? New Member: Sudden reversal of progress

[EllBell_C]

Hi all, my cat George was diagnosed with diabetes in October last year. At time of diagnosis, he had pancreatitis, UTI and a weird sound when he was eating that was confirmed to be due the affects on his kidneys. After starting him on PZI and up until January, all results were improving although all still relatively high and so not in remission. His behaviour was also becoming more normal for him. However, since January, his results have gone right back up to where he was at diagnosis and all his symptoms have worsened again. The vet has said it could be how we are administering the insulin, the insulin itself or insulin resistance. I am 99% certain we are administering it correctly however we are going to do a video for the vet to check. The insulin appears fine with no clumps but it may have been left out for 30 mins or so and shaken a bit too roughly, would this cause it to become denatured or is this unlikely given that there are no clumps? The vet seems to think it is unlikely however we did get the new vial in Jan. We are going to change the insulin once we have ruled out with the vet that the issue is definitely not how we are administering it. Since he has concurrent diseases that can exacerbate diabetes, I believe it is more likely insulin resistance. Sorry for the essay. We are lost, as is the vet, as to why he was responding first and now he's not. Has anyone else had this experience? I would be grateful to hear back, thanks

 

[EllBell_C]

Hi all, my cat George was diagnosed with diabetes in October last year. At time of diagnosis, he had pancreatitis, UTI and a weird sound when he was eating that was confirmed to be due the affects on his kidneys. After starting him on PZI and up until January, all results were improving although all still relatively high and so not in remission. His behaviour was also becoming more normal for him. However, since January, his results have gone right back up to where he was at diagnosis and all his symptoms have worsened again. The vet has said it could be how we are administering the insulin, the insulin itself or insulin resistance. I am 99% certain we are administering it correctly however we are going to do a video for the vet to check. The insulin appears fine with no clumps but it may have been left out for 30 mins or so and shaken a bit too roughly, would this cause it to become denatured or is this unlikely given that there are no clumps? The vet seems to think it is unlikely however we did get the new vial in Jan. We are going to change the insulin once we have ruled out with the vet that the issue is definitely not how we are administering it. Since he has concurrent diseases that can exacerbate diabetes, I believe it is more likely insulin resistance. Sorry for the essay. We are lost, as is the vet, as to why he was responding first and now he's not. Has anyone else had this experience? I would be grateful to hear back, thanks

 

[JanetNJ]

Insulin needs change. Do you have some kind of log or spreadsheet with numbers

 

[EllBell_C]

Insulin needs change. Do you have some kind of log or spreadsheet with numbers

Hi thanks for the reply. New to this forum so not sure how it works to bear with me! Do you mean the type of insulin or the vial? We do not have our own log no, the vet has been doing it.

 

[JanetNJ]

Hi thanks for the reply. New to this forum so not sure how it works to bear with me! Do you mean the type of insulin or the vial? We do not have our own log no, the vet has been doing it.

Ok so you aren't testing his bg at home? I would strongly recommend you do to avoid hypoglycemia and to make sure the dose is appropriate. I have a video in my signature showing how I tested my cat CC.

What insulin and dose are you giving?

 

[Gill & Mac (UK)]

Hi I haven't come across this but my reply will bump your post back up the board.
Good luck I'm sure someone will have helpful comments for you.
Gill

 

[Bron and Sheba (GA)]

Hi and welcome.
Just a few questions.
Are you home testing the blood glucose?
What dose is George being given?
Has he always been on the same dose or has it been increased by the vet?

What type of food are you feeding? Wet or dry? Low carb?

If you could answer these questions it will help us help you.
Bron

 

[Marje and Gracie]

Welcome to FDMB.

I moved all the posts to Main Health where we ask all new members to start.

Thank you!

 

[Lisa and Witn (GA)]

What is your current dose of PZI and what are you feeding your cat? Both affect glucose levels.

We recommend that you start testing George's glucose at home to get an accurate understanding how well the dose is working. There are a few reasons we recommend home testing. First, you will test before every shot. This will prevent you from giving insulin when his glucose levels are too low and prevent hypoglycemia. Hypoglycemia is when the glucose levels drop too low and can be very dangerous or even deadly for a cat.

The next reason to home test is to understand how well the dose is working. You want to know how low he drops between doses to determine if the dose needs to be changes. Tests at the vet are not really very accurate since it is only a snapshot at that time. Since stress can affect glucose levels significantly, George's readings at the vet may be considerably higher than they would be at home. If the dose is increased because of these readings, then it may be possible the dose is too high. Again, this could potentially lead to hypoglycemia or bouncing.

We can help you learn how to test. You can use either a human glucose meter or pet specific one. We generally suggest the human meter since the test strips are available at most pharmacies and are much cheaper than the strips for the pet meter. Both work the same, so it is just a matter of personal preference.

 

[EllBell_C]

What is your current dose of PZI and what are you feeding your cat? Both affect glucose levels.

We recommend that you start testing George's glucose at home to get an accurate understanding how well the dose is working. There are a few reasons we recommend home testing. First, you will test before every shot. This will prevent you from giving insulin when his glucose levels are too low and prevent hypoglycemia. Hypoglycemia is when the glucose levels drop too low and can be very dangerous or even deadly for a cat.

The next reason to home test is to understand how well the dose is working. You want to know how low he drops between doses to determine if the dose needs to be changes. Tests at the vet are not really very accurate since it is only a snapshot at that time. Since stress can affect glucose levels significantly, George's readings at the vet may be considerably higher than they would be at home. If the dose is increased because of these readings, then it may be possible the dose is too high. Again, this could potentially lead to hypoglycemia or bouncing.

We can help you learn how to test. You can use either a human glucose meter or pet specific one. We generally suggest the human meter since the test strips are available at most pharmacies and are much cheaper than the strips for the pet meter. Both work the same, so it is just a matter of personal preference.

Hi,

Hi I haven't come across this but my reply will bump your post back up the board.
Good luck I'm sure someone will have helpful comments for you.
Gill

Thanks

 

[EllBell_C]

Hi and welcome.
Just a few questions.
Are you home testing the blood glucose?
What dose is George being given?
Has he always been on the same dose or has it been increased by the vet?

What type of food are you feeding? Wet or dry? Low carb?

If you could answer these questions it will help us help you.
Bron

No, we are not currently testing George at home because he doesn't like to be touched and it stresses him out. We understand that hyperglycemia can occur when the cat is in distress hence we have chosen not to do this at the moment but are seriously considering it now. We also consider that blood glucose will rise at the vets when he goes in because of this. But, to be honest, we have only just been able to do the insulin injection itself. It's been a real struggle even doing that, needing 2 or 3 people at a time at one point as he hates it so much, but thankfully it is easier now. Although we don't bloods at home, we do urine dipsticks, but I do know that these are very inaccurate and crude!

George is on 2 x 4 units a day. He is a big cat so we are thinking he needs more than this anyway. He began on 0.8 in Oct and the vet has been increasing it but now they are saying he is so diabetic we need to increase it quickly. The vet has said we are administering correctly so it must be insulin itself or insulin resistance. We have changed the insulin now so we will see if it is the insulin over the next few days or so.

With regards to food, he is on Purina diabetic food, 2.5 wet pouches with some dry biscuits, a day. However, we were skeptical about dry food before as we have read loads on in it that even the diabetic stuff isn't good but vet says it's fine. We don't want to take him off dry completely at the mo because we are worried about hypoglycaemia, especially since we aren't testing at home. Also, we feed him 1 teaspoon of Gourmet broth when he has the insulin as this is the only way he will tolerate it. We have read the ingredients and it says 0% carb and again the vet says this is ok. But still not sure if it is! It's a minefield.

Thanks for your reply. I really appreciate the advice.

 

[EllBell_C]

What is your current dose of PZI and what are you feeding your cat? Both affect glucose levels.

We recommend that you start testing George's glucose at home to get an accurate understanding how well the dose is working. There are a few reasons we recommend home testing. First, you will test before every shot. This will prevent you from giving insulin when his glucose levels are too low and prevent hypoglycemia. Hypoglycemia is when the glucose levels drop too low and can be very dangerous or even deadly for a cat.

The next reason to home test is to understand how well the dose is working. You want to know how low he drops between doses to determine if the dose needs to be changes. Tests at the vet are not really very accurate since it is only a snapshot at that time. Since stress can affect glucose levels significantly, George's readings at the vet may be considerably higher than they would be at home. If the dose is increased because of these readings, then it may be possible the dose is too high. Again, this could potentially lead to hypoglycemia or bouncing.

We can help you learn how to test. You can use either a human glucose meter or pet specific one. We generally suggest the human meter since the test strips are available at most pharmacies and are much cheaper than the strips for the pet meter. Both work the same, so it is just a matter of personal preference.

Hi, with regards to home testing, he has had one ear prick in the past by the vet and it didn't heal for 2 weeks. Is this normal? We are thinking about home testing George soon (see the above replies if possible) but we haven't been doing it so far as he really doesn't like to be petted and we have only just been able to administer the insulin! The vet has to sedate him to even get a blood test !!

Thanks for your comment

 

[Bron and Sheba (GA)]

I am glad you have been reading up and educating yourself about FD. There is a lot to learn but you are well on the way.
I agree don’t stop the dry until you are home testing. When you remove the dry, the BGs will most likely drop up to 100 points or more and there is a risk of low numbers so you need to be checking the BG. Giving dry food which is high carb is like giving candy.

Using the broth is a good idea. As long as it doesn’t have onion or garlic in it, you can use it when you give the injection and when you test the BG. You can give more than a teaspoon ... it’s fluid and perfectly ok to give. Can you tell me the ingredients please so we can make sure it is ok. I used to make my own and used it all the time. I froze or in ice cube trays and brought it out each day to keep it fresh.

Please don’t let your vet increase the dose quickly. That is dangerous. Saying he is so diabetic it needs to be increased quickly is a very odd statement. A cat is either a diabetic or he isn’t. Some cats are easier to regulate than others. Sometimes one insulin is better than others. But the dose should be increased in a timely manner otherwise you will run into problems including hypoglycaemia.

What I would do is think about home testing. Read up on it. We can help you. Buy a human meter as they are cheaper to run and our dosing methods are based on the human meter. We have lots of people say they can’t possibly test their kitties but I can’t think of one that didn’t succeed. My Sheba used to come running when she heard me at the testing equipment because she knew she would get a treat.
Start off with choosing a place that would be a good place to test. Always use that spot. Take George there and just rub his ears and give him a treat. A small low carb treat such as a small cube of chicken. Do this multiple times a day for a few days. Don’t rush him or force him. Let’s get him used to that.
And please don’t increase the dose at the moment. We don’t know if he is dropping low and bouncing or just staying high. I know it is frustrating and upsetting but we can help you get sorted.

Don’t buy a meter yet. I am assuming you are in the US so I will ask @Chris & China (GA) as she is in the US to suggest a meter that needs a small amount of blood.
How does all that sound?
Here is a link to hone testing for you to read.
Keep posting and asking questions.

click on this link https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Do you have a hypo kit incase of low numbers it is really important to have one. Print this page and put it on your fridge
https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

 

[Bron and Sheba (GA)]

Also meant to ask, are you testing for ketones?. It is always a good idea to do so if George isn’t regulated You just need to buy a bottle of Ketostix from Walmart or a pharmacy and test the urine. Anything above a trace needs vet attention. The glucose sticks you are using may have the ketone test on them

 

[Bron and Sheba (GA)]

Hi, with regards to home testing, he has had one ear prick in the past by the vet and it didn't heal for 2 weeks. Is this normal? We are thinking about home testing George soon (see the above replies if possible) but we haven't been doing it so far as he really doesn't like to be petted and we have only just been able to administer the insulin! The vet has to sedate him to even get a blood test !!

Thanks for your comment

No this is not normal for it not to heal for 2 weeks. What on earth did the vet do?
Most of us can test multiple times during the day and there are no problems at all with the ears. Occasionally there might be a small bruise but if you hold the site for just a minute that should not happen. I’m not surprised the vet had to sedate him if his previous experience was the ear prick from the vet.
Poor George.

 

[EllBell_C]

No this is not normal for it not to heal for 2 weeks. What on earth did the vet do?
Most of us can test multiple times during the day and there are no problems at all with the ears. Occasionally there might be a small bruise but if you hold the site for just a minute that should not happen. I’m not surprised the vet had to sedate him if his previous experience was the ear prick from the vet.
Poor George.

I am really not sure. He is a white cat so I'm guessing we will see the scab more but we were surprised that it took so long to heal. This is one of the reasons why we have avoided glucose testing so far as his poor ears wouldn't take it but we may be able to do a better job!? He has always hated the vet so maybe they struggled to do it and did it wrong? I am not sure how it works I'm just speculating here!

And in response to your other comments, we test for ketones and glucose on the dipstick yes and so far no ketones which is good! We are in the UK but we are going to look into the glucose meter as you have suggested. Rubbing his ear and giving him a treat sounds like a good place to start. What is the hypo kit? We were told to have honey (which George loves!) nearby incase but is the kit better? The broth ingredients are just chicken, meat derivatives and vegetables (but it doesn't say which, so could be onions?). Whats wrong with onion and garlic?

Thanks so much for your comments

 

[Critter Mom]

Hi there,

This is one of the reasons why we have avoided glucose testing so far as his poor ears wouldn't take it but we may be able to do a better job!?

Shortly after Saoirse was diagnosed she was taken in for a curve by the vets at the practice with which we were registered at the time. They made mincemeat of her ears. I wasn't testing at home at the time (I wanted to but they were positively hostile to the idea) and, like you, I got worried about doing it myself when I saw the state of her poor ears.

The following week she went in for another curve and this time they hadn't quite finished with her. I was waiting for her in the hospital area, and then I discovered why her ears had been such a mess. It took three of them to get a blood sample from her ear, and they were trying to draw it from the wrong part of the ear. My poor girl was really frightened, and I didn't blame her. (((Saoirse)))

Thankfully I'd seen videos of other cats being tested by their own caregivers in the home setting so I knew it was possible to improve on what I'd witnessed at the vets.

Fast forward to the time when I had learned to home test and Saoirse's regulation was much improved as a consequence. Here's a pic of Saoirse at her station just before her sugar check:

(Not exactly trauma central, eh?)

Vet BG check and home BG check? Chalk and cheese.


Mogs
.

 

[Critter Mom]

We are in the UK but we are going to look into the glucose meter as you have suggested.

Several UK members recommend the Gluco Navii meter. Test strips are, I believe, the most affordable on the market and the meter is reliable. You can get the meter and strips on Amazon or eBay. Since you need to order them online it would be a good idea to get a decent stock of the strips in to start and then, as you finish a pod, order the next one. That way you're not likely to run out of strips.

There's lots of helpful UK info in the following thread:

https://www.felinediabetes.com/FDMB...-vit-b12-and-other-need-to-know-stuff.137376/

Here are links to the info for managing low numbers:

How to manage a hypo (print out a copy to keep with the toolkit - and remember you can always post here for urgent help).

Hypo toolkit

(@Elizabeth and Bertie - could you recommend some suitable UK medium and high carb foods for a hypo kit, please? I can never remember them. )


Mogs
.

 

[Critter Mom]

PS: Thrive freeze-dried protein treats are diabetes-friendly. Also, Zooplus do similar (Cosma Snackies).


Mogs
.

 

[EllBell_C]

Hi there,


Shortly after Saoirse was diagnosed she was taken in for a curve by the vets at the practice with which we were registered at the time. They made mincemeat of her ears. I wasn't testing at home at the time (I wanted to but they were positively hostile to the idea) and, like you, I got worried about doing it myself when I saw the state of her poor ears.

The following week she went in for another curve and this time they hadn't quite finished with her. I was waiting for her in the hospital area, and then I discovered why her ears had been such a mess. It took three of them to get a blood sample from her ear, and they were trying to draw it from the wrong part of the ear. My poor girl was really frightened, and I didn't blame her. (((Saoirse)))

Thankfully I'd seen videos of other cats being tested by their own caregivers in the home setting so I knew it was possible to improve on what I'd witnessed at the vets.

Fast forward to the time when I had learned to home test and Saoirse's regulation was much improved as a consequence. Here's a pic of Saoirse at her station just before her sugar check:


View attachment 59898


(Not exactly trauma central, eh?)

Vet BG check and home BG check? Chalk and cheese.


Mogs
.

Aw bless her, what a lovely cat! I'm looking up all your suggestions, thank you so much

 

[Rose aka princess]

I know I'm a newbie here, but I thought maybe it would be encouraging to hear from a newbie regarding giving the shots...
I did not think Rose would ever trot over for a shot, but after 2 weeks of shot with treat routine, she sees me getting the insulin out, preparing the shot and she comes over to "the shot spot". I have everything ready and then I take out the treat bag and set it in front of her, closed. She waits for the shot with eyes on the prize. After shot I immediately open the bag and give her the treats. Lots of petting afterwards. This group really helped me. The shot then treat routine really works. I held her down to give shot before! Now she trots over to "the shot spot". Try the routine with George for his shots and see if he responds favorably. It may take a couple weeks.
(By the way, I'm still struggling with the ear blood testing too, I haven't got that one down yet. I still need my husband's help on the ear pricks and I admit, we don't do it everyday yet. We're only 2 weeks into this, so there is room for improvement!)

 

[Bron and Sheba (GA)]

I know I'm a newbie here, but I thought maybe it would be encouraging to hear from a newbie regarding giving the shots...
I did not think Rose would ever trot over for a shot, but after 2 weeks of shot with treat routine, she sees me getting the insulin out, preparing the shot and she comes over to "the shot spot". I have everything ready and then I take out the treat bag and set it in front of her, closed. She waits for the shot with eyes on the prize. After shot I immediately open the bag and give her the treats. Lots of petting afterwards. This group really helped me. The shot then treat routine really works. I held her down to give shot before! Now she trots over to "the shot spot". Try the routine with George for his shots and see if he responds favorably. It may take a couple weeks.
(By the way, I'm still struggling with the ear blood testing too, I haven't got that one down yet. I still need my husband's help on the ear pricks and I admit, we don't do it everyday yet. We're only 2 weeks into this, so there is room for improvement!)

That’s a great success story!