New diagnoses, trying to learn everything, super worried

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Ele's Human

Ele's Human

Member Since 2021
Hi, trying to learn quickly as Ele (short for elephant based on color, not size) is not doing so well. Unfortunately, my currently chaotic life led to a late diagnosis, Ele is underweight and was very dehydrated when I brought her to the vet, despite consuming somewhat ridiculous amounts of water. Started Hills M/D dry food on 9/8, she took to it right away.. Started Vetsulin at 0.45ml (I think I did that conversion correctly [1.5 units in a 3/10cc syringe]) on 9/10, once a day. Appetite and energy were improved over the conditions that led me to take her in until 9/16 at which point she stopped eating and mostly stopped drinking. I started worrying by evening of 9/17 due to lethargy and poor motor function, started researching found this site, learned a bunch my vet didn't pass on, and cracked open a can of tuna. She has been drinking tuna broth since ( i add water and mash up the tuna), and her energy is definitely better. 9/18 bought a home glucometer (Contour next One): 428 mg/dL. I stopped worrying about hypoglycemia and started worrying about malnutrition and dehydration. Called the vet, they weren't much help, told me not to give her the insulin. So here I am, really not sure where to go from here, if anything pops out at you, and you have some direct advice/ feedback, it would be appreciated.
 
Welcome to FDMB!

If you're feeling overwhelmed, that's totally normal at the beginning of learning how to manage your cat's diabetes. And, it's wonderful that you went out and bough a glucometer and started to home test!!

A couple of basic points. Insulin dosing is in units, not ml. Syringes are sized but what's most important is that the syringe and insulin match based on insulin concentration. Vetsulin is a U40 insulin. The "U" value of insulin indicates its strength - the number reflects the number of active insulin units in each mL of liquid. You could think of 40 "units" as 40 tiny pieces of insulin floating in each mL of solution. You want to be using U40 syringes -- the U40 is consistent between the insulin and syringe. If you're using U100 syringes (they typically have an orange cap vs a red cat for U40 syringes), you need to convert the dose.

A word about insulin... Vetsulin is fine to use, especially if cost is a concern. However, since 2018 it is no longer recommend by the American Animal Hospital Assn for the treatment of feline diabetes. I've linked their guidelines. The issue with Vetsulin is that is is a relatively shorter acting insulin -- it lasts roughly 8 - 10 hours and is then out of your cat's system. In addition, it is harsh -- it can drop blood glucose (BG) numbers fast and hard. As a result, you may see wild swings in your cat's BG numbers. The AAHA recommends either Prozinc or Lantus for treating feline diabetes. These insulins last longer and are gentler.

You also mentioned that your are giving your cat insulin only once a day. There is no insulin I know of that's dosed once a day in cats. Cats have a fast metabolism which requires that they get a shot every 12 hours.

Your cat's not eating or drinking and being lethargic is a concern. I would strongly encourage you to get ketone strips (e.g., Ketostix) at any pharmacy and test your cat's urine for ketones. If the inappetence and lethargy are still present, you may want to consider going to an emergency clinic and getting your cat tested for ketones. The presence of ketones can quickly develop into diabetic ketoacidosis (DKA) which if untreated can be deadly. Treatment can often mean a hospital stay. I honestly don't mean to scare you but I become concerned when someone describes their cat as not eating and is lethargic. Ketones can occur is there's not enough insulin and not enough calories and an infection or inflammation and from what you've noted, you've got at least 2 of 3 boxes checked. With a BG of over 400, your cat needs insulin.
 
Oi, I also have never worked with a message board, and haven't slept much in a few days so there's that. thanks for the info, I was already leaning in the direction of a new vet, now I am convinced. DKA seems likely. I explained all of this to vet yesterday, I was told to skip the insulin. Doesn't make much sense to me from what little I am coming to understand. Thanks for responding, I didn't really think I needed direct support from someone who knows wtf they are talking about, but it sure helps me feel like I have a bit more of a grasp on something. U40 syringes, yes....although why everything cant just be in SI units I'll never understand. I am going to test BG administer insulin and recheck....if I can get that much blood from her poor ear...
 
Ele's Human said:
Oi, I also have never worked with a message board, and haven't slept much in a few days so there's that. thanks for the info, I was already leaning in the direction of a new vet, now I am convinced. DKA seems likely. I explained all of this to vet yesterday, I was told to skip the insulin. Doesn't make much sense to me from what little I am coming to understand. Thanks for responding, I didn't really think I needed direct support from someone who knows wtf they are talking about, but it sure helps me feel like I have a bit more of a grasp on something. U40 syringes, yes....although why everything cant just be in SI units I'll never understand. I am going to test BG administer insulin and recheck....if I can get that much blood from her poor ear...
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I wouldn't skip. If the problem is ketones you definitly want to make sure she's getting insulin.

Head to the store and pick up some ketone strips. They go in fresh urine then you read it against the bottle at 15 seconds. If it said trace you need to get food water and insulin in her and monitor really closely. Id also get her to a vet. Anything over a trace is an emergency. There are also ketone blood meters that work the same as a bg meter.... There's lots of them on amazon but you may or may not find them locally.

I agree with what was said above. Insulin is ment to be dosed twice a day. Otherwise he's spending a majority of the day with no insulin support at all. Pick a time am and pm that works 12 hours apart. The recommended starting dose is 1 unit twice a day.

If the dm food you are giving is dry, switch to all wet. You don't need perscription food, just a low carb wet food. Most of us feed fancy feast classic or Friskies pate foods.
 
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JanetNJ said:
I wouldn't skip. If the problem is ketones you definitly want to make sure she's getting insulin.

Head to the store and pick up some ketone strips. They do in fresh urine then you read it against the bottle at 15 seconds. If it said trace you need to get food water and insulin in her and monitor really closely. If also get her to at. We can help. Anything over a trace is an emergency. There are also ketone blood meters that work the same as a bg meter.... There's lots of them on amazon but you may or may not find them locally.

I agree with what was said above. Insulin is ment to be dosed twice a day. Otherwise he's spending a majority of the day with no insulin support at all. Pick a time am and pm that works 12 hours apart. The recommended starting dose is 1 unit twice a day.

If the dm food you are giving is dry, switch to all wet. You don't need perscription food, just a low carb wet food. Most of us feed fancy feast classic or Friskies pate foods.
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Just gave her insulin. How long before a retest would be helpful? As far as food is concerned, I was so happy that she started eating the tuna I am headed to the store to get more. I will pick up some of the suggested foods too, and the keytone strips...though I think she is too dehydrated to urinate in the near future.
 
BG:336 before insulin, 280 after. And she just ate a 1/4 can of food. I got the ketone strips, but as I said, she is still too dehydrated to urinate.
 
If she's slurping up the tuna water, that's good. You can always add water to her food so it's a bit soupy. Water is a good thing for diabetic cats.
 
Vetsulin usually peeks 4-6 hours after injection. That's a good time to get a test when you can.
 
No, I did fall asleep for a couple of hours, but she is in the same spot. I am going to test and then give her 1 unit of insulin.
 
291 up from 146 3 hours ago. I gave her 1.5 U. She definitely has more energy, but she is having some trouble with he hind legs...neuropathy? That is my next research project...
 
Ele's Human said:
I REALLY appreciate this forum, by the way. Thank you guys for existing.
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These ladies are great. The more I learned from them the less I listened to my vet. 5 month newbie here and my cat is doing good thanks to these ladies.
Warm sock to the ear works wonders. I used a baby sock filled with rice. Microwave 15 seconds
 
Ele's Human said:
291 up from 146 3 hours ago. I gave her 1.5 U. She definitely has more energy, but she is having some trouble with he hind legs...neuropathy? That is my next research project...
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You're doing great! In addition to being the bg under control to help neuropathy, most find adding b12 methylcobalamin supplements help. A popular choice is the brand zobaline which is on amazon.
 
Woke up to a cat healthy enough to jump on my chest and cuddle. It's been a while since that happened (and not just because I haven't been sleeping enough)! If I hadn't found this forum I don't think she would have made it through this weekend. I feel empowered to handle Ele's diabetes now. I just had to look back at when I started this thread, because it felt like weeks ago, but that didn't seem right...Sunday. Last Sunday. As in, 3 days ago. Time is a weird thing; a stubbornly persistant and very odd experience.
 
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