New member - potential diabetes diagnosis

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Virginie & Chewie (GA)

Virginie & Chewie (GA)

Member Since 2022
Hi everyone,

My name is Virginie and I just signed up here to get advice regarding my 15-year-old cat Chewie.
Chewie has always been the healthiest of my kitties, until she damaged her back jumping off a tall bed in March this year. Vet diagnosed lumbar IVDD (rare in cats apparently), which was treated as follows: 5 days of buprenex BID for pain, a tapering course of prednisolone (5mg a day for 5 days, 2.5mg for 5 days then 2.5mg every other day for 5 days), and laser therapy/acupuncture once a week for 6 weeks. She recovered much better than the vet expected, she has a little shuffling walk with swaying hips now, and we put pet steps everywhere, so she gets around pretty well. She is also on twice monthly Adequan for arthritis, and takes an occasional 25mg of gabapentin on days when she seems sore.

I noticed over the past couple of months that she seemed hungrier than usual, but didn’t increase her food since I thought she had to stay lean to avoid putting pressure on her back and joints. Fast forward to her annual blood work on 7/16: her blood glucose levels were pretty high, higher than could be expected with stress hyperglycemia (she really freaks out at the vet’s, especially since her back injury), and she had lost weight (a pound since March). I can’t remember the exact number the vet gave me over the phone, but I’m planning on calling the office to get a copy of the bloodwork results tomorrow. Both the vet and I were confused, as she has no risk factors - not overweight, has always eaten grain-free canned food or raw food over the years (she’s been eating raw only - Darwin’s Naturals turkey mostly - for the past 7 years). The only thing she could think of was the course of prednisolone for her back, and she said she might be “on the tail end” of an episode brought upon by the pred, so she scheduled a recheck of urine glucose on 8/28.

Since then, I have been feeding her more and more: she used to get 42g of food 4 times a day (I have an IBD cat that needs small meals so everyone is on the same schedule) now I’m giving her 52g each meal, plus 4 pieces of kibble once a day in two tablespoons of canned pumpkin to help her transit. She has barely gained any weight back so far and she is absolutely ravenous. I have also never seen her drink so much water, even during heat waves.

My question is, do you guys think the hypothesis that she might be getting slowly better from diabetes caused earlier by the pred is likely? Should I wait the full time the vet wanted to wait to do the recheck, or call to move up her appt and ask for a fructosamine test instead of urine glucose?

It’s heartbreaking seeing her eat so much and not put on weight. I’m reweighing her tomorrow and hoping to see an improvement but I’m really worried waiting isn’t going to help. Hoping to get your experienced opinion to balance out my anxiety!

Edited to add: I couldn’t wait and reweighed her and she gained about 100g in a week (=3.5oz)

Thanks so much in advance,
Virginie and Chewie
 
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See if they did a frutosamine test which gives you a 3-week average of the bg as opposed to a spot check. I know you’re worried about the weight loss but I’d stay away from anything dry as it’s only going to make the diabetes worse if that’s in fact what she has. You can up the wet food and low carb treats. It’s more about the calories than the grams. What’s her weight now and what’s her ideal weight? A good rule of thumb is 20x ideal weight to get the daily calorie intake she should be getting and if she needs to gain weight, you can up that more. Diabetic cats do require more food since they can’t process the nutrients efficiently and burn calories just by peeing (their urine has sugar in it). Last thing, you can buy urine test strips at any pharmacy and test her average levels for both sugar and ketones at home
 
And I agree that you want to start on insulin asap if her diabetes is confirmed. The best insulins for cats are the long lasting ones like lantus and prozync
 
Thanks both - they did not do a fructosamine test, just a regular senior panel, but I would like them to do the fructosamine instead of just the urine glucose test when I take her back. If she needs treatment, better to have detailed data upfront.

Her ideal weight from when she was in full health (late 2021) is 11.3lb (5.12kg) and at the exam 3 weeks ago she was 10.25lb (4.64kg).
Today she weighed in at 11.1lb (5.04kg) but she had just drunk a bunch of water (not sure if that impacts anything).
Her meals amount to about 240kcal a day right now - should I increase that?
 
She should be at 226 and you’re giving her a bit extra. It also seems like the good news is that she’s almost back to her ideal weight. Water/meals can add just like with us. Best time to check is on an empty stomach. For confirmed unregulated diabetic cats, we tend to suggest to let them eat as much as they want for the reasons cited above. Until they’re regulated and then you can pull back. Does she still ask for food like she’s starving all the time or does she seem content?
 
And the fructosamine is a must whenever there are steroids in the mix since those can increase the bg and give you a false positive on a random spot check. The other thing that we see happen a lot when that’s the culprit, is that cats go into remission once they’re on insulin and off the steroids so that’s why it’s important to monitor the bg at home. Diabetes is also easily managed and we can give you many many helpful tips and resources. When is the vet check up?
 
She was on steroids for two weeks in late March/early April, and hasn’t had any since, so both the vet and I are hoping that any steroid-induced diabetes might be slowly getting better. The vet wanted to wait a full six weeks from first high value we got in order to give her time to get into potential remission by herself before retesting her levels with a urine glucose test (scheduled appt is in 20 days). I will definitely ask to for fructosamine instead.

I am slowly increasing how much I give her at mealtimes to see how far I can go without her throwing up. She doesn’t really beg between meals, but will definitely come to the kitchen if she hears any food-related noises in there - that’s not a new habit though, she has always been a mooch for snacks :) If she seems insistent I will typically give her a spoonful of Wellness turkey bits in gravy canned food to pacify her.

What brand urine strips would you recommend to monitor at home? The ones I saw on Chewy had good reviews for dogs but not for cats.
 
Welcome to FDMB. I hope that you don't have to be here for long but welcome, nonetheless.

A couple of thoughts. As others noted, find something other than dry food as a snack. Give Chewie some of the raw or other low carb canned food. Alternatively, any freeze dried protein will be a good option as a treat. Many here use freeze dried chicken. The majority of dry food/kibble is high in carbohydrates. If you're hoping that your kitty will go into remission, get rid of any unnecessary source of carbs. Just a cautionary note -- the Wellness food you're using may be high in carbs. The turkey from the signature selects line is 28% carb, healthy indulgence is 19%, and the cubed/sliced/minced turkey flavors are around 13%. These are at best, in the medium carb range. As a rule of thumb, if a food contains gravy, it's likely to be higher in carbs. This is a chart that contains nutritional information on various brands of canned food so you can pick foods that are lower in carbs. We consider low carb under 10% although most of the members here use varieties that are in the 5% range.

Urine glucose tests are unreliable. They don't measure highs or lows accurately. In addition, they do not measure glucose levels at the moment. By the time food is in your cat's system and metabolized and urine produced and collected in your cat's bladder, hours have passed. Even with stress hyperglycemia, a blood glucose (BG) test is far more accurate. As several people noted, a fructosamine test will give you an average of the past 3 weeks. Unless it is totally impossible to test your cat, we encourage people to get a blood glucose monitor. The least expensive choice is Walmart's Relion meter. The strips are reasonably priced. The only urine testing we encourage is for ketones. Ketodiastix will test both for urine glucose and ketones but as I noted, urine glucose testing is not reliable. We have lots of resources to help you get started with home blood glucose monitoring.

One other source of higher numbers may be if Chewie is still experiencing any pain or inflammation from the back injury. Anything that causes stress, like an injury or pain, can raise BG levels.
 
I was going to say gravy food is high in carbs but Sienne beat me to it. Pates are typically lower than 10% but def use the chart she provided. Most of us feed FF Classic. The raw food should be fine too, but I’m not 100% sure.

As Sienne also said, the urine test is not reliable and it won’t give you her exact bg level, but if you’re trying to confirm the diabetes, and she’s constantly showing sugar in her urine, it would give you a better idea. The vet should def do the fructosamine @Sienne and Gabby (GA) any reason you think why the vet would want to just do a urine test?

you mentioned vomiting for the first time on your last post, how often? Is she on any anti vomit/nausea meds? Did the vet say anything about the vomiting?
 
Thanks so much for all the info - it’s a lot to take on board but some changes are easy to make. I am definitely not giving her the 3-4 pieces of kibble in pumpkin anymore starting now. I have freeze dried duck liver that I can add to the pumpkin instead.
I will check the list of canned foods and try out some of the super low carb options. She loves her raw food (which is below 3% carbs), but it’s handy to have one or two safe canned foods I can use in a pinch. I had no idea the gravy foods were higher in carbs (never something I had to worry about), they’re her favorite of course.

Calling the vet tomorrow morning and asking for a fructosamine test ASAP. We’re moving from West Coast to East Coast and driving across the country with all 4 senior cats at the end of September, I want a handle on this before then! (Yikes)

Clarification about vomiting: she only throws up when she eats too much at once, ie eats her food and then steals leftovers from another cat. Happens maybe once every 3 months. But she’s always eaten about 45g at most at a time so I can’t just give 70g without going slowly or she’ll inhale it all and probably barf it. As of today we’re at 55g x 4 times a day, which is approx 265kcal.

Thanks for the explanation about urine strips and blood glucose meters! I read the stickies about testing in that sweet spot in the ear, that shouldn’t be a problem, she’s really good about letting me do that kind of stuff. Sounds like I just need to get her test done asap and get her on insulin if her levels are still high.

One other source of higher numbers may be if Chewie is still experiencing any pain or inflammation from the back injury. Anything that causes stress, like an injury or pain, can raise BG levels.
If that was indeed the cause of her high blood glucose (even combined with stress hyperglycemia), would she have the symptoms of ravenous hunger, increased thirst and weight loss? Only other likely thing I can think of is hyperthyroidism, but Senior panel tests the thyroid so I’m assuming the vet would have said something if her thyroid numbers were sketchy (her kidney function is stellar btw).
 
As I understand it, inflammation and/or infection on a feline with diabetes can drive the BG even higher yes.

If no diabetes at all, and the inflammation/stress had only caused a momentary spike in BG then no, I do not think she would have those symptoms. Those are symptoms that come from high BG for an extended period of time, not a one time spike, as I understand it anyway.


as far as I know high BG causes those symptoms because when the BG is high for an extended duration, above the renal threshold, all those other symptoms happen as a result of the body not being able to break down the glucose into energy.


kitty is always hungry, always thirsty, and the body cannot make use of nutrients to build fat and muscle. Weight loss happens, and ketones develop.


This is my understanding as a layperson who just went through 6-7 months of it with my cat, who was diagnosed January 5th of this year and is now in diabetic remission thanks to the expert advice I got here at the FDMB -- I stopped using my vet for the diabetes and just followed the Tight Regulation dosing method. Worked wonders.


If I got anything wrong here one of the experts will surely correct me :)
 
I agree. Those symptoms are consistent with diabetes she’s been fighting for some time

keep an eye on the vomiting. When the pancreas is compromised other issues can come up.

home test would be the best thing for her so happy you think it’s doable. You don’t need an expensive pet meter. Most of us use human meters like ReliOn from Walmart. The test strips are the one thing that can get pricey and Relion is the most affordable. I also stopped listening to my vet when it came to her diabetes. They prescribed high carb food and always want to dose by the preshot numbers. I was like, thanks but I got this!
 
Yeah... I have been through this process with my vet for my kitty with chronic pancreatitis and asthma, as well as another one with IBD - people on boards knew so much better than all the vets I saw over the years! I just emailed them to move up her appt ASAP and do blood glucose and fructosamine instead of urine glucose. I'll order the meter and strips right away, since with her symptoms it seems she will indeed need insulin (and thanks to you I know to ask for Lantus instead of whatever she will be offering me first... so grateful I found this community).

Edited to add: so it's my understanding that I would need the Relion Premier meter, as well as lancets and test strips, correct?
 
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This is my understanding as a layperson who just went through 6-7 months of it with my cat, who was diagnosed January 5th of this year and is now in diabetic remission thanks to the expert advice I got here at the FDMB -- I stopped using my vet for the diabetes and just followed the Tight Regulation dosing method. Worked wonders.

So glad your kitty is in remission so soon!! Thanks for sharing your experience, it gives me a lot of hope for Chew :)
 
Virginie said:
So glad your kitty is in remission so soon!! Thanks for sharing your experience, it gives me a lot of hope for Chew :)
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You're very welcome. To answer your question above -- no, you do not need to get the Relion there are many many brands of meters. However, the Relion is used heavily by members here due to it's accuracy, availability at Walmart, low price and in particular the low price of the test strips.
 
re: lancets -- some people use the little lancet device that comes with the meter, but some find that the loud clicking sound is no good and startles the kitty.

we tried to use a lancing device and could not, so we switch to freehand -- just holding a lancet in your hand and poking kitty's ear. Worked wayyyyyyyyy better for us personally.

we bought lancets off Amazon like these:

(this is just an example, there are many kinds and sizes but these worked well for us after we got the hang of it)
https://smile.amazon.com/gp/product/B098R7HB5W/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1
 
I think ReliOn Premier is the one that replaced Prime, so yes you can get that one. I honestly had everything ReliOn, meter, strips, lancets and syringes too. For beginners we recommend a slightly larger lancet gauge so it’s easier to get enough blood when you prick the ear. Like a 28 or even 26. Once you get the hang of it, 30 works fine. One tip on syringes, you want the get the ones that are 1/2 unit marked as we advise folks here to adjust the doses by 1/2 units and not full units, as most vets like to do.

Ask away as you navigate through this. We’re here to help!
 
Yes @Ale & Minnie (GA) makes a great point -- we could not get a blood drop in the beginning using a 30G lancet. We started with 26 I think.

after the ears 'learn' to bleed and the caregiver learns to do the pokey, many find they can switch to a smaller lancet and this helps the ears heal more quickly as well from all the pokes. Because it makes a smaller hole.
 
Ohhh good to know for the lancets. I'll make sure to order a bigger gauge. Poor little ears.
And for insuline, I would want a script for generic insuline glargine, right? Lantus brand is so expensive.
Thank goodness I'm a medical translator and familiar with all these names and concepts, or I'd be losing my mind!
 
Virginie said:
Ohhh good to know for the lancets. I'll make sure to order a bigger gauge. Poor little ears.
And for insuline, I would want a script for generic insuline glargine, right? Lantus brand is so expensive.
Thank goodness I'm a medical translator and familiar with all these names and concepts, or I'd be losing my mind!
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I was able to purchase a generic with a Lantus script for what that's worth. But yes ideally if it just says insulin glargine, than for sure no issue getting a different brand than Lantus
 
Just talked to the vet and scheduled their first appointment which is on Aug 19th for bloodwork and urinalysis.
In the meantime, I'll go to Walmart and purchase the meter and strips etc. and test her every day so I have data to give the vet.
When should I test her if no insulin is involved? Before and after a meal every day?
 
Withhold feeding 2 hours prior to testing , then test and feed, wait 3 hours after feeding and test again , yoiu can do another test @+6.

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up
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6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
Take a look at the lancets ,you will see one side points up, that's the side you want to poke with
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming
You can also put a thin layer of vaseline onthe ear ,to help the blood bead up
 
Warming up the ears as Diane said was also always key for me. Call Walmart first as they don’t always have everything in stock. As for Lantus, most of us here order from Mark’s Marine Pharmacy in Canada because it’s less than 1/3 of the cost. I think I was getting 5 Lantus pens with shipping for $189. You just need to email them your prescription.
https://canshipmeds.com/
 
Ale & Minnie (GA) said:
Warming up the ears as Diane said was also always key for me. Call Walmart first as they don’t always have everything in stock. As for Lantus, most of us here order from Mark’s Marine Pharmacy in Canada because it’s less than 1/3 of the cost. I think I was getting 5 Lantus pens with shipping for $189. You just need to email them your prescription.
https://canshipmeds.com/
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Ooooh that's another question I had: do I want pens or a vial?
I checked on goodrx and they have pretty good prices on insuline glargine generics, but great news for that Canadian pharmacy (I will also check their prices for asthma meds, right now I'm getting my other cat's inhaled steroids through InHouse Pharmacy)

I bought all the stuff at Walmart last night, warmed up Chewie's ear, had to prick a couple of times to get some blood (it's so hard to get over the "causing pain" factor!), but then I messed up and put the strip flat on the drop of blood instead of letting it "sip" it and didn't get a reading (or maybe it wasn't enough blood who knows). I'll get vaseline before I try again. She was an absolute angel throughout.
 
The great news is it gets easier! Another tip, whenever possible, i preferred scooping up the blood droplet onto my clean nail and then testing from there because sometimes Minnie would flick her ear and I’d lose the blood. And if she’s being easy to handle like Minnie was, you’ll be fine. Are you giving her a treat after too?

Mark’s is not cheaper than in-house. I was getting my asthma inhalers from them too. I’m actually selling 3 boxes in the supply closed so check it out if you’re interested.

it’s a matter of preference I think. The vial will last a lot longer but if you ever accidentally drop it, you lost all of it as opposed to a pen. I’d check the expiration too because on a low dose the vial may last longer than it’s good for
 
Ale & Minnie (GA) said:
The great news is it gets easier! Another tip, whenever possible, i preferred scooping up the blood droplet onto my clean nail and then testing from there because sometimes Minnie would flick her ear and I’d lose the blood. And if she’s being easy to handle like Minnie was, you’ll be fine. Are you giving her a treat after too?

Mark’s is not cheaper than in-house. I was getting my asthma inhalers from them too. I’m actually selling 3 boxes in the supply closed so check it out if you’re interested.

it’s a matter of preference I think. The vial will last a lot longer but if you ever accidentally drop it, you lost all of it as opposed to a pen. I’d check the expiration too because on a low dose the vial may last longer than it’s good for
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So sorry to hear about the loss of Minnie :'-(
I just reordered from InHouse last week, but I'm on an asthma board where supplies sell pretty fast (if you're not on it already it's: https://felineasthmainhaledmedications.groups.io/).

I'm lucky with my cats, I have had them since they were 4 weeks old and they're very easy to handle. Chewie was just purring and happy to get pets last night, but I still gave her a freeze-dried treat every couple of minutes, to reinforce that messing-with-the-ear-time is a good time.

Great info re: pens vs vials. I'll make sure to order a pen. Might get the first one locally with goodrx and then figure out my options long term.
Reading Hendrick's story is super inspiring and gives me hope that Chewie might be able to get in remission too!
 
Virginie said:
Reading Hendrick's story is super inspiring and gives me hope that Chewie might be able to get in remission too!
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Hendrick says Chewie can do it! It does take some committment and dedication from the caregiver and most of all -- trust in the process. There were weeks where it seemed like his numbers were not improving and I was quite down and depressed, but the wonderful folks here just kept giving me advice and we marched on, continuing to do what we were doing, day in and day out and then --- the magic happened, where his pancreas finally started to work again.

The theory behind Tight Regulation is that if you can keep the cat's BG within a normal range for as much of every day as possible, it allows the pancreas to sometimes heal. This means getting comfortable with some lower BG numbers and watching out for hypos like a hawk (make sure you get that hypo kit going!)

theory turned into actuality with my boy Hendrick but he is only 10. It may be more difficult in an older kitty to achieve regulation or remission but you won't know if you don't try right? That's what I had to go all in, just pour myself into this process and live, sleep, eat and breathe feline diabetes. I had to know that I gave it everything I had and gave him every chance I could or how could I live with myself yknow?

 
I'd get the pens also :cat: You can get the generic lantus also glargine
Check this out also
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1
The 5 pens will last about a year





I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens

You will need U-100 syringes with half unit markings for lantus , just insert the syringe into the pen and draw out the insulin.
13.47 for a box of 100 Here is the link to buy them from
If they say you need a script from you vet they will call the vet to fax it over 'ask for refills and give your vets office a heads up . I know that some member didn't need a script at all ,I did I live in N.J. So I guess it depends on where you live

https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct



We use the pens just like a vial , just stick the syringe in the gray rubber stopper and draw out your insulin
Just take the cap off the pen and use a U100 syringes and pull the insulin out of the pen!
syringe-in-pen-pic-jpg.45006


Posted by another member
One members posted this
. I paid $175 for a box of 5 pens at Walmart pharmacy, but GoodRX coupon says you can get it for around $90 if you have a Rite Aid pharmacy near you.

The reason we don't use the needles that would go in the pens is because you can only dial the pens by whole units
With the U-100 syringes with half unit markings we can adjust by 0.25 units at a time
 
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Check this out also
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1
The 5 pens will last about a year

Basaglar is also Insulin Glargine, it acts the same way.

Here is a saving card for basaglar for 5 pens
Check it out just put in where it says set your location
https://www.goodrx.com/basaglar

I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens

Call around and ask for the prices
 
You guys are the best - thanks for explaining all this! I had no idea you could just draw insulin from the pen as you would a vial, that sounds so much more convenient (especially regarding expiration date). The prices are also definitely a lot less scary than I anticipated, thank goodness. I'll probably try to get a year's supply to be safe, since it'll probably take a bit to find a good vet in the new town (not a process I look forward to haha).
 
Virginie said:
You guys are the best - thanks for explaining all this! I had no idea you could just draw insulin from the pen as you would a vial, that sounds so much more convenient (especially regarding expiration date). The prices are also definitely a lot less scary than I anticipated, thank goodness. I'll probably try to get a year's supply to be safe, since it'll probably take a bit to find a good vet in the new town (not a process I look forward to haha).
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Just keep the pens on the middle shelf of the fridge :cat:
The pens will probably have an expiration date on them either end of 2023 or 2024
 
Whew, I was able to get a fasted reading tonight! Recruited my boyfriend to hold the meter and shine a light directly on that little black ear, and got a good drop on my second try. Chewie was great and docile throughout and got tons of liver treats after <3

Her value was 338. How bad is that, generally speaking?

Edited to add: reading through the forum got me scared about ketones so I also just ordered a box of Keto-diastix that should get here Thursday. Chewie eats a lot and I add a lot of water to her food so hopefully this won’t be an issue before she starts treatment.
 
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Virginie said:
Whew, I was able to get a fasted reading tonight! Recruited my boyfriend to hold the meter and shine a light directly on that little black ear, and got a good drop on my second try. Chewie was great and docile throughout and got tons of liver treats after <3

Her value was 338. How bad is that, generally speaking?

Edited to add: reading through the forum got me scared about ketones so I also just ordered a box of Keto-diastix that should get here Thursday. Chewie eats a lot and I add a lot of water to her food so hopefully this won’t be an issue before she starts treatment.
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first of all: Wooohoo!!! Congrats on a successful home test you are doing awesome. It took me and my wife a while to get that far. Really really great, I am impressed.

fasted reading? How long was food with held?

338 by itself doesn't really mean much. We need more data, numbers from different times of day, populate the spreadsheet and build a picture of what the levels are doing.
 
Thank you! Food was withheld for two hours before testing: it was between her first dinner at 5.30pm and her second dinner at 10.30pm, but she had had a small freeze-dried snack at 8pm so I waited until 10.30pm to test.

At 3am she woke me up meowing forlornly from the kitchen. I got up and gave her half a small can of Koha LID turkey from the low carb list, and she devoured it like she hadn't eaten in days.
I weighed her again this morning before food, and she's been at 10.15lb for several days (her normal weight is 11.3).

After reading Hendrick's story and the ketoacidosis resources, I just don't feel good waiting so long to see the vet, so I'm going to go to the clinic in person and see if I can get her seen sooner.
This just doesn't feel right.
 
I’ve never had another set of hand to help me with testing so I used to hold a small flashlight in my mouth and aim it at the spot. It makes all the difference in the world! Congrats on your first successful home test :bighug::bighug::bighug:
 
Virginie said:
After reading Hendrick's story and the ketoacidosis resources, I just don't feel good waiting so long to see the vet, so I'm going to go to the clinic in person and see if I can get her seen sooner.
This just doesn't feel right.
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That is a good idea. Time is of the essence as far as DKA risk, and the chance for the holy grail of remission. Sooner you get her on track with insulin and home testing the better.
 
You could also try high caloric kitten food as long as it’s low carb. I also used to give Minnie Gerber baby food to supplement and Tikki makes those lickable sticks that are low carb
 
That’s a good idea! I bought her some Koha LID turkey which is higher calories than her usual raw food, to supplement whenever she comes begging for food. I add a couple of tablespoons of water to make it soupy, she loves it. I will check the PDF to figure out a couple more low carb, high calorie options.
 
Keto-diastix shows trace of ketones tonight :(
I’m going to test her BG then feed her a big meal of soupy LC canned food with extra water.
Our appointment is at 4pm tomorrow, not a minute too soon… I haven’t slept more than a few hours in the past three days worrying about DKA… she was a bit subdued today, less chatty than usual, but responsive to pets, moving around and eating well, so should be fine until the appointment? It’s so hard to not let anxiety take over.
 
I think traces is okay but also a warning sign that it’s there and you don’t want it to get any higher. Make sure they test her ketone levels today. I think she should start on insulin asap
 
Ale & Minnie (GA) said:
I think traces is okay but also a warning sign that it’s there and you don’t want it to get any higher. Make sure they test her ketone levels today. I think she should start on insulin asap
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I watched her like a hawk last night, thankfully she made it through the night just fine. Bright and hungry this morning. I'll bring the vet the BG readings I have so far and will tell them about the ketones and make sure they include it in the testing. Our appt is at 4 so hopefully if they write the script today I can get insulin at the pharmacy tonight before it closes.

Is it safe to give a starting dose of insulin in the evening? Or better to wait until morning to keep an eye on her?
Right now the Feline Overlord Meal Schedule is 7.30-8am, 1-1.30pm, 5-6pm, 10.30pm, but from what I read it's better to give insulin 12h apart. Would you recommend changing their schedule?
 
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