New and scared

[MelanieP and Ninja]

My beautiful Ninja (8 years old) was diagnosed with Diabetes Friday. I am feeling all the emotions you can imagine... scared, sad, overwhelmed, guilty, etc. My vet did not start treatment Friday since his office was closed over the weekend (in case of emergency) so he is teaching me tomorrow how to do injections. He said Ninja's numbers were "over 400." Of course I didn't know what that meant. He talked about Ninja coming in weekly for curves for at least the next 2 or 3 weeks, and maybe longer. I asked him if it was possible to home monitor like humans do (before I read up on this site and even knew this was a possibility); and the vet said yes it was possible, that he had "a few" people doing that, but was definitely not encouraging about the practicality of a layperson (me) doing this. After reading the info on this site, I think the home monitoring seems to be the best method - assuming I can get Ninja to tolerate this -- which I understand will take work and patience. I asked the vet if we could start with a lower dose of insulin to begin with, considering how we are trying to change her diet to a low carb, wet one from Hill's Science Diet original dry (which I understand is high carb) - and I am most concerned with insulin overdose in the early days. He responded, "We will start with an appropriate dose." I am not sure what that means. I asked him if he believed the Hill's dry (all her life) contributed to her diabetes. He said no. The vet sells Hill's products in their practice (they have a Hill's mini store in their practice). In my brief reading this weekend, I don't think Hill's is the best option for Ninja (vet sold me some Hill's MD canned food which Ninja wouldn't touch anyway).

Ninja is very addicted to Hills original formula dry food. She has never eaten treats or other varieties of Hill's (like the chicken flavor), despite me trying every food on the market some 7 years ago when I first adopted her. So getting her to wet is going to be a challenge. As noted above, she wouldn't touch the Hill's canned. I bought some Evo dry food that is supposed to be low carb. My thinking is that maybe I can transition her from a combination of the Hill's dry and Evo dry (over time) to all Evo dry -- then to an all Evo wet (or other recommended brand). This will take time though, as the vet said not to let her go without food (in other words, don't try to starve her into changing).

Questions for the group (any advice on any or all questions would be appreciated).
1. Insulin: The vet prescribed Lantus. Do you have an recommendations as to what I should say to the vet about starting dose? I would really like to start lower and go up...but don't want to do so if that will hurt Ninja. And the vet seems adamant about starting at what he believes is an "appropriate dose" though he did not say Friday what that would be.
2. Insulin: In the early days of trying to do this, what happens if I am not able to give two doses a day (say, if Ninja hides from me or otherwise won't tolerate). Is her life in danger? I feel that in time, I will get used to doing this (same with the testing...) but in the early days, I am afraid of what will happen if I miss an injection here and there.
3. Insulin: what if I don't do it right and hit a vein. I am terrified of this!!!! Also...can you recommend a needle size? the one prescribed by the vet look HUGE to me.
4. Home testing: How do I restrain a cat who doesn't want to be tested? Ninja has NEVER been a lap cat. She is very independent and doesn't like to be held (ever). She likes brief petting and will lay next to you for brief periods -- but if you reach out to touch her or otherwise get in "her space," she will relocate. Still, she is very loving. I know that sounds like a contradiction, but you cat lovers will understand. PS: I live alone so will need to be able to restrain Ninja myself. Does the lancet used in home testing hurt her (is it painful)? Any advice on brand.... freestyle or use those pen things...and to what setting... I am clueless on the lancets.
5. I am wondering if I should change vets. Based on the info above, what do you think?
6. Anyone have an opinion about Hill's products? Am I right in to try to get Ninja to eat a brand other than Hills MD canned (ultimately). Is Hills really the best choice for her? Any recommendations/comments are appreciated.

Thanks to all for taking the time to respond to any or all of my lengthy questions. I have been a nervous wreck since Friday, crying and at various times doubting my ability to do this; but I am determined! There is no choice. Ninja means the world to me. Thanks!!!!!!!!

 

[Carl & Polly & Bob (GA)]

I wish I was on my computer where all my links are stored....
Please visit catinfo.org to read what an expert vet has to say about dry food and specifically about Hill's. I would avoid it like the plague!
Google "AAHA Guidelines for insulin for cats". That will give you an idea of appropriate starting doses. Anything more than 1 unit twice a day, 12 hours apart is probably too much.
Sorry for not being able to link you to more, but others will...
Carl

 

[Larry and Kitties]

Welcome:
1. Insulin: The vet prescribed Lantus. Do you have an recommendations as to what I should say to the vet about starting dose? I would really like to start lower and go up...but don't want to do so if that will hurt Ninja. And the vet seems adamant about starting at what he believes is an "appropriate dose" though he did not say Friday what that would be.
The standard starting dose is 1 unit twice daily unless there are circumstances that dictate otherwise. I do not see any in your case.
2. Insulin: In the early days of trying to do this, what happens if I am not able to give two doses a day (say, if Ninja hides from me or otherwise won't tolerate). Is her life in danger? I feel that in time, I will get used to doing this (same with the testing...) but in the early days, I am afraid of what will happen if I miss an injection here and there.
It is not that bad to miss a shot but not hard not too.
3. Insulin: what if I don't do it right and hit a vein. I am terrified of this!!!! Also...can you recommend a needle size? the one prescribed by the vet look HUGE to me.
You should be using human syringes with a 3/10 CC capacity and half unit markings. You want the needles on the syringes to be 30 or 32 gauge. the higher the gauge the smaller the diameter.
4. Home testing: How do I restrain a cat who doesn't want to be tested? Ninja has NEVER been a lap cat. She is very independent and doesn't like to be held (ever). She likes brief petting and will lay next to you for brief periods -- but if you reach out to touch her or otherwise get in "her space," she will relocate. Still, she is very loving. I know that sounds like a contradiction, but you cat lovers will understand. PS: I live alone so will need to be able to restrain Ninja myself. Does the lancet used in home testing hurt her (is it painful)? Any advice on brand.... freestyle or use those pen things...and to what setting... I am clueless on the lancets.
I place my cats in my lap. That way I can use my forearms to help restrain the cat. Use 25 gauge or a little smaller diameter (higher number) since it is easier to get blood. I use the lancet pen that comes with the meter. Some use the lancet freehand. Try both.
5. I am wondering if I should change vets. Based on the info above, what do you think?
I thin the vet is OK based on the info you supplied. I would not change yet.
6. Anyone have an opinion about Hill's products? Am I right in to try to get Ninja to eat a brand other than Hills MD canned (ultimately). Is Hills really the best choice for her? Any recommendations/comments are appreciated.
Any good lo-carb canned food is as good and even better than the Hills and is less expensive. Many here fed the Fancy Feast Classic pate since they typically are low in carbs.

 

[SabrinaFaire]

First, {{HUGS}} We've all been freaked out, new, and terrified. :smile:

I'm not the best expert on this but I'll try to answer some questions.

1. Others will be better able to answer the dose thing, I'll leave it to them.

2. & 3. Ninja may not even notice that you're giving her a dose. The needle is tiny, a U100 for Lantus, trust me, it's small. (Your vet should tell you for sure, but I'm fairly certain that's what most folks use for Lantus, that's what I used for Hobbs) Also, you don't inject into a vein, you do it into their skin. You *can* miss and get a "fur shot" but once you get used to it, those will be few and far between. As for missing an injection, it's not the end of the world. Missing several is not good, but if she hides, what can you do? I would try to get her used to sitting next to you and you handling her. I know you've probably tried this over the years since she's your cat and you want to cuddle her, but try again. Also, some cats seem to start to "get it" and associate you poking them, either with insulin or their ears with feeling better, and they become more compliant.

4. Kitty Burrito. My cat is very easy going, I'm super lucky with that and he let's me test him. However I recently helped out a woman with her diabetic cat, showing her how to do it, and her cat would not sit for it. I suggested the kitty burrito method, wrap the cat in a blanket or towel, not too tightly to hurt, but tight enough that she can't wriggle out too well. Hold with one arm, test with the other. It may take several goes to get it right. Just be patient and don't do too many failed attempts at once or you'll really freak her out. Do the lancets hurt? Well if you try them out on yourself, they don't tickle. But they aren't the worst things ever either. Most folks here use the Relion meters you can get at Walmart. Lancets are lancets though, most will go into the lancet device that comes with the meter, so get whatever is cheap. As for the setting, mine came with a "clear" cap so I could see where I was aiming, in which case there's only one setting.

5. Can't say for sure yet. There's a lot of vets that don't believe or encourage home testing, doesn't mean they are necessarily bad vets. But as for their comment about a "lay person" doing home testing... hogwash. You wouldn't give a child insulin without knowing their blood sugar levels, why would you do it to a cat? You don't need a degree to do hometesting.

6. I've never liked them but if your cat eats it, that's the most important thing. Most folks here will recommend you try to switch her to a low carb wet food. Plenty of cats (My Hobbs included) have gone off of insulin with a diet change. The www.catinfo.org site has information on how to rehab a dry food addict. There's plenty of foods out there that are commercially available, better, and cheaper than the Rx ones you buy from the vet. Lots of people here feed certain types of Fancy Feast but you could even buy a high end premium food and it will be cheaper than the Rx foods.

One other thing, where are you located, if you don't mind sharing? Sometimes folks that live near you can come out and help you with hometesting, show you how to do it, sometimes people learn better that way. Otherwise there's also videos on YouTube on how to do home testing of cats, I found that it helped me TONS.

 

[Ry & Scooter]

SORRY if I flash edit this on someone. It is very early, I'm groggy, and making a lot of typos :lol:


1. Good, Lantus is good. 0.5u or 1u twice a day is what we start at. Formula is .25u of insulin per KG (NOT pound) of ideal weight. So if her ideal weight is 4 kilos, she would start somewhere around 1u. We increase by .25u at a time. However, Lantus is dosed based on the NADIR (lowest point of the cycle) so you need to do what are known as mid-cycle tests. A cycle is the 12 hrs between each shot. Generally a cat's nadir on Lantus is anywhere from 4-6 hrs after the shot. You ALWAYS want to test immediately before every shot to make sure it is safe to give your cat insulin.

2. Missing an injection here and there is normal in the beginning. Don't beat yourself up for it. Sometimes cats hide, squirm, fur shots happen. But don't get discouraged. Positive reinforcements ie. a treat afterwards go a long way towards helping. Your emotions will affect her too... if you go in to poke or test with a strong confidence and positive attitude, you will have far more success than if you go in scared and stressed out.

3. You won't hit a vein. You're shooting under the skin. To inject, you pull up the skin to form a "tent"... and you shoot into the tent, parallel with the cat's body. The scruff works, but I prefer to inject into my cat's side, between his shoulder and ribs.

You want needles that are 8mm long, or 5/16 in. You can stick those all the way in the tent and as long as the needle is not straight down you won't hit muscle. They should also be 30-31 gauge (bigger number=thinner needle), 100u, preferably with half unit markings. You can get Lantus and its syringes at any pharmacy but you will need a prescription. You can also buy meters, strips, syringes, etc. on sites like American Diabetes Wholesale.

4. Kitty burrito. Take a towel, wrap her firmly in it so only her head is showing. I saw someone suggest placing her between yourself and the arm of the couch so you can squash her in there good and hold her still. But you will probably only have to do the kitty burrito for the first few days or a week or two... it is not that the poking hurts, it's that being restrained and fiddled with is weird to them, at first. Positive reinforcement will make them realize hey this isn't so bad and I don't get the towel when I hold still, so I think I'll just do that from now on, because I get treats faster that way. They are smart, lol. Scooter is not a cuddler, he prefers to sit beside you as opposed to on you, so holding him in my lap for tests was something he was extremely uncomfortable with. I had to burrito him at first and he would yowl and try to run, but you have to buckle up and do what you have to do. And only a week later he was content to sit in my lap and hold still, for the most part. Now he calls ME to test him, sprawls out in my lap, purrs up a storm, and doesn't want to get up when we're done :lol: As far as meters go, anything that is cheap will do. Walmart's Relion Micro and Confirm are very cheap and accurate. Accucheck Aviva, One Touch Ultra, and Bayer Contour are some other popular but more expensive ones. Avoid anything with True in the name ie. TruResult, and also avoid the Freestyle Lite. Both read much lower than normal and can lead you to underestimate your cat's condition

5. I think your vet has gotten you off to a pretty decent start. It is normal for vets to push Hills food. They don't really know why they do it, they just know that Hills pays them to. Most people don't question it, but we know better. You can feed your cat whatever you want, your vet can't refuse you anything because you don't want to feed your cat crappy expensive prescription junk in a can.

6. Hills is trash IMO. Look at the ingredients. Pork liver, byproducts, wheat gluten... absolute garbage. There is no "magic" ingredient that makes Hills/SD any better than any other brand of food, as much as they'd like to make you believe. You can get the exact same food in terms of quality at Walmart for $1 for a big can. It's NOT worth the money, the food is NOT good quality, and there is NOTHING special in it. Many of their "prescription" formulas actually aggravate medical issues. Like the dry food meant for urinary tract issues and crystals. How is feeding a cat an extremely dry, moisture depleted diet going to help them with urinary issues? How is feeding a diabetic cat a food equivalent to Twinkies and Coca cola gonna help them get their diabetes under control?

I understand that it can be tough to transition dry addicts to canned. Your vet was right in the sense that it is better for your cat to eat Hills than to starve. But it is FAR better for your cat to eat low carb canned than ANY dry food period. Like I said, high carb dry is like a human diabetic eating nothing but Twinkies, potato chips, and Coke. Sugar, carbs, and more sugar. It's just going to make treating her more difficult and opens up the gates for more health issues in the future, like CRF, which is VERY common in cats.

I, personally, would pick up a few small cans of a low-carb pate like Fancy Feast, Friskies, etc. and see if you can find anything that Ninja is interested in. Wet food comes in TONS of flavors from chicken and turkey to duck, rabbit, beef, buffalo, seafood, and so on. Generally anything without wheat, corn, potatoes, etc. should be low-carb but you can use Janet and Binky's list here. Look for anything under 7% carbohydrates or so. I try to keep it close to what a cat would eat in their natural world, ie. not a lot of beef because when does a cat take down a cow honestly, and try to avoid a lot of seafood because of the high mercury content. Chicken, duck, and turkey with the occasional beef are the faves in this household. :lol:

 

[nwnews]

HI Melanie - everyone who loves their cat is scared when the dreaded words "your cat has diabetes" happens. Its hard not to be scared because of the unknowns. That being said - this is a disease that can be managed and many cats live long lives with diabetes. Its not a cheap disease to be sure but there are ways to lower the cost on it so it doesn't break the bank. First thing is food - Hills is not a great food and your vet is encouraged to sell it. There are many, many low carb options on the market and there is no doubt in my mind one that your cat will eat. Here is the bible to cat food guide - Janet and Binky's list: http://binkyspage.tripod.com/canfood.html. Go for canned food that is less then 10% carbs - most folks try for between 4% & 7% but anything under 10 is fine.

Do check out the youtube videos to start working towards home testing. Find a spot that your cat is comfortable and start by holding & petting/handling the ears. Work up to warming the ear with a rice sock (old sock filled with rice and warmed in microware), pill bottled filled with warm water, or (my trick) wetting a washcloth and microwaving for 20 seconds. All the while give treats with each step so kitty associates these new behavoirs with food. Then start trying to poke the ear with a lancet - a flashlight helps to see where the veins are to guide poking. Home testing not only saves a great deal of money its also a safety issue. Cats will sometimes have lower blood sugar numbers and, and if given insulin, can have hypoglycemic episodes which can be fatal. A human would never give themselves insulin without testing their blood sugar first so why should it be any different with a cat? Yes it takes time but once you get it down its a 5 minute routine.

Lantus is a good insulin and yes its a wise idea to start low and go slow. Lantus works best on shots 12 hours apart but if you are late its not the end of the world. Testing before shooting is absolutely essential. It can take time for Lantus to build up in the system so whatever dose you start with hold it for 3-6 cycles before changing to avoid blood sugar bounces (going high in response to more insulin). The recommendation is to start at .5 or 1 unit (getting syringes with half unit markings is a must in my opinion) and then increase as testing dictates.

Your vet sounds okay - not maybe super knowledgable but at least one you can work with. With testing many folks here just fax the results to the vet then discussing dose changes.

It takes time but managing this is doable and your kitty has many happy years ahead of him!! BTW - my cat is 19 - just diagnosed last year and she is doing very well. Jan

 

[BJM]

While you want the syringe gauge to be a 30 or 31, for lancets to prick the ear or paw pad for blood testing, you may find it helpful to start with 27-28 gauge.

And, to test the ear, observe where the vein is which runs along the outer edge of the ear. You want to prick between that vein and the outer edge, about 1/3 of the way up from the head. If, after 2 attempts, you don't get it, go ahead and aim for the vein, but be prepared to get a drop of blood quickly (on your fingenail, if you have to!) and apply direct pressure, because the vein is likely to bleed quite freely (why we don't use it routinely). Then follow up with a low carb treat such as Pure Bites or boiled chicken bits to reward tolerating the test.

 

[jkbank]

Hi Melanie and welcome

I had a lot of the same feelings as you did when Gem was first diagnosed. Gem had always eaten Science Diet feline maintenace dry her whole life, never ate treats, never interested in people food, freaked out if I put anything else in front of her. She was also not a lap cat, not real cuddly etc. I couldn't imagine how I was going to treat her. My vet tried to get me to get the prescription diabetic food - canned or dry. Luckily, they didn't sell it and I never got around to buying any. I did find the website that some have referenced here about cat nutrition and read about how wet food was so much better for all cats. I went out and bought a bunch of flavors, mostly Fancy Feast "classic" and I was amazed at how quickly she took to it. As for the shots, after I got over my nerves, I barely had to restrain her to give them. She didn't even flinch most of the time. I was not concerned about hitting a vein, more that it was not really going in. I suspect at times, it didn't, but it wasn't the end of the world. The BG testing definitely took the most time to get going. I did it myself, just by trial and error found a position that restrained her enough to get the shot without freaking her out. It did take time to get the right spot, and to get enough blood. I blew through many many test strips! But stick with it and you'll get it. I stumbled upon the fact that she would now eat bits of plain boiled chicken (left over from soup-making) and I used that as a treat after the BG test.

Good luck to you. I promise it will get easier. And the fact that you found this place early in the game is great - the people here are so supportive and helpful. Keep asking questions, no question is too simple! Someone will almost always have an answer as they've been there before.

 

[MelanieP and Ninja]

Amazed and appreciative of the outpouring of advice and encouragement within minutes of my post! What a supportive community!!! Thanks everyone!! I'm sure I will have more questions as I go along and thank everyone who responded!!!!!!

 

[Pumbaa]

4. Home testing: How do I restrain a cat who doesn't want to be tested? Ninja has NEVER been a lap cat. She is very independent and doesn't like to be held (ever). She likes brief petting and will lay next to you for brief periods -- but if you reach out to touch her or otherwise get in "her space," she will relocate. Still, she is very loving. I know that sounds like a contradiction, but you cat lovers will understand. PS: I live alone so will need to be able to restrain Ninja myself. Does the lancet used in home testing hurt her (is it painful)? Any advice on brand....

Hi Melanie!

My Pumbaa was diagnosed just about 2 months ago, and I went through the same emotional roller coaster you are going through. As I was told many times in the beginning, just take a deep breath...you'll be fine!

As for home testing, my Pumbaa was a little wiggle-butt who only ever wanted to be held on his own terms. This is what I did:

My cats get fed on a table in my kitchen (don't worry, we don't use it for anything other than feeding the cats). I thought this was the best place for testing since I could have all of my supplies on the table in front of me, it was near the microwave (for heating the rice sock), near the garbage can, and near the fridge where I keep a dry-erase board to mark down test results until I have time to enter them in his spreadsheet. And I was able to restrain him between my arms and lap and still have my hands free to test.

I sat Pumbaa on my lap with his face and paws on the table in front of us. I put down some smooshed up sardines (packed in water, no salt), to distract him during the testing. After a few weeks, I didn't even have to bribe him with the sardines anymore, and he will sit there on my lap and purr during the testing. Also, when I grab him for the testing, I make sure I am petting him on the way to the table to make this a good experience.

I apply a tiny bit of Neosporin with pain relief ointment to the outer edge of his ear and rub it in.

Use the rice sock (1/4 - 1/2 cup of rice tied in the bottom of an old sock) to warm the ear first and get the blood flowing. My rice sock only has to heat in the microwave for 12 to 15 seconds to get it warm enough. I alternate rubbing his ear and rubbing his neck with the sock, to make this a pleasurable experience.

As for the Lancets, any brand is fine. I started with 28 gauge because in the beginning, getting the blood is a little more difficult. I've gone up to 30 gauge and get just enough blood with it now even though the needle is thinner. I like the flat lancets the best because they don't roll off the table, but now I look for price.

Also, I use the lancets without the pen, as I was afraid that the popping sound would be a negative for Pumbaa, and I feel like I have more control freehanding the lancet.

Oh, and, something I was confused about..you don't want to hit the vein at the outer edge of the ear...you want to prick between the vein and the very outer edge of the ear.

As for catching your cat, I could tell you stories! *LOL* Last night, Pumbaa led me on a couple of wild chases around the house. At midnight, I caught him in the covered litter box. I had followed him in there after 5 minutes of chasing him around the living room/dining room, and after a couple of minutes I didn't hear any scritch-scritching in the litter box, so I took the lid off and he was laying down in the litter, playing possum, and hoping I would go away. Hahahahaha!

Good luck to you! Everyone here is awesome, and tremendously helpful!

Suze

 

[MelanieP and Ninja]

One more question... is a small amount of milk ok for Ninja? She will not eat treats and the only thing she likes (other than cat food) is whole cow's milk. Typically I give her a tablespoon in the morning and evening as her "treat." I am hoping to use this as her treat, after poking her ears for the self test. She has never shown interest in any other kind of treat (not commercial treats, or even pieces of chicken, tuna, etc). Ninja is very limited in her tastes. LOL!! Do you think this small amount of milk is ok on a daily basis?

 

[Squeaky and KT (GA)]

Welcome Melanie and Extra Sweet Ninja!

No milk....milk contains lactose - lactose is 'milk sugar'. There are some substitutes you can get at most pet stores such as 'CatSip' at PetSmart. It's usually near the bottom shelf. Soy is carb so no soy milk either. KT misses his milk, we look around before getting it out or he'll come begging even tho' he knows it does no good.

Freeze dried treats! They have them in the cat sections of most stores but check the dog sections - they're the same thing but usually quite a bit cheaper.

"new and scared"....Hey, I resembled that remark.... :roll: 360 days ago - our first 'anniversary' is June 8th. KT comes for testing when he hears his meter beep. He turns to our 'shooting position' when I show him the syringe. June 7th last year, I would have said ABSOLUTELY NO WAY if someone told me I'd be sticking my cat twice a day within 24 hours...but I did. I cried, I shook, and I stuck my kitty....and he purred...and looked at me like "Hey, what's the big deal?" I poked his ears, I shook, he purred...and we tested.

You'll do just fine - it's a bit different this sugar dance but you'll soon learn the steps.

BIG HUG!