New Member - Recently diagnosed with diabetes after leg weakness

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Elmo's Mama

Elmo's Mama

Member Since 2020
Introduction
​
Hi everyone, I'm so happy I found this site (thanks, Reddit!), I've been perusing posts for the last few hours and I already feel somewhat equipped to handle our Sugar Bunny's (no pun intended) diabetes diagnosis.

Name: Elmo
Type: Orange Shorthair, Indoor
Age: 6 yrs
Weight: 12 lb. (12/20)

Diet: Free feed kibble, 2 cans of wet food a day, and about 8 treats in the AM. Too much love.


Elmo's Health History​

Ear Infections (Sept. 2020)
Elmo has been lucky enough to have a clean bill of health up until this year (sigh, 2020). In September, he lost weight, had a protruding eyelid, wasn't blinking and slept with his right eye open so off to the vet we went. Vet falsely said he was blind in the right eye and referred us to a cat ophthalmologist. He did, however, find that our Elmo had ear infections in both ears and polyps in the right ear. Vet cleaned the ears and sent us home with Prednisone and some nausea medicine. Soon after, Elmo stopped eating, became lethargic, became even bonier, and dizzy. Vet said it was vestibular disease from the ear infections. Thankfully, our baby recovered almost fully a month later. Eyes are fine.

Diabetes (Dec. 2020)
Elmo woke us up at 2am because I heard him throw up. Usually when he hears me get up, he comes running for pets (regardless of time of day). I turned on the lights and found that he couldn't walk! He was dragging his hind legs. He wasn't meowing and didn't seem to be in pain - but he did look rattled that he suddenly lost ability to move his legs. After taking him to the vet in the morning, the vet thought it was Saddle Thrombus (stroke caused by blood clot from Heart Disease). After bloodwork and x-rays, Elmo was diagnosed with diabetes (BG 384) and cystitis. As for the leg issue, the vet isn't sure if it's related to the diabetes or if it's a thromboembolism/stroke. However, within 24 hrs. Elmo has regained feeling in his legs and can walk again. The right leg is still weak so he is limping still.

The vet sent us home with his Vetsulin and an antibiotic, Amoxi Clavu, for his cystitis. Overall, his prognosis seemed to be optimistic.

Looking back, his pee has been smelling weirdly sweet for the past few months, he has been drinking a lot of water, eating more than usual, been less active, and his muscle mass has changed. Regretfully, we overlooked all these symptoms as just signs of getting older.

Moving Forward

Our goal is to lead Elmo into remission. We have cut out dry food completely. We plan to feed a high protein, low cal diet of wet food (he likes Friskies, never cared for Fancy Feast) 12 hours apart and give him his insulin right after eating. After an initial vet visit for his glucose test, I plan to test at home.


Questions
- Should I ask my vet for Lantus once the Vetsulin is finished? I read that most of you use it.
- Is there a better way to throw away insulin needles? My vet gave us a biohazard box to bring back once full, charging $35 each time.
- How often should I be testing his blood glucose?

Lastly, any tips or insight you have for a mom of a newly diabetic furkitty is greatly appreciated. How do you manage cat health anxiety? I'm nervous about him having hypoglycemia when no one is home. I've been reading that this new normal will get time to get used to, so here's to hoping for good health and many long years of life!​

Diagnostic Results (high):
ALT: 180
GLU: 384
RBC: 10.62+
HCT: 54.95+
 
Hi. Nice Introduction.

First - You shouldn't aim for remission as your sole goal. You should aim for keeping the bg under the renal threshold to start with, which is under 230.

Secondly - An evenly spread out wet food, 4 to 6 times for every 12 hour cycle is better.

Thirdly - You should set up a Spreadsheet were you fill in all daily bg's, Insulin type, Insulin dose, Blood tests, Side notes https://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
That is one sure way to be in charge of your 'anxiety' - be on top of everything and leaving nothing to chance.

Then - Yes you can ask the vet for Lantus. All us in U.S and Norway, Sweden, Denmark and Germany have no problem getting it by the vets. With one big difference in U.S vs Nordics, the price for Lantus in U.S. The U.S Lantus users buy it from pharmacies in Canada instead which are cheaper.

And - BD syringe brand makes smaller needle tip cutters, which once full we simply hand in to a pharmacy, and the plastic parts goes in the plastic recycling trash at home for burning.
 
  • when you get a chance ,It would be helpful if you can set up your signature so we don't have to ask you the same questions over again. Members will look at this first .
  • It appears after each post in gray, look at mine,



  • On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
    • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
    • Add any other text, such as
    • Caregiver & kitty's name (optional)
    • DX: Date
    • Name of Insulin
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


tap on your avatar where it says your name ,then hit profile page ,tap on that ,then go up to the very top, upper right hand side and tap on your name ,it will bring down a drop box, tap on signature, the signature will be under settings, tap on the signature then and you can start to add what I posted above, make sure you hit save ,
Welcome to the best place you could ever be and an awesome group of people

The signature appears after everyone's post at the end in grey
 
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So, I don't know if all vets do it or if it's just mine, but because of Lantus being so expensive they used a sterile vial and put a couple months worth of insulin in it. That way I didn't have to worry about it going to waste, and didn't have to spend an insane amount of money. They charged me about $40 for the vial. Again, I don't know if that's a common practice.
 
phakewishard said:
So, I don't know if all vets do it or if it's just mine, but because of Lantus being so expensive they used a sterile vial and put a couple months worth of insulin in it. That way I didn't have to worry about it going to waste, and didn't have to spend an insane amount of money. They charged me about $40 for the vial. Again, I don't know if that's a common practice.
Click to expand...
How many ml in the vial? One can usually purchase a single pen (3ml) of Lantus for about $90 or so. One can usually use up the whole 3ml before it goes bad.
 
Welcome, with Vetsulin, you should test every AMPS ( AM pre shot, first thing in the morning make sure his BG number is sa iffe to give him the insulin)

Then feed and WAIT 30 MINUTES after eating then give Vetsulin, to make sure their is food on board


It's a harsh insulin and will drop his numbers quickly.
You should go out and asap and buy a meter and start testing.

Did your vet test for ketones?
Does Elmo seem to be in any pain

Do you live in the US?
Most of us use human meters from Walmart
The Relion Prime costs 9 dollars or The Relion Premier
17.88 for 100 test strips
Buy 26 or 28 gauge lancets they will make a bigger hole so Elmo bleeds better
Cotton rounds to put behind his ear just in case you poke yourself
Then hold it on his ear and press gently for about 10 -20 seconds to stop the bleeding
Some test using the lancing device, I like to freehand just using the lancet
I can see better where you are poking. Buying from Walmart you can run into there
and buy them instead of ordering on line and have to wait for them.


I'll post a diagram for you

Always have honey or Karo on hand in case he ever drops to low and you need to
get his numbers back up to safe levels


You said he likes Friskies , I will post a link of the food chart, we like to stay under 10% carbs
Friskies Pate will be fine


Also pick up some Friskies in gravy medium carbs and high carbs in case he drops too low.


This is what you need to feed if he ever drops to low, don't have want a hypo
Such as

You should always have a few can of these on hand in case you need to bring up


Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs


Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy. 15% Med Carbs




Fancy Feast Gravy Lovers Turkey Feast in Gravy. 15% Med Carbs


Fancy Feast Gravy Lovers Chicken and Beef Feast in Gravy 15% Med Carbs

It's mostly the gravy that has the higher carbs in it

Look at the food link I gave you , for Friskies in Gravy with the same amount of carbs as the Fancy Feast. I just listed these for you to show you what high and med percentages are

Also the treats you are feeding what are they?
Want to make sure they are low carb
 
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Here is BD's small needle tip clipper

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And the small Lantus cartridges, 5 in one pack, 1 small cartridge is hardly used in a month due to the small doses the 0,5 - 2,5 U is.

62C67336-A274-4316-A004-0008E60D34B1.jpeg



And different syringes. Mine all BD's. Short needle 8 millimeter, with 0,5 Units marks on.
 

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If you want to switch to Lantus you would need U-100 syringes preferably the ones with half unit markings. When we increase or decrease the dose he do it
by 0.25 units. It will make it easier to do this.

Walmart should have half unit markings , just make sure they give you the correct ones

You will probably need a script from your vet.
35.00 dollars is crazy to buy them from your vet.

Lantus is expensive in the US so we buy from Marks Marine in Canada
I'll post the link.
A 5 pack of pens will probably last you a year depending on the dose.

Also we have a supply closet here where members will sell supplies when their
kitties have passed.
Right now I see someone selling Lantus pens for 125.00 for 5 new pens
Can't beat that price
 
https://www.felinediabetes.com/FDMB/forums/supply-closet-for-sale-or-free.15/


Lantus pens for sell
Discussion in 'Supply Closet - For Sale or Free' started by Steve and Buddy, Dec 7, 2020.

Unwatch Thread

  1. Steve and Buddy
    Joined:
    Jun 25, 2019
    My Buddy passed, and just stocked up on Lantus . A box of 5 unopened pens. A box of 90? Syringes 125 dollars St. Louis area text <phone number removed for privacy by moderator, please message him instead
Go to the supply closet the link I gave you and tap on his pic and start a conversation about buying the pens
 
https://rxcanada4less.com Marks Marine pharmacy

Here is the link for Canada with the pens we use them like a vial because with the pens you can only increase or decrease by whole units, so you would just take your syringe and stick it in the little grey rubber stopper and just draw the insulin from that







Lantus Solostar Cartridges 5x3ml per box (temp. gauge. ice pack, express-air mail) Brand 100u/ml 15 ml $159.99 USD

rx.gif
Lantus Solostar PEN CAN (temp. gauge. ice pack, express-air mail) *single pen open box* Brand 100iu/ml one pen 3 ml $49.99 USD

rx.gif
Lantus Solostar PENS 5x3ml per box (temp. gauge. ice pack, express-air mail) Brand 100u/ml 15 ml $164.99 USD

rx.gif
Lantus VIAL Insulin (10ml per vial) (temp. gauge. ice pack, express-air mail) Brand 100u/ml 10 ml $110.99 USD


Like I said you are better off buying the 5 pack of cartridges or the 5 pack of pens
They will last you way over a year
After your vet writes the first script you won't ever need another script.
Call them and will tell you what to do
They are very nice people

Oh when you buy the pens they will have an expiration date on them
Most likely 2022 or 2023 by now.
Put them in the frig , a middle shelf
As long as you don't puncture them they will be good until the expiration date
So you are actually saving a ton of money
 
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
c2b8079a-b471-4fa6-ac36-9ac1c8d6dcca-jpeg.57072
fec17d29-5ab4-44a8-912b-3a91944c3954-jpeg.57073

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 she won’t stand still, you can get the blood onto a clean finger nail and test from there
 
https://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

Here are instructions to the spreadsheet we use to enter our cats BG.
In case you need help with dosing, or an emergency we look at your spreadsheet
to give advice. It's a very useful tool,

If you have trouble setting it up just hollar and we have 2 wonderful members that
can do it for you in a minute.
I suggest you do this as soon as you start testing at home.



This link explains about the spreadsheet, take a look at mine it's at the end of everyone's post
Mine says Tyler's spreadsheet. You can look at anyone's spreadsheet

https://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/
 
We feed our cats their breakfast, then at least 2-3 times in between until the Night Cycle , and then do the same with the night cycle

Do not feed any food 2 hours prior to testing both AM and PM tests, you don't want them to be food influenced.
 
You talked about his legs, is he walking on his hocks?, like a rabbit, flat footed?
It could be neuropathy, once you can get him regulated it should get much better.

A lot if us give Methyl B-12
I will give you the link






Here is the link https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6

Alot of members use this , I use it myself you can buy it on line from Vitacost
Vitamin B-12 Methylcobalamin -- 5000 mcg - 100 Capsules
It's 17.99 just be sure this is the one you buy.

Some use Zobaline
The only difference is the Zobaline has 200 mcgs of folic acid
So I buy the folic acid at the supermarket and crush it up and add it to the B-12
If you can't find the 200 mcg get the 400 mcg and cut it in half and crush it up
The Vitacost brand is a capsule so just open it and pour the powder on the wet food and I always add some water to the wet food.
Has no taste, no need to crush it up
The Zobaline is 33.99 for 60 pills, too expensive
I saw a big improvement I'd say 3 months, could be sooner. One capsule a day.
Once you get your kitty better regulated the B-12 methyl will help


Vitamin B-12 Methylcobalamin -- 5000 mcg - 100 Capsules

  • SKU #: 835003001804
  • Shipping Weight: 0.23 lb
  • Servings: 100
 
Well that's about all I can tell you if you have any more questions just ask
Everyone here is amazing, so helpful and very knowledgeable.
You couldn't have found a better group of people
 
Vetsulin is also called Caninsulin and was designed for dogs. It is a harsh insulin and hits hard and fast. It is best to feed a main meal 30 minutes before shot time and then snacks through the first half of the cycle.
So, yes, Lantus is a better, more gentle insulin for cats.

Do not change the diet until you are hometesting. Just switching to a low carb diet can drop a cat's overall numbers by up to 100. The dose may then be too much for the cat and potentially dangerous.
 
Would you recommend getting drugstore B12?
GUEST_a1415b15-c04b-4740-919b-6189af5b95c8


Also - we are testing BG at home using the Relion meter. How do the numbers translate for cats? Moreover, what is the healthy range using a human meter?

Thank you a million!
 
Elmo's Mama said:
Would you recommend getting drugstore B12?
GUEST_a1415b15-c04b-4740-919b-6189af5b95c8


Also - we are testing BG at home using the Relion meter. How do the numbers translate for cats? Moreover, what is the healthy range using a human meter?

Thank you a million!
Click to expand...
I not sure but I don't think so I will bump this to the top to see if anyone responds
 
You talked about his legs, is he walking on his hocks?, like a rabbit, flat footed?
It could be neuropathy, once you can get him regulated it should get much better.
Do you plan on home testing yet
 
Diane Tyler's Mom, He isn't flat footed, a week ago, he completely lost control of his legs and was dragging them. Since then, he's regained full motion in the legs. However, he struggles to jump still. He's getting better every day, maybe because his diabetes is getting under control!

JaxBenji, thank you so much! I have the ReliOn Prime and tested for the first time today, but I think there wasn't enough blood on the strip... so the meter didn't give me a number. I'll try again soon!

Thank you both so much, your support is getting me through this and making me feel strong enough to help my baby!
 
I have few more questions I keep forgetting to ask:

1. I keep reading conflicting things about when to feed. 12 hours apart or throughout the day? Right now, Elmo's eating about 2 cans of Friskies daily and a little dry food as a snack. Before insulin, he would eat almost 4 a day + free feed dry food.

2. How do we choose between SLGS or TR? My understanding of these:
SLGS: Start with a low dose of insulin and keep upping it until control is achieved. No change in diet. Test before insulin. (2x)
TR: Test every 2 hrs. Only feed before testing, no food throughout the day. Give insulin based on GL.

3. If he's grazing throughout the day, he won't eat a full meal at insulin time. Is this an issue?

Unfortunately, my vet doesn't seem to be very knowledgeable about feline diabetes. When we first got his diagnosis, we asked the vet if we needed to change his diet and he told us no.


Thank you in advance!!!
 
Elmo's Mama said:
1. I keep reading conflicting things about when to feed. 12 hours apart or throughout the day?
Click to expand...
In case you haven't already discovered it yet, here's the link to the FDMB Vetsulin Guidelines.

With Vetsulin, you need to give a substantial feed before each dose and then wait 30 minutes before administering the injection since this insulin tends to hit hard and fast in the first few hours of each cycle. It's OK to give small snacks later in the cycle, but preferably not after +7 (assuming not in low numbers at this point) since typically the dose starts petering out at that point. You can adjust the size of any snacks to make sure that your kitty has a good enough appetite at preshot time. Remember to lift all grub 2 hours prior to preshot time so that the preshot BG is not influenced by food.

Elmo's Mama said:
How do we choose between SLGS or TR?
Click to expand...
The SLGS and TR dosing methods are only relevant to users of Lantus/Basaglar and Levemir insulins. (They are depot insulins and work very differently to Vetsulin.)

The recommendations for feeding, testing, and dose adjustments when using Vetsulin are covered in the guidelines linked above.


Mogs
.
 
Critter Mom said:
In case you haven't already discovered it yet, here's the link to the FDMB Vetsulin Guidelines.

With Vetsulin, you need to give a substantial feed before each dose and then wait 30 minutes before administering the injection since this insulin tends to hit hard and fast in the first few hours of each cycle. It's OK to give small snacks later in the cycle, but preferably not after +7 (assuming not in low numbers at this point) since typically the dose starts petering out at that point. You can adjust the size of any snacks to make sure that your kitty has a good enough appetite at preshot time. Remember to lift all grub 2 hours prior to preshot time so that the preshot BG is not influenced by food.


The SLGS and TR dosing methods are only relevant to users of Lantus/Basaglar and Levemir insulins. (They are depot insulins and work very differently to Vetsulin.)

The recommendations for feeding, testing, and dose adjustments when using Vetsulin are covered in the guidelines linked above.


Mogs
.
Click to expand...
Thank you Mogs :bighug::bighug:
 
Thank you :)

He looks like he's put on little weight since starting the insulin and his appetite is growing again it seems. He is running faster than before, however! I'll try to test again today - hopefully it works this time!
 
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