New diagnosed 16 yr old

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Maceo

Member Since 2013
Hi - have been checking out the forum and reading as much as I can - 16 yr old overweight (lost four-five pounds in past three months and is currently at 14lbs) orange tabby "Maceo". Just diagnosed last evening & was instructed by the vet over the phone to start insulin last night. Gave him 2 units of Lantus (no idea what his bg was at the time, as his blood had last been drawn four days earlier at his appointment) as soon as I got back from the pharmacy. Was instructed to give him 1 unit BID for the next 10-14 days & then bring him in for a curve test. No discussion of glucose meter testing with vet. ***He was given his 1 unit this am - was due about an hour ago and I am wondering if I should be giving him a whole unit - I went out and bought a Relion meter and got a result of 114. This is his pre-shot glucose. Is it ok to give him a unit at this level - or will it drop him too low?**** Have also switched him over to wet food - and he is eating some - not as much as I would like - but he probably managed 1/4 -1/2 can today - his appetite has obviously been off as his significant weight loss shows (he was on pretty high-carb Hills Prescription kidney diet since February - prior to that grain free premium dry food - always free fed in the basement so did not track his eating habits). He has been having problems with excessive thirst and urination for at least four months although blood work and urine glucose/cytology were supposedly normal at his February annual exam.

Thanks for input - Kris B.
 
i got about half way thru....to that 114 and wanted to post this bit then i will go back and finish reading

NO, do not give insulin right now

brb :-)
 
ok, now to explain some :-)

first, welcome to FDMB

now, typically when first diagnosed, people set a cut off number that they don't shoot insulin if kitty is below that. typically that number is 200. that way kitty stays safe while the human is learning everything they need to know, working on diet, figuring out dose, getting hometesting going, etc.....

down the road, as you have corrected the diet if possible and gotten a decent amount of hometesting data, yes, you can shoot on a lower number because you will have figured out how your kitty responds to the insulin, etc....

soooooooooo, no, at this point i would say do not give him that unit right now. what you can do is stall and keep testing and shoot late, if he goes high enough to need a shot, AND if your schedule tomorrow is flexible. you want to keep the shots as close to 12 hours apart as you can because shooting two shots too close together actually acts like an increase in the dose and that can harm kitty.

in other words, if you shoot late tonight, can you shoot late tomorrow? if not, then just plan on skipping the shot tonight and calling the vet in the morning to discuss the numbers you are getting and the dose.

i'm still at work and am being called to go test drive a car so will leave it at that for now and will be back in a bit. the not eating enough needs to be addressed/investigated and maybe someone else will cover that by the time i get back but for now, no shot, keep kitty safe
 
Thank you very much - the 114 result I got at 8pm - will plan on rechecking him at midnight unless anyone tells me differently. Need to get him closer to a 7A/7P dosing schedule before I head into work this weekend (12 hour shifts); so I am guessing that I will be better off skipping tonight's dose rather than move further from my necessary treatment times? I will be around tomorrow & need to come up with a plan for when to check his blood sugars (not that he was very happy about having his ear pricked tonight, mind you).
 
yeah, i'm leaning towards skipping too.

the only mitigating factors that could change that are some answers to some questions.......which to be honest, i'm not a daily poster anymore like i used to be so i'm sure i'll forget some of them but hopefully others can help

is there any other health issues with kitty? you mention the prior food he was on being a kidney food so does that mean he's been diagnosed with kidney disease? and if so, have those numbers been checked as of late? (BUN, Creatinine, Phosphorous)

as far as the not eating enough, do you think it's because of the food change or do you think it's because he's not feeling well? if the food change is the likely culprit you may have to go back and include some of his old food and transition him over slowly. lack of eating in a newly diagnosed diabetic can lead to other complications which you definitely do not want to rear their head, i.e. hepatic lipidosis, ketoacidosis. both can be beat with determination and a hefty wallet so if we can avoid those, we do, even if it means feeding a not so diabetic friendly diet at first while kitty learns a new routine

which, that reminds me, as far as the ear pricking.....they learn to not mind it. what you have to do is make it a happy experience for them, reward them with something they thoroughly enjoy, maybe a treat that they only get at test time, or extra pets if they like those, something you'll figure out will work for you and your kitty. i had to cycle thru half dozen or more types of treats before my first diabetic started not caring about having her ears pricked (i have 2 diabetics, one in remission and one still on the insulin). now, Mousie comes willingly to the same spot every morning and night with no human chasing her around the house :-) all i have to do is pull on the zipper on the meter kit case and ta-da, there she is, on the kitchen counter on top of her log book :-)

k, gonna let this one post as i feel i'm writing a journal and see if anyone else has spotted your 911 :-)
 
I would skip the shot tonight but continue to get some tests until you go to sleep. mainly, that is so you get better at the testing and also to gather some data. We will see how quickly your cat climbs up from that low of 114.

When I saw that 2U as a starting dose, my eyes went really wide. Most kitties should not be started on more than 1U (unit).

Here are some great testing tips and tricks to help you : ear testing tips
 
I am glad you didn't shoot, as Lynn said, we advise newbies not to shoot under 200.

Skipping will also allow you to shoot on schedule tomorrow... Tomorrow,test. Then if he is over 200 then shoot 1unit at the most. You dont want feed for two hours before the shot, so that the preshot test isn't influenced by food.
However if he is under 200, don't feed and don't shoot. Come back here and post and then retest in 30minutes to see what his blood sugar is doing naturally.

It would be very useful information for you, and us!, to get a midnight test. Since that's four hours after your 8pm shot time, we call that a +4 test.. Although in this case you didnt shoot.

I usually advise people to get a test before every shot (mandatory!), one mid cycle during the day ie between +5 and +7, and before bed. Depends on your life schedule though.

Wendy
 
Maceo had labs drawn in February - will get copy of them for his file tomorrow - was told his kidney values were elevated, but nothing out of the ordinary for a kitty his age. She recommended putting him on the Science diet kidney - am wondering if the huge increase in carbs content of his food had something to do with the quick down-hill swing he took. As I mentioned though, he was already having increased thirst & urination prior to his food being changed. Also behavior changes (howling) and peeing all over the house. I will post his labs tomorrow - know it will be a balancing act between trying to keep his renal function and diabetes under control.

As for his appetite, I think that he is still not feeling 100%. To complicate things, we put him on Prozac last week when he went in to get additional bloodwork done - thinking that his inappropriate urination was behavioral since his February blood/urine workup was negative. He was taken off that yesterday, but it made him drowsy & the vet says that it tends to suppress the appetite. As I mentioned before, he lost about 4-5 pounds just recently in a very short amount of time - not sure how acute his loss of appetite has been. Am hoping it will increase, I do have a bowl of dry food sitting out downstairs that they can get at - do not think he has been eating out of it - but he has at least made an effort to eat a tablespoon or so the four times I offered him canned food today. He will eat every friskies/pounce dry treat I give him (which are not good, I know). I have a dropcam video that I can use to monitor feeding at the dry food bowl (bought it when I was trying to pin down who was peeing all over). Am thinking I should leave this dry food out for a few more days while I try to transition both of my cats over to the wet food.
 
Wendy, I will post his midnight and recheck him at 8am tomorrow morning. Should I pick up the dry food I have sitting downstairs for the night? He probably hasn't eaten more than 1/2 can of wet food today (total). I will follow your advice and try to get the four glucose readings tomorrow. Thank you for your input.
 
Am thinking I should leave this dry food out for a few more days while I try to transition both of my cats over to the wet food.

It can take some time to get a cat to eat the wet food. Some go over to it in a day. Some take months. I used every trick in the book, this article on Transitioning your Cat from Dry to Wet food. Transitioning tips. It was hard but persistence paid off.

Transition slowly to minimize tummy upsets. It's more important that your cat eats right now than that he gets over to eating a lower carb wet diet. That you can spend a little time working on.

There is a list around somewhere of low carb foods that are also low in phosphorus which will help the kidneys. Stay away from fish as those tend to be too high in phosphorus.

ETA: Can't find the shortcut list of low phosphorus foods but this food charts lists almost all the canned foods available in the US. Look for carbs <10%, 3rd column of numbers, and phosphorus under 210, 4th column of numbers.
 
Thanks Deb - I will check out the list. Will put my spy cam into use tonight & see if he is eating any of the dry food. I agree that I need to make sure he is eating adequately at this point - will go out and get him some baby food tomorrow if it looks like he is not. Bought some grocery store brand cat foods today (9 lives, Fancy Feast) - they are usually pretty appealing - although most of them DO have fish. Will look into the phosphorus content. And discuss with my vet tomorrow. Thanks again.
 
Just checked Maceo's blood sugar again - twice - first reading 415 - second immediately following 361. Going to go ahead and give one unit of Lantus now since he is so high. Quite a bit of variation in my readings though, eh?

Kris
 
if you shoot now you will have to figure out a way to shoot 12 hours from now. is that doable? and then you slowly move the shot time back to when it should be, by roughly 1/2 hour each shot time. if that's going to be a problem, him being high for a few more hours isn't going to hurt him. i assume it's midnight or later where you are? so you could shoot in 6 or 7 hours and be on your 7am/7pm shot schedule you want

meters are built with 20% allowable variance figured in to the readings so technically you are within that variance so no, the difference isn't really that different. if that makes sense?
 
Ok - so it took me a while to get him settled down and draw a sample this morning. One unit of Lantus given @ 0000 last night. +9 (9am) sugar this morning was 280. Assuming at this point that I should recheck him next prior to his noon dose. Again at 6pm. And again before his midnight dose tonight (which I will move to 11:30pm in order to restructure his schedule to earlier). Am I missing anything?
 
Kris,

Can't find the shortcut list of low phosphorus foods but this food charts lists almost all the canned foods available in the US. Look for carbs <10%, 3rd column of numbers, and phosphorus under 210, 4th column of numbers.
OOPS! Sorry, forgot to include the link to the Food Chart I talked about last night. Here it is: http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

I had the number wrong last night. You want to look for phosphorus < 250. Rhiannon and Shadow made up this shortcut list with all the canned foods that are <10% carbs and then listed the phosphorus content at the end. You'll need to go thru the list and pick out those < 250 in phosphorus. Here is the link to the shortcut list : http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=94685 It's much shorter than the Food Chart so should be easier for you to use.
 
You have a good handle on testing times. I would go ahead with the testing you outlined in your earlier post.

When you have a little bit of time, I'd like you to add some information to your User Control Panel if you would please. this will help us to help you better.

1.Go to the upper left of your screen and click on the words User Control Panel
2.A set of tabs will appear, select the Profile tab
3.Along the left hand side is a list of options. Select Edit Profile
4.Go down to the Location field and enter in your Country, State/province at a minimum. City or general area if you are willing to share this information
5.Click on Submit to save this change.

This will let us know what the time difference is between you and your helpers here on the board. Since we all live in different time zones, your 9am and midnight may be radically different then it is for someone else.

Next, we'd like to see some information in your signature. You can look at my posts and below the post data, underneath a line going across the screen, is the information I have included about my cat Wink.

1. Still in User Control Panel, Profile tab
2. Select Edit Signature from the left hand side of options
3. A free form text box will appear, just like the one where you write a post.
4. Useful information to have here is Your name, your cats name age and sex, diagnosis date for the diabetes (e.g. dx 4/3/13), what meter you use for testing, what insulin you are using, any complicating medical conditions your cat has like the CKD and need for low phosphorus foods, what foods you are feeding - wet vs dry, any additional medications your cat is on.
5. Click submit to save this info.

This gives us a quick snapshot of your cat and helps us to help you better.

At some point, we would like you to setup our standard format spreadsheet and put a link to that in your signature. It's a handy place to track the BG (blood glucose) numbers, units of insulin given, food fed, lab test results, comments about how your cat is feeling/appetite.

The link to tell you how to set up that spreadsheet and link it to your signature is here: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207 There are people to help you set this up if you need help. Let us know.
 
Made it through our first day of testing & don't know what exactly to make of the results. Any input? Should I be giving less than a unit BID? Maceo seemed to have a pretty good appetite.

Insulin given at midnight - one unit.
In the morning (9am) he was 280.
At noon he was 399 - gave one unit.
At 6pm he was 52. Seemed a symptomatic. Encouraged him to eat & gave some friskies treats.
At 11:30pm he was 82 - holding insulin and going to bed.
Have to leave early tomorrow & will be gone to dog show all day - not back till 5:00pm. I will check him at 8:00am - if he is over 200 - should I give him a whole unit - or try to give him less?

I offered him wet food with every blood sugar check - had the spy cam set up & did not see him eat any dry food.

Kris
 
I don't use Lantus so I cant help with dosing advice. Although, If it was me I would give less. Especially if you are gone all day & won't be able to test to know if he drops low.
You gave 1u into 299 & he dropped low.
I alway tend to go less when I know I am going to be gone & leave extra food. It helps me not worry as much while I am gone. This might help you too.

Good luck ;-)
 
Do not give any insulin if the pre-shot test is < 200. That is our recommendation for new members that join the board.

That one unit may be too much for your cat. How much does he weigh?

We want to be able to find a dose that you can give BID. That twice a day dosing is what works best in a cat.

Would you please let us know where you live?
 
he went failry low yesterday so I am wondering.. But first to confirm - these are the readings you got?

Wed PMBG 114 skip
+4 414/361

Thur AMPS 399 1 unit
+6 52
PMBG 82 skip

You need to find a dose you can shoot twice a day. You might want to reduce to 0.5unit and try that. Do your syringes have half unit markings?

What happened with his readings today and how is his appetite?


Wendy
 
I have completed my profile/signature & am working with tech support trying to link my Spreadsheet - having trouble probably because I am using a MAC computer. Anyways, an update on Maceo -

Yesterday @ 8AM - sugar 363 - gave 05 units & had to leave him for the day
8PM - sugar 374 - gave 0.5 units

This morning @ 9AM - sugar 155 - did not shoot. Going to recheck at +4 and +8 hours today. Will not be home to dose him at 9PM tonight. If his +8 glucose is over 200 however, I feel safe having my hubby give him 0.5 unit at 9PM. He can not test him first. Can I safely draw up the 0.5 unit and keep in fridge for 3 hours (have to leave for work at 6:15PM)? Or does he need to draw up?

Maceo's appetite seems to be increasing, still not eating a full can/day - but eats some every time I offer & I did see him nibbling on dry food on my spy cam in the basement yesterday afternoon once.

Thanks - hope to have SS up soon.
 
When you get a chance, and after you have stopped *&*@##*&%! at your computer for not linking your SS in correctly, would you please do one thing?

Go back to your very post in this thread. Click on the editing icon over towards the right hand side. Change the 911 icon radio button to the none icon radio button.

I think the crisis has passed and we can take off that 911 now.
 
I use a MAC and have no issues - let us know if you keep having issues though and one of us can help.

Wed PMBG 114 skip
+4 414/361

Thur AMPS 399 1 unit
+6 52
PMBG 82 skip

Fri AMPS 363 0.5units
PMPS 375 0.5units

Sat AMPS 155 - skip

Thats great on his appetite! I would teach hubbie how to draw up. also need to teach him to test at some point as it always makes me nervous shooting without testing first.
 
9AM - 155 glucose - did not give insulin

1PM - 240 glucose

5:30 - 421 glucose - gave 0.5 unit Lantus

Will recheck when I get home in the AM.
 
your link to your SS isn't working - i think it might be missing some coding? Did you select it all before copying and pasting?
 
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