New Diagnosis - Unsure of what to do

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Mom2Missy

Mom2Missy

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Hi all! My name is Krista and my kitty's name is Missy. She was diagnosed with diabetes on Wednesday 08/18/10. The vet is unsure if it is primary diabetes or secondary due to pancreatitis. She also has an ulcer in her mouth that causes pain with eating. She was initially started on 2.5 units of insulin. I'm unsure of what type of insulin she is on. I would check, but she is napping on my lap. Her glucose on Wednesday was 351. She received 2.5 units that night and the next morning. She stayed at the vet yesterday for IV fluids. They told me her glucose was at 87 both times they checked it. I was told to skip last night's dose and give half a dose this morning. I was nervous about hypoglycemia, so I only gave her 1 unit instead of 1.5. She went back to the vet today and her glucose is 59. I was told to continue 1 unit at night only and follow up next week for a glucose curve.

With her glucose being only 59, I'm nervous to give her more insulin. She was previously on a diet of dry food only. Due to the ulcer, I am syringe feeding her. Could the change from dry to wet have reduced her need for insulin so quickly? I'm planning on getting a glucometer so I can check her levels at home, but I'm not sure at what level I should go ahead with the insulin and when I should hold off on it.

Thanks in advance for the advice. I had a cat pass away last year due to complications from this same disease. He was diagnosed with severe diabetic ketoacidosis, spent the weekend in the emergency vet, and passed away the next Tuesday. I am so fearful that history is repeating itself. I want to make sure I do everything I can to make sure Missy stays well.
 
With little data to go on one unit may be too much. How long (we use terms + (number of hours after shot) to convey that information.

Welcome. I recommend that you learn to measure your cat's blood glucose (BG) at home using a Human meter. Frequently BG measured at the vet are higher than they would be in real life at home. Home testing will help avoid the problem that you experienced with you last cat too.

Yes going from a dry food to canned (must be canned to be syringe fed) can reduce insulin needs and cause a cat to go into remission because canned food is much lower in carbs than dry.

Edited to say canned is lower carb than dry. Did say canned is lower carb than canned.
 
Yes - the diet change can have a pretty fast effect on blood sugar.

Get yourself a meter kit and if her blood sugar is below 200 at shot time -- do not give a shot.

It could be that the diabetes is transient or short term due to the pancreatitis and mouth ulcer.

Since a dose of 1 unit has made her drop down to 59 ( normal), that dose may be a bit too much depending on what time the 59 occurred with respect to what time the injection was given.

59 is an ok, normal number for blood sugar if NOT getting insulin. If getting injections of insulin, it is possible to keep going lower and lower. Please read about HYPOGLYCEMIA so you know what to do if it happens.
 
She was prescribed ProZinc 40units per mL. The vet said this one lasts longer than previous insulins, so I won't need to throw it out every thirty days or so. She ate 6mL of canned food at 610am followed by 1 unit of insulin. She ate another 6mL of food at 1115AM and the glucose was check at 1145AM, showing a level of 59. The vet provided some insulin syringes to use, but said they are the wrong ones. They are BD Ultra-Fine 3/10cc syringes. They are super tiny, so I can't measure out much less than 1unit.
 
If you are using a U40 insulin with U100 syringes and pulling to the 1U line, then she is getting only .4U.

She may not need insulin.

Get a glucometer and learn to test. That's the only way to know for certain.

I feel hopeful. (Thank goodness for the wrong syringes.)
 
Those are lovely syringes -- the only thing is they are for U100 insulin (100 units per milliliter), so as Venita says -- if you fill to the 1 unit line with PZI U40 (40 units per ml), then you are actually giving 0.4 units of insulin.

by the way, Larry made a typo in the last sentence ---

Yes going from a dry food to canned (must be canned to be syringe fed) can reduce insulin needs and cause a cat to go into remission because canned food is much lower in carbs than XXcannedXX. should be DRY
 
Her need for insulin will also not only depend on what food you are giving her but how much.
6ml doesn't sound a great deal to me (even twice I think you mention)

It does inded sound like you have given .4u in reality. Check on the side of the box/syringes and see if it does say u100 on either.
BD 3/10cc are what I used and they were u100 syringes.

Also concerning is that your 59 test was only 30 minutes after food.Food artificially raises bg's so she could have been even lower.

Can you get a test in before you give any insulin?feed and wait at least 2 hours, test again. If the number has started to go down, means she is making her own insulin.Usually you are best to be checking for keytones (I guess you know about thiss from your last kitty-so sorry to hear about them).
 
I did some searching and found the glucometer I bought for my previous kitty. I never got to use it because he was at the emergency vet from the time he was diagnosed until the time he passed away. My plan is to watch lots of YouTube videos to figure out how to use this thing and I will start checking her levels in the morning. Something deep down tells me she does not have full blown diabetes. I think it is an incidental finding related to the mouth ulcer and pancreatitis. I have absolutely no experience with any of this, but I don't feel comfortable continuing with the insulin and just waiting until next week to recheck the glucose at the vet.

Another question... how long/soon after feeding do I give the insulin if she needs it? The vet said to give insulin immediately after feeding, but I've read other posts that said to wait an hour or two. Should I check glucose, feed, wait two hours, recheck glucose, then give insulin if the glucose is over 200?
 
Hey there. I'm not going to comment on the insulin, because it's really easy for me to put my foot in my mouth. But one thing I thought of: you said your cat passed away last year? Unless you've gone out and bought more - you might want to check the expiration date on your testing strips. I don't know if there's any difference between the expiration date and when they "really" expire, but it's always good to play it safe.

Hang in there!
 
In regard to the potential pancreatitis, you may want to ask the vet to run a PLI test. This is more expensive than other "usual" bloodwork (about $150 in NYC) and takes a while to get the result, maybe 4 or 5 days. That should tell you at the pancreas.
 
Vet has informed you wrong unless your using a short acting insulin (and even then still not really correct)

You must test BEFORE FOOD,this gives you an accurate bg number. If you test 1-2 hours after, the bg has been affected by the carb content of that food.
This could be a very big explanation for why your getting lows.

As suggested, make sure your strips are still test worthy (could do a control test too)

If possible I would monitor for keytones if your holding off the insulin (you just don't know for sure as have no 'real' numbers to go by)

If you look at the stickies in health, I'm pretty sure there's one there that gives you tips on home testing as well as watching videos. Bits and bobs that make it easier.

Good luck
 
I agree with Kate, that doesn't sound like much food at all. That could have a lot to do with the lower numbers.

I know it must be difficult trying to feed her but I hope you can get more into her. I would be afraid of other complications if she doesn't get more to eat. Even just two cans of Fancy Feast a day is 6 ounces of food.

I am sorry to hear she has this ulcer. :( Does the vet figure it will be a while before it heals?
 
If your vet uses Idexx labs for their sent-out blood work the results for the Spec fPL test is available the next day.
http://www.idexx.com/view/xhtml/en_us/s ... b=Benefits

SaraJaye said:
In regard to the potential pancreatitis, you may want to ask the vet to run a PLI test. This is more expensive than other "usual" bloodwork (about $150 in NYC) and takes a while to get the result, maybe 4 or 5 days. That should tell you at the pancreas.
Click to expand...
 
Ok - with PZI insulin you can test-feed-shoot within a few minutes.

Some insulins like Humulin N hit really hard, and so it is better to test & feed 30-60 minutes before shot time
 
The main concern I have with her right now is her lack of appetite. She refuses to eat anything. I've tried dry food, canned food, warmed up food, food sprinkled with cheese... The vet said to syringe feed her 6mL every 4 hours until her appetite returns. I'm planning on going out tomorrow to stock up on different varieties of canned food to try to find one she might actually eat on her own. Once she starts eating, I'll feel much better about this whole situation. Any suggestions would be greatly appreciated.
 
So, after about six tries, I was able to get some blood to check Missy's glucose this morning. She is at 96. I syringe-fed her 12mL of food. I just printed off the list of low carb canned foods, and I'm going to the store to try to find something she will eat on her own. I opened up a can of food this morning and she licked the lid. I was so excited! I poured the can of food onto a plate, warmed it up, and gave it to her but she turned her nose up at it. I put the food in her usual food bowl, and again she walked away. I've tried everything I can think of to get her to eat on her own, but nothing has worked. I don't know if she's just being stubborn or if her mouth still hurts from the ulcer. Has anyone had any experience with FortiFlora? I've read that this can entice cats to eat canned foods. I'm wondering if his has actually worked for anyone.
 
I haven't used FortiFlora but I know lots of other people have with success.

One other idea to try. I know this sounds ridiculous, but sometimes if you feed them with your finger, they will start eating again. Just put some catfood on your finger and offer it. There is something unique about cats that when they go off their food, whether it's because they are not feeling well or their sense of smell is off or whatever, it is sometimes hard to entice them back into eating again. And then once they start, all's good again.

You are right, it is imperative that she eat.
 
This happens to me a lot. Sometimes my cat will ignore his bowl, but will eat if I take a scoop onto my hand and put it infront of him. Strange, huh? Good luck


Sue and Oliver said:
I know this sounds ridiculous, but sometimes if you feed them with your finger, they will start eating again. Just put some catfood on your finger and offer it. There is something unique about cats that when they go off their food, whether it's because they are not feeling well or their sense of smell is off or whatever, it is sometimes hard to entice them back into eating again. And then once they start, all's good again.

You are right, it is imperative that she eat.
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Fancy Feast is the winner! It looks like she prefers shredded meats over the pureed canned food I have been feeding her. I just re-checked her glucose and she is at 109. I guess I'll just keep doing what I've been doing over the weekend and follow up with the vet next week.
 
Mom2Missy said:
Fancy Feast is the winner! It looks like she prefers shredded meats over the pureed canned food I have been feeding her. I just re-checked her glucose and she is at 109. I guess I'll just keep doing what I've been doing over the weekend and follow up with the vet next week.
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Oh good Krista, glad to hear you found something she will eat.

Yes, Forti-flora is good. I use it when Tigger has those off times. Dr. Lisa highly recommends it as an appetite stimulant just sprinkled over the top.

Also, not sure if you have tried Parmesan cheese sprinkled out of the can? Or even Romano out of the can works too.

Have you tried baby food? Make sure there are no onions or garlic in it.

Tanya has a great page on her site, "Persuading your cat to eat". There are some good tips there on which baby food to get and other helpful suggestions:

http://www.felinecrf.org/persuading_cat_to_eat.htm

There are many causes for mouth ulcers. Did your vet have any idea what might be causing it?
 
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