New member. My story first post.

Hello! So Im totally new to this but I think I could use some support. Here is my story/introduction.

So my sweet Pikachu (Pika) was diagnosed February 16th 2023. At diagnoses his BG was 364 and he had ketones at like 15.. pretty high. My pika had lost almost 4lbs in like a month and a half before diagnoses. We didn’t notice the heavy urination because on Thanksgiving we were in the Kitty ER due to crystals in his urine and his non urinating (he wasn’t blocked) so we started the Hills prescription C/D food. Took care of crystals and vet wanted him to drink more water and he always took large pees. So we didn’t notice the uptick in water but we did notice how much pee. Fast forward to February and I’m concerned due to weight loss, lethargy, and his “miss jumps” often.

So we started at 1 unit of Glargine am and pm. And we were not home testing. Went in after 4 days to see how his sugars were and they were at 376… vet wasn’t happy they went up. So he wanted 2u am and 1u pm. Pika was free fed (still is with the dry I know shouldn’t but I have two other cats that have been free fed one IBS and doesn’t do well with “meals”) and he wasn’t eating enough for me to be comfortable without testing his BG to give the full 2 units am. So fast forward a week and his BG was up to 383 at vet office so we placed a Libre 2 sensor on him.. since I was so apprehensive about causing him to go Hypo I don’t want to kill my cat. And I know you don’t give insulin without BG numbers. Once I got the sensor placed I was comfortable to give the suggested dose since I could see some numbers actually. And that brings me to the FDMG.

so I am a month in (sensor only 10 days in since he removed first one once I had a break through and he dropped below 200 for first time) and I had a second one placed the next day after he took off the first, lasted only 8 hours before he pulled it off BGs were around 300-250 so he was feeling better. I couldn’t get a new one placed till 3/14 and he is back to uncontrolled all over the place with numbers and not dropping below 250 and all progress was lost. I did buy the alpha trak (not recommended on the FDMG I know) just incase he removes his 3rd sensor (he is in a shirt to prevent pulling it off and he is being okay in his shirt)

but I have been going crazy trying to get my Pika back to Pika.. and this is where I need support. I’ve messed up his shots a few times (fur shots) and I feel like I’m failing him as a cat mom. Thank you so much. I can upload his graphs. If needed. He has been maintaining his weight at 12 lbs (was 15 before diagnoses at diagnoses he was 11.7) but since his average BG level is about 350 I’m worried about him as we all are about our little bundles of fluffy joy!! Thank you once again everyone! Sorry it’s a rant. But that’s my story. And I am looking forward to being a member.

Love you all for all your help and support
Pika and Shellz

 

Hello and welcome. Here is a link to a post for new members, some information for you so we can help you better.
New? How You Can Help Us Help You!

First, one thing that's not helping you is the food. It's OK that Pika is grazing, but he's not on a food that's good for diabetics. We suggest people feed food under 10% carbs. I know the c/d wet is really high carb, 23-28%, I can imagine the dry is even higher. We've had a few cats show up here because of the c/d.

What food does the rest of your crew eat? Just wondering if we can think of something that will help Pika, but the rest will also eat. My non diabetic had a urinary episode a week after my Neko got her diabetes diagnosis, and it was a battle with her blood sugars partly because she kept trying to steal his food. So I had to come up with a food both could eat.

The thing about the AT is the cost of test strips. It's a fine enough meter, but I've seen some people be conservative in testing due to the cost of test strips, or even run out of test strips because they have to wait for either delivery or the vet to open. Human meters win the convenience and price battle. The Libre is also a human meter. Plus our dosing methods were designed before pet meters were a thing, so that's what the majority here use. Not saying you can't use the AT if you really like it.

 

I spaced the change of food.. we did go to the Hills prescription M/d dry and I have tiki cat pate and mouse but he got to where he was only eating half eating it so I let him have one of my other cats Fancy Feast Classic pate and he loves that wet stuff. He will eat the whole 3 oz can at AM/PM shots. I fully believe the C/d caused his diabetes and the vet wanted him on the W/d tried it for a week or two then I found FDMG and I insisted on the m/d. So we have gone to a lower carb diet. He does get his wet can at his insulin time but I do leave the dry out. I tried to transition them all to meal times.. but none were eating enough.. and I have an kitty with IBS and the not being able to eat whenever cause Noriko major puking episodes plus I couldn’t give full insulin without him eating. and I don’t want to starve my cats. Especially since I work retail (short staffed so I’m working overtime a lot) and husband also is retail so we are gone most the day when we work.

Yes the AT test strips are super expensive but I haven’t used them yet, it’s my back up if he pulls his sensor off. I did buy the freestyle human one as well.. so I have two.

so his breath smells super acetone still so he still has ketones I’m sure.. due to his high sugars and my “fur shots” I’m trying my best no to freak out about ketones but…. It’s something to worry about. I don’t have any ketone strips I go by his breath.

 

Hi Shellz!

Pika has such soulful eyes. I hope we can get him back to himself as soon as possible!

The problem with the food isn't the free feeding, it's the high carbs. Unfortunately all dry foods are too high in carbs. You can find some that are lower, but they won't be low enough.

Have you looked into a timed feeder for wet food? Pumpkin also needs lots of little meals. I ended up getting her two CatMate C500 feeders, one for the morning and one for the evening so that she can get 10 mini meals spaced out throughout the day. I realize that might get a little ridiculous when multiplied by three cats though. Maybe look into a SureFeed?

For the fur shots, I read someone else's technique on here that ended up working really well for me. Let me see if I can describe it:

I start by making a part in Pumpkin's fur, a little towards her tail from her shoulders. Then, using my thumb and index finger, I pinch her skin closer to her head from the part. My index finger is closer to her head and my thumb closer to her tail (and to the part). Then I roll my thumb over my index finger. That creates a nice, broad, and stable place to inject. 80% of the time, I can already see her skin. Sometimes I have to rearrange the part a little with the hand that's holding the syringe so that I can clearly see her skin. Once I've got a nice and stable part where I can see her skin, I inject perpendicular to the skin right in the middle of the bare patch. Press in the plunger, and I know for sure that she got her shot because I watched the needle go right into her skin.

 

I made a video of my technique (minus the injection because I don't have enough hands ). https://imgur.com/a/wJ3YYte

 

I have thought about it.. I just haven’t pulled that trigger on that purchase. Yet.

okay I like that roll vs pinch and tent. That was a great explanation on how to actually do it. Thank you!! I will be trying that in the AM! For he already got his dose for the night. I’ll go watch that video! Thank you Jacques!

which brings me to a question.

So I had to have missed his shot (missing 4 hours with of data due to work) this morning so he was 400+ for most the day. Then when I gave him his shot tonight at PMPS 392 @ 845 seemed to kick in really fast and drop him down two 230 by 11 then he was already climbing back up by by 1130 to 250+. I’ve noticed this on this dose 2u Am/pm Glargine. his big drop is about 3-4 hours in then it’s a steady rise after. I wish I could post my screen shots of his charts. Is this a normal response? And he is staying on the lethargic side.. with his acetone breath. How long does it take for ketones to start working out? And will his back legs get stonger? I’m all sorts of worried that something is wrong from how strong his breath is but he has a super healthy appetite. And his walk is sometimes swaying like.


He is my sweet boy who sucks his paw like a baby when you hold him. He will be 9 in July.

 

Can you get Ketostix? They should be available at most pharmacies. Ketones above trace really need to be dealt with by the vet. Try to get as much food and water into him as you can. Maybe watering down his food? Fluids can help flush ketones. More here: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters

In the post I linked first for newcomers is instructions on how to put together a spreadsheet showing blood sugar values. Most members have one in their signature, if you want to take a look. Seeing the data might help us understand what is happening with his numbers on Lantus. Sometimes cats will have a strong reaction for the shot after a fur shot. Maybe that's what you are seeing?

Back legs could be neuropathy, or low potassium. Feline Diabetic Neuropathy You can go to Youtube and see videos of neuropathy to see if that's what it looks like. It is reversible.

 

I’m not the best at interpreting curves but it’s a lot easier if you can start a spreadsheet @Bandit's Mom can help you out if you have any trouble.

Instructions here: https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

I’m still early with Punpkin but I’ve read a lot of members who’ve had their cats recover their leg strength once they get well regulated.

For now just stay focused on getting him regular shots and figuring out how to get him to a low carb diet.

 

Now I’m all sorts of worried about DKA I though that insulin would help the ketones but he has been uncontrolled for almost 3 months.. I’m adding in when January when we noticed weight loss and larger urine could be closer to 4 months.

why wouldn’t my vet have addressed the ketones at diagnoses they were at like 15mg/dl when he got the UA done?! I almost want to go to an emergency vet but I think I’m just being super obsessive and overthinking. If he was higher BG for awhile ketones would be more likely. But getting him under 300 should help that a little? Hopeful thinking. He doesn’t like to get below 250 for some reason.

 

Some vets (like my ex vet) don't "look at" ketones. I have no idea why. If your extra concerned you can get a ketone blood meter same day delivery on Amazon, I use ketoBM. You can also grab ketostix at any pharmacy, those are the urine dip tests. I prefer the meter as I'm a testing overachiever lol.

 

How is your kitty now?
Is he still lethargic?
Is he eating OK for you? Are you feeding him extra food? its important you feed extra food to help combat the ketones.
I'm a little confused...Are you hometesting the blood glucose or are you still using the libre?
I see you bought an alphatrak meter.
I'm going to ask @Bandit's Mom to help you set up your spreadsheet and signature so we can see what is going on.
Don't skip any doses of insulin as insulin is really important to help keep ketones away as well. If the BG is not high enough...stall, dont feed and test again in 20 minutes to see if the BG is rising. And post and ask for advice.
Try and get those ketostix so you can monitor the ketones each day.
If Pika is not eating or gets more lethargic I would take him back to the vet.

 

I’m using the libre 2 sensor with him at the moment I have not actually poked him myself to test his BG.

he slept with me on the bed all night till 6 am then he got up to nibble on some food (breakfast at 8 with wet food) I did give him extra wet last night since he seemed so hungry for more wet.

It’s just been so long since he has had his zoomies and his normal energy levels. But we have got him go play and he wants to play just gets tired easy especially if I mess il his shot like I did yesterday morning.

He just jumped back up onto the bed waiting for me to wake around 7:45.

His cycle last night went 8:45 PMPS 392 (libre sensor)
+1 328 +2 277 (lowest point was between +2 and +3 at 225 at 11pm) by +3 253 +4 264 next scan +6 355 +10ish 370

I will admit that I cannot get the perfect 12/12 schedule due to work so he is sometimes 13/11 or 14/10. This is where I also fail him as a diabetic kitty mom. But also why I leave dry food out. (3 kitties in total indoor only)

yes I need to buy those test strips for ketones I’m just worried ill spiral if he is in the middle ground.. and the vet doesn’t open till Monday and his regular dr is out of town for the week.


Thank you all so much!

 

Ive asked @Bandit's Mom to help you set up the spreadsheet and signature so we can see what is happening.
You can only do your best with the cycles...so don't worry. We all have to work to pay the bills!
You dont need the vet to get the ketostix to test the urine for ketones. Please get those today...very important we know what the ketones are doing.
Also try and feed a bit more. If he is hungry that is great!

 

Even diabetic cats without DKA can be lower energy than healthy cats. Remember that DM results in every cell in their body starving for energy, so they're constantly going to feel both very hungry and very fatigued. If they're developing neuropathy, that's going to be even more tiring!

I test Pumpkin regularly for ketones, it's always negative, and she's still pretty low energy. For a while, she wasn't even interested in snuggles, but after a few weeks of treatment she was feeling more like herself and started curling up on me when I come from for work like she'd been doing her entire life. It was such a relief to have her a little more back to herself again!

I think if Pika is hungry for the wet food, plays for at least a bit, and has the energy to come get snuggles, you're doing okay. You need to resolve those ketones ASAP, but for now I would mainly worry about changes in energy level.

Hopefully you can get a spreadsheet going soon so that we can guide you through dialing in a dose that starts to get Pika regulated.

 

Okay I think I got the signature and the spreadsheet down! I just started with my yesterday numbers to get it started… and yesterday morning was a FS I’m sure from seeing his numbers be 400+ basically all day. I did loose the first 4 hours of data due to only storing 8 hours on libre sensor. (And the most critical hours the first 4 after dosing)

I’m pretty sure the vet didn’t want to scare me with the ketones and he was almost positive they would start to clear out with getting him on insulin. His weight did start to even out. He went from a beautiful 15lbs cat (he does have mainecoon in him) on December 12,2022 to 11.7lbs at diagnoses. Last weight in last week was 12lbs. So he stopped loosing and started maintaining.

yes he does try. Like when my husband woke up he ran in to the bedroom to say good morning. He gets more vocal the better he feels.. and I could be over analyzing him.. but no I will go buy those ketone test strips I won’t lie im terrified to do it.. I tend to get overly stressed about my kitties. Like my husband doesn’t know what to do or say to me with my stress.. and I know my stress affects Pikas stress so I’m trying really hard. But those darn ketones are scary and can they stop on their own or are they something the Vet has to do?

But he does have a healthy appetite and he will jump up on stuff and he’ll beg me to hold him and carry him around so he can suck his paw like a baby sucking their thumb.

 

For the fur shots, I’d suggest using a flashlight or an additional light source so you can see the skin when you part the fur and you can see the needle going into the skin. Once I started using a flashlight, I never had a fur shot again. You need to see what you’re doing and if you see the needle go into the skin, you know it’s not a fur shot. Also, if you touch the spot and the fur is wet, then you know it’s a fur shot. I also used to smell the spot to make sure because insulin has a very strong scent.

 

I did ask the vet the shave me a spot so I could actually see his skin. I do great when I do it in that spot but I try not shoot exact same place every time so sometimes I venture into his longhair and that’s when I get to having some of my issues. Using an additional light is a great idea I do have a head lamp!

his breath this morning is not as strong acetone as it was last night! As he was bathing himself you could smell it. This morning it’s not as strong but I’m getting dressed to go out and buy those ketones UA sticks even though I’m scared to see. But then that lets me know if he needs to go to the vet again.

but yea healthy appetite ate all his FF 3 oz can plus half 2.8oz can tiki. Then he also has gone for some dry as well. I did add additional water to his FF pate this morning. And he is up moving stalking something. But it’s not his usual energy still. But all good signs. I’ll keep updating my spreadsheet up till I go to work. Thank you so much everyone!

We will get Pika regulated and back to his wild Peaker Beaker self. With head tosses and all!

 

Shellz -- your cat's breath smelling of acetone strongly suggests that ketones, at a higher than desirable level, are present. Please get Ketostix and test your cat. Ketones can be life threatening. When my cat was diagnosed, I had my vet and the ER vet where she was hospitalized, tell me that she might not survive. I was very lucky. We take ketones very seriously. Ketones typically result from the presence of an infection or inflammation, not enough calories, and not enough insulin. Pika's spreadsheet suggests she may need more insulin. It's great to hear that he's eating. Like Wendy suggested, add water to his food. It helps to dilute the ketones.

Please keep in mind that the only way to overcome the effect of feeding your cat a high carb food is to give more insulin. If Pika likes Fancy Feast, it's fine to feed him that. Many members here feed their cat Fancy Feast Classics. There is nothing that is specific to diabetes in the so-called diabetic prescription food. (Read the ingredients.)

 

Overfeeding him if he smells like ketones. I was able to treat my cat with ketones at home. I won't lie and say it was easy as he wasn't eating, but if your cat is still eating it will be easier. Tons of food, at 11.7 lbs 4 cans of fancy feast a day is the minimum, aim for 6 with ketones. Add water to the food. Food and water consistently will help

 

Are you able to syringe feed him if he doesn’t want to it all on his own?

 

Yes he will syringe feed cause he was a bottle baby. I don’t think I need to do that since he eats freely on his own. He actually loves it when I syringe feed him.. I can do that to help him get a few extra calories.

 

Get a lot of extra calories if you can! It can only help

 

Hi Shellz - Any luck with the ketostix and the extra calories?

 

i haven’t had luck catching him in the litter box but he is getting a lot more food into him. He is getting his full 4 cans and then his dry food too that is always down. And some mid day snacks.. and his breath seemed to get more of that kitty breath smell so I’m sure things are cleaning out.

And since he is on the libre sensor he has been wearing a shirt. To prevent him from pulling off his sensor. And last night he puked up the biggest hair ball I’ve ever seen in my life. I sure he is getting bothered by the shirt since he cannot groom himself like he is used to.. so im brainstorming on what I can do to protect the sensor but give him his more body to lick. But I do believe I will have so give him some sort of hair cut to be more comfortable in his shirt… He has been such a good trooper to wear a modified shirt! And he looks so darn cute in it.

 

Still no luck on getting a urine sample to test. But today I did successfully (thanks to all of the info from FDMB and your fine videos) took a BG sample from Pika due to his sensor giving me error codes for over two hours. I am replacing his sensor on Wednesday at the vet but in the meantime I will be testing his glucose with AlphaTRAK3.

How many times should I test in his cycle. I know to test before I give him is insulin. And I am using the AlphaTRAK3 for the official BG numbers (since it is calibrated to cats) I do have a human meter as well it’s the freestyle persesion neo but it stops at 500. And AlphaTRAK3 goes to 750

a so his number this morning was insanely high.. umm what the freak am I doing wrong with him? I know there is a good chance he has been going this high this whole time since I’ve been on the sensor that only goes to 400. Seeing 718 was very very discouraging. And I am feeling like a cat mom failure at the moment..