New Member, looking for advice and support

Status
Not open for further replies.
A

Alyson

Member Since 2014
Good morning from the island of Corfu in Greece.
Thank you for accepting me as a member.
I am completly new to all this and have never been a member or posted on any forum before.

I have just joined as one of my 5 cats has been diagnosed with feline diabetes. My vet is away until end of august and so no insulin treatment can be started until then. I have no other vet I trust in this case. So we decided all we could do for now was monitor his BG and drastically change his diet.
After searching the net I came across this forum, as you can imagine I have many questions.
I have started him (Eddy, 11 year old longhaired male tabby) on the home made food, following the recipe for food with bones. Luckily I have a very helpful butcher (he is himself a diabetic) and he minced the chicken for me. I also have managed to obtain the vitamins and salmon oil and have no trouble sourcing chicken livers and hearts. So far so good and Eddy loves it :)
Originally the vet took blood samples on 2 different days and the results where BG 300 and BG360, so we started testing every morning around 8.30am before feeding the cat. The results have been between 400 at the beginning and now seem to hover around BG280 to BG 295, with one result being BG 195 (I was so happy to see this result, but the next day was up to 299 again, so I have a feeling this was a false result).
My questions are now: 1. how often per day and when should I test his BG?
2. do I have any chance in lowering his BG with the diet alone?
3. what advice can anyone give me as to how to proceed until my vet returns and we can get Eddy started on insulin?

I feel although the BG is not going down, Eddy is better in himself, he has put on a bit (1/2 kilo) in weight and interacts much more with us again. He comes to tell me he's hungry! I feed him ca. 160 gram of the food per day, divided in to 3 or 4 portions spread over the day with 4-5 hour intervals.
Any advice and feedback is sooo welcome. Thank you
 
Welcome to FDMB.

A food change to a low carb diet may reduce the glucose level 100 mg/dL. You may have already gotten that. It is likely you will need to use insulin to lower it further. Are you following the recipe from Cat Info?

We strongly encourage home glucose testing using an inexpensive human glucometer. Abbot makes soe which may be available in Greece. You'll need matching test strips, pluc 26-28 gauge lancets to slightly prick the outer edge of the ear for the blood droplet. Tests should be done before eating, and when using insulin, always done before giving insulin. Then tests are done around the nadir, the lowest glucose level between shots. When not giving insulin, snag a test around +2 to +3 hours after the shot.

Insulins which have worked well for cats in Europe are Lantus and Levemir (human insulins), and Hypurion PZI. Greece may or may not require you to start with an animal insulin, Caninsulin (also called Vetsulin) the numbers you have gotten so far suggest he may need some insulin.
 
Please read my signature link Glucometer Notes for more info on how these meters work and what the numbers mean in cats.
 
Welcome! What a great job you are doing with your Eddy already! Congratulations on getting him on a good diet. I am unclear whether the BG results you have are from the vet or if you are testing at home. If you are not testing at home, I would definitely start that. If you need help, we have videos and other suggestions.

I would test him before he eats and at different times during the day. Their levels do fluctuate so he may go down to a lower number and then back up.

We consider a cat generally regulated if they are inthe mid 200s at preshot and then double digits at nadir (the lowest point of the insulin cycle - usually somewhere between 5-7 hours after the shot) but not below 50 which is nearing hypo territory. A cat is considered in remission if they range from 40-120 OFF INSULIN for 2 weeks.

I'd keep (or start) testing him at home so you will have good data for the vet when he returns. Is there any chance you can buy human insulin without a prescription in Greece? (There are two human insulins that work well in cats. I suppose you could consider starting him on a low dose with one of those if you can get them, until the vet gets back - IF you are home testing)
 
Dear BJM and Sue &Oliver,
thankyou for your replys. I have been home monitoring Eddy's BG, those are the figures I mentioned in my original post. It was just the first 2 values of 300 and 360 that where done by the vet. So I was hoping that due to the diet the BG would be lower by now. over the last week his BG has been around 280 to 295 with the one result of 195, that I now think was a false reading. I test his BG every morning around the same time.
I use a human BG meter, supplied by the greek pharmacy (it's a glucocard S made by Arkray) and I have no problem getting blood from Eddy, so this is fine. My main problem is not knowing what BG levels I should be hoping (aiming) for.
How often do I need to test etc.
thank you for nyour help
 
[Glucose reference ranges are unsubstantiated and have been removed by Moderator]


* * * * * * * * * * * * * * *​
Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
Good morning and thank you for your speedy replys. I have reached my vet and he wants me to use insulin Lantus, 1 click, i.e. one unit per day for the next 4 weeks until he gets back and to continue with the BG home testing and the home made food. He would like me to also use some wet comercial food. I can get the Friskies tinned cat food here. What do you think about this??? By the way Eddy is abour 3.5 to 4 kilos in weight. All answers are very much appreciated as I'm a bit lost. Thank you
 
Hey that's great that he wants you to start with lantus! Do you need a prescription to purchase it?

Not sure what he means by "one click".

If he means give 1 unit, that is a safe starting that we recommend on this board. Dosing protocol: viewtopic.php?f=14&t=88159

In what form can you get the lantus? It comes in two forms in the US - a vial which holds 100 units and in pen form, which holds 30 units (I think). It's basically a smaller version of the vial.

We recommend getting the pen form and using U100 insulin syringes to get the insulin out of it. Do NOT use the needles that are sold with the pens. Those are fine for human use, but not cat use. Purchase a box of U100 syringes that are 3/10 mL (cc) and holds 30 units or less and if you can get ones with 1/2 unit markings that would be easiest for you.

You can get long or short needles (I prefer short) as they are thinner, smaller and I think easier to use.

here is a link that further explains insulin syringes with a graphic of what the ones with 1/2 unit markings look like: http://www.bd.com/us/diabetes/hcp/main. ... 7&id=63631

When you have time, please visit the Lantus forum and read the "starred" information on using, storing and dosing Lantus. It does have a learning curve, but as you are already home testing and diet changing, you're steps ahead. viewforum.php?f=9

You asked about the canned food. Honestly, if your cat is happy and enjoying the raw food diet, I see no reason why you need to supplement with canned food. You are already giving a high quality diet and know exactly what is in the product.

If you do give canned food and Friskies is a widely available brand in the states, you need to be sure that it is the "classic" version of Friskies and is pate style only. The types with gravy, chunks, pieces, grilled, sliced, diced, etc are usually high carb and not recommended.

We do suggest that you keep a few of these high carb versions handy - especially ones with lots of gravy - and put that in you hypo tool kit....meaning that once on insulin, if you see a huge drop in a short period of time (like over 200 points in 2 hours) or you cat hits 50 or below, you want to pull this out and serve very small quantities to bring the BG level back up. Here you can read more about a hypo tool kit and how to handle it here:

hypo tool kit: viewtopic.php?f=14&t=2354

how to treat hypos: viewtopic.php?f=14&t=1122
 
OK, we have started. Eddy has hat 1unit of Lantus, his BG before was 224 and he is now eating his 2nd meal of the day. I'm now checking his BG every 2hours. I can only get the Lantus pen, and on advice of the vet I used 8mm needles and injected in the back of Eddys neck. I'm not quite sure how much acctually went in, fingers crossed I got it right.
 
Are you able to get the insulin syringes I mentioned? Check in a human pharmacy - because you want to make sure you give the correct dose without making mistakes, such as giving 10 units when you intended to give 1.
 
Thank you Hillary&Maui, and everybody else who has answered and followed my post so far

thank you for your detailed post. The Lantus pen I've got has 100 units (3ml) and i gave one click, that is one unit. I did nor need a prescription but had to buy a box with 5 pens in it. My vet insisted I use no 8needles, as the human ones where no good.
I will continue him on home food, I don’t want to buy any other tins, my other 4 cats can have what’s left and then I might change them to home food to. It's not that easy, as we are quite rural, in fact halfway up a mountain in a tiny village, and all my cats are inside/outside and up until now, “eat when you want” cats.
So Eddy is now locked in our bedroom, with his food and a litter box and the others have their food put down twice per day. I confiscate any leftovers, so as to make sure Eddy can't get at it. He dos soooo love his biscuits (Kibble ).
So at 2pm we gave 1unit Lantus and the BG was 224 and he had food
now at 4pm after 2hours the BG is 145, so I must have gotten some of the insulin into him.
By the way I gave it to the back of the neck, but my vet also mentioned that I could inject in to the "side" of his belly, not quite sure what he means by this. :?:
Unfortunately I have an added problem in that since yesterday I have been laid up in bed with a slipped disc and seized lower back, so taking this insulin job on is a bit difficult and has ended up being mostly my husband Denis’s job. Bless him.
Using my laptop whilst lying flat is also a bit of a challenge.
Regarding getting the syringes, I will have to look into this when Ibrobrufen pain killers allow me to be mobile again. In the meantime I'll try to get as much reading in as possible. I am so grateful for all the helpful posts.
 
thanks for the additional information.

You're vet is wrong, you can and should purchase insulin syringes instead of using the needles that are attached to the pens. The reason being - is that what you have is not 100% accurate and for a human it's fine if it's off a little, but as much as a 0.25 adjustment can be a big deal for a cat.

Just remove the pen tip you, purchase (in the US they are usually sold 100 in a box) U100 syringes that are 3/10 mL (cc) and holds 30 units or less and if you can get ones with 1/2 unit markings that would be easiest for you.

You will insert it like this: http://i214.photobucket.com/albums/cc28 ... raw2-1.jpg

just remove the pen tip and insert the syringe into the rubber stopper - now make sure that once you draw insulin into the syringe and you draw up too much - DO NOT push it back into the pen. You can ruin the insulin if you do that.

It is very easy to use.

Regarding shooting in the side (or flank) as we call it - it's the space where the rear leg joint goes into the body (think of it like your own hip joint) here is a photo that may help show you better

http://i214.photobucket.com/albums/cc28 ... raw2-1.jpg

if your cats are used to grazing, you can continue allowing him to do that as it is a more natural way to eat. of course you don't want to let raw food sit out too long otherwise you have contamination issues. but you can let your others graze on the raw/canned foods.

one of the tricks we use to keep it moist longer is to add water to the food. When I use canned food, I typically add a full can of water to it and mush it together. this keeps it moist for hours and ensures that the cat drinks plenty of water, which they tend not to do....and if you do that as well as change to all raw/canned - don't be surprised if they stop drinking from the water dish - the reason being they are getting plenty of water from the food you are providing.
 
Ok, I will get the syringes asap

I've just done another BG, this is n4hrs after Insulin and it is 66, so I have given some home made food, ca. 1 tabsp.
When should I test again?
thank you
 
what was his bg when you gave insulin? it's important to know how much he dropped and test again in 30 minutes since you just gave him some food. you may have to give him more food with higher carbs in it - such as some of the canned food you may have - in order to not let him go below 50

this is the time you need to read about hypos and how to treat them


viewtopic.php?f=14&t=1122

viewtopic.php?f=14&t=2354

and 1 unit may be too much - or you may have given more than 1 unit using the pen attachment and not realize it.....
 
we also have a safety zone for new people with a no shoot number if under 200 don't give insulin - of course you are testing and gave insulin and that's ok -

please keep in mind that normal bg range is 40-120 --- when first starting out if the bg is in this range at amps or pmps - you may want to:

1) skip the shot
2) reduce the dose
3) stall giving the shot and test in 30 minutes, and if still low, follow step 3 again
 
now 1/2 hour after giving some food BG is up to 79 again
sorry but what does" amps or pmps" exactly stand for? confused_cat
 
amps - morning pre shot test
pmps - night pre shot test

as we are all in different time zones - we talk in am and pm and use hours after shot isntead of writing 4 pm or 8 am.....

ok test him again - and good that he is rising slightly... let's keep him above 50!
 
It is now 6 hours after Insulin and BG is 87.
I hope to get syringes tomorrow and start a regime of Insulin as suggested in the above posts. I will keep you informed.
Thank you so far
 
ok -- hopefully he will stay at this level -- which is very good by the way! you want him at this range. i

before you decide to give insulin next - please go onto the lantus forum and post the pre-shot bg level so that you can get immediate advice on whether it is safe to give insulin. it may be that if he is at 100 or lower that you skip the shot and test and see how he does.

no matter - please take the time to read the information about hypos and to visit the insulin support group - lantus to learn more about that insulin.
 
Hallo everybody,
this is what has been going on with Eddy over the last 2 days.
Unfortunatly so far I have not been able to get the correct syringes and have been working with the pen, the pharmacy is trying to get them, but i have no idea when.
Tues July 29.
......... .... 02:00 pm ........ +00.00 ........ 224 / 12.4 ... 1.00 u ... Eddy had been fed 80gramm 5hours earlier
......... .... 04:00 pm ........ +02.00 ........ 145 / 8.1 ... ....... ...
......... .... 06:00 pm ........ +04.00 ........ 66 / 3.7 ... ....... ... fed 1tblespoon
......... .... 06:30 pm ........ +04.50 ........ 79 / 4.4 ... ....... ...
......... .... 08:00 pm ........ +06.00 ........ 87 / 4.8 ... ....... ... fed 2tblespoon
Wed July30
......... .... 01:30 am ........ +11.50 ........ 84 / 4.7 ... ....... ...
......... .... 09:00 am ........ +19.00 ........ -- 356 / -- 19.8 ... 1.00 u ... fed 80 gramm
......... .... 11:00 am ........ +02.00 ........ -- 244 / -- 13.6
......... .... 01:00 pm ........ +04.00 ........ -- 220 / -- 12.2
......... .... 03:00 pm ........ +06.00 ........ -- 195 / -- 10.8 fed 1tblspoon
......... .... 05:00 pm ........ +08.00 ........ -- 259 / -- 14.4
......... .... 07:00 pm ........ +10.00 ........ -- 235 / -- 13.1 fed ca 50gramm

What do you think of this so far, I think you call it a curve?
When should I give Lantus again? The smallest amount I ncan give at the moment is 1unit.
Eddy seems quite happy, but hungry all the time. So as he is quite skinny, I have been giving him a bit more of the home made food. I suppose it works out at ca. 200gramms per 24hours, divided into 5 portions. To larger ones morning and evening and smaller ones during the day and one before bedtime.
Any feedback will be greatly appreciated.
Alyson
 
it will be easier if you can set up a spreadsheet - here is the link to how to do that and attach to your signature - this way we can easily go through it viewtopic.php?f=6&t=18207

overall doesn't look bad - it does look like when he got the lower numbers on tuesday that his pancreas got scared and he bounced. I'm not great at explaining what this means - but essentially it means that he is so accustomed to being in higher numbers that when he dropped low, the pancreas freaked and he went higher --- the goal is to even this out so he stays as flat as possible without the highs and lows.

hope that makes sense - i'll let someone else explain it better.... ;-)

one thing if too much testing is stressing you or him, take a break - especially if he is above 100, and by break you don't have to test every two hours, skip some testing and see -- you could take a look at Maui's spreadsheet that is attached to my signature -- Maui's SS -- as well as other people's spreadsheets.

of course if you all are fine with the testing frequency, keep going - cause the more information the better!
 
The effects of Lantus build up over several days. How many days has he been on it?

If you can measure/eyeball 0.75 units, I think you may need to reduce the dose a bit. He is going low enough that after several days, he may go too low into hypoglycemia.
 
BJ - they only have the pen needles - not sure they can adjust the dose on that - hence why stuck at 1 unit....and I believe only on insulin a couple days....ps - she is in Greece (the country!)
:-D
 
She may need to feed a slightly higher carb level, then, to keep from going hypo on the 1 unit.

With it being only a few days, and the number going pretty low on the 1st day she listed, I am concerned that the increasing effects of Lantus will not be offset by enough glucose as she continues.
 
What do I do now????
His latest result is:......... .... 09:00 pm ........ +12.00 ........ -- 280 -- 15.6

Do I give one more unit of Insulin as BG is over 200? I can not give smaller dose than 1 Unit as I only have pen.
 
No need to panic. You are likely seeing a bounce. This happens when the glucose drops fast OR the glucose drops to a number the cat hasn't experienced in a while. Compensatory hormones kick in and release stored glycogen, which converts to glucose and the level rises. It can take about 3 days for the levels to settle down.

Just be patient and stick to the 12 hour schedule.
 
yes that is what she means - give 1 unit now... and try to get the syringes asap so you can reduce his dose - i'm wondering are you able to squirt out a little insulin into the sink with the pen without squirting/pushing it all out? try it and see and if you are able to do that - then dose him that way for now.... while we won't know for sure the actual amount, we will know that it is less than 1 unit.
 
I mean if it is his regular shot time, give it to him, but not early.
Giving Lantus early acts like a dose increase because there is more overlap.
Giving Lantus late acts like a dose decrease because there is less overlap.
 
BJM and Hillary,
yes I wanted to know if I sould give it at all.
BJM I don't think I have a regular shot time yet, as this was only Eddy's 3rd dose ever, I'm really not to sure abaout what I'm doing.
Hillary, trying to get the syringes asap, things not so easy here :sad:
I've just had a bit of a play with the pen, I thinl 1unit is 3 or 4 drops, so I might be able to discard first bdrop, but it will be very hit and miss and I don't think I'd know how much he's had.
I have just tested2hrs after last dose and BG is 124.
I think it's going to be a long night
thank you for your input
Alyson
 
here is a quick primer for giving insulin - you want to give every 12 hours and stick as close to that time when using lantus (other insulins are more forgiving). You can give 15 minute late or early but no more than 30 minutes late or early - otherwise it will be considered a dose adjustment.

So try to stay as close to your 12 hour window as you can.

For now, given how he is reacting to the insulin, shaving off a drop even two drops is a good idea - NO you won't be exact in knowing the dose, but you can be sure that it will be less than 1 unit and that is the goal. Better being a little uncertain and not exact than giving a full unit and it being too much insulin.

so if I understand correctly:

PMPS 280 - 1 unit
+2 124

ok feed him some higher carb food so we can slow this drop and then get a +3 test and you may need to repeat more food and test....

do you have any food with gravy? If you do, just give him 2 teaspoons of gravy...reason this will slow the drop without making him full, especially if you will need to repeat this a few times.
 
Sorry Hillary,
have only just seen your post, it is now +4hrs since last shot and BG is 77, so I'll give him some gravy from a tin of regular catfood. I.e. the type I would not give him normal. Is this correct?
PMPS 280 - 1 unit
+2 124
+4 77
 
yes correct

what you are going to do now is same as you did last time --

1) give 2 teaspoon of gravy
2) test in 30 minutes

If number continues to drop repeat steps 1 and 2

you will continue this until you get 3 consecutive rising numbers!


make sense?

And if you have an emergency - please go to the lantus forum - and put 911 need help in your subject line -- this will get immediate attention from the people there.
 
Hillary , BG has shot up to 281, that is PMPS + 5.30. I think Husband gave more like 2 Tablespoons of gravy, not teespoons
 
ok he will come down from that eventually, it's why we say teaspoon not tablespoon - cause you don't want him being a yoyo and bouncing high to low to high....hold off on any more at this point and see how long it takes to wear off

you are probably in bed and that's fine... regroup and start over tomorrow... remember to shave a drop off the dose if possible.
 
If 1 unit is too much and you can't reliable knock a drop off the pen, another alternative is to carefully measure out a couple of teaspoons of medium or high carb food and mix them into his meal OR, if you are home, feed that at roughly +2 when the normal food spike is starting to resolveand the insulin is starting to kick in more strongly.

In other words, if you can't adjust the insulin, adjust the carbs to balance the insulin.
 
Status
Not open for further replies.
Back
Top