New Member, super lost and a question

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SamberlyStevens

SamberlyStevens

Member Since 2021
Hi everyone!
I'm extremely new so I read that I should introduce myself and my cat Dante. I'm Sam and Dante is my profile picture. He's basically my son. We are very close. I got him a little before my own diagnoses with multiple autoimmune diseases. I'm fully disabled and Dante and I are together 99% of the time. He was previously abused so it did take a long time to have him open up and now hes very attached to his mom. He came to us with scabs all over his neck and what we suspected was cigarette burns. I'm sure he's been though hell. It took years but hes mostly a normal boy now. He's been with me through a lot and he's very used to me around. Especially the last year, I have no immune system so I couldn't even see my doctors.
Dante does have a sister, Beatrice, she is the healthiest pet I've ever had (knock on wood). She prefers her dad over me but she loves her big brother. The two of them are very close.
Dante is about 14, we think, and has FLUTD, arthritis, and PTSD from his previous abuse.
The PTSD really is just that he has really bad nightmares and I can't touch him during them because that makes it worse. He has stress relief spray and I've learned how to recognize when he has one. And as for arthritis, he's just a little old dude so it makes sense.
His FLUTD we caught about 4 years ago and he immediately went on s/o food and has been doing great with it. My whole family has cats and unfortunately all of our males get this disease. It's pretty crazy but luckily he's been well-maintained with the s/o food and has never had a blockage. He was on a mix of the wet and dry up until he started loosing a lot of weight.
He dropped from probably about 10 pounds to 7.9 pounds practically overnight. It felt so quick. Then he started going pee out of the box. Initially I thought it the FLUTD but the pee was practically clear and had no odor. Our vet didn't want to see him til July 22nd (!) because they are so over booked from everyone getting pets during the pandemic. While I'm happy more fur babies have homes, I was devastated by that timeline. It took a lot of calling and begging but luckily we got him to be seen right away.
That day he was diagnosed with diabetes- again. I should have probably put that before but about a year ago he lost some weight (not nearly as much) and the vet diagnosed him with diabetes, his sugar was 510. I went in a week later for his onboarding on insulin and they told me that he wasn't diabetic and to go home. His sugar was at 90, when I asked how that could happen, they didn't know. Its been a very weird time. And yes, I know I need a new vet. Again with Covid no one is taking new patients.

Anyway... he was diagnosed again. His sugar has consistently been above 600. I'm not sure if this is allowed, I'm still very lost but he was prescribed Lantus- 2 units every 12 hours. I keep awful hours so I decided that 12 and 12 would be best for us. Tonight should have been his third dose.
The last two doses have ended up being only 1 unit. The vet tech said that if he doesn't finish his food, then to only give him half his dose - 1 unit. He was so used to grazing for his food so it's been a bit of a learning curve for him, so hes only been able to finish half his food at a time.
His last two doses, I wasn't able to check his blood sugar. That's entirely my fault. I'm still learning and I hate having to prick him because he hates it so much and I'm his trustworthy person. Also the vet told me I don't have to keep checking. But I'm a nervous person and have been told that I'm like a Ma Hen when it comes to my boy and something told me to check tonight. I was able to check and he was letting me. So normally he eats about 11:45 and then gets his shot around 12. Tonight I checked at 8pm and it was 89. I thought that was great and prefect! I checked again before his dinner at 11:25 and it was down to 77. I figured that's fine since he was going to eat soon. At 11:45 he ate but seemed wobbly, a little shaky. I thought the food would help so I even checked again at 12:15, mainly because the shakiness worried me. More that 20 minutes after he stopped eating, his sugar was down to 65. In less than an hour he went down by 12 and food didn't seem like it helped. I panicked and to be completely honest I don't know if it was justified I'm still learning a lot and I know I'm a worry wart. I ended up putting a little Karo syrup on his gums (vet suggestion if he got too low) and within a few minutes he was walking fine and actually went o hangout with his dad. About 20 minutes after he went to take a nap and hes been resting ever since.
I feel like you all know so much more than me and I feel so lost. Is this normal? I obviously skipped his dose tonight. Recently my grandmother was rushed to the hospital for low blood sugar, her nursing home gave her wayyyy too much insulin. She is okay now thankfully but I worry about that happening to Dante too! I've read that its better to be too high than too low? To be honest I feel like I need a For Dummies book about diabetes in cats because I truly feel like I don't understand anything.
I'm hoping this forum can help me out and I plan to be pretty active on here. Dante is my best friend and I just want him to be okay. Thank you guys for reading all of this, I know its a lot!
 
Hi and welcome Sam and Dante to the forum. Yes! We can help you and your beautiful boy!
Im sorry he has been through so much but he obviously has a wonderful home with you now.

I’m going to ask @Bandit's Mom if she will set up a spreadsheet for you as I think you could do with a little help. She is a whizz with them. She will send you a PM so be on the lookout for one. Once the SS is setup if you could add all the blood glucose numbers you have got so far, that will help.

Obviously the insulin has been too much and the dose needs to be reduced.
Im very glad you put some Karo on his gums and he responded and I’m glad you skipped the dose.
Was 65 the lowest reading or did he go down 12 more points….can’t quite work out which it is?
Either way, under 68 on the alphatrak meter is the take action number and where you either give high carb food or some honey or Karo and test again 20 minutes later to see the BG is rising
I would reduce the dose to 0.5 units twice a day.
Please test before every dose of insulin to see it is safe to give the dose and again at least once during the cycle to see how low the BG is going…around+3 to +7
Until you have more data I would not shoot under 200. If that happens, stall dont feed and test again in 20 minutes to see the BG is rising. And post and ask for help.

Im going to give you a link for new members.in it it has how to set up a hypo kit and set up your signaure plus other useful information
Here is the link

Are you still feeding the s/o food?

HERE is a link to home testing information
 
Thank you for your help! 65 was the lowest! I'm still feeding about a third of the s/o loaf can mixed with Sheba perfect portions. I normally wouldn't at all but he LOVES it and it gets him to actually eat and not just pick at it. I'm actually going to test him again in a little bit because its been over 2 hours since the karo syrup and I eventually have to sleep and I want the peace of mind that its hopefully going up.
I'm glad that I was only doing the 1 unit instead of the full 2 the vet wanted. Thank you again for your help and for tagging Bandits Mom. I keep record of everything so it'd be great to be able to plug everything in online. Also I saw on another post about ketones. I can confirm that his kidneys are perfect and they found no ketones!
I did put a call into my vet, I doubt I'll hear back before Monday but I'm going to checking his sugar like you suggested and not injecting under 200.
 
Great no ketones!
Reducing the S/O will drop the BGs quite a bit, so I would not reduce any more of the S/O until you are managing the hometesting a bit better.
The s/o is very high carb so swapping to a wet low carb diet, when you are able to test very frequently during the swap over, will be much better for the diabetes and the urinary track issues.
Please make sure you reduce the insulin dose further as I suggested as the 1 unit is too much.
And please test the BG after the Karo syrup. It is best to test again 20 minutes after giving it to see the BG is rising and not falling.
 
Welcome to FDMB!

You're in exceptionally good company here. We're all devoted to our own cats and all of the other member's cats. You'll fit right in!

The link that Bandit's Mom provided to Dr. Lisa's page provides great information about diet and nutrition. She's a big proponent of a canned food diet. Given the concern about FLUTD, she's an advocate of getting as much water into your cat's diet as possible. I routinely add water to my cats' food even with their being fed a canned or raw diet.

As for dosing, 2u is a large starting dose. The initial dose of Lantus is based on weight if you follow the Tight Regulation Protocol (initial dose = 0.25 x ideal weight in kilograms). If Dante was underweight at the time of diagnosis, you want to use his actual weight which would be 1.0u for Dante. If you follow Start Low Go Slow, the starting dose is 0.5u. TR is a published dosing method; SLGS is another method that we use here so your vet won't know what you're talking about.

Some of the ups and downs with blood glucose (BG) may be due to what we term a "bounce." If numbers drop low, Dante's liver and pancreas may overreact and dump a stored form of glucose along with counterregulatory hormones into his system. This will cause numbers to spike upward. It can take roughly 3 days for the bounce to clear.

As for knowing more that you do, being lost and overwhelmed is completely normal. I've been here for over 10 years. I would hope that I've learned a bit over that time!! Everyone here is very generous with their time and knowledge. Please let us know how we can help.
 
Bron and Sheba (GA) said:
The s/o is very high carb so swapping to a wet low carb diet, when you are able to test very frequently during the swap over, will be much better for the diabetes and the urinary track issues.
Click to expand...
I'm a little confused, the vet prescribed the s/o and told me that I can't switch him off at all or change too much because his FLUTD will come back. I wanted to try the feline diabetic food but the vet went on a rant about how they're digested differently and that it was impossible for Dante. I'll definitely check out the link though!

Also I checked his BG at 3am before I fell asleep and it was up to 186. Not terribly high but better that before the karo syrup. I'm going to be checking again in a few as he's due for his insulin.
 
I just check his BG about 20 minutes after eating ALL of his food. It was 220 but he was extremely stressed out. I'm skipping his dose right now too. I'm worried that because of being stressed its gone up and its not that much of an increase since 3am. I'm still waiting on the vet to call.

Otherwise besides the stress of me checking his BG, Dante seems really good. He's playing with Beatrice more and actually using the litter box. I've had piddle pads scattered across my apartment for the last week. This is already a big change since last week when his BG was 650.
 
Are you giving Dante a treat every time you test? Cats are quite smart and once they make the association between testing and treats, the stress begins to diminish. There are kitties that will run to their testing spot and sit patiently for you to test. We recommend low carb treats -- most people here use either a freeze dried protein (e.g., freeze dried chicken) or even cooked chicken. (One of our members indulged her kitty with shrimp!!) The other aspect of testing and shooting is that Dante is learning that what you're doing is causing him to feel better. No doubt someone will tell you that managing your cat's diabetes creates a special bond with your cat. It's not something we made up.

I want to provide some information for you to consider. Lantus is dosed twice a day at a 12-hour interval. You do not have much flexibility with regard to moving shot time. Lantus is a depot-type of insulin. If you move shot time, it has an effect on how the insulin is stored and used (A late shot acts like a dose reduction whereas an early shot acts like a dose increase.) If you skip shots or shoot late or early, it can yield wonky numbers. Once you have collected more data, we would likely urge you to take all of these factors into consideration when making a decision whether or not to shoot.
 
Sienne and Gabby (GA) said:
I want to provide some information for you to consider. Lantus is dosed twice a day at a 12-hour interval. You do not have much flexibility with regard to moving shot time. Lantus is a depot-type of insulin. If you move shot time, it has an effect on how the insulin is stored and used (A late shot acts like a dose reduction whereas an early shot acts like a dose increase.) If you skip shots or shoot late or early, it can yield wonky numbers. Once you have collected more data, we would likely urge you to take all of these factors into consideration when making a decision whether or not to shoot.
Click to expand...

I understand I'm just extremely worried about him having super low BG again. That was really scary. I'm hoping the vet calls back tomorrow morning. Dante is also due for a "curve" visit on July 6th.
 
Just for context, I know a 77 seems low right now. Normal range is 50 - 120 (on a human meter). For an experienced Lantus user and if you're using the Tight Regulation Protocol for dosing, a dose reduction isn't given unless numbers drop below 50 if the cat is within the first year of diagnosis. I know you're not there yet. Like I said, it's a matter of experience and comfort level.
 
I’m sorry I have updated in a bit and I’m on mobile so I’m sorry for any errors.

After my last post, what should have been his next dose ended with Karo syrup again. Finally after the poor guy had to go through that twice, the vet lowered his dose to a half unit and agreed that he needed the syrup both times. But he hasn’t gotten the half unit yet. Since then he’s been at a normal BG level. I test periodically and before I would give him a shot, about 15 minutes after food, and the highest he’s been is 220. The vet said don’t give him the half unit unless he’s over 300. It’s been over 48 hours now with normal BG and I’m cautiously optimistic. He’s been great. Eating and drinking and playing all normal. It’s so odd. Good but odd.

I mentioned that he was diagnosed last year and then undiagnosed. It was very similar to this minus the insulin. I know he was stressed before his diagnoses both times and then after the stressful thing passed, he was fine. Last year was a big move and this time was my sisters Bachelorette party, which I was a wreck about. He definitely knew both times. I’m worried that either it is all stress or that I’m oversimplifying. I wish this was all more understandable.

I’ll keep you guys updated the best I can and I thank you tons for all your help. Has anyone heard of something like this? It’s like he’s totally okay practically overnight!

Also I definitely plan on keeping up his food and insulin schedule but still checking his BG before any potential dose. I’m just feeling even more lost because he’s doing so much better. No more litter box issues, playing with his sister, jumping on the bed. I don’t want to look a gift horse in the mouth but it all seems so weird.
 
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