New and need some help

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DaniCoz

DaniCoz

Member Since 2011
I've posted to the Health Forum a few times and was directed here to get a question answered. I've just started home testing, and still don't have many #s because I'm not getting enough blood every time I test. I'm going to copy/paste some of my previous posts and hope that I can get some advice and see if I'm doing the right thing. Here goes:

Charlie was acting not quite right and losing weight, so we took several visits to the vet and got lots of tests. His BG was somewhat high, so he went back to the vet for a fasting BG and then went downhill fast. After being at the vet for two days I took him to the "kitty ICU" where both my regular vet and ICU vet agreed he had a 50/50 chance of surviving. In a week he had lost a pound, become dehydrated, developed DKA, liver failure, anemia... you name it. As sick as he was, I couldn't take that 50% chance away from him. Luckily, he got a little better every day. After a 5 night stay in the hospital, an ultrasound, insulin CRI, IV fluids and antibiotics, 2 blood transfusions, and placement of an e-tube, we were able to bring him home. This was back in mid-December. When he was sent home he was on 2u of Lantus twice daily. Pre-dx and hospitalization he was eating Iams dry indoor formula, with the occasional can of wet, then getting IV fluids for a few days, then started on Hills a/d through the tube. After 2 weeks of tube feeding he was fully transitioned to low carb wet (4 small meals per day) and has been for 10 days.

Now the part that I'm looking for help with. On Saturday, Charlie got his annual checkup and rabies at the vet. He also got his feeding tube out! The vet tech called a couple hours after his appt. and said the vet wanted him to get his shot only once a day b/c his bg was low. I swear it sounded like she said 22, but he was showing no signs of hypo and eating normally, so I'm not sure yet. I haven't called them yet because I want to have data to present when I call. I didn't think that just one shot blindly per day made sense, and luckily I had already started trying to test at home. I tried to test Saturday at +12 but couldn't get a reading. So I skipped the shot just be on the safe side. Tried to test yesterday (Sunday) pre-shot, but again, not enough blood after 3 pokes...Charlie is such a trooper! I gave him 1u because I was still worried about hypo but was also afraid to not give him his dose. Well he did great yesterday, including have a great appetite. OK, now I'm getting to the numbers. Sorry this is so long! I tested yesterday at +9 (about 4-5 hours after he ate). His BG was 132. I tested again at +12: 119. I skipped his shot and gave him his dinner. I tried again before going to bed last night but no dice. He got his midnight meal. This morning I tested at what is now +24 from his last 1u shot. He was at 115!! So I skipped his shot and gave him his meal. I tried to test several times throughout today but only got 2 more results: At +3 (really +27 from last shot, but 3 hours after eating) he was at 139. At +8 (really +32, and 2 hours after his lunch) he was at 112. Tried to test again before the time he would usually get his shot, but not enough blood after 3 sticks (he tends to move his head a lot). Since I only have 5 numbers I haven't started a SS yet and don't have a real clear picture of what is going on. I can't imagine him spiking above 150 before his next shot, but if he does get that high maybe I should just do a small dose? If it's still around 110-115 should I skip it again? Is it possible that diet alone is enough to get him regulated so quickly?

Sorry this is so long. We are still so new to this, so I don't know if this is normal. I want to do what is best for him and wish I could get blood every time I stuck him. He is pretty cooperative, but I don't want to overdo it because I don't want him to run away every time I walk in the room!

Thanks for reading :smile:

Danielle and Charlie
 
If he is still in normal numbers (40-120) when it is time for his shot then no don't give him any insulin as he doesn't need it...It is very possible especially since it looks like he drops on his own after eating that the low carb diet is doing the trick for him.

My Maxwell was 485 when he was diagnoised, If you look at his spreadsheet in my signature you will see just how quickly a change in diet an a little short course of insulin can put a cat into remission...I adopted Maxwell as a diabetic from this very board, he was fostered by one of the ladies here for a week as transport was being set up for him, she started him on Lantus and changed his diet from cheap dry food to low carb canned food. Then she put him on a plane with no insulin, he flew from Boston Mass to Omaha NE, where we picked him up, drove 3 hours home and tested him...I really expected him to be high, due to stress and no insulin. That very first night he tested 160 so I gave him is 1u, then a couple days later he got .5u and that was the last shot he ever had, he has been in remission and diet controlled for over a year now. He was officially declared OTJ on Nov 1st. 2010. :-D

Right now as new as you are and without a lot of data and those drops anything under 200 I would be leary of giving him any insulin on. A couple of things that really help me when I was learning to test was to take the cap off the lancet pen and use it without the cap...the other was warming the ear up really warm.

Mel, Maxwell, Musette & The Fur Gang
 
Additional monitoring tactics, which may be helpful

Amount of water drunk
- measure what you put out each day and subtract what is left when you refill. Divide by number of hours to get an hourly average of water drunk and/or use daily totals (measured at same times each day). As control improves, less water will be drunk.

Weight
- obtain a digital baby scale (Craigslist may have them occasionally) and weigh weekly. As control improves, weight should approach the 'normal' weight, ie if underweight, gains; if overweight, reduces.

Urine ketones &/or glucose
- Obtain urine test strips from your local pharmacy, generally in the diabetes supply area. Follow directions to test (fresh specimen, dip strip quickly, compare to colors on container. Note that results reflect the past several hours combined. These are important to use when a cat is unregulated, ill, or has a history of diabetic ketoacidosis

The 5 Ps (Whole Cat report)
- purring
- poo-ing normally, formed stool, not hard as rock, nor liquidy
- peeing normally, no lakes or swamps created
- playing or energy level improved
- preening - grooming fur

Blood ketones
- For a cat that ever had diabetic ketoacidosis, a blood ketone meter is recommended. Test strips for these may be pricey. If you're having difficulties with blood testing, these will likely be difficult too.
 
Thank you both for responding, it is reassuring to know I'm doing the right thing. We are still getting the testing thing down, but the highest he's tested is 154 after eating a higher carb food (kcal/carb% in mid teens - ran out of Wellness :oops: ) and after 49 hours with no shot. Typically he has been below 120 before his meals.

As far as the other indicators:

I have been eyeballing the water but measuring is a good idea. He is drinking much less than before treatment.

He has already gained back 2 lbs, and is very close to an ideal weight. :smile:

I have ketone strips, but haven't gotten a sample yet. Either I'm not home when he pees or forget to cover the litter with plastic. I am trying to get better and hope to get a reading tonight.

The 5 Ps are all Perfect!
 
another trick to getting a urine sample is to give him a box with aquarium gravel in it, as that won't absorb the urine, and I know here my cats just can't resist a clean box, they have to jump right in to mark it. So when I really need a sample from Musette I just give her a clean box with aquarium gravel and put her and it in a separate room and wait...Of course I have 13 cats so I have to seperate her or I would have no idea who's pee is who's..lol

But if he only went to 154 on a fairly HC meal, I would guess that you have a diet controlled diabetic. :-D Now to just get that testing thing down so you can start his 2 week OTJ trial and offically declare that he is OTJ, then break out the party hats!!!

Another way to test OTJ status is to test, feed, wait 2 hours and test again if he can drop on his own then he has a functioning pancreas, the amount he drops will tell you how well it is working.

Mel, Maxwell, Musette & The Fur Gang.
 
I will try the gravel tomorrow.

I wanted to post an update and I finally added his SS to my sig...4 hrs after his dinner and he is at 101!!! We are now at +64. :smile:

His numbers look kinda funky. I think that is partly because we are still trying out different foods as he has been a little picky. He doesn't always eat the full amount and sometimes steals civvy Misty's food. (Who eats what he does, except she gets one or two meals of the higher carb foods).

Thanks again to everyone who has helped me out!
 
Hi Danielle,

Charlie and you are doing really well. The small frequent meals of low-carb wet food can really help. This is really amazing given his back story of serious DKA and all the horrible things that can go with that.

I too encourage periodic testing of his urine for ketones. Even though his BG levels are low, he still can develop ketones. We have seen it happen. So watching his 5Ps, ketones, and BG levels is a good thing to do.
 
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