New member - Jackie and Boots

[Jackie55 & Bootsie]

Boots was diagnosed with diabetes around Mem. Day after and episode of DKA. Since then she has been on Basaglar insulin 2x/day. She initially wore the Libre blood sugar monitor for about a month in an attempt to establish her BG curve. I am a nurse and well acquainted with the mechanics of diabetes and my husband is a diabetic due to some medications he takes r/t a solid organ transplant but I am really struggling with believing Boots is in a good place with her BG's. I have read many posts here and can identify with the issues, she is always hungry, always running to the kitchen when we stand up or move, she begs for food and when she is not begging for food she is laying stretched out on the floor or our counters. Her last fructosamine level was within the range our vet wanted but I do not know what it was. I am also concerned as she seems to have some weakness developing in her back legs, she can still jump but her legs slide out to the side if she stands to long. And I feel like her pupils are usually quite dilated so I am assuming she has cataracts also. I intend to discuss all of this at her next vet appointment but may come back to you all for further advice. This is a great site. Thanks

 

[Sienne and Gabby (GA)]

Welcome to FDMB!!

We are firm believers in giving you the information you need to make informed decisions. First, a fructosamine test is very useful for diagnosis. Just like a HgA1c, you also need to home test. Frankly, most of the members here rely more on home testing and do not pay the vet for routine fructosamine tests or in office curves. The Libre is helpful in that regard. (I also encourage members to learn how to home test using a glucometer since the one time the Libre fails is when you need it the most.) Many members use the Walmart Relion meter since the strips are the least expensive around. (Although, as long as your husband doesn't mind, you can borrow his meter!)

Given your description of Boots appetite, it doesn't sound like she's regulated yet. It's not surprising -- it takes a while to get a kitty regulated. We hope to see that BG levels are in the normal 50 - 120 range. Once numbers are lower, Boot's will be less ravenous.

What are you currently feeding Boots? We strongly encourage a low carbohydrate, canned food diet. We consider low carb to be less than 10% although most members feed their cats 5% carb, give or take. This is a link to a food chart we rely on since it has the nutritional values for most canned foods listed. Just to add, most vets do not like to see a diabetic cat in normal numbers. They leave a very wide margin for safety. However, given that we are advocates of home testing, you have the tools to ensure that your cat is safe and you can use higher carb food to steer numbers if they are dropping into lower ranges. Most vets do not encourage their clients to home test. We also have many cats who have gone into remission and their diabetes is diet controlled.

Weakness in the hind legs is typically the result of diabetic neuropathy. Methylcobalamine (methyl-B12) can be very helpful in mitigating the effects of neuropathy. Zobaline is a brand that's available on Amazon and is formulated specifically for diabetic cats (i.e., no sugar). Vitacost also sells methylcobalamin in bulk. You just add it to your cat's food. The combination of getting your cat better regulated and the supplement will help considerably in reversing the neuropathy.

We also encourage everyone to create a signature that includes basic information about your cat (e.g., data of dx, insulin you're using, any health issues) so we don't keep asking you for the information repeatedly. We also suggest you set up a spreadsheet to track Boots' progress and so we can follow along. The information on how to do his is in this post on helping us to help you.

The members here are very generous with their time an knowledge. Please let us know how we can help.

 

[Jackie55 & Bootsie]

Thank you for your response. And you are right - my vet never mentioned in home BG monitoring. But we would never give insulin to a patient without knowing their BG before dosing them. So here are my questions:
1. When do you test? Before each dose in the morning and evening? Do I test again at any point during the day?
2. How do you test the urine for ketones? I mean I know how to do the test but how do I get the urine out of the litter box which is filled with litter?
Your question about food - I have been feeding her wet cat food, usually Fancy Feast Classics or Friskies Pate. I found Dr Lisa’s nutrition site early on. And I do have supplies should she develop hypoglycemia.
I will look into the methyl-B 12 for her as it seems it can not hurt her as a water soluble vitamin. I added my signature and will create the spreadsheet.

Thank you for your help.

 

[tiffmaxee]

Welcome Jackie. We always test before giving insulin to make sure they are at a safe number to shoot. We test, feed to make sure they will eat, and then shoot, all in about 10 minutes. A +2 test is often the next test to get as it can be like a crystal ball into whether the cycle will be active as that is when lantus onsets for most. My cat onset between +2-3 however unless he was close to earning a dose reduction. If at onset the bg is lower than the preshot more tests might be needed. If higher it likely won’t be an active cycle. Mid cycle tests when possible let us know the nadir, lowest point in the cycle. Lantus dosing is based upon nadir.

When you have time hop over to the lantus forum and read the stickies at the top. Tons of info there including the two methods we use. Ask as many questions as often as you have them.

 

[Bandit's Mom]

How do you test the urine for ketones? I mean I know how to do the test but how do I get the urine out of the litter box which is filled with litter?

You can either use ketostix which are urine testing strips. Here are Tips to catch and test a urine sample.
You also get blood ketone meters if catching a urine sample is difficult.

Testing for Ketones
Simple urine tests can detect ketones. This is done by collecting a urine sample and inserting a special dip stick into the urine. Some urine ketone strips detect only ketones while other types test for both glucose and ketone levels. Urine ketone strips will detect only some of the ketone bodies produced by the body, not all of them. Strip storage, handling, and testing procedures are similar to those used for glucose test strips. Strip test results are indicated by presence of color changes, indicating presence of ketones, either quantitatively (giving you a number for the ketone concentration) or by descriptive terms (for example, negative, trace, small, or large). False positives may occur if you are also using certain medications or vitamins, or if the strips have been handled or stored improperly. It is extremely important to follow the directions on use of the urine ketone test strips as the time to read the strip is generally within 15 seconds but may vary by brand.

If you wish to test blood instead of urine for ketones, there are four meters that allow for home testing; most members use the Nova Max Plus Glucose and Ketone Testing Meter or the Abbott Precision Xtra Meter. The premise behind blood testing for ketones is the same as that for favoring glucose testing of blood over urine. Some of the meters also do glucose testing with meter-specific glucose test strips. Blood ketone strips can be obtained at
American Diabetes Wholesale.




Here's a sticky on Feline Diabetic Neuropathy (weak back legs)

 

[JL and Chip]

How do you test the urine for ketones? I mean I know how to do the test but how do I get the urine out of the litter box which is filled with litter?

If the suggestions already provided don’t work for you, you might consider getting a “Smart Cat Box.” I picked up a one years ago when they were sold on FDMB and it worked great. I don’t believe FDMB sells merchandise any more, but the Smart Cat Boxes appear to be available on Amazon now.
https://www.amazon.com/SMART-CAT-BOX-Starter-Kit/dp/B005ZKMMWE/?tag=felinediabetesfdmb-20

The “litter” is non-absorbent, allowing the urine to funnel down into a reservoir that’s beneath the box. I only used the box when I needed a urine sample (not daily use) because the reservoir isn’t huge and would overflow quickly.

The link above is for the basic unit plus litter and scoop. The company also sells a few different packages on Amazon, including ones with extra reservoirs, extension panels that makes the sides higher, and more bags of litter/seed, so if you’re interested, it’s worth browsing. I have a few bookmarked because I’ll eventually pick up another one.