New diagnosis need help

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ISIL&TIFIL

Member Since 2011
Hello beautiful people,
I've been reading this site for about two weeks trying to find answer for what is going on with my cat, trying to do my best with so many difficult situations I have been through since one mounth. At last, I gave up, understood that I can't handle it alone and decided to write. I hope, with the wonderful people out here I am going to overcome.
First of all, I want to apologize for my funny English. I am Turkish and English is not my mother language but I will do my best to express my self in a way or another..
1 month ago (5/18/2011) when I came from work, I found my sweet cat TIFIL (10 years old) laying on the floor with her head in the water bowl unconsciously. She drank a little then she throw up. My husband and I immediately called the vet. The vet told us not to give her water and wait till next mornig!!!! we waited and couldn't sleep because she was really looking bad. Next morning we went to the hospital and she had her blood tests. BG was 558. ketone in her urine (+) anemia, these were some of the results. TIFIL stayed in the hospital untill 6pm and the vet told me that I can take her home :idea:
That night was a disaster. anyway, the next day we went again to the vet. TIFIL was dehydrated, she was in a really really bad situation. they gave her IV Flueds, force feeded her, gave her insulin and so on. after 5 days I wasn't confident of leaving her there anymore so I brought her home (she is a neurotic cat, afraid of everyone, only loves me even doesn't like my husband so much :)
The point is, I am not sure what happened was a DKA or not. What I am sure is that I was all alone in my country with no vet to help me about a diabetical cat!!! next day I met with an angel, she is a women that has lived the same despair 10 years ago. She couldn't find anyone to help her in our country and communicated with this site and saved her cat by the agency of you people...
She came to my house, brought me equipment (glukometre,lantus solostar pen, food...) She taught me how to home test and many things. So with her guidance I started home testing and giving insuline. I stoped feeding her with dry food. She gave me some recipies of making raw home food and so on...
In Turkey we only have fancy feast from all the low carb. canned foods on the list. So TIFIL is on ff
The problem starts from this point. we started "start low go slow" but things are not working well. I don't know why :cry:
sometimes her BG'S start going down on +8. sometimes it doesn't go down, it stays stable. more and more strange things ...here are some of the testing results. I will be very happy if you can help me on the dosing. Thank you very much for reading...
ISIL

PMPS 360 1iu
+5 278
+8 188
+9.5 289

AMPS 250 1iu
+6.5 129
+9 93
+10.5 256

PMPS 327 1iu
+2 327
+4 218
+6 205
+8 157
+10 125
+11 189

AMPS 233 1iu (I am sure it's not a fur shot, her tummy fur is shaved because of xray)
+2 300
+8 259
+10 272
+11 278

PMPS 238 1iu
+1 292
+3 331
+6 341
+7 318
+8 315
+10 280

AMPS 244 1 iu ( a little higher)
+2 198
'+4 235
+10 124

PMPS 137 0.5 iu
+2 130
+3 169
+4 170
+6 230

AMPS 209 1.0 iu
+1 165
+2 139
+3 106
+5 103
+8 114
+10 110
+11 129

PMPS 146 0.5 iu (I didn't know what to do, I was going to go out for about 6-7 hours, couldn't dare to give 1iu)
+1 152
+8 309 :(


I'm using Bayer Ascensia counter and Roch Accu check Active.

Now there is about 3 hours for me to give the next shot, please help :cry: :cry: :cry: :cry: :cry: :cry: what's wrong with my kitty
 
Welcome!!

I'm just about to go give a lecture but I've put a call out for some of the folks here to stop by. Please read the info in the starred, sticky notes above on the Tight Regulation Protocol. That will give you a foundation. Also, if you've just been giving Lantus for a few days, it takes about 5 - 7 days for the insulin for form a depot or shed. Once that happens, the insulin will be better able to do it's job.

I'll be back later.
 
Thank you very much for the quick answer, I will immediately read all the information you suggested..
 
Hi there and welcome!!! Tifil's numbers really don't look too bad for a kitty who has just started on Lantus. It takes a little while for Lantus to really start working and you need to know to keep her dose the same for 5 to 7 days. That will allow her "shed" to fill up. This is like a little reservoir in her body where she stores insulin to use as she needs it. Keep the dose at 1u for the 5 to 7 days and keep track of all her numbers just like you're doing. You're doing a GREAT job!!! Provide her with plenty of water and continue feeding her the low carb FF only and everything will start to improve!!! Just like Sienne said, read all the stickies at the top of the message board and this will give you sooo much important information. You really are doing well and Tifil's numbers aren't in a danger zone, so rest easy. We're all here to help and to lend you support!!
 
Hello!!!! & Welcome!!! :) You will feel right at home here! You have come to the right place. I read on here for weeks before I actually wrote for help. I am so glad I did. They saved my sweet furbaby! Can you start a spreadsheet? I think it would help the dose advisers a lot!

You are doing great with the hometesting!! Keep it up! :) It's a lot to take in, but you'll get the hang of it. There are lots of personalities here, and it can get intimidating. Just remember that everyone here is trying to help your kitteh and has the best of intentions. :)
 
Thank you Thank you thannkkk you :)
So nice to have lovely people helping me, I am grateful..thanks god for the person who discovered internet :smile:
I am not sure if I am feeding her so much. she gave weight, She is 4kg now. 2 cans of ff is not enough, she is allways begging for food. Is it ok if I give her boiled chicken?
 
she is not drinking water anymore. I'm adding water in ff, maybe that's why she doesn't need water. But still urinating alot.
I will prepare a spreadsheet as soon as possible.
There is something I don't understand, when her amps or pmps's are low (under 150) should I still shot 1iu ?
 
Hi welcome to Lantus Land :-D

When cats are newly diagnosed they are very hungry. What we do here is feed small meals; one at preshot, then at +1, +2, +3...all before nadir, which you will discover is not always at +6.

Many people give boiled chicken to their cats, but I dont know what recipe they follow.

Fancy Feast is ok. Most of us use FF.

Try to set up the spreadsheet. Follow the instructions in this link Create Spreadsheet

Keep asking question. We are all in the same boat and there are excellent experts here to help you (I'm not one) :lol:
 
tifil&isil said:
she is not drinking water anymore. I'm adding water in ff, maybe that's why she doesn't need water. But still urinating alot.
I will prepare a spreadsheet as soon as possible.
There is something I don't understand, when her amps or pmps's are low (under 150) should I still shot 1iu ?

Adding water to the food is the best thing you can do if she DKAed. When they eat wet food they dont drink as much water.

Cannot help you with dose. The only thing I can say is that Lantus likes consistency and requires patience (which i dont have :lol: :lol:). An expert will come soon to help you.
 
I sure wish I could advise you about dosing, but I can't. You need a dosing expert to give you exact instructions as to what to do in that case. I know what I would do which is this....I would give the 1u of insulin, BUT because you don't have a lot of data yet and don't know how Tifil will react, you would need to be able to monitor her constantly. You would need to have a hypo kit ready to go. This would include high carb gravy food, Karo syrup or honey, and A LOT of test strips. You would need to test her at +1. If her number gets below 100, you would test again in a half hour. Depending on her numbers, you would continue testing every 15 minutes to a half hour, giving her a little food and possibly honey or high carb gravy (no human gravy!!) as her numbers dip. You DO NOT want her to get below 50 if at all possible. I'm sure others will come on and give you advice. I hope they will correct anything I've told you that may not be a good idea for you in your situation.

Someone will be here to help you through all this if you do decide to shoot a low number. Make sure to read the sticky on shooting low numbers and it will give you all your options, whether to shoot, not shoot, shoot a reduced dose, or stalling (and not feed) under her numbers rise to an acceptable level.

I give my cat boiled chicken as a treat. It doesn't even have to be cooked all the way through and the cats love it!!
 
:razz: :razz: :razz:
At first, I gave her unstable amounts...but for 4 days I've been giving 1 iu and it is really hard for me to be patient also @-)
But Tıfıl is teaching me something, when I pock her ears she is licking my hand :) she is really a strange cat giving me a life lesson :lol: :lol: :lol:
 
my pmps and amps's are in a strange time.. I am working in a University so my overtime is not stable everyday. But when I have to be in school I come home for lunch time to give amps. 12pm is not a good time to shot but I don't have another chance. So the feeding part is alittle hard to fix when I am not home.
 
welcome!

a dosing expert will help you decide fine tuning (for clarification- these are people who are more experienced with dosing, lantus, and the protocol, sienne is one of them)

natalia has given you instructions for the spreadsheet, it's set up through google, that way everyone can view it easily. load in the numbers you have since this group is very data driven, so the spreadsheet is really helpful (it also means that both you and your husband can access it from multiple computers or from offsite)

she's at 4kg (everyone else here that's a shade under 9lbs)- is that more or less than she normally is?

you are located in turkey, correct?

keep asking questions.
 
Tifil sounds like a little sweetie!!!! She knows you're trying to help her and she's just saying thank you and she loves you!!

Some people freeze portions of FF that they've mixed with water. They can leave out some frozen FF while they're at work and the food will slowly defrost for the kitties to eat. I've never done this so I can't advise on how to do this, but I know there are lots of people out there who can help you. Also, some people have their schedules arranged so they test, feed, and shoot when they first wake up, feed at +1 while they are getting ready for work, and then set out +2 when they leave for work. It can be a real juggle to figure out what works best for you.
 
I ordered bayer ketone stripes from internet, I am waiting for them to come. Actually I am afraid of the result. There is not a good vet that can handle a DKA here. I have a vet friend in Canada helping me alot, when Tıfıl was in bad situation we tried to find a vet broadminded for consultation with my friend in Canada. BUT COULDN'T :( neither one accepted that....
 
tifil&isil said:
my pmps and amps's are in a strange time.. I am working in a University so my overtime is not stable everyday. But when I have to be in school I come home for lunch time to give amps. 12pm is not a good time to shot but I don't have another chance. So the feeding part is alittle hard to fix when I am not home.

You shot at 12pm and 12am? Am I correct?

See if they sell cat feeders in your town. I use it when i go to work. I just mix cans of food with water ( to a soupy consistency) put the mix in ice trays and into the freezer. Then I just put one "catcicle" in each compartment of the feeder and I leave for work.
 
it's super easy to do, and pretty much exactly like patty described.

we use an ice tray and an automatic feeder.

the ice tray has a lid so we don't get cat food water all over the fridge.

we put either a 1/4 can of ff on it's own in the cube slot or an 1/8 of a can with water. then pop the cubes into the auto feeder and hope he doesn't break open the auto feeder (we have a very very clever cat).

it works beautifully.
 
tifil&isil said:
I ordered bayer ketone stripes from internet, I am waiting for them to come. Actually I am afraid of the result. There is not a good vet that can handle a DKA here. I have a vet friend in Canada helping me alot, when Tıfıl was in bad situation we tried to find a vet broadminded for consultation with my friend in Canada. BUT COULDN'T :( neither one accepted that....

Her numbers do not look bad at all, so lets hope she is better. Good Vets are hard to find. There are horror stories everywhere.

My cat DKAed too. She was in the emergency room for 4 days. Now she is doing just fine :-D

You and Tifil are in the best place there is for help.
 
she's at 4kg (everyone else here that's a shade under 9lbs)- is that more or less than she normally is?

you are located in turkey, correct?

keep asking questions.


Yes she is 4kg. She was about 7kg 5 or 6 mounths ago. she started losing weight but I thought it was good because she neaded to. I was so silly not to understand that it was because of a health issue :( During the stay at the vet, she really lost alot. when she came home she was 3.5 kg..

I am located in Turkey ( I know it is a funny country name :)
 
I buy my Lantus in Turkey :-D

If she was overweight at 7 kg, then maybe 4 kg is good and lean. Do you see her too thin or just right?

Enana lost about 1/2 her weight when she DKAed. She was a little in the "round" side. Now she is in the perfect weight. :-D
 
yes there are auto feeders here. I am planning of buying one..The reason I decided for the shotings to be at 12am 12 pm is because after I shot I immediately go to work again so after 3 or 4 hours I will be back home. So if she has an hypo I will be at home by the time the bg's starts to go down. Because I am new (and so is Tıfıl) I wanted to be at home as much as possible. But after few mounths, when tıfıl starts to have more stable numbers, I am planning to change the time of the shots to the morning.
 
Champ went from 9.75 kg to 7.2 kg before I realized something was wrong (17.5 lbs to 15.9 lbs). Don't feel bad. It happened to us all!!!
 
hello and welcome to the group!

glad you found us! please don't worry about any possible problems with language. we can all ask each other questions if there's something we don't understand. we'll get along just fine! congratulations on learning how to test tifil's blood sugar at home!

you've already been given some very good information.

5/18 - found tifil sick - head in water bowl, lethargic, vomited
5/19 - took tifil to vet BG 558, positive for ketones, anemic - took her home
5/20 - back to vet. tifil was dehydrated, gave IV fluids, force-fed, and insulin for 5 days

it *sounds* like tifil may have been in DKA when she stayed with the vet for those 5 days. i'm glad you have ordered some ketone strips to test her urine at home.

tifil is eating low carb canned fancy feast. this is wonderful!

are any of the high carb varieties/flavors of fancy feast available in turkey? usually the fancy feast flavors that are high carb are the ones with gravy such as Grilled Beef Feast, Grilled Chicken Feast. Grilled Turkey Feast, Minced Beef Feast, Minced Turkey Feast, Sliced Salmon & Chicken Feast, and Sliced Turkey Feast. The food charts can be found here: http://binkyspage.tripod.com/CanFoodOld.html. we like to have some high carb food in the house to help bring kitty's numbers up if they begin to drop too low. we also use syrup or honey (maple syrup, karo syrup, etc.) to bump numbers up when they drop too low.


AMPS 360 1iu
+5 278
+8 188
+9.5 289

PMPS 250 1iu
+6.5 129
+9 93
+10.5 256

AMPS 327 1iu
+2 327
+4 218
+6 205
+8 157
+10 125
+11 189

PMPS 233 1iu (I am sure it's not a fur shot, her tummy fur is shaved because of xray)
+2 300
+8 259
+10 272
+11 278

AMPS 238 1iu
+1 292
+3 331
+6 341
+7 318
+8 315
+10 280

PMPS 244 1 iu ( a little higher)
+2 198
'+4 235
+10 124

AMPS 137 0.5 iu
+2 130
+3 169
+4 170
+6 230

a few questions...
--- are the BG numbers above current (from the last four days)?

--- tifil weighs 4kg (8.8 pounds) is she overweight or underweight?

--- did the vet tell you if tifil had an infection? if the answer is yes, was she given any antibiotics for the infection?

--- is tifil taking any other medications?

--- how is tifil feeling? is she bright, active, and alert?

--- is tifil eating well? two cans of fancy feast may not be enough for her. you may want to feed her three cans per day... and yes, you can feed her boiled chicken. you can also mix a little water in her food to help keep her hydrated.



can you test her about one hour before her shot is due and then post the number? it'll give us a better idea about what to suggest for a dose.
please, keep asking questions and take time to read the stickies (starred posts near the top of this forum). we're more than happy to help!
 
Isil, Jill is one of our wonderful experts and can give you THE BEST advice along with Sienne, Laurie, and others. If she tells you something to do, you know you've gotten very good advice.
 
before answering all the questions I have to tell that after half an hour I have to shot. so I will test her now and write the result.
By the way, the results are for the last 4 days, I have more data starting from 5/27/2011. But the insuline doses were not stable..
 
tifil&isil said:
before answering all the questions I have to tell that after half an hour I have to shot. so I will test her now and write the result.
By the way, the results are for the last 4 days, I have more data starting from 5/27/2011. But the insuline doses were not stable..
no problem. post the result and we'll talk. :-D
 
AMPS 137 0.5 iu
+2 130
+3 169
+4 170
+6 230

+11.5 209

for some reason, we often see a little dip in the numbers at the end of the cycle with lantus. it's not unusual. i'm glad you were able to get that test.
do you have syringes marked with half units or are they marked with whole units only?

resource.gif
 
a few questions...
--- are the BG numbers above current (from the last four days)?

yes they are...
--- tifil weighs 4kg (8.8 pounds) is she overweight or underweight?

İt is underweigt. she gained a half after coming from the vet
--- did the vet tell you if tifil had an infection? if the answer is yes, was she given any antibiotics for the infection?

no there is no infection. the levels on the blood are ok. but the vet told me that he gave antibiotics during the stay. don't know why, maybe for possible pancreatitis.
--- is tifil taking any other medications?

no, I am giving B12 for anemia. 2 days ago I gave her zyrtec for her constant itchings, but the bg levels rised so much I immediately stopped giving. By the way her left eye has a problem now. It is watery and third eyelid is allways there :) but the vet said that it dosn't need antibiotic. I gave her omega 3 fish oil for itching. she is eating spirulina also. I don't know if it's good.
--- how is tifil feeling? is she bright, active, and alert?
She is super these days. She was allways a sleeper all the time and she is again sleeping alot. but she really looks wonderfull. her fur looks grate bcause of Fish oil I guess.

--- is tifil eating well? two cans of fancy feast may not be enough for her. you may want to feed her three cans per day... and yes, you can feed her boiled chicken. you can also mix a little water in her food to help keep her hydrated.


She is a great eater, she even tried to eat my finger because it was smelling fish oil :):):):):) my husband was anxious that she is going to eat us while were sleeping :)

I am buying the classic version of ff (the ones without gravy) before buying them I read the stuff written in fdmb :) But there is a big problem. Nestle stopped bringing ff to Turkey for some time because of the new virus in Europe. so I ordered about 200 cans :)
 
if tifil is underweight, i'd definitely give her more to eat. she'll probably be happy if you let her have 3 cans of fancy feast per day.

i haven't heard of anyone giving spirulina to their kitty, but i did a quick google search and there does seem to be some possible benefits.

i'm concerned about her eye. perhaps you can get another opinion from a different vet?

i'm happy to hear she's feeling well! :-D

syringes --- i had a hunch you had syringes marked with only whole units. half-unit marked syringes don't seem to be available in every country. however, you might want to talk to a pediatrician or ask about half-unit marked syringes at a hospital. oftentimes, they're available for dosing children.

with as much as you've been testing combined with the probability that tifil is prone to ketones... i think your best bet is to continue with shooting 1u twice a day. if tifil presents you with a preshot number lower than 150 - 180 post the number here and ask for advice.
 
You may need to be creative with the syringes. Are you able to order syringes on-line (and it not cost a fortune). It's likely that you can find out where to get syringes if you call a pediatrician's office. Infants or children with diabetes may need insulin doses in small amounts. Calling a hospital pharmacy may also be a resource.
 
Hi! Is your name Isil? Welcome to lantus land. You've had some of our best people giving you advice today but everyone here is amazing and has something great to contribute to getting your girl well and keeping you sane. Your English is absolutely fine!!! Great job all around and we are so glad you found us.

I just wanted to welcome you and let you know we are all here to help. As Tifil fills her lantus shed, she should start acting more and more like her old self and gain back her weight. At first, some of the symptoms do include always hungry but losing weight, drinking alot of water, and sleeping alot. It is good she allows the pokes!! As someone else said, it is very helpful to add extra water to her food and to test her regularly for ketones.

There is usually always someone around to help if you get into a low number situation. Alot of us have a link to information on Handling Low Preshots and Low Numbers in our signature blocks (I do).

BTW, my husband and I lived in Germany for six years and travelled to your beautiful country. We have always loved Turkey and the people there and I have some wonderful mementos (carpets :-D ) from there. Let us know how we can help.
 
just wanted to mention...

when a kitty drops to lower numbers than their body is used to their numbers may jump up and remain higher for up to the next 3 days. we call it a bounce. i believe some of the higher numbers you're seeing are from tifil dropping to numbers in double digits.

Somogyi rebound aka "Somogyi's phenomenon" is a common phenomenon in pet diabetes : When blood sugar levels drop too far or too fast, the animal will defensively dump stored glucose from the liver into their bloodstream, resulting in high blood sugar.
http://petdiabetes.wikia.com/wiki/Rebound

when this happens, ignore the fluctuations in numbers. once the bounce clears, the numbers will come back down.


i know you're probably busy, but as soon as you can put a spreadsheet together, the better. you'll be able to see these patterns for yourself on a spreadsheet.
 
you are doing a great job taking in all of this information!

everyone here is very supportive and invested in helping.

my boyfriend's mother speaks some turkish, she visits turkey at least once a year.
 
we've given you a lot of information to read and absorb. please ask any questions you may have. there's a huge learning curve to using lantus with our kitties, but in no time at all you'll be offering advice and suggestions to others.

is it shot time yet? :-D
what is tifil's preshot number?
 
Thank you very much everyone. I gave her shot 1iu, gave her ff with lots of water in it, gave her love, she pured at me as if saying thank you ::):):):):)

On Monday my first duty will be investing the half unit syrings. I will call the medical school of he University I work in. I hope they can show me a way.
Re: New diagnosis need help
BTW, my husband and I lived in Germany for six years and travelled to your beautiful country. We have always loved Turkey and the people there and I have some wonderful mementos (carpets ) from there. Let us know how we can help.

It is very nice to hear very good words about my country from you, if you would like to come here again one day please know that you have one house here that you are always welcome to :)


Re: New diagnosis need help
by mococo » Sat Jun 18, 2011 4:06 pm
my boyfriend's mother speaks some turkish, she visits turkey at least once a year.

So nice :) Turkish is a hard language, even I am still not capable of talking correctly :)

My father had his master's and PHD degree in Yale, he always tells memories that he experienced and always mentions about helpfull people that gave so much to him while he needed support. I am so lucky that I also have the chance to meet those people that my father always talks about gratefully...thank you for everything.....
 
I am a real slow writter :) sorry for replying so late.
After I got your message about giving 1iu, I gave her shot, it's about to be 40 minutes. should I test her at +1 ?
Can Tıfıl's eye be horner's syndrome? or can it be because of the polen allergy?
 
Yes test her at +1. That way you know if her blood sugar is dropping or not. If the +1 is higher than the preshot you will be ok, but if the +1 is lower the chance is that she is going to keep dropping.

That's why I asked you about shooting at 12am. :shock: Isn't 2 am there right now?
 
Getting tests at any time is good!! Any time you are shooting a lower number than usual we encourage you to get a +1 and a +2 test. In the "New to the Group" sticky note, there is information on what an "ideal" curve would look like. The +1 number should be higher than your pre-shot test since it reflects the influence of food (or, what we refer to as a food spike). The +2 number should be about the same as your pre-shot. If either of these numbers are lower than your pre-shot test, it may mean that it's going to be an active cycle.

I wouldn't be able to even guess if this is Horner's Syndrome. However, some sources indicate that if it is, it's not something that often requires treatment. If this is allergy, you might want to see if L-lysine powder, mixed in to Tilfil's food will help. L-lysine is an immune system booster. At least in the US, you can find it at health food stores. You mix 1/8 teaspoon into food twice a day.
 
Sienne and Gabby said:
Getting tests at any time is good!! Any time you are shooting a lower number than usual we encourage you to get a +1 and a +2 test. In the "New to the Group" sticky note, there is information on what an "ideal" curve would look like. The +1 number should be higher than your pre-shot test since it reflects the influence of food (or, what we refer to as a food spike). The +2 number should be about the same as your pre-shot. If either of these numbers are lower than your pre-shot test, it may mean that it's going to be an active cycle.

I wouldn't be able to even guess if this is Horner's Syndrome. However, some sources indicate that if it is, it's not something that often requires treatment. If this is allergy, you might want to see if L-lysine powder, mixed in to Tilfil's food will help. L-lysine is an immune system booster. At least in the US, you can find it at health food stores. You mix 1/8 teaspoon into food twice a day.

There is L-lysine here but I am fiving spirulina for the same reason, İmmune system booster and in addition it is a great protein suplement (+all kind of minerals). I am a vegetarian I use spirulina, I wondered how it can effect my cat and did a research in the internet. Its even written that its good for diabetic cats. let's see how it will effect.
 
Isil go to your first post, click edit and write this in the subject line

6/19 TIFIL PMPS 209 +1 165

then edit with subsequent tests.

That way people know how she is doing :-D
 
Hi! Just wanted to welcome you to LL! I'm so glad you joined in on the conversation. As you've already seen, the information and support here is tremendous.

Hope Tifil is feeling better!
 
Hi I too wanted to welcome you to our group. You've received alot of information already, I won't add any more. I am glad that you have found us. This is a great place, and I know you will get the help you need with Tifil.

WELCOME!
 
it's good morning time for us here :)
I've updated my new results in the first edit.
Thank you to everyone for your warm welcome messages....feels so great to have lots of helping people when not knowing what to do... :smile:
 
Hello,
Thanks for the welcome.. ;-)
I will prepare my spreadsheet as soon as possible...
I still don't know what to do when I have low PMPS or AMPS's. today my preshot was 146, I couldn't dare to shot 1iu. Now her numbers are pretty high :(
 
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