New and grateful to these forums, hoping for advice

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Luckyducky

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Hello! These forums have been a tremendous help to me, and I was hoping the folks on these forums might be able to give some advice or insight on my current situation. It would be greatly appreciated!

A little over a month ago I started taking care of a friendly stray cat (large, orange and long-haired) that was camping out on my doorstep. But then he ran into some health problems: one day I found that he had stopped eating the food I left out, and was spending a lot of time laying about, looking kind of sickly. On Feb. 18 I noticed his eyes looked strange (I could easily see the second eyelid, which I'd never seen on a cat before) so I decided to bring him to the vet hospital.

After some blood tests and questions about the cat's condition, the vet explained that the cat was likely diabetic, and was possibly experiencing the effects of ketoacidosis. The vet took a urine sample and found ketones in the urine, which seemed to confirm that the cat was diabetic. The urine also appeared bloody, which they said suggested an infection of some sort. I was given the grim news that the cat likely only had days to live, and that I had two options: either expensive emergency treatment (possibly in the thousands of dollars), or euthanizing the cat and putting him to sleep.

After a lot of worrying, tears and soul-searching, I finally made the decision to bring the cat to the emergency hospital, where they kept the cat for 3 days in order to stabilize its glucose levels and hopefully remove all the ketones in its urine (the cat was also dehydrated, so it was placed on an IV and given lots of phosphorus injections). The treatment seemed to be a success and the doctors said the cat made a remarkable and surprisingly fast recovery. He was in good health and spirits when I brought him home, and I was glad I had taken the path to save his life.

Unfortunately the emergency treatment cost an arm and a leg, approximately $2400. The cat was prescribed pill antibiotics (Enrofloxacin and Metronidazole), as well as 2 units of glargine insulin twice a day. Thanks to the information available on these forums, I was able to convince the doctors to prescribe the Solostar insulin pens, to help keep the insane costs as low as possible for me. I brought the cat home on Feb. 20th, learned the ropes of giving the pills and insulin, and scheduled a follow-up appointment with my vet on Feb. 28th.

On my appointment on the 28th the vet took a blood glucose reading and found that the cat's glucose was really low (in the 40's range). Till that point I had been carefully giving the insulin shots on time at the prescribed dosage, including the one immediately prior to the appointment. Given that, the vet suspected that the cat's pancreas might have been jump-started by the emergency treatment and that the cat might have returned to normal, and asked if I could leave the cat for a glucose curve to find out. Not being at all familiar with glucose curves, I decided to give the go ahead, and left the cat with the hospital for the day. I also asked the doctor if I should buy a glucometer and test strips, and though she generally didn't recommend it, she said she would make the determination after the cat's dosage had become properly regulated.

That afternoon when I went to pick up the cat, the vet explained the glucose curve results: the numbers were low at the start of the day, but eventually climbed back up to the 200 range by the end of the day without his second shot. She suspected that he was still diabetic, but that the originally prescribed insulin dosage was too high. She set the new dosage to 1 unit twice a day, and explained that I should come back in a week for another glucose curve.

I followed her instructions and a week later left the cat with the hospital again for another glucose curve (this past Wednesday, the 4th of March). When I returned that afternoon, the doctor explained that she was confused by the new results, because the cat's glucose was still reading in the low 40's range and climbing back up over the course of the day (IIRC it was rising up into the 90's range, but I don't recall specifically since none of my paperwork has the numbers written down). I showed her the syringes I had been using, which were 29 gauge and 1/2 mL cc (the kind the emergency pet hospital had given me the previous week). She suspected that this type of syringe might have been making my dosing measurements less accurate, and told me to switch to 31 gauge and 3/10 mL cc syringes instead. As for the dosage, she was concerned that the cat's glucose levels were still low despite the lower dosage, and explained that it wasn't possible for me to give the cat doses lower than 1 unit. She decided the best option would be to reduce the insulin dose to 1 unit only once a day, and mentioned that I should schedule another appointment for a glucose curve next week, on this coming Wednesday.

As of late, the cat's recovery seems to have been incredible, in that he's a lot more active and lively than he was when he was on my doorstep. He's indoors now, and is very curious and exploring all the nooks and cranny's. After my second appointment, though, the cat's demeanor has gotten kind of strange --- he had been eating only a can of Fancy Feast Classics a day, but now he seems to be really hungry at various points throughout the day (he's getting over 2 cans already, though maybe that's normal for him since the doctor said he should eat about 2 cups of dry diabetic cat food per day [I stopped feeding him the dry food because he kept throwing it up]). In the past two days he also seems to be experiencing diarrhea, since his poop has started coming out like pudding instead of clumps. He hasn't been vomiting though, nor has he been drinking inordinate amounts of water or acting lethargic (on the contrary, he's much more energetic than when he first came to my house).

And that's been my journey so far. Sorry for that long explanation, but I thought it would be better to cover as much as possible to give a better picture. These are the questions I wanted to ask:

My first question is if anyone has any thoughts, remarks or concerns about anything that I've experienced in this dramatic past two weeks thus far. Part of me is grateful that these doctors seemed to have saved this cat's life, but another part can't help but be doubtful/skeptical, mostly because of how much money I've had to spend so far. I hate coming across as doubtful about the doctor's work, but I've had the wool pulled over my eyes enough times before to know that not everyone in the world is always honest about their work.

My second question is about the blood glucose curves. They've been costing me an arm and a leg too, at about $160 for each curve. As far as I can tell, it seems like just a matter of testing the cats blood glucose levels with a glucometer every few hours throughout the day and determining a proper dosage based on the results. I know I'm a novice when it comes to feline diabetes, but I can't shake the feeling that I could be doing these expensive tests myself at home with a glucometer at a fraction of the cost I'm paying the vet. Am I having a terrible misunderstanding? My spleen drops into my gut every time the vet tells me to come back for another glucose curve, especially without a foreseeable end in sight. Come this Wednesday I'll have spent $450 on these curves, and I guess I just want to make sure that it's been money well spent.

Thank you all so much for the help and information you provide on these forums, and any help you can give for my situation (it's very much so greatly appreciated).
 
Oh boy. What a journey you and your new charge have had. What is his name please? I will not be surprised if you tell us his name is indeed Lucky Ducky, 'cause he certainly is that! Bless your heart for giving him a home.

First off, the vet who told you it's not possible to give doses of insulin below 1U is incorrect. You can get the type of syringes you have now - 3/10 cc, 31 gauge needle with half unit markings. You can also learn to give incremental doses by following these pictures: http://felinediabetes.com/FDMB/viewtopic.php?f=10&t=34424#p360982 They were taken of a syringe with the half unit markings. You may have to call around to pharmacies which have them, try Costco, Wal-Mart, or WalGreens and we can also point out places online if you still can't find them.

Second of all, stop with the curves at the vets. You can get a glucometer from the link at the top of the page, and do the exact same curve at home with better results which won't be influenced by stress your kitty may be experiencing at a noisy, strange vet clinic. We can help you learn how. You will also need lancets, but most glucometer kits come with a few, then you can buy more when you need them. The test kit link may offer lancets as well, I'm not sure.

As for what the results of your curves mean and how to change the dose, we can help with that too! Lantus (glargine) is a marvelous insulin for cats and sounds like it's working well for him.

I'm sure others will be along over the next day or two to offer more suggestions and congratulations on a job well done for this lucky little man, but I hope I've helped you feel better about where to go from this point.
 
Welcome, welcome! You can get the help you need here. What a kind heart you have to take in the sweet kitty.

I joined two months ago and we have really seen a turnaround with Simon. I would second Vicky's recommendation to home test. You can either get a meter from the newbie kits link, or you can go to Walmart and buy the Relion Confirm meter. (other meters are fine, too. Here is why I'm recommending that one--strip cost is the ongoing expense. File this away: The Arkray Glucocard 01 test strips match the relion confirm, are sold at american diabetes wholesale for cheaper than walmart). The meter is cheap, but the strips are the ongoing cost. But the strips are much less than that $160 curve and provide more info! At the price you've been paying for curves, you can test a LOT. At Walmart they also have the half-unit marked syringes Vicki mentioned. That is what I'm using with Simon. There was a learning curve measuring micro doses because Simon is already on less than a unit also.

What is your kitty eating right now? We can provide tips on that also. You want him on a low-carb, canned diet. It doesn't have to be a prescription food from the vet.
Other things to do: read the stickies in the Lantus/Tight Regulation forum (the items at the top in all CAPS). Such as: new to the board. Ask your questions! People are here to help. You will probably get more eyes on your topics if you post in the Lantus/TR forum now that you are using Lantus. There is more traffic there if you need a quick answer.

You have the insulin (enough to last awhile). You have the advice here. You do not have to take him in for curves--you have the juice so you are not reliant on his permission to home test! Just put it in the refrig and take good care of it and it will carry you quite awhile. There is also a sticky on that :)
:-D :-D Good to meet you!
 
Hello and welcome! You and your sweet lucky kitty are in the right place. :-D

No need to pay for curves, you are totally capable of hometesting and it is the best way to keep kitty safe. Bailey and I use the ReliOn meter from Walmart and we like it. Here is a video that shows the testing process. We will be happy to help you learn to test your cat! http://www.youtube.com/watch?v=_zE12-4fVn8

Bailey and I also use Lantus and are very happy with it. Kim and Simon mention the stickys over on the Lantus board - here are links to a couple of them to get you started. http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=151
http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=150

It is great that you stopped the dry food, as it tends to be much higher in carbs and it's not such a great choice for diabetic kitties. FF Classics is a good choice - if your kitty likes it I would just stick with that.

Again, welcome to FDMB. There is no need to go broke just because your kitty is diabetic! You can learn to take control of this disease and save lots of $$$ in the process. ;-)
 
You can dose smaller than 1 unit. There are half unit marked insuiln syringes available. Here is what they look like:

resource.aspx


To see what each line represents, see this picture It has only bee labeled up to the 5 unit line but you can figure out what the rest of the markings are :smile: For an even close up picture of an actual syringe and how to measure teeny doses smaller than 1 unit, see http://steverapaport.com/jock/SyringeFineGradations/
 
Hi and welcome!

You've gotten a lot of great advice so far, but I just wanted to pop in and say hi. I definitely agree with what everyone is saying with hometesting. No need to waste money doing it at the vet. Our vet gave us two options when Kitten was diagnosed, "You can bring him in every 1-2 weeks for a curve for $200, or you can do it yourself at home and we can interpret the results for $30." Right away I knew I wanted option 2, but I had no idea how to go about it. Then I found this place, and everything that I ever wanted to know was right in front of my eyes or there were people willing to help me. Its just such an amazing place. I went out and bought a Bayer Contour meter and strips (we wanted the Relion but they are not available in Canada) and with a lot of determination learned how to home-test. I joined the Lantus ISG, read all the stickies, and realized that with the help of the wonderful people here who have so much experience, I can learn to interpret the results myself! Kit hasn't been back to the vet since that first day he was diagnosed, and I think he's doing fantastic! I owe so much to the wonderful people who have helped me.

Definitely you can give less than 1U, using the correct syringes. Kit's on 0.5U now, but I've seen people who are giving even 0.25, 0.10, and numbers in between.

It's overwhelming at first, but this is a great place to ask questions, vent, get advice, etc. Pretty soon, you'll be the one giving advice to other newbies! We've only been doing this for 2 months and I already feel so much more confident! I went from tears, frustration, confusion, etc (not gonna lie, I was a mess at the beginning lol)...to a total 180!

Keep us updated!
 
Hello there - I'm pretty new to the forum but when I came on this place is a super place for support. As others have posted you can run a curve yourself after you start home testing. To run a curve - do a pre-shot test & feed as normal. Then at 3 hour intervals retest his blood sugar until the 12 hour mark when you would shoot the next dose. So you will do AM pre-shot, then at +3, +6, +9, and +12 for pm preshot you will test blood sugar levels. Voila - you have your curve - this will allow you to see how kitty is reacting to the insulin and dosage. Lantus is a long lasting insulin and also builds up a shed (or reserve) so changing doses should always be done at 3-5 day intervals - don't keep changing doses daily it will give you some strange numbers. My cat Sitka - the first three weeks on Lantus her blood glucose numbers were all over the place and didn't settle down until she hit the 4th week. When I told my vet about my financial situation (hubby laid off) she immediately said "learn how to home test - here is how you run a curve and just bring me the results. As is said "knowledge is power" and home testing gives you vital information about your cats health. Jan
 
Home testing is the way to go as everyone has mentioned. In the meantime I would ask for copies of the curves done at the vet, especially the most recent one, and ask what they were using to do the testing (lab test, or portable human or pet calibrated glucometer).

About the food- a rapid switch from the dry to the fancy feast wet food can cause diarrhea, even a slow changeover gave my guy some runny poo (it cleared in a couple of days for me). It can also have a major impact on the blood glucose in a good way, lowering the BG values and thus your cat can end up with drastically lower insulin requirements. Home testing is the best way to stay on top of this.

Fancy Feast all seems to be about 90 kcal per can, depending on your cat 2 cans per day might not be enough. Are you monitoring kitties weight and is it currently ok?

You can also test the urine for ketones on your own. You can pick up ketostix or ketodiastix (these check for glucose at the same time, more info is always good) at the pharmacy (they're pretty cheap, like $10 for 50). As you've learned the hard way, treating full blown diabetic ketoacidosis is expensive. The earlier you catch ketones should a problem arise again the better off your kitty (and your wallet) are.
 
What an incredible person you are!!!!! OMG. You are a dream. You totally saved this guy's life. I'd like to know his name too.

You were right (of course) thinking that you can test him yourself. You're going to be great at it. Go to WalMart and get a ReliOn meter and strips....the strips are cheap. Get him on some wet food - most canned pate food is low carb.

Lantus is an incredible insulin. Both myself and my mother got both our cats into remission with Lantus....you never know. There's always that chance.

I think you are on the right track and doing an incredible job with your boy. Thank you for helping him!
 
I want to thank you all from the bottom of my heart for your thoughtful, heartfelt and informative replies. The Internet can be a harsh place sometimes, so finding a forum with so many kind-hearted individuals willing to reach out and be so helpful and supportive, truly warms my heart. Thank you all very much.

It's a relief to hear that the glucose testing can be safely done at home. I hope the vet is receptive to the idea when I call her tomorrow. I'll also have to ask her about the half unit dosing some of you mentioned, especially since the new needles I purchased surprisingly have the half unit increments mentioned above (I'm surprised it hadn't occurred to me that they were there before, and it makes me wonder why the vet didn't set the dosage at 0.5 units at twice a day, instead of 1 unit once a day).

It was also good to hear that the cat's diarrhea might be related to a sudden change in his diet. He had originally been on the Fancy Feast before I moved him over to the dry diabetic cat food, so it sounds likely to be the cause of his diarrhea. I've kept him strictly on the Fancy Feast classics for the past two days, and his poop started looking more normal today (it's still gooey, but it's in clumps now instead of a pudding puddle). Hopefully he'll return to normal soon, but we'll see.

Now that you all mention it, I might have to ask my vet about what should be a normal weight for the cat. He's fairly large, and I recall the vet saying that the cat was underweight the last time I visited, but it hadn't occurred to me to ask what a normal weight should be. Luckily, his appetite has increased a lot these past few days and he's up to 2 cans/day now, so hopefully he'll be able to build up more flesh and muscle soon.

I just today purchased the ReliOn glucometer, lances and testing strips, so I'll be looking at the resources some of you mentioned along with those available on these forums to try and figure out the process.

And most of your guesses have been right, I've been leaning towards calling the cat Lucky because of his great recovery (I haven't decided on it 100% yet though). Luckyducky is a cute nickname I call him sometimes. :-D

I wish my brain would allow me to respond and write more right now, but it's very late right now where I live and I should be heading to sleep (taking care of this cat has taken so much more time than I would've ever expected, but it's been worth it). Thank you all so much again for your heartfelt help and support, I will try to update again when I get a chance.
 
Hi Hon-

You are doing amazing!!!! Congrats on getting your home testing kit. You may also need an ear warmer to help his ear bleed. Sometimes cat's ears are cold and they don't bleed as well. Warming them helps. You can make an ear warmer with a little sock with some rice in it. Then tie the sock in a knot. You microwave it for about 15 seconds and then put it against his ear before the poke.

You are very quick and perceptive. Your vet doesn't sound like she's got much experience with diabetes. A lot of vets don't. They say that vets only have a day of education in school on this. You will be educating her no doubt. Not only can you dose less than 1 unit, there is also micro-dosing. I used to do one drop (lots of people do here) towards the end of my cat's time on insulin.

The wonderful people here on this board live and breathe feline diabetes. We are obsessed with it. Take a look at the sticky notes on the Lantus section of the board. Lots of interesting stuff. If you need testing help there are videos you can watch. Just ask. People will point you in the right direction.

Keep up the great work!!!
 
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