New Member - Freya

[Tim & Freya]

Hello! Just getting started on this journey with Freya. Freya's a 9-year-old who started having incontinence issues, which led to a fructosamine test indicating she had diabetes. The vet also said she had pancreatitis.

Yesterday I tried using the Lantus Solostar pen and that didn't go so well. She pulled away and I wasn't sure the dose got in properly, so quickly got some syringes instead and started those this morning. So much easier and she didn't even seem to notice when I injected her. We're starting on 1U at 7AM and 7PM. Going to keep my spreadsheet updated regularly to keep track. Luckily, I work from home so I can do testing throughout the day. She's always been weird about having her ears touched, but she's not been too difficult.

My main concern right now is she's not eating all that much. She was mainly on the Fancy Feast Gravy Lover's, so I bought a bunch of the classic pates instead to get a lower carb option. She eats up the freeze-dried tuna bites I give her as treats for testing but really need her to start eating more complete meals. She's used to being a grazer throughout the day.

So far, today's readings have been:
AMPS: 428
+3: 336
+6: 301
+9: 307

Is it best to remain on the 1U for a while to see if she starts getting a lower nadir, or should we start adjusting within a few days? Was hoping it might get down to at least the low 200's with just the 1U.

Also, just did a ketone urine test and that came back negative, though I'll try and use the blood ketone test tonight also just to be sure.

 

[Dyana]

Hi and Welcome Tim & Freya to the best place you never thought you'd want to be.

I feed my diabetic a combination of Fancy Feast regular chicken and turkey and beef pates and also the Fancy Feast Gravy Lovers Pates.

Lantus is a depot insulin which means it takes about 7 days for the depot to fill at first.
We recommend that you wait the first 7 days on the dose unless her BGs go too low and if that happens you would then decrease the dose.
Did you get the syringes with the half unit marks?

Great job to both of you on learning to test, and you for setting up your spreadsheet so we can help you!

Let us know all your questions.
We are here to help and support you and your kitty.

 

[Tim & Freya]

Thanks Dyana! I saw that mentioned in another thread and ordered some of the gravy lovers pate as well. Hoping that's something she'll take to.

Forgot to mention, I also gave her a dose of Cerenia in case she was feeling nauseous (had left over from my CKD girl I lost a few months ago). I've also got mirataz, but I'll hold off until her appointment tomorrow to discuss with her vet if she's still not eating.

I did get the half unit marked syringes, luckily amazon shipped them even though technically a prescription is required in NY.

I completely messed up yesterday with the pen. I didn't think it injected (there was a drop on the needle when she pulled away) and redid it. She was at 139 at +6 and 135 when it was time for her next dose. Ended up skipping that dose and reset this morning with the syringe.

Good to know about the 7-day depot, will hold out on worrying too much about high nadirs until next week.

 

[Dyana]

I completely messed up yesterday with the pen. I didn't think it injected (there was a drop on the needle when she pulled away) and redid it. She was at 139 at +6 and 135 when it was time for her next dose. Ended up skipping that dose and reset this morning with the syringe.

Please never shoot a second dose if you think all of or maybe none of the dose went in. You never know how much they got. I'm so glad you were able to test and keep her safe. Do you have a hypo kit set up and ready in case she goes low?
Please read the yellow stickies in the Lantus forum when you have a chance. I know there's a LOT there to read, and may require more than one reading of each, but there's a wealth of information there.

 

[Connie & Parker & Moonie]

Hi Tim and Freya!

I’m too new to be offering dosing advice but I wanted to say welcome. And that I can understand your pain as my cat Moonie was a Fancy Feast grilled in gravy fiend and it took a LONG time to find something that she’d tolerate.

Here are some food charts in case there’s something on there you think Freya would like. Anything under 10% carbs is LC.

https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

https://www.bizave.com/foodlists/Main List.pdf

For us, Moonie would completely turn her nose up at pates so we ended up going with mousse textures that would mimic the gravy better.

Please don’t worry about the fur shot as it’s happened to all of us especially in the beginning. And as Dyana mentioned please don’t reshoot as you never know how much insulin got in the kitty and you could be giving her too much.

 

[Tim & Freya]

Yes, lesson learned to never redose. My vet didn't really explain that much about the process, so I'm on a crash course figuring everything out.

I'm lucky she didn't end up getting too much and going hypo. I do have Karo syrup, so I should be able to deal with it if it does happen though.

 

[Tim & Freya]

I just tested her blood ketones and it came out at 1.2mmol/L. Ranges I'm seeing are 1-2.4 could be mild ketosis.

Is this something I should be worried about asap or just keep an eye on? Wondering if it could be the cause of her not eating so well.

 

[Dyana]

When my kitty Jackson started showing ketones I upped his food by 50% and added more water to his food.
Keep checking ketones and let us know what the results are.

 

[Tim & Freya]

I ended up letting her eat some of the gravy lovers, needed her to eat something at least. Retested ketones just now and it's at 0.6 mmol/L. I think we're safe from an emergency situation tonight, but I'll bring it up with her vet at the appointment tomorrow.

I may need to do a more slow food transition, mixing the bad gravy lovers with some of the pate to see if I can get her used to it.

Thanks for the feedback and listening to me. It's super stressful here at the beginning with all this new information and procedures, and it's nice to have people to discuss with.

 

[Tim & Freya]

Morning update. Her AMPS glucose was 288, so actually lower than her entire previous day.

However, her ketones read 1.3. So back up and a little higher than last night. I'm bringing her to the vet this morning, hopefully we can get her regulated and eating normally soon.

 

[Dyana]

Try to get her to drink as much water as she will to help flush the ketones. Do you add any water to her food? Do you have an HydraCare?

 

[Tim & Freya]

I do add water to her food, especially the low carb ones to try to make it more "gravy-like", though it's been incredibly difficult getting her to eat any of them. I do have some HydraCare, I can see if she'll take it but if I remember right, she wasn't interested previously.

The vet did bloodwork and said her electrolytes were all good, and she actually didn't think she had active pancreatitis. She seemed suspicious of the ketone readings from the KetoMojo monitor, urine ketones were negative. Said since she's acting normally just to monitor for any vomiting or other issues and not to jump to hospitalization yet.

Her glucose reading from the bloodwork was 50 points higher than the ReliOn monitor, which the vet also suggested switching to an AlphaTrak for more accurate values. We applied a FreeStyle Libre 3+ to get continuous monitoring, and the vet said if the only thing she'll eat is the higher carb food do so for now. She did end up eating quite a bit of that when i brought her back home, so it may not be a nausea issue but more that she's really resisting a switch in food. However, her glucose readings have gone back up. 356 on the ReliOn (from 269 before her appointment) and the FreeStyle is pegged at 400, which I think is the maximum value it'll record.

I'd really love to get her off the high carb gravy lovers, but I'm thinking it's more important that she eat at this point (she's lost 1.5 lbs since June). I've got the pate version coming tomorrow, hope that she might take to that. I've got literally 20 different types of low carb Weruva/Tiki Cat/Fancy Feast pates I've tried and she refuses all of them. Why can't she just understand I'm trying to make her feel better!