New Member and Newly Diagnosed

Hi everyone. First of all, I'm so grateful for this website and forum. My name is Karen and my cat Soupey was just diagnosed on 8/21 and I've been scrambling to take a crash course in cat diabetes since then. The vet sent us home with Prozinc insulin and DM canned food, telling us to cut back his feeding to twice a day instead of the 3 times we were previously feeding and told us to give him 2 units twice daily after eating. They didn't say anything about testing from home. He made a quick and easy switch over to the canned food, thankfully not being at all finicky about it. We started the insulin Friday evening. Saturday morning, after his shot, he started acting lethargic and out of character laying in a place that i've never seen him before. After looking online I saw that you could give a cat some honey if you're concerned that they've had too much insulin. So I gave him some and he started to act more normal after a few minutes. It was at that point I decided I had to start testing him. I did a full curve on Sunday and since then I've been testing him twice daily.
I started to use the ReliOn Premier Classic glucometer yesterday evening and the number was considerably lower than it had been with the True Focus meter from Walgreens. Each test I've done since has also been lower, so now I'm just worried about which meter is accurate. His PMPS last night was 64 so I didn't shoot. His AMPS this morning was 115. I gave him .5 units because I was worried that he might need a little since I hadn't injected him last night.
Since he has lost 3 lbs and was not getting a full can down between 2 feedings only, I decided today to start giving him lunch, just making sure it was plenty before when I'd be testing for pre-dinner and potentially insulin. His pre-lunch number was 67 and PMPS tonight was 102, so I didn't shoot. The 2 units that the vet prescribed seems like it was too much now, especially when switching him to the DM food at the same time. I guess I'm looking for some guidance and reassurance from you guys because I feel like I've learned a lot more here in the past few days than from our vet. I'm just so scared that I'm doing something wrong and would appreciate any advice and feedback.

 

Thank you so much for taking the initiative to test. You have saved your cat's life.

It could be that what you were feeding pre-diagnosis was higher in carbs than the Purina DM canned. Switching to a low carb food can make a difference of up to 100.

You are right. A number of 102 is too low to shoot. And so was the earlier 115.
From the Prozinc stickie:
NEW TO THE GROUP: THE PROZINC BASICS. PLEASE START HERE.
The proper sequence for dosing insulin is: Test/Feed/Shoot. In the beginning, if your cat’s BG is not up to at least 200 mg/dL {11 mmol/L}, if your schedule allows, you can stall (without feeding) for 20+minutes, then retest the BG. You are looking for a number that is rising, not falling and up to 200 mg/dL {11 mmol/L}. If you stall once, but can’t do another round of stalling and your cat hasn’t reached a BG of 200 mg/dL {11 mmol/L}, you’ll need to skip the dose and wait until the next cycle.

In case you see low numbers, read and print this out.

• How to treat HYPOS - THEY CAN KILL! Print this Out!!
• jojo and bunny's HYPO TOOL BOX

• New? Seeing Low Numbers? How You Can Help Us Help You

Feeding only at shot time is old school. It is best to give a decent sized meal at shot time and give a couple of snacks especially during the first half of the cycle.
FYI: there is nothing special about the Purina DM. Fancy Feast and Friskies pates (and just the pates) are low carb and are fine to use.
Here is a food chart put together by a vet which lists the carb percentages of wet food.

• Cat Food - Nutritional Composition, data compiled by Dr. Lisa Pierson, DVM (2017)

Does Soupy have any underlying health conditions? I'm wondering if he had a steroid shot recently. Steroids can sometimes lead to diabetes in cats.

I'm tagging @Deb & Wink and @Panic who are most knowledgeable in Prozinc.

We can help you keep Soupey safe.

 

WELCOME TO FDMB! You want guidance well you've found it! And we are so glad you did! Your trial by fire was just that! I dont know why Vets start out at 2 units but most do. It was wise of you to research and find the honey trick. You may want to start here:
How You Can Help Us Help You!(oops dont know why thats in bold type )

You and Soupey have found a safe place to land with plenty of good people to help you navigate this site and this disease. We look forward to helping you with Soupeys journey

Again welcome to the best darn site to learn everything you need to know about feline diabetes
Please give that adorable Soupey some scritches from us!
jeanne

 

Thank you so much for your response and the additional information. This has been a bit overwhelming and I just want to make sure I’m doing everything possible to keep Soupey safe.
No underlying health conditions. He had just recently started losing weight and drinking LOTS of water.

 

Red already said everything that I was thinking. Mainly that his previous food may have been higher in carbs and with the new food his numbers are naturally lower. We also suggest starting at 1 unit not 2 as recommended by your vet.

I just want to say welcome and girl you’ve got some AMAZING instincts. I totally agree you saved Soupey’s life, who is adorable btw!

 

Thanks so much Jeanne!

 

What food was he on before the DM?

 

Hi Karen! Sounds like you already have some more sense than your vet.

It's possible all Soupey needs is a diet change, ie his pancreas may not be that damaged. His numbers do not look that bad so far.
I would stick to 0.25u for a while, unless pre-shot is below 200. As Kel (Red) posted above, you could skip or do a token dose (which is 10-25% of the regular dose) if the pre-shot is below 200. Don't be tempted to up the dose if the pre-shot is higher than usual though, we base dose on how low the insulin takes the BG, not by how high the pre-shot is.

On SLGS, a reduction is earned any time they drop under 90. Soupey has earned that reduction today, so give 0.25u tomorrow if the BG is over 200. Tonight I would skip.

Try to get a test in two hours after insulin - this will tell you if Soupey is dipping lower than safe. Make sure he has a snack of his food at that time too, and a couple more times before nadir (the lowest point of BG in a cycle). Don't forget to do it at night too, they drop lower then. You can get an autofeeder (Petsafe 5 is popular) to achieve this.

If you did not give insulin this evening, get a test two hours after as well - we want to see if there's pancreatic activity.

Purina DM is fine to feed but as stated, there's cheaper, healthier options. Kitties also tire of it quickly so don't be surprised if Soupey decides he doesn't like it later.
I would not restrict food from an underweight cat - so if he needs to gain a few don't be concerned with only giving him a certain amount.

 

And you said he lost weight. What’s his weight now and what should be his ideal weight? A good rule of thumb for daily calorie intake is 20 x ideal weight. Minnie is 16 pounds so times 20 it means she should have about 320 calories a day. Make sure he’s eating enough so he can gain weight back. Diabetic cats lose weight even when they’re eating well because they can’t process the nutrients in food efficiently. They also burn calories just be peeing since there’s sugar in their urine. I agree with Panic and I’d feed him a little over the number you get right now to be safe.

to answer your question about the meter, I use ReliOn as well. Meters have a normal 10-20% variance between them, but rest assured ReliOn is one of the best rated for accuracy out in the market

 

Thank you so much and I’m so grateful I found you guys!

 

Was Soupey tested for hyperthyroidism? That can cause weight loss and water consumption to go up.

What other symptoms or testing was at the vet to confirm the diabetes? and rule out other health conditions?

 

Oh great point!

 

Yes, was a fructosamine performed?

 

This is extremely helpful Elizabeth, thanks so much

 

They tested his thyroid, liver, kidneys and glucose. My husband was the one who took him to the vet and he thought he recalled them saying his BG was over 400. I’m taking him in for a follow up this coming Tuesday and will confirm that number with them.

 

They also did a urinalysis to check for ketones? That thankfully came back negative

 

Your vet should be able to email you with the test results. My vet's office will do that when I ask.

 

I’m not sure Is that something that he should be tested for? There’s so much I need to learn about FD. It’s a bit overwhelming

 

its a blood glucose test dont worry.

 

He was on grain free Taste of the Wild dry kibble

 

Ok thank you, I’ll see if they can do that tomorrow.

 

I looked at the Rocky Mountain venison and smoked salmon flavour. Roughly 27% carbs.
While "grain-free," it contains:

Chicken meal, peas, sweet potatoes, chicken fat (preserved with mixed tocopherols), pea protein, potato protein, roasted venison, smoked salmon, natural flavor, ocean fish meal, DL-Methionine, potassium chloride, taurine, choline chloride, dried chicory root, tomatoes, blueberries, raspberries, yucca schidigera extract, dried Lactobacillus plantarum fermentation product, dried Bacillus subtilis fermentation product, dried Lactobacillus acidophilus fermentation product, dried Enterococcus faecium fermentation product, dried Bifidobacterium animalis fermentation product, zinc proteinate, vitamin E supplement, niacin, manganese proteinate, copper proteinate, zinc sulfate, manganese sulfate, copper sulfate, thiamine mononitrate, vitamin A supplement, biotin, potassium iodide, calcium pantothenate, riboflavin, pyridoxine hydrochloride, vitamin B12 supplement, manganous oxide, sodium selenite, vitamin D supplement, folic acid.
​

Grain-free is not necessarily carb-free.

Low carb (LC) is under 10%
Medium carb (MC) is 11-15%
High carb (HC) is over 15%

 

So he went from dry to wet. Yes big carb content difference and it would explain the lower numbers for sure.

 

It’s a test that gives you a 3-week average for the glucose so it’s a good reference as far as knowing if your cat has had elevated numbers for a while and it wasn’t just a fluke that day at the vet

 

I can't really add anything to what the old hands have told you, being a newbie myself, but welcome! It is scary getting to grips with FD, but there's lots of helpful information here. I just got my first glucometer yesterday - went on an online shopping bonanza for hypo kit last week (I haven't yet told my husband what the bulb syringe and lube are for ). It sounds like you're doing a fab job so far!

 

Oh wow, thank you for that information. I had looked on the side of the bag trying to find the carb content with no luck, but seeing that number, it explains a good bit

 

Thank you so much and it sounds like you’re doing a great job too!
It is scary for sure, especially not having a whole lot of proper guidance from our vet. Everyone has been so helpful and welcoming here though and I’m very grateful to have found this site.

 

Good to know, thank you, I’ll ask about that.

 

hahahaha sounds like our house. I just tell hubby SURPRISE!

 

Ooh er, missus!

LMAO!


Mogs
.

 

Hi Karen. Adding my welcome to yourself and Soupey.

Regarding the fructosamine test, it is a necessary component in a diagnostic workup for feline diabetes. A spot check at the vet's office only tells you the blood glucose (BG) level at that instant. Such readings can be temporarily elevated by travel/vet stress. Clinical signs should also be assessed. The following are hallmark signs of diabetes:

* Peeing and drinking much more than normal (polyuria/polydipsia, PU/PD).

* Eating more than normal, possibly constantly ravenous, and possibly losing weight despite increased food consumption.

* Lethargy.

* Low mood/depression.

* Poor hair coat condition.

The above clinical signs can be caused by other conditions. The only way to make a definitive diagnosis of feline diabetes is by fructosamine testing. As as already mentioned above, it gives an average of the BG levels over the previous fortnight (at least). An elevated fructosamine result (outside the normal range) indicates that the cat has been on average running in diabetic numbers for that period. The result is not influenced by temporary stressors.


Mogs
.

 

Thank you Mogs I will definitely be asking for a fructosamine test when I take him for his follow up next week. I did not shoot this morning because his BG was 90 and when I tested him before lunch, his BG was 62. He definitely had been drinking lots more water than normal, he had been acting lethargic and just not like himself and his fur has also looked different to me. I just need my little man to be alright and I'm trying to learn as much about FD as quickly as possible. From what little I have learned thus far, it sounds like changing his food up might have been all that was needed, seeing his last several numbers.

 

An unregulated diabetic cat can have flaky skin and not the best coat of fur. This changes once the cat is regulated or in Soupey's case, possibly no longer a diabetic.

There is a saying here: Once a diabetic, always a diabetic. Soupey should stay on a low carb diet.

 

Did Soupey have any treatment with steroids for some other problem recently?

Thank goodness you're testing, Karen. As Red said above, you saved Soupey's life.

Re the fructosamine test, your vet may have already run one. As Deb suggests above, perhaps give your vet's office a call and ask them to email you a copy of all the test results because you'd like it for Soupey's records.


Mogs
.

 

Humour us. Is it an actual kit that you bought? or one you are putting together?
I'm concerned that you plan to syringe anally.

 

I'm so grateful I found you guys Mogs because you all are the ones that drove home how important home testing is

I'm looking at the receipt that my husband was sent home with and we were charged for the following labs: Chem 12, CBC, Electrolytes, Lipase and Thyroid. I will call the vet tomorrow on my lunch break and ask them to email me the results so I'll have them

 

It seems like the food alone is making a huge difference with Soupey. I tested again this evening prior to feeding and it was 82, so definitely still holding on the insulin. I'm going to test again in 2 hours as someone had kindly suggested last night.

 

Awesome sauce!

 

Sorry, I’m still learning how to respond to posts properly it seems, lol.

Elizabeth, in case you didn’t see my question buried in your original post- what BG number range am I looking for 2 hours after eating, to show that there’s proper pancreatic activity going on?

 

That’s a tough question but I think anything under 120 is considered normal and not diabetic. Is that right @Critter Mom ?

 

Soupey's Mom wrote:

Sometimes BG levels will be lower +1.5 to +2 hours after eating when the pancreas is producing pulses of insulin in response to food intake. You're looking for any dip in BG level below the reading taken before the food is eaten, not a specific number.


Mogs
.

 

Right, we're just looking for a sign of pancreatic activity.

 

Do I get my brownie point now, Elizabeth?


Mogs
.

 

You deserve it!

 

Thanks so much for clarifying that!

 

Never had chocolate brownie points before. Yum!!!

Thank you, Elizabeth!


Mogs
.

 

One I'm putting together, based on the hypo emergency instructions. Tubes of glucose gel (I don't eat a lot of sugar), couple of dosing syringes for hand feeding, test strips and lancets for the glucometer, that kind of thing. Also Ketostix, though they're not for hypo, obviously. Perhaps "diabetes kit" would be a better word.

The hypo emergency page explicitly states that as a last resort, a cat that is having seizures can be given a dose of glucose rectally if you can't get sugar onto their gums. This is very much a "hope I never have to use it" thing!!

If that advice is wrong, it needs removing from the page.

 

I read that post too and bought a bulb syringe and lube - I also hope they will never have to be used!!!

 

Oh no, it's not wrong. Last resort though, before you head to the 24 hour emergency vet. Or even possibly for the drive there, while someone else does the driving for you.