, but what happens with the egg white getting stuck on the needle every time, is that it microscopic builds up thickening, so the needle becomes 'invisibly' thicker with the result of causing m o r e thickness and friction, which actually becomes painful each time for our babies. So it is both that egg white build up, eventual fungus, viruses and bacteriad you want to scrub off well so you can re-use. I have a set of Canula needles I do this with and works perfect. So yes that's fine, just don't boil.


Second

If not eating. Lower the insulin dose immideatly from high 2 U down to safe 0.5-1 U if don't know T's actual daily blood glucose when not eating.
To keep him Safe from Hypoing when not eating.

And until you can work something out with Vet and Home Testing strip wise.


If you are in U.S, the In-House Americans can perhaps help give you Diabetes Cat Care Funding Tips.
 
Thank you, Ann! That is very good to know about the lancets and about reducing the insulin to be Safe.

T only ate about a can of food throughout the day (the small Fancy Feast size cans). I gave him 2 units of insulin at 11 AM after he had eaten about a half can throughout the morning. I had 2 test strips left and just used one to test his blood sugars before giving him a shot this evening. He is at 224. I feel inclined to hold the shot this evening. He has been lethargic and cranky all day...

I did go to the pet store and blew his cat food budget on an array of canned foods that might be more appealing... I just have him 1/2 can of one (it was Nutro MaxCat with Savory Venison Chunks) and he wolfed it down -- yay!! I just researched it online and it looks okay for diabetic cats (only 4.6 percent of calories from carbs).

So, I'm happy he ate. And at least his blood sugars are within a decent range (i.e., not off the charts at 37 or 449). I hope I am making the right choice to hold off on giving him a shot tonight.
 
I had to cheat there and use the converter http://www.felinediabetes.com/bg-convert.htm
224 equals 12

Yep that will be safest to hold out on night insulin

Normal Rule Of Thumb is not to give any insulin if under 10 which is 180 for you. So you are right there and doing the right call given his low eating. Better One Shot Too Less - Than One Shot Too Many and a Sudden Hypo - especially since you are out of test strips, and a Hypo requires like faaaaaast Action Testing About every 15 to 20/30 mintues to Ride It Out Stuffing full with Dextrose, Syrup, High Carb Food until the Hypo turns straight back Up again number wise. In the stress a lot of missed sipped test strips might have to be put aside too, loading with new. Once, luckily not in a Hypo, I stuck 7 times!!! not getting a n y blood! and quit and was ready to go down to the police station and report myself for animal abuse! That was what it felt like. So many sip test strips have ended up not getting enough blood to sip up, thus having had to be throw away and keep take new ones.

So trying to be on the safe side when not having so many test strips, is a good choice.

Hope he likes some new food.
 
I was just reading an article a few minutes ago about converting Euro numbers to US and visa versa -- mutiply by 18 or divide by 18. I'm glad I know that now -- I was reading a post on here earlier that made no sense with the numbers! Now I understand -- she was in the UK.

Thanks -- I would much much rather be safe than sorry... it's been a very stressful week for both of us here... he seems to be feeling better this evening than he has all day. Napping beside me and purring when I scritch him.
 
Once you get money - What meter are you using? The walmart relion brands offer cheap strips. especially the prime although it needs more blood. Walmart also sells lancets cheap ?$8?

Try DCIN (diabetic cats in need) to see if they can help with stuff -also try the supply closet for free stuff - http://www.felinediabetes.com/FDMB/viewforum.php?f=15

You could switch to Friskies pates - bigger cans and cheaper

Wendy
 
Thanks, Wendy! I have been using the TRUEtrack -- it came with a mail-in rebate offer and 10 free test strips. And that was the last money I had.

I didn't realize the Friskees pates were okay for diabetic cats -- I bet he would like those. He likes that kind of stuff. I was really, really surprised he liked that 'high-end' stuff I offered him yesterday -- he generally turns his nose up at that kind of food but there he was, plowing through the Savory Venison like he was all 'gourmet.' He generally has 'street cat' food tastes... he would think he died and went to heaven if he ever got his paws on some Meow Mix... but never, never again. No dry food. It's a distant memory...
 
DCIN is who is sending me the glucometer and test strips -- they are supposed to arrive tomorrow. I can not wait! Everytime I give him a shot, I am so nervous... and am being very conservative until I have some numbers to go on.

He has been doing VERY well today -- I'm so happy to see his energy and spunk back! I thought I'd never see him like this again... he has been feeling so very, very poorly the past 2- 3 weeks... seeing him perking up again only lets me realize how much so.

Whiskers crossed this lasts.
 
T's numbers:

So, last night I gave him 1 unit of insulin and I gave him 1 unit of insulin this morning at about 10. (Lantus) His new glucometer was here when I got home around 4 and I tested him right away: 331. I tested again before his evening shot (about 8:30) and it was 262. I fed him and gave him a half unit of insulin because I am STILL being very conservative and would much rather see high numbers at this point than numbers under 100. I tested him again an hour later and it was 252.

I am going to do a mini- curve (like this: http://www.felinediabetes.com/bg-minicurve.htm) on Saturday b/c I'll be around to do it right.

Trying to figure this all out...
 
Great!

First Can you set up a spreadsheet? That would help you track his numbers and us to advise you. Heres a link that explains how but let us know if you need help with it: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Second -Lantus is a depot insulin. This means any dose change takes a few days to build up (or drain) from his system. So you won't see an impact of a dose change for a few days. So its important to hold the dose for a few days before changing. If you aren't comfortable with low numbers, for now perhaps try 0.75 units for a few days? (unless he drops under 50 which is always a 0.25 decrease)

Lastly - instead of a curve, I recommend 3-4 tests a day. It gives more data since cats vary day to day and you don't want to base dose changes on just one day.

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

let me know on the SS
thanks

Wendy
 
Thanks, Wendy! I am just jotting the numbers down on an index card for now but plan to set up a spreedsheet this week. I may not always be able to do the mid-day test, but for now I am testing him before both shots and holding steady at 1 unit.

Thanks for the info about Lantus being a depot insulin -- I hadn't realized that and it is important to know.
 
Great job on the SS! It helps SO much. Can you get a before bed test? 2-3 hours after PM shot? I want to know if he is dropping low at night to try and judge how this dose is doing. So far its nice to see a blue. Will be curious what he does tonite.

Protocol says you need to hold this dose for at least 3 days (unless he drops under 50) to let it settle before a dose change : http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581.

If you keep seeing blue or green you would hold the dose another 2 days to make it a total of 5. Otherwise you increase tomorrow night to 1.75. But lets see how he does over the next day. let me know

Wendy
 
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