New Member - Vet Issues

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I just wanted to let you guys know Daisy is doing ok. I've been checking her blood before her feedings and shots to make sure she isn't low. I think I will keep doing this all this upcoming week and next weekend I will try and do the curve. Hopefully, this will give her body enough time to react consistently and I will get an accurate curve. I would like to thank all of you for helping me last week. It really does put my mind at ease knowing you guys are here to help and you do seem to genuinely care.
 
Thanks for the update. We appreciate it. We worry about family members if we don't here from them in a while.

Let us know how things go over the next week.
 
I am a newbie to all this too and welcome to a VERY support group of folks here!

Both of my cats were dry food free feeders and I switched them to wet food free feeders.
The non diabetic took to the wet food like a sea lion to the ocean - it was one of those "Where has this food been the last 12 years?!" type moments.
Of course the diabetic cat took a few days to get converted and I did spend the first 2 whole weeks feeding them both 4x/day.

When my vet asked me how feeding was going and I told him this he looked at me like I was crazy and said to just put down half the food in the morning and the other half in the evening and see how they do. They both self regulated right off the bat. As he explained it to me - cats outside don't put their food in the fridge to keep for later - as long as I keep into consideration the overall environment - like a 90 degree day then they should be fine for 12 hour stretches and so far it has been true.

So maybe give free feeding a try even on the wet food.

I hope it can work because it SURE helped me get back out of a sleep deprived state.
But of course every cat is different and every cat's bean is different!

Welcome and the very best to you and your kitty from a fellow newbie :)
 
GReat! You dont want to shoot if she is under 200 for now. Also it would be good to get a mid cycle test (5-7 hours after shot) to see how low she is going - that way you know if the dose is too high or too low.

Wendy
 
It's time for Daisy's 5pm feeding and shot. I tested before feeding twice because the first reading was low. Each test was from each ear. The first was 121 and the second was 170. She's eating right now. Should I skip this shot and wait until her 5am shot?
 
I fed her right after testing. I also called the vet and he said to give her the shot as long as she's above 90. I don't feel comfortable giving her the shot with one of the tests being 120. I feel like her body is still adjusting to all of this.
 
On here, we advise newbies not to shoot under 200 unless they have a spreadsheet and data to know how the cat is going to behave. So skipping is the right idea.

However what you can do next time is test, and if she is under 200, wait 30 minutes (dont shoot or feed) to see if she has gone up naturally without the influence of food. That is also why we advise not to feed two hours before shot time - so you know for sure that food doesnt play a part in your reading.

Get a test in a few hours though so we can see what she does without the shot.

Wendy
 
Oooooh. When I feed them I leave the food out. Maybe I should have my fiancé remove their food bowls before he goes to bed at night and I can remove them when I get home from work. This way I'll know for sure she hasn't eaten anything at least 2 hours before I test her, feed her, and give her shot.
 
Might catch the occasional test when you do pick up the food, just in case there's a surprise low. It can happen.
 
I'm having a hard time figuring out the best way to make sure the insulin shot goes in Daisy. I grab her to make a "tent" but I can't get a good tent. Sometimes it goes straight through the other side. Do you guys have any suggestions for a better way to do this?
 
4 Ps for injecting:
Pull up the skin into a tent.
Gently Poke the syringe into the tent, at an angle of about 30 degrees up from horizontal.
Push the syringe plungerinto the barrel.
Pull out the syringe.

Where
horizontal = 0 degrees
perpendicular to the skin = 90 degrees
The desired angle is about 30 degrees, less than halfway tilted between 0 and 90.
(Halfway between 0 and 90 degrees is a 45 degree angle; you want less than that.)
 
Update
Daisy's doing ok. We've got the shot routine down pat. She even lets me know when it's time to eat every morning and evening. She gets sassy if I don't feed her between 4:00 and 4:30. Unfortunately, she is pulling her hair out again. I think this has to do with her thyroid disease. She hasn't been on that medication since we started the insulin since it was more important to get her insulin under control and her thyroid levels were slightly low on her last blood test. I have a feeling we're going to have to change the food or increase the insulin. I hope I'm wrong. I'm doing a curve today. The +3 reading was 506. I'll post the curve results before I go to bed tonight...
 
I took Daisy to the vet last night and left her there all day today so they could do a curve on her. She's home now and happy to be. Here are the curve results:
feeding and shot time462, +2 - 410, +4 - 284, +6 - 260, +8 - 253, +10 - 278. The vet said to increase her dose from 2 units twice a day to 3 units twice a day. I fed her at 6:30 and gave her 3 units. I will check her before I go to bed which will be +2.5
 
We don't usually recommend a dose change more than 1/4 unit as you can miss the good dose. Also how does the vet know she isn't bouncing? Its a shame you don't have a spreadsheet set up - it would tell us so much more.

Did you check her for ketones? I really really hope so because you don't want DKA - its very serious, and very expensive to treat...

Wendy
 
I've been Daisy's hooman for 10 years. I was hanging out with her previous caretaker recently and found out she's 3 years older than I always thought she was. It turns out she wasn't 3 years old when I adopted her. She was 3 years OLDER THAN HER HOUSEMATES! :o Anyhow, I'm doing a curve today. I have been a bad caretaker for the last month or so. I have been dealing with the possibility of losing my job. I suffer from depression and do not do well in these sort of situations. I will not just go with the flow and let the chips fall where they may and not worry and stress about it. In my brain, I catastrophize the situation even though it hasn't even happened yet. If you have any knowledge of depression, you will understand. If you do not understand, please don't judge me as I judge myself every second of the day. I've been doing feedings and shots on schedule and doing random BG tests but I am sure Daisy could use more attention. Her BG levels are not going down very well. She looks like she is losing weight again. She is still drinking tons of water. She diarrheas 4-5 times during the week. I know it's her because last night while I was scooping the boxes she laid one out in the box next to me. She doesn't cover it up and it's a light tan color. It almost looks like putty. I'm debating on taking her to the vet today to get kidney and liver labs done due to this diarrhea. She still follows me around and talks to me and gets sassy. I promise I will do a better job at keeping this updated. Should I start another thread in a different board; like maybe a Lantus board?
 
somestrangegirl said:
...She diarrheas 4-5 times during the week. I know it's her because last night while I was scooping the boxes she laid one out in the box next to me. She doesn't cover it up and it's a light tan color. It almost looks like putty. I'm debating on taking her to the vet today to get kidney and liver labs done due to this diarrhea..
Click to expand...

The light tan/putty colored diarrhea sounds like her pancreas may not be producing enough enzymes to digest the food properly. This is called exocrine pancreatic insufficiency and is treated with replacement enzymes which aren't too costly. The proper test for this requires fasting for 8-12 hours and can be pricey. An alternative is empirical treatment, ie treating 'as if' that is the diagnosis without doing the test. Discuss this with your vet. (Mercola makes a product for pets.)

Note: enzymes are different from probiotics. Those can be helpful too, if there is an imbalance in the normal bacteria of the gut. (Ex Forti Flora)
 
I am getting concerned. I called the vet and they want Daisy to go in on Monday. Ok fine. But I want to run her symptoms by you guys. Please let me know if I'm overreacting, underreacting, and/or if you have any suggestions for my next step.
Symptoms: Eats like a pig, drinks tons of water, light tan puffy poop pile, losing more weight(super skinny), lazy(walking very slowly up the stairs)
Her BG SS is available in my signature.
Please give me some advice! Tell me to simmer down or go to the ER. Last time she was lethargic she was hospitalized for a few days and put on fast acting insulin drip and I don't want this to happen again. Her BG seems fine at the moment. I hesitate to use the 911 icon but I need some direction! Thanks in advance!!
 
Unfortunately, I can't provide much advice based on her symptoms. However, since you've displayed a 911 icon on your last post, in order to attract more people to your thread, go back to your first post in the thread and edit that one and display the icon there.

If you do that, it will show up in the list of threads with the 911 icon next to the thread. Otherwise, people would need to read the entire thread to realize that with your last post you are having an emergency issue.

Have you tested for ketones recently? What was the result?

According to http://en.wikivet.net/Diabetic_Ketoacidosis symptoms of acute ketoacidosis is depression, weakness, vomiting, diarrhea, acetone-smelling breath, slow deep breathing and early symptoms include polyphagia (excessive hunger) and weight loss.

If you have tested for ketones and there is even more then a trace amount, then you have a serious emergency on your hands and I would go to the emergency vet ASAP.
 
Here BGs are on the high side but not that bad. The eating/drinking suggests other problems like hyperthyroidism or could be something else. If no ketones and continues to eat you could wait until Monday morning.
 
I took Daisy to the vet. She was sleeping with her head hanging over the edge of the water bowl which made me very concerned about her kidneys. They drew blood, took her temp and took her blood pressure. Her blood pressure was normal and so was her temp. I wont get lab results until Monday but they ordered a T-4 total, comprehensive chem panel and complete blood count. I will continue to do a BG curve.
 
Great job on the SS - her BG isn't that bad but probably does need a slight dose increase. Does she still only get the FF classics? no dry or anything?

As regards her poops - it does sound like it could be exocrine pancreatic insufficiency like BJ said. Ask your vet about it. My Bailey has it. I don't know if i would even bother testing for it, just start the enzymes and you should know in a few days if its working..

keeping my paws crossed for her!

Wendy
 
Well, Daisy's labwork came back normal. The vet is adamant I change her diet. He doesn't want to change her insulin dose as he is afraid it will go too low when it goes down. This makes sense to me. We have to figure out why she is spiking. She is still drinking a ton of water and her BG spikes a few hours before her evening shot. Her mornings start out around 400 and steadily goes down and then spikes over 600 a few hours before her evening shot. There is nothing different during the time between the feedings and shots. Same food and same amount. She gets Friskies Pate Turkey & Giblets Dinner or Friskies Pate Mixed Grill. Any ideas?
 
The Friskies Mixed Grill is 11% carbs. The Friskies Turkey and Giblet is 8%. We recommend trying to stay under 10% carbs. For that reason, I don't feed my sugardude Wink the Mixed Grill flavor.

If you can find the Friskies Special Diet canned foods, most of those are 4-5% carbs. I found some recently at my local Petco.

The Fancy Feast classic pates (3-5% carbs) are also about half the carbs of the Friskies classic pate style foods.

Daisy is dropping into the blue numbers mid-cycle, so that is encouraging. I just don't think the 3 units is enough.

I'd like to see the numbers on the SS for the last couple of days, to see the trends after the depot has filled. Usually can take a couple of days to see an affect from the dose increase.

If you noted on your SS, which foods you feed which days, that might help us to see if Daisy is carb sensitive, and you should eliminate the Mixed Grill from her diet. Just a thought.
 
I agree with Deb I would tweak the food a little.

The vets fear is preventing Daisy from getting her blood sugar into normal cat levels (50-130). Normal cat levels will help her body heal and possible even remission. Since you are home testing you can ensure she stays safe and doesn't drop too low. However if you change her food a little to say the fancy feast classic pates, she might come down naturally without increasing the insulin so I would give that a try first

Wendy
 
Update -
Daisy was on 3 units in the am and 4 units in the pm and eating only Friskies Turkey & Giblets. Her poop issues never did improve so I recently switched foods. So I changed her food about 1.5 weeks ago. I switched to Authority Chicken pate because it seems to have lower carbs than the Friskies. I also changed her units to 3 in am and 3 in pm because of the lower carbs. I did not want to risk her going too low with the change in food. Her BG is hovering around 300 before her feedings and her poop is still light tan and "puffy" looking and reeks horribly. She will be due for a refill of her insulin in a couple weeks and I'm wondering if I should request trying a different one from the vet.
Should I give the new food more time? Is there another food I should try? I've been seriously considering trying Dr. Pierson's recipe. Also, any thoughts on changing the insulin? Any suggestions would be very appreciated.
 
Did the vet test for exocrine pancreatic insufficiency after fasting her for 12 hours?

It still sounds like EPI to me. Hows her weight?

Before changing insulin can you update your SS with more data so we can see how the insulin is working? You will need pre shot tests plus a few mid cycles for at least 3 days to really know how its working. 3 days will account for any bounces and give a good picture of her BG.

I usually recommend 3-4 tests a day to give a good idea of what the insulin is doing

- always before the shot - this is the highest point of the day for many cats
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low the cat’s blood sugar is going. The low point "nadir" is what you base dose changes on since you don't want the cat dropping too low (under 50).vary this test within the 4-8 hour window.
- before bed (2-3hours after Pm shot) to get an idea of what the cat's overnight plans are. If this number is less than the pre shot test number , set the alarm for a test a few hours later as this implies an active cycle.

Wendy
 
Well it looks like I have to go back to Friskies until I can figure out which food to try next. Petsmart is constantly out of the Authority Chicken pate Adult and they are the only ones who sell it :(
 
Since Petsmart doesn't seem to keep their OWN brand of cat food(Authority) in stock on a regular basis, I decided to look for the Friskies Special Diet Turkey & Giblets while I was there yesterday. I found it! I was so excited :razz: The cats had some last night. I think I'll do a curve over the weekend after they've been eating it for a few days. Until then, I'm doing random BG tests.
 
FYI - The PetSmart brand is called Great Choice, not Authority - that is a name brand like Purina, Fancy Feast, Friskies, Blue, Whiskas, etc. not PetSmart's store brand.

You may want to talk with the store manager however about ordering Authority. They may do that. Additionally, if you cannot find it locally, there are many online stores that you can purchase from and ship directly to your house, including petsmart.com, wag.com, petflow.com, petfood.com, etc. - check online and their websites for coupon codes, discounts, free shipping, etc. Some of them if you sign up for their newsletter you will receive coupons, discounts etc.
 
I knew Great Choice was their brand but I assumed Authority was also since it is only sold there. I have not found it available on any websites. Some of the websites say they sell it but once I go to their website Authority isn't listed. Also, the Authority website has the PetSmart logo on the tab in my browser which led me to believe it was their brand.
 
somestrangegirl said:
Since Petsmart doesn't seem to keep their OWN brand of cat food(Authority) in stock on a regular basis, I decided to look for the Friskies Special Diet Turkey & Giblets while I was there yesterday. I found it! I was so excited :razz: The cats had some last night. I think I'll do a curve over the weekend after they've been eating it for a few days. Until then, I'm doing random BG tests.
Click to expand...

The Friskies Special Diet T&G is what my two kitties eat. It can't be beat for the low carbs, the low phosphorus, and the higher protein content, all for the super low price! :-D
 
somestrangegirl said:
I knew Great Choice was their brand but I assumed Authority was also since it is only sold there. I have not found it available on any websites. Some of the websites say they sell it but once I go to their website Authority isn't listed. Also, the Authority website has the PetSmart logo on the tab in my browser which led me to believe it was their brand.
Click to expand...

It's "exclusively sold at PetSmart," according to their website. Not sure what that means.
shrug.gif
 
Probably means they contracted with a specific manufacturer to label a generic product just for them.
 
I started the cats on the Friskies Special Diet Turkey & Giblets Tuesday night. I've been giving Daisy her usual doses. This morning her BG was 80 before I fed so I did not give her a shot. How do I determine how much insulin to give her once she goes up again?
 
If you are using Lantus, then you do not want to feed within 2 hours of shot time (unless the cat goes under 50), as you won't be able to tell if she is just plain rising or it's a spike in BGs because of the food.
You can wait 2 hours and test again, and if she is at a number you are comfortable shooting, you could give the insulin then, but post for advice first, please.

If you give her her shot 2 hours late, that means tonight's shot will be 12 hours after you give her the insulin this morning, so you would need to have flexability in your shot schedule.
 
Can you update your spreadsheet with her most recent numbers, please? That will help others to help you.
 
I'm at work and I can't update my spreadsheet from work. We can't access file-sharing sites. I had my fiance test her blood 2.5 hours after her feeding and her BG was up to 127. Obviously, I can't give her a shot from work so she is missing her morning shot today. I will test her blood when I get home and update the SS and request dosage instructions based on that.
FYI...Here is our usual schedule:
Mon - Fri(No work Sat & Sun)
4:20am Feed & give shot
4:50am Leave for work
2:30pm Arrive home from work
4:20pm Feed & give shot
8:30pm Bedtime
 
Daisy's SS has been updated. Based on her PMPS I just did, which was 187, I think I may only give her 1 unit after she's done eating.
 
Wheb you aren't comfortable with a pre-test, stall 30 min without feeding and re-test.
This let's you see if the number is rising. If it is, it may be OK to shoot if you can monitor the first few times you do that.

Please stick with 1 unit for 3 full days, unless the glucose drops below 50 mg/dL on a human meter or 80 mg/dL on a pet-specific meter. Lantus needs that time to stabilize at a new doseage.
 
Yes, I would probably increase to 1.25u and see how Daisy does. Hold it for a minimum of 3days/6 cycles and if you're not seeing better numbers, then you might need to increase again.

Now that you have a spreadsheet set up, if you want to join one of the Lantus sup-group forums, they'll be able to give more specific dosing advice.
 
In short, Daisy hasn't had a shot in 2 days due to her bg being <100. She is walking awkwardly on her rear haunches. And she isn't eating very much.
 
Go to an emergency vet. We can't diagnose over the internet, nor can vets.

Possible diagnoses include hepatic lipidosis (can be fatal), plus it sounds like she has been ill, possibly with pancreatitis (can raise glucose), and/or exocrine pancreatic insufficiency.

These must be treated by a vet.

The last person who wanted to wait until the vets office opened in the morning lost her cat.
 
I was out of town for 2 weeks until last night. As soon as I got home, I noticed Daisy was in worse shape than my fiance lead me to believe. I took her to the EV before I even got a response on here. She's gone. Her BG was fine but her kidney's were failing and she had pancreatitis. I could not put her through any more. Thanks for all your help in the past.
 
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