New diagnosis - very overwhelmed and looking for advice

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pedeysmom

Member Since 2022
Hi everyone! Been reading as much as I can - would love thoughts and recommendations. Our beloved boy (age 10, 11 in June) was diagnosed with diabetes last week. He is a very good boy, but also VERY picky - we've been trying to convert him to wet food for years, and I thought I'd found a low-carb food for him, but alas we've failed - he's been free-fed Stella and Chewy raw-coated kibble for a while now. We offer him wet food every day, but typically he refuses it or only has a few bites. He also has a pretty sensitive stomach, so the few times we found a can he'd eat, he'll vomit profusely to the point that we get very worried about dehydration.

When diagnosed Pedey had BG at 380, and then a few days later at 395. Our vet started us on 1 unit (U100) glargin 2x/day, and gave us the Hill's W/D dry food, which I know from my research is a terrible dry food. We are working REALLY hard to transition him to wet food, but in the meantime, are also really scared about hypoglycemia if he's not getting enough food in him. Of course, we gave him some of the Hill's W/D dry in the meantime, and he's loving it, so that's not great because I think the Stella and Chewy he was on was actually lower carb.

I've ordered Dr. Elsey's cleanprotein turkey (chicken was completely out of stock everywhere I looked), and AlphaTrak2 home glucose testing machine, and we started him on insulin this morning. We asked our vet if we should hold off on the insulin and try and convert him to wet food first, and our vet was worried he'd get much worse BG results before we succeeded, if we did at all, based on his history. Would love any:

1. Suggestions on other dry foods to try (I've seen Young Again recommended but then also read that people's cats had major diarrhea reactions to it, so am thinking we'll wait on trying that until we are more stabilized).

2. Suggestions on how to get him to transition to wet food without starving him/risking hypoglycemia with the insulin (the only thing that's slightly working is to sprinkle VetriScience periosupport on his food, but then he literally eats the pieces with the supplement and walks away). I've purchased a bunch of different kinds to offer him using the cat food info sheet provided here as a guide so hoping something strikes his fancy.

3. Recommendations on lancets that would be easy to get blood from him for testing as we are total newbies.

4. Advice on how often to home test.

5. General advice on what we should be aiming for with his BG levels, what to look for to make sure he's not going into hypoglycemic shock, etc.

6. Anything anyone thinks would be helpful to know.

Thank you all SO MUCH in advance.
 
Hi and welcome to the site.:D I am not sure I can answer your questions but I can point you to some great links thAt can help.

1. I believe Epigen 90 is another option. Since your kitty likes Stella and Chewys have you tried the freeze dried raw. It is intended that you add water to it but my cat loves it dry as a treat. You can try that and gradually add water maybe. There is some information here on transitioning to wet

https://www.felinediabetes.com/FDMB/threads/transitioning-your-cat-from-dry-to-wet-food.956/

2. So you have found the link about stimulating appetite, my cat really likes forti flora. Also sometime I shove some kibble or treats into his wet food to get him to eat. But you ate correct that making sure he eats is important. How often are you feeding him? Diabetic kitties do better with smaller meals throughout the day rather than two big meals twice a day.

3. Larger lancets seem to work better when starting out and poking by hand rather than the lancing device seems to work better for some people. And it does get easier with time. Their ears develop more capillaries so it is easier to get blood. Here is a link for more advice on hometesting

https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Also there really isn't a need to use a pet meter. Most people here use human meters and most of our dosing protocols are based on readings on human meters. And they are much less expensive. If you live in the US you can go to the Walmart pharmacy and get a Relion meter for $9 and 100 test strips for $17.99.

4. It is best to test our kitties before each dose of insulin. Actually we don't feed 2 hours prior. Test, then feed then give insulin. This is to ensure that their BG is not too low to give insulin. We also test at least once more during the cycle, usually somewhere near the mid point so we can catch how low the dose of insulin is bringing them. But if you are able to test more often that would be preferred. We keep track of the BG readings in a spreadsheet so it is easy to see patterns and other more experienced members can see the data and offer advice. You can find more information on that here and the spreadsheets.

https://www.felinediabetes.com/FDMB/threads/the-basics-new-to-the-group-start-here.18139/

5. The link above has some information on what regulation is and what it looks like in terms of BG readings. What we are also aiming for ideally is getting our cat's into remission.

Also here is some important information on hypoglycemia

https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

6. If you would like to stick around and get advice from our experienced members you can set up a spreadsheet and fill out your signature on your profile. If you look over at the Lantus/glargine/biosimilar group you can see that people post their daily BG readings and get feedback and dosing advice.

https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

Here is information on filling out your signature on your profile.
Make sure your signature is up-to-date.
On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback. There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.Add info we need to help you:
Caregiver & kitty's name
DX: Date
Name of Insulin (do not include dose or frequency)
Name of your meter
Diet: "LC wet" or "dry food" or "combo"Dosing: TR or SLGS or Custom (if applicable)
DKA or other recent health issue (if applicable)Acro, IAA, or Cushings (if applicable)
Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.
 
Food: Whatever food you use, you should transition slowly since it sound like your kitty has a sensitive stomach. In addition to the foods mentioned, ZiwiPeak has an air dried line of foods. Stella & Chewy's had a freeze dried raw line. As Chris noted, it's good to add water with any food your giving and especially so with a dry variety.

Enticements: Many cats like freeze dried protein (e.g., chicken) that's a treat. If you wander the aisles at a pet food store, you'll see lots of options. (The dog food treats come in larger bags and are usually cheaper.) Crushing some over your cat's food may be an enticement. My cats like the Stella & Chewy's freeze dried that I mentioned but there are lots of options.

Lancets: You will want to start with a 28 gauge or lower number lancet. (The larger the number the thinner the lancet or syringe.) Eventually, you can graduate up to a 30 but it takes a bit of poking to get the capillary bed along the edge of your cat's ear to develop so he'll bleed more easily.

Home testing: The minimum number of tests is 4 -- your AM and PM pre-shot tests (AMPS and PMPS) and at least one test during each of the 12-hour cycles. Ideally, you want to test closer to the nadir (the lowest point of the cycle). We recommend getting a test before you go to bed every night so you can not be worried that numbers are dropping too low. That said, people test a varying amount. I was a testaholic. I had a kitty who could drop into low numbers very quickly plus, I liked having data. Take a look at the spreadsheets in people's signatures to get a sense of how frequently they test. Also, some people have continuous glucose monitors which is a different system and it looks like they are testing all the time. Don't panic if you see an hourly test! Also, you will need to get curves -- testing every 2 hours for a 12-hour cycle. This will tell you when insulin onset and the nadir fall for your cat as well as how much duration you're getting. This information will help to make managing your cat's diabetes a little more predictable.

Hypoglycemia: The best protection against hypoglycemia is to home test. You want to have high carb food on hand. If your cat won't eat canned food like Fancy Feast Gravy Lovers, you'll want to have something like Karo syrup (e.g, corn syrup), maple syrup, honey, etc. on hand to use to steer numbers upward. The W/D dry that you have will work. However, it takes longer for dry food to be metabolized and bring up the numbers so that's something to keep in mind.

Normal blood glucose (BG): Ideally, you want your cat to be in normal range numbers. The range we use is 50 - 120. At the beginning of managing your cat's diabetes, you will reduce the dose if numbers drop below 90. This is a link to information about Lantus (glargine). There are several sticky notes at the top of the board that will provide background about how the insulin works and dosing methods.

I suspect we can inundate you with information. The beginning of this process is overwhelming. It truly does become easier! I'd suggest looking at the links, looking at spreadsheets, and reading some of the other threads. Please ask questions. The members here are very generous with their time and knowledge.
 
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The method I use to transition cats over to canned food is to start with placing 1 or 2 spoonful of the canned food in the bowl and then add the dry on top. I press some of the dry into the canned food. This may take a few days before they will eat some of the canned. Then I slowly start increasing the canned food while decreasing the dry food. It may take 2-3 weeks, depending on how well your cat cooperates. Eventually I get it to where it is canned food with just a few pieces of the dry. After a few days, it is just canned food. With most cats I have had, they are eating only canned foods in about a month. I have only had one that took a lot longer to convert, but she was a stubborn cat to begin with. :cat:
 
Thank you all so much!!! This board, while a little overwhelming, is clearly going to be the most invaluable resource we have in helping Pedey get and stay healthy.

We tried measuring out meals for him, but he threw up a lot once/won't eat more than a bit when we give him a 'meal' and so today we've been letting him graze just as we are so paranoid about having an adverse reaction to the glucose since it's his first day. Likely on Monday, we'll go back to measuring out a few small meals of dry food a day - thinking about 1/3 cup 3x/day; he's a big boy (18 pounds) so we don't want to reduce his intake too quickly, but let us know if you think that's less of an issue. We've also got a non-diabetic cat (who could stand to lose a few pounds) so it makes it a bit harder to track consumption with free-feeding to know how much Pedey's used to consuming.

We did have one random question from what our vet told us - he said we could use the insulin for up to 6 months as long as it's not cloudy and we keep it refrigerated but the bottle says 28 days. Does that make sense to anyone here?
 
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
 
Diane is correct -- The Tight Regulation (TR) Protocol stipulates that your cat is eating a low carb, canned food diet only. You'll want to look over the Start Low Go Slow (SLGS) method until/if you're able to transition Pedey to a canned food (or raw) diet. If you're able to switch him to one of the freeze dried raw foods, that qualifies for using TR.

Many of us have used our Lantus (glargine) until the last drop in the vial or pen. You want to be reasonably careful with the insulin. You don't want to shake your insulin. It doesn't need to be mixed so rolling or shaking isn't necessary. I'd also suggest not keeping it stored on your refrigerator door since you open and close the door. (It's unlikely it will be a problem but it's a relative precaution.) Also, Lantus is expensive! You have options. There are now generic forms -- also called "biosimilars" -- Basaglar and Semglee. The latter is the least expensive. You will likely need to call around to see if a local pharmacy carries them. Another alternative is to mail order your insulin from a Canadian pharmacy. Many people here use Mark's Marine Pharmacy. A box of 5 Lantus pens if purchased in the US can cost close to $500. If you buy Semglee or order from Canada, the price is about $125.
 
Thank you all for the suggestions and the correction about TR! We've got a toddler, and I'm going through a high-risk pregnancy (it never rains but it pours!) so I apologize for not getting to this sooner - we are just treading water, so please continue to correct me as I am so appreciative/we are probably making tons of mistakes and we want to get this right for Pedey. It should be updated now to SLGS; I for some reason thought it meant if you were doing a strict every 12 hour insulin vs. one that allows for some variation - shows you how much I need this forum. Once I can get my bearings I will pull together the spreadsheet.

My husband will be so glad to hear you guys recommend not storing it in the fridge door - we did for about half of the first day until he looked up and said, wait, we open the fridge door...so that's one thing we've gotten right! And thank you for the recommendations for Mark's Marine Pharmacy/semglee; we'll make whatever sacrifices we need to, but anywhere we can save is a win. I think we want to try the pens just so that we can't mess up the dosage and to avoid being worried we didn't inject properly. Unfortunately we may need a sitter for him sooner than later for when I go into labor; luckily, my parents will be here looking after our toddler so at least he will be supervised but I don't think we can ask them to do the injections (they love the cats from afar but after 10+ years are still scared to pick them up, and they are super chill cats). Do you think the pens or injections are easier for a sitter to use?

Tonight we study how to take blood glucose! The one benefit of having a toddler is I've definitely got a child's sock to fill with rice for warming his ear :). We practiced rubbing his ear last night with him just to get him used to it and he thought we were quite weird, but the good news is he's actually following us around to get his insulin at the right time because we give him a good brushing with two of his favorite cat brushes simultaneously right after. Slowly, we are making some small progress on what seemed to be impossible at first, so feeling quite hopeful.
 
pedeysmom said:
Thank you all for the suggestions and the correction about TR! We've got a toddler, and I'm going through a high-risk pregnancy (it never rains but it pours!) so I apologize for not getting to this sooner - we are just treading water, so please continue to correct me as I am so appreciative/we are probably making tons of mistakes and we want to get this right for Pedey. It should be updated now to SLGS; I for some reason thought it meant if you were doing a strict every 12 hour insulin vs. one that allows for some variation - shows you how much I need this forum. Once I can get my bearings I will pull together the spreadsheet.

My husband will be so glad to hear you guys recommend not storing it in the fridge door - we did for about half of the first day until he looked up and said, wait, we open the fridge door...so that's one thing we've gotten right! And thank you for the recommendations for Mark's Marine Pharmacy/semglee; we'll make whatever sacrifices we need to, but anywhere we can save is a win. I think we want to try the pens just so that we can't mess up the dosage and to avoid being worried we didn't inject properly. Unfortunately we may need a sitter for him sooner than later for when I go into labor; luckily, my parents will be here looking after our toddler so at least he will be supervised but I don't think we can ask them to do the injections (they love the cats from afar but after 10+ years are still scared to pick them up, and they are super chill cats). Do you think the pens or injections are easier for a sitter to use?

Tonight we study how to take blood glucose! The one benefit of having a toddler is I've definitely got a child's sock to fill with rice for warming his ear :). We practiced rubbing his ear last night with him just to get him used to it and he thought we were quite weird, but the good news is he's actually following us around to get his insulin at the right time because we give him a good brushing with two of his favorite cat brushes simultaneously right after. Slowly, we are making some small progress on what seemed to be impossible at first, so feeling quite hopeful.
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Sending lots of well wishes and support. Best of luck with Pedey and please take care of yourself!
PS the folks at Dr Elseys were so great and they sent me samples of all the kibble flavors and two flavors of cans ( if your guy doesnt like turkey) ALSO the loose stools may happen with Dr e’s as well. Apparently the rich high protein is a bit of a shock to the gut. Good luck!
 
Hi everyone - here with a quick update and another few questions...thank you all SO much for the help so far. Still haven't gotten my spreadsheet pulled together but am keeping very careful hand log so that I can transfer data.

We started doing BG testing yesterday and we got two successful results in a row! Successful meaning we got results, but I'm a bit confused about what they mean...because the mornings have been crazed with toddler getting up and ready for school at the same time we are doing morning dosage/feed, we only did PM tests yesterday and today (it's after she goes to bed) to get comfortable. Thinking we can pull off an AM and PM test tomorrow, and we are going to have the vet do the first curve just to make sure we are getting proper results.

As yesterday was just a practice run, we did it right after we finished the meal/shot (we didn't want to upset Pedey and then not get his shot in). He was at 307...by way of reminder, when diagnosed he got two BG results of 380 and then 395, respectively. Today, we tested, then fed, then dosed (I think that's the order it should be) and he was at 303. This was day five of insulin and while we're transitioning to almost all Dr. Elsey's (he's taken to it quite well), he's still kind of always got a bit of food in his bowl so essentially free fed still. We are upping canned food (he ate a good amount of his Sheba today, so I am SO hopeful this kibble addict is on his way to recovery) and slowly decreasing the Dr. Elsey's. We had a mix of the Stella & Chewy+Dr. Elsey's up through today and I think he's ready to transition to just Dr. Elsey's even with his sensitive tummy.

Any thoughts on whether the 307 and then 303 are progress, an indication that he needs more insulin (we'll of course talk to vet during his first curve on Friday), etc? I honestly don't know what to think!

Thank you all so much again for everything.
 
Great job getting going on the home BG testing! I struggled with that so mightily, I'm impressed.


pedeysmom said:
Any thoughts on whether the 307 and then 303 are progress, an indication that he needs more insulin (we'll of course talk to vet during his first curve on Friday), etc? I honestly don't know what to think!
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I remember asking the same when I first started home testing, but the truth is there is no way to answer that without more data. 307 and 303 don't mean much without knowing how low the dose took him (nadir), I mean they are certainly better than the 380 and 395 you got when he was diagnosed. So it seems an improvement somewhat!

dosing increases or decreases are based on how low the dose takes him so getting AMPS, PMPS and at least one or two other tests in between is good, to paint the picture, if you can.

I am pretty new here myself so I will let the real experts weigh in further. :)
 
pedeysmom said:
Hi everyone - here with a quick update and another few questions...thank you all SO much for the help so far. Still haven't gotten my spreadsheet pulled together but am keeping very careful hand log so that I can transfer data.

We started doing BG testing yesterday and we got two successful results in a row! Successful meaning we got results, but I'm a bit confused about what they mean...because the mornings have been crazed with toddler getting up and ready for school at the same time we are doing morning dosage/feed, we only did PM tests yesterday and today (it's after she goes to bed) to get comfortable. Thinking we can pull off an AM and PM test tomorrow, and we are going to have the vet do the first curve just to make sure we are getting proper results.

As yesterday was just a practice run, we did it right after we finished the meal/shot (we didn't want to upset Pedey and then not get his shot in). He was at 307...by way of reminder, when diagnosed he got two BG results of 380 and then 395, respectively. Today, we tested, then fed, then dosed (I think that's the order it should be) and he was at 303. This was day five of insulin and while we're transitioning to almost all Dr. Elsey's (he's taken to it quite well), he's still kind of always got a bit of food in his bowl so essentially free fed still. We are upping canned food (he ate a good amount of his Sheba today, so I am SO hopeful this kibble addict is on his way to recovery) and slowly decreasing the Dr. Elsey's. We had a mix of the Stella & Chewy+Dr. Elsey's up through today and I think he's ready to transition to just Dr. Elsey's even with his sensitive tummy.

Any thoughts on whether the 307 and then 303 are progress, an indication that he needs more insulin (we'll of course talk to vet during his first curve on Friday), etc? I honestly don't know what to think!

Thank you all so much again for everything.
Click to expand...
Btw… yes you got the order correct! Test / feed / dose ;) take care and hooray for successful tests!
 
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