New Member - Sandy (mom) and Betty

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Betty'sMom

Betty'sMom

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Hi, my name is Sandy, and I have a 15yo female cat, Betty. Single mom with two kids (14/16)

Sorry in advance for the mini-novella.

Betty used to be huge. Way overweight. We tried weight control food, etc, but used dry. (I know ) and nothing we did helped. She just kept getting bigger. The vet said she didn't have diabetes at that time.

About a year ago, I started switching both cats to wet food (to try and manage the weight). Tried friskies which they initially loved, while supplementing with the dry they seemed to prefer. Then went to fancy feast when they started leaving a lot behind and it was getting wasted.

Betty started losing weight, so I thought she was doing well. At the same time I was going through some dramatic custody and child mental health issues and was not paying much attention to Betty's heath. She lost too much weight. It was only when I started noticing how much water she was drinking and how bad the litter was getting (i was going through so much) that I realized something was really wrong.

I took her to the vet on Apr 27 (after getting my income tax check) and she was diagnosed with diabetes. (blood sugar was 29)

She was put on 1 unit of insulin 2x a day and advised to feed 3/4 can of ProPlan DM wet food. After 1 week she was at 17 for blood sugar, so they bumped her up to 1.5 units per meal. 1 week later she was at 4.2. They kept me at 1.5 units.

I started waking up to vomit on the floor, so I called the vet. They prescribed an anti nausea med to help.

I didn't wait a week and measured the glucose again (5h after meal) and she was at 2.2! I gave her a snack (because she was driving me crazy for food) and the info they gave me told me she was dangerously low and needed food stat. But then she didn't eat her dinner, so I couldn't give her insulin. The next day again after the dose she was dropping to 2.4. It was the weekend and the vet was closed, so I decided to drop the unit to 1 until I could talk to them.

On the Monday, they advised to keep the dose at 1, and check the sugars daily. her blood sugars still kept bottoming out so we further dropped to 0.5 units.

The problem is that she now eats about 3/4 of a can in the morning, and even though she drives me crazy starting at noon for food, when I feed her at supper she just wants to graze. It can take her an hour to eat half a can... Or less. The vet said to not give insulin if she doesn't eat her full portion.. So... This is why I'm here.

Qns...
1) I've been waiting (sometimes up to an hour after she gets her food) til she's done her portion to give her the insulin... Is that right?

2) if she only eats half her food in the evening, should I leave it out til she is done, even if it takes two hours or more?

3) should I still give her insulin if she has only eaten half?
 
Side note... My other cat was a beautiful boy named Bolt who passed on May 28/21 due to crystals. He had an emergency blockage two weeks after Betty's diagnosis and while we fought hard to save him, with four separate ER visits and multiple days in hospital, we finally had to let him go. We are pretty devestated and feel distrustful of our current vet.
 
Hi Sandy, I can tag a few members for you
@Wendy&Neko

@Bandit's Mom

One thing we feed our cats more than twice a day
After their morning insulin we give them small meals , maybe about a tablespoon of wet before their night cycle
Same goes for the night cycle
Thank god you were home testing and caught those very low numbers
Nothing special about the Pro Plan DM Wet food except the price

Most if us feed Fancy Feast Pate or Friskies Pate
I see you are from Canada , I pretty sure you can buy these there. We have a lot of members from Canada.
Let's wait until you get a reply :cat:
I'm so sorry about your other kitty Bolt, my heart goes out to you ♥
 
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I asked the vet if I could move to three mid sized meals because she always seems hungry and is severely underweight, but the vet said no.

I want her to gain some weight, so I'd be interested in learning how to both get her eating well AND manage her insulin.

Thank you!
 
Hi Sandy,

Welcome to the best place you never wanted to be! I'm so sorry you are having a hard time with Betty on the heels of the loss of Bolt. :bighug: We will do our best to help you and Betty. You are home testing and have low carb food already, so you're already ahead of the game. :cat:

Your vet is right to tell you that you should not give insulin if Betty doesn't want to eat. The reason for that is the food helps prevent steep drops that kitties might experience from the Levemir. We usually advise to TEST, FEED, then SHOOT. Testing will let you know if her levels are safe for administering the insulin, and most of us give our kitties insulin when they have their heads in the bowl. If you get a number that is below 200 mg/dl (we're a US based board and understand these number better, just multiply your number by 18), DO NOT FEED, STALL, and get some advice here before proceeding.

I'm assuming the DM wet food is a 5.5 ounce can? How much does Betty weigh now and what is her ideal weight? My Ruby weighs a little over 11 lbs and so I used to feed her 2 - 2.5 cans of Fancy Feast (3 oz cans, or 6-7.5 oz) in small meals throughout the day. Smaller meals are easier on their stomachs and pancreas. She might be getting her fill early in the day and then not that hungry in the evening. Also, when the blood sugars go lower, they generally get less hungry than when they are hyperglycemic.

You can give insulin if she eats half a can. I usually fed only an ounce or an ounce and a half of food at shot time, then a quarter can in two hour intervals after. You can leave it out if she doesn't want to finish it all in one sitting.

Levemir onsets usually 4 hours after the shot, so it's important to watch her glucose levels around +3 or 3 hours after her shot to see where her blood sugar is, then if it's too low to feed a small amount of food. We want to keep her hungry in case her sugars drop and she needs to eat more.

It would be great if you could set up a spreadsheet so we can see all of the readings you are getting at a glance so we can be more helpful. Here's a link on how to do that and lots of other helpful info: NEW? HOW YOU CAN HELP US HELP YOU!

Come back at us with any more questions! :bighug:

 
PerfumedCatMom said:
Hi Sandy,

Welcome to the best place you never wanted to be! I'm so sorry you are having a hard time with Betty on the heels of the loss of Bolt. :bighug: We will do our best to help you and Betty. You are home testing and have low carb food already, so you're already ahead of the game. :cat:

Your vet is right to tell you that you should not give insulin if Betty doesn't want to eat. The reason for that is the food helps prevent steep drops that kitties might experience from the Levemir. We usually advise to TEST, FEED, then SHOOT. Testing will let you know if her levels are safe for administering the insulin, and most of us give our kitties insulin when they have their heads in the bowl. If you get a number that is below 200 mg/dl (we're a US based board and understand these number better, just multiply your number by 18), DO NOT FEED, STALL, and get some advice here before proceeding.

I'm assuming the DM wet food is a 5.5 ounce can? How much does Betty weigh now and what is her ideal weight? My Ruby weighs a little over 11 lbs and so I used to feed her 2 - 2.5 cans of Fancy Feast (3 oz cans, or 6-7.5 oz) in small meals throughout the day. Smaller meals are easier on their stomachs and pancreas. She might be getting her fill early in the day and then not that hungry in the evening. Also, when the blood sugars go lower, they generally get less hungry than when they are hyperglycemic.

You can give insulin if she eats half a can. I usually fed only an ounce or an ounce and a half of food at shot time, then a quarter can in two hour intervals after. You can leave it out if she doesn't want to finish it all in one sitting.

Levemir onsets usually 4 hours after the shot, so it's important to watch her glucose levels around +3 or 3 hours after her shot to see where her blood sugar is, then if it's too low to feed a small amount of food. We want to keep her hungry in case her sugars drop and she needs to eat more.

It would be great if you could set up a spreadsheet so we can see all of the readings you are getting at a glance so we can be more helpful. Here's a link on how to do that and lots of other helpful info: NEW? HOW YOU CAN HELP US HELP YOU!

Come back at us with any more questions! :bighug:
Click to expand...
Thank you Katherine :cat:
 
Betty'sMom said:
I asked the vet if I could move to three mid sized meals because she always seems hungry and is severely underweight, but the vet said no.
Click to expand...
This is a way of managing food and older insulins used for cats like Vetsulin, and doesn't apply to newer insulins like Levemir. Most vets are not up to date on feline diabetes management, even the younger ones. They also tend to treat cats like small dogs, even though diabetes in cats is vastly different from that in dogs. Small meals throughout the day are important for our kitties.
 
Thank you all. I will see if I can work on the spreadsheet tomorrow. I confess, my documentation went south when our other kitty went into crisis, and having just said goodbye late Friday night... We're all in shock and not functioning well.

Once I've got that set up, I'll let you know (and put a link in my signature). Thank you all for welcoming and ALREADY giving me helpful advice.
 
Hello, waving at you from BC.:) I had a kitty diagnosed with urinary issues one week after Neko's diabetes diagnosis, it's hard dealing with two crises at once.:bighug: I was lucky my urinary kitty made it. So sorry yours did not.
Betty'sMom said:
I asked the vet if I could move to three mid sized meals because she always seems hungry and is severely underweight, but the vet said no.
Click to expand...
Sorry, your vet is wrong about food. Small frequent meals are fine, though try to withhold food in the 4 hours or so before the next shot so she's still hungry. That plus the DM is totally unnecessary, any low carb commercially available wet food is suitable. This food list contains one available in the US, but many are also available in Canada. Look for something under 10% carbs as low carb.

Levemir is a great insulin. I am surprised your vet who lacks knowledge of feeding a diabetic cat put Betty on that insulin, but good on him/her. The part about not giving insulin if kitty hasn't eaten is not true. Levemir is a gentle insulin, and typically does not onset (start to take effect) until four hours after the shot. For my Neko, it was closer to 5 hours. That meant I had five hours to get food into her before the insulin took effect. So if you think your kitty will eat, but maybe later and before onset, then it's OK to give insulin, provided her numbers are high enough that it's safe to do so.

Hopefully spreading out the food to smaller meals will also get her a little hungry at dinner time too. The DM is supposedly 191 calories. Depending on Betty's activity level and current weight, she might not need 3/4 of a can twice a day (if you were feeding that way). My girl was 14.5 lbs (Maine Coon cross plus an endocrine condition that put out excess growth hormone), and she maintained her weight on about 200 calories per day with about 6 smaller meals.

As for the spreadsheet and data, most meters keep a couple weeks of data in memory, so you should be able to retrieve that. And that's enough data for us to figure out how to help you.
 
Wendy&Neko said:
The part about not giving insulin if kitty hasn't eaten is not true. Levemir is a gentle insulin, and typically does not onset (start to take effect) until four hours after the shot. For my Neko, it was closer to 5 hours. That meant I had five hours to get food into her before the insulin took effect. So if you think your kitty will eat, but maybe later and before onset, then it's OK to give insulin, provided her numbers are high enough that it's safe to do so.
Click to expand...
Thanks for setting the facts straight on that, Wendy. I thought Levemir worked the same way as Lantus, but clearly does not because of the later onset.
 
PerfumedCatMom said:
Hi Sandy,

Welcome to the best place you never wanted to be! I'm so sorry you are having a hard time with Betty on the heels of the loss of Bolt. :bighug: We will do our best to help you and Betty. You are home testing and have low carb food already, so you're already ahead of the game. :cat:

Your vet is right to tell you that you should not give insulin if Betty doesn't want to eat. The reason for that is the food helps prevent steep drops that kitties might experience from the Levemir. We usually advise to TEST, FEED, then SHOOT. Testing will let you know if her levels are safe for administering the insulin, and most of us give our kitties insulin when they have their heads in the bowl. If you get a number that is below 200 mg/dl (we're a US based board and understand these number better, just multiply your number by 18), DO NOT FEED, STALL, and get some advice here before proceeding.

I'm assuming the DM wet food is a 5.5 ounce can? How much does Betty weigh now and what is her ideal weight? My Ruby weighs a little over 11 lbs and so I used to feed her 2 - 2.5 cans of Fancy Feast (3 oz cans, or 6-7.5 oz) in small meals throughout the day. Smaller meals are easier on their stomachs and pancreas. She might be getting her fill early in the day and then not that hungry in the evening. Also, when the blood sugars go lower, they generally get less hungry than when they are hyperglycemic.

You can give insulin if she eats half a can. I usually fed only an ounce or an ounce and a half of food at shot time, then a quarter can in two hour intervals after. You can leave it out if she doesn't want to finish it all in one sitting.

Levemir onsets usually 4 hours after the shot, so it's important to watch her glucose levels around +3 or 3 hours after her shot to see where her blood sugar is, then if it's too low to feed a small amount of food. We want to keep her hungry in case her sugars drop and she needs to eat more.

It would be great if you could set up a spreadsheet so we can see all of the readings you are getting at a glance so we can be more helpful. Here's a link on how to do that and lots of other helpful info: NEW? HOW YOU CAN HELP US HELP YOU!

Come back at us with any more questions! :bighug:
Click to expand...

HI, sorry for the delay. Been so exhausted and the kids have been really struggling.

I tested Betty before feeding today and BEFORE insulin, her blood sugar was 5.1mmol/L (91.8mg/dl). My son needed to come home from school so the pickup interfered with me getting her sugars within 4-6 hours of her breakfast.

Am I right in thinking I shouldn't give her insulin because she's already so low? Is that why she may have been throwing up overnight? Maybe she's bottoming out overnight?

She is eating the 5.5oz cans.
She currently weighs 9.6lbs (which is way underweight... I can see her spine and her bones are so prominent now.

She seems to be way hungrier in the morning, so she'll eat close to 3/4 of a can... But in the evening, she is lucky to graze on half a can.

Today I gave her a 1/4 can snack at 130pm and she is eating dinner now.

Am I guessing I should not give her insulin if she is already so low?

Also, I really struggle with glucose tests. I have used a flashlight and try to get the vein in her ear, but sometimes need a few tries, and neither of us like that.

I still need to do the spreadsheet. Today did not go as planned, but I will try for later tonight.
 
For someone who is new to feline diabetes and testing, we suggest not shooting if numbers are below 200 at preshot test time. So definitely skip! Throwing up could have been a sign of going lower. Once you get the spreadsheet set up, we can help you with dosing going forward.
 
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
Are you using 26 or 28 gauge lancets?
 
Thank you! I have been trying to hit that vein because that's what the vet said! She didn't tell me to go for the sweet spot.

I'll try this tomorrow.
 
Ok... I think I did it. (Thank god for your instruction threads! ) The link to the spreadsheet should be in my signature now. :)

I feel bad because I was originally told to take a reading 4-6h after morning shot, once a week. In the beginning, this meant not a lot of data.

Today is the first day where I did a pre-feed reading, gave the shot and then took another reading about 5 hours after eating.
She is still throwing up overnight... brownish mostly liquid, not a lot of food in it. Smells kind of like bile. The vet prescribed me an antinausea drug to give after evening snacks, because they thiink maybe the insulin makes her feel nauseous, but I am worried it's more due to a blood sugar spike or plummet overnight? Thoughts? Should I give her the anti nausea meds? I really don't trust my vet at this point.
 
Also, as it relates to SLGS vs TR... I have no idea what I was. I am guessing based on my vet's recommendation of doing only 1reading per week, that would have made me SLGS, but I worry that is not safe for my Betty given her nightly vomiting, low body weight, and advanced age, so I think I want to do more tighter regulation to better understand how her blood sugar is being monitored. I do not want to risk losing her.

So... I think I am TR.
 
We can't see your spreadsheet you have to go back and hit share
You need to changes the permissions. If you go to the top right and hit "share", a new box will come up. At the bottom you'll see "Get Link".

Change it to "Anyone on the internet with this link can view"
 
@Betty'sMom Have you started posting in the Lantus/Levemir group yet? A bunch of us post every day. You can do that, too. It will help you learn the journey. Not sure if anyone above mentioned this (i didn't read the entire thread).
 
Margaret (and Pearl) said:
Hi Sandy! Glad you made it over here! I'm the girl talking to you on FB. You can see my Pearl's spreadsheet here - you can see in the beginning how wonky it was, too!
Click to expand...

It is all over the place to start. It's a bit overwhelming at first to understand what the numbers mean (Esp since I use the mmol by default and don't know the colours), but maybe it means that she's not as bad as I thought?
 
Betty'sMom said:
No, I am a bit overwhelmed so I'm not quite sure what I am doing.
Click to expand...
You'll get there.

Here is the link to the Lantus and Levemir forum (you are now in the Welcome/Main Forum here). You can go to this link, and you posts there just like you did here. You will see everyone else's posts to read there. Let us know if you need help or don't understand, someone will help you do this.

https://felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

You can also find the forum if you go to the "Forums" link on the top of this page (scroll all the way up), but I always use the link - it's easier ;)

I will tag you in a post over there so you can see where it is.
 
Betty'sMom said:
It is all over the place to start. It's a bit overwhelming at first to understand what the numbers mean (Esp since I use the mmol by default and don't know the colours), but maybe it means that she's not as bad as I thought?
Click to expand...
The more BG data you get, the more you will understand the pattern. The pre-shot numbers are going to be likely the highest numbers in the entire cycle. The goal is to randomly test between those shots so you can find the lowest number (NADIR), because any dose increase or decrease will be based off the low number, not the high numbers.

Does this make sense? It is ok for now if you don't understand the pattern, people will help you learn.
 
Margaret (and Pearl) said:
The more BG data you get, the more you will understand the pattern. The pre-shot numbers are going to be likely the highest numbers in the entire cycle. The goal is to randomly test between those shots so you can find the lowest number (NADIR), because any dose increase or decrease will be based off the low number, not the high numbers.

Does this make sense? It is ok for now if you don't understand the pattern, people will help you learn.
Click to expand...
So my vet had said to always test within the 4-6 hr window post dose... Do you think I need to go outside that window?

They also said to not give snacks... So I wasn't. But in another thread they said that maybe a snack was ok. Yesterday I gave her two single tablespoon snacks between breakfast and supper, but her numbers were higher all day. I'm thinking of giving her one single tablespoon around the 5h mark (after her am reading) and see if that keeps her from bottoming out.

Because she is so thin, it's hard for me to not feed her if she's hungry (it feels cruel), but it also messes up how much she eats in the evening.

The good news is that I didn't wake up to vomit this morning!
 
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