New members - Deborah & Shasta

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Deborah & Shasta

Member Since 2012
Hello from Florida,

My name is Deborah and my cat, Shasta, was diagnosed April 2011. Here is our story:

Shasta is a 14 year old, "American short hair" tuxedo cat, weighing in at ~10lbs. Since I rescued her 14 years ago, she has been an indoor cat and an only child. I had always free fed her dry food (Purina or something like that) and maybe an occasional can of wet food. Aside from her love for me, she's not a particularly nice cat to anyone, especially the people at the vet's office.
At the time of diagnosis, my vet recommended that we start her at 1u (Lantus) and monitor. He suggested I start her on Hill's Prescription Diet m/d dry (1/3 cup a day - free feeding due to my schedule) & wet (a forkful at each insulin shot) and call if she seemed to be getting worse. Oh, I forgot to mention that she has a heart condition which makes sedating her very troublesome (she's on Atenolol for saddle thrombosis).
She seemed to be doing fine...until I had to go out of town - March 2012. When I got home, she was not well...very lethargic and lacked the desire to eat. I took her to my vet...only to find out that he had just retired! =( The new vet ran blood work, etc. We worked at getting her eating again (thank goodness for Friskies wet food! She HATES the m/d taste!) The next time I took Shasta in to see the new vet, she was her usual grouchy-self. I was told that because of her disposition, they wouldn't be able to do much more for us other than yearly shots/check up. (meaning, if Shasta ever needed to be "hospitalized", they wouldn't be able to do anything for us...which I understand the predicament, but I didn't appreciate her lack of willingness).
Recently, I noticed some hind leg weakness with Shasta (puts front paw on ottoman and pulls with her front and pushes with her hind; update: no longer showing signs of neuropathy.). I stopped by the clinic (mid-morning) to ask advice and was told the vet would be in touch. She finally called at 6:30pm...it was a Friday. Anyways, she suggested I up Shasta's dose to 1.5u or 2u and call back after the weekend. (meanwhile, no one suggested I home test! Just blindly shoot my cat!) This vet has "tried" to be helpful (kind of), but I started feeling very anxious and irritated. So, I started researching online and finally got myself logged into this wonderful site!

I just transitioned Shasta off of dry food and transitioned her from Hill's m/d to Fancy Feast and Purebite freeze dried turkey treats. Also, I just started home testing on Friday (7-13-12). Day 2 was a horrible day for home testing, but it has gotten much better. After reading advice from this site and Dr. Lisa Pierson, I dropped her Lantus back to 1u as I took her off of dry food. I'm not sure if this was a smart move...advice welcome! Maybe someone will see something that I don't know to look for. Please check out her tiny SS. Any advice/help/calming that can be sent my way would be greatly appreciated.

Also, I would appreciate any advice on a feeding schedule and suggestions for snacks. I am a teacher and when classes start back up, my schedule keeps me away from her for a good portion of the day. =( Any suggestions for automatic feeders?

Thank you, in advance, Deborah & Shasta
 
Welcome, Deborah and Shasta, to Lantus Land, the best place you never wanted to be. :lol: :lol: You are definitely in the right place to get the best help possible in treating feline diabetes. You are doing a great job! Home testing is critical. It gets easier as you do it more. Lots of petting and a treat will encourage Shasta to be a little more patient with the whole process. Warm ears help too. I blow on Zener's ear. Others use a heated sock with rice.

The wet food is also important. The dry food has too many carbs and it's, well, dry. Diabetics are always dehydrated. Janet & Binky's page has nutritional information on just about every single brand and flavor. Most people try to feed about a 4% or 5% carbs. Zener is ultra picky and we feed him 10 or 11% and are happy with that.

In my unexpert opinion, the 1u BID is a good place to start. Someone with real expertise will stop by and give you advice about how to proceed.

We use the PetSafe 5 compartment feeder. If Shasta is aggressive about food, she may be able to break into this one.

You are doing a great thing for Shasta. Be sure and ask lots of questions. It's rather overwhelming but you'll figure out what works for you and Shasta. Be sure and read the starred sticky notes at the top of the forum - they are chock full of good information.
Liz, Zener's other mom (I sign when I visit, Anne doesn't)
 
Hi Deborah and Shasta!!

Welcome to Lantus Land!! I'm glad you found your way over to us :-D

I'm sure you’re feeling more than a little overwhelmed. If you take a look at the number of people in this forum, you’ll realize that there is a lot to learn and a lot to do but it is very manageable once you learn the ropes. The front end of the learning curve is rather steep, though. The people here will answer your questions and help you. All you need to do is ask!

There is a lot of important information regarding lantus that is available for you to read. We suggest you print it, put it in a folder or binder, and then you have it handy if you need it quickly. The info is found at the top of the Lantus TR forum that you are in....they are called "stickys". Here are quick links to them:

New to the Group-provides great, basic information ....a must read first :-D
Tight Regulation Protocol - more on this below
Proper Handling and Storage of Lantus/Levemir - very important as we store our insulin in the frig, do not shake, roll, warm, prefill syringes, etc.
Insulin Depot - discussion on how lantus/levemir work
Dealing with Low Preshots - very important to have on hand
How to Handle Low Numbers - also very important to have on hand

The vast majority of the members of this Insulin Support Group are using a dosing protocol that is based in clinical research and that has been published in leading veterinary journals. It is referred to as the Tight Regulation (TR) Protocol (or by other names as well, the Tilly Protocol or the Rand/University of Queensland Protocol). They are all the same. A modified version of the protocol and links to the formal versions is available in the Tight Regulation sticky. This approach will give your cat the best chance of going into remission or keeping his/her blood glucose numbers in a range that will prevent organ damage.

It is not mandatory that you follow this approach. However, you should be aware that most of us do and it is how we approach dosing decisions. As a result, we are very numbers oriented.

This protocol was developed by lay people who are members of the German Diabetes-Katzen Forum and It has since been published in the Journal of Feline Medicine and Surgery. In other words, there is research to support the use of this dosing protocol. The majority of cats do very well on this protocol; some cats do not. Every cat is different (ECID). Also, results do not occur overnight. Lantus will teach you patience. It is more time-consuming than most other protocols but still definitely doable if you work a regular full-time job. Many people here have challenging schedules.

We strongly urge you to test for ketones regularly to start with and know about diabetic ketoacidosis (DKA). Be aware that ketones don't occur once a cat is (and remains) properly regulated. Most of us buy ketostix at the pharmacy and test urine...it's easy and quick. Shasta should be eating the right diet: high-quality low-carb canned food or raw food exclusively. It is best to feed your cat lots of small meals spread over the day, free-feeding canned food can be an option for some cats. I don't use an auto feeder but many members do and one of them could suggest a good one for you.

Do you give her B-12 Zobaline for her neuropathy?

As overwhelming as it may seem right now, these steps are not that hard to carry out and we've seen many people who didn’t think they could do this, slide into a TR approach once they got started. Home testing is a critical part of this approach. As with any other insulin, in order to insure that blood glucose levels are high enough to safely give a shot, you need to test prior to injecting.

Here is a typical lantus cycle:
+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

The first few days when you are building data, it helps to get a test at PS,+3, +6, and +9. But another helpful test is the +2. If Shasta's +2 is much higher than her PS, it will likely be a quiet cycle. If it's the same or close, you should expect a typical lantus cycle meaning she will probably come down as shown above. If the +2 is much less than the PS (like it is tonight), you can expect a cycle where she might drop early on.

I've given you alot of info and we don't expect you to absorb it all at once. We ask that if you get a low number during the cycle, please post and we will help you with it. If you get a low preshot, please DO NOT FEED, but post and ask for help and we'll walk you through it.

Finally, one of the things that would help us help you and Shasta the most is if you could please do a profile for her. Here are the instructions and if you have any questions...please PM me and I'll walk you through it:
Creating a Profile

Welcome and please let us know how we can help you. You will find a warm welcome and a community of people who are devoted to their cats and just as interested in yours and who will generously share their knowledge with you.
 
Quick moment of panic...it's +4 and her BG just read at 39?! I freaked a little and retested...34?! She's been napping next to me for the past 2 hours, but that shouldn't cause such a drop in her BG, should it?!

I just gave her 1 Friskies hairball treat (she loves them) and a few tiny bits of my turkey sausage. After that, she ate the last bit of her dinner and is now sitting on the footstool. Also, I just put down about 1/4 FF chicken feast. Her appetite is not diminished!

I'm a professed Nervous Nellie when it comes to her, but the BG number seems awfully low to be 4+.

Advice?!
 
Yep, that is too low. 50-120 on a human meter is normal range for a cat. Do you have any high carb food (15 to 20% carbs) or karo syrup? You can put two drops of karo on lower carb food. How much did she eat? If more than 2 teaspoons, then re-test in 30 mins.
Liz
 
Deborah, you just got excellent advice above, so I just want to say "welcome", and good for you finding these boards and taking control of Shasta's care!

Marje mentioned the profile, but what helps everyone with giving dosing advice and seeing the overall cat experience is when you start a spreadsheet of Shasta's dosing and BG numbers and any additional information you want to include, like what she was fed and when, and ketone testing, and overall demeanor on that particular day. The instructions to starting a spreadsheet for Shasta are here: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207. The directions have probably changed a bit since Google Docs now changed to Google Drive, but hopefully you can figure it out.

Good luck to you and Shasta! You have come to the right place!

Suze
 
Deborah

Liz is correct on two points...until you are used to dealing with low numbers, use the 911 button above the subject line. Go the first post in the thread, click "edit" then click the 911 and submit.

If you haven't given it to her yet, please give her some HC gravy or karo and retest in 20 mins from that....and please post. I'll be checking in on you.

Suze...she already has a SS link :-D
 
If napping next to you can bring down their bg :mrgreen: , you can run a DM clinic care centre Deborah!
Welcome to LL!
 
Good....great job, Deborah. One of the things I put in my long post was that if her +2 is much less than her PS, then you can expect a possible drop. Glad my crystal ball is working :lol:

Please keep testing her tonight until you have two rising numbers not influenced by food. They can turn around and wobble and then come back down when the HC wears off.

She earned a reduction with that number so her new dose will be .75u. In the first Sticky..new to the group...there is a pictorial showing that dose.

In addition, she might "bounce" tonight or in the morning. When the liver senses a number that it lower than it is used to, it releases counterregulatory hormones and glucagon to bring the BG up. Don't worry....the liver is doing its job and it is normal. We all just have to wait bounces out and they can take up to six cycles to clear. You just want to hold the dose until the bounce clears and don't be tempted to go back up. We will try to keep track of those six cycles with you.

I know you will have a lot of questions.

Can you please retest 30 mins from the last one and let me know her number?

Suze...no worries ;-) :-D :-D :-D
 
tortie58 said:
If napping next to you can bring down their bg :mrgreen: , you can run a DM clinic care centre Deborah!

haha! I guess if that were the case, she never would have been diagnosed to begin with! :razz:

Thank you ALL for your support and advice! Shasta is done eating and using the little box...now she's chillin' on the floor. Meanwhile, I'm trying to get over my mini-heart attack! :cry:

I knew that when I registered for the FDMB site, I was going to be greeted by wonderful, helpful people...and I was right!
 
Marjorie and Gracie said:
Glad my crystal ball is working :lol:

Can you please retest 30 mins from the last one and let me know her number?

I'm glad your crystal ball is working! Do they sell those on Amazon?! :-D Thank you, again! I am going to jump in the shower and then test her again. Will post new number shortly!
 
dbest said:
Meanwhile, I'm trying to get over my mini-heart attack!
I think we all had one of those the first time our cats went below 50! Think of it as the initiation process. (((HUGS)))

When Shasta is on the rise again, for sure, you need to go treat yourself to some chocolate or wine or Frito's or whatever indulgence is going to congratulate your adrenaline-high body for having dealt with this.

Suze
 
haha...did I mention how much of a Nervous Nellie I am?!? So much, that I just retested before my shower...and will probably test again after my shower/before bed.

Her most recent BG is 88. :YMSIGH: She's very alert and would like to know why I'm not giving her more food right this very instant!
 
Great. I'm glad she's coming up. It's still early in the cycle so it's good you can keep up with the testing for a bit. You can probably give her an hour now.

I'm off to bed....running on a bit of a sleep debt here. If she comes back down, post for help...at least you know what to do and so you'll be nice and calm.

And Suze's suggestion is worthtwking :-D

Good work..hope you get some rest. Good night ...and don't forget to reduce her dose in the a.m.

BTW...it's always good to go back and read through your condo again...when we cross post, you can miss important things like her earning a dose reduction.
 
I will reduce her dose in the morning and re-read everything and more! Also, I will set up her profile....now that I know I can! Thank you for your help and sleep well!
 
Deborah, as long as you know that Shasta's numbers are going up due to ingesting low-carb foods and not just the additional carbs you gave her, you'll be out of the woods.

Giving them high-carb foods (gravy foods, honey, Karo syrup) etc., will bring the numbers up temporarily and help avoid a hypo experience. But, just like a human eating a candy bar and getting the sugar rush, cats also come down from that quickly. Make sure that Shasta has plenty of low carb food to nosh on, right now. High protein/low carb food is going to help her in the long term, to prevent further drops later this evening.

When Pumbaa has taken green dives, I've given him pure protein to eat, like chicken meat cooked for human consumption, and sardines (packed in water, no salt). I've found that when Pumbaa drops low, he instinctively eats more, to give the insulin something to work on. Don't hold back food at this point...give Shasta all the low carb, high protein food she can consume. And limit the amount of high carb foods you are feeding, to prevent huge bounces. Just use enough to bring her numbers up out of the dangerous level, quickly, then use the high protein, low carb foods to keep her out of the dangerous levels.

Hope the above makes sense! You're doing great!

Suze
 
Pumbaa said:
Deborah, as long as you know that Shasta's numbers are going up due to ingesting low-carb foods and not just the additional carbs you gave her, you'll be out of the woods. Hope the above makes sense!

It does make sense. I gave her 1 hairball treat & 2-3 nibbles of turkey sausage (she's crazy for both) and then I gave her FF canned chicken feast (and I just gave her a little more, but I think she ate it all so I will put some more down just in case she's hungry while I'm alseep.) Also, she got several small bits of Purebite freeze dried turkey treats every time I poked her!

As of this past weekend, she only has access to her water and wet food (Fancy Feast classics - from Binky's list/Dr. Pierson's approval). No more dry food.

I just poked her for 6+ and her BG is 160. These bounces are what freak me out the most...from 34/39 to 160 in 2 hours! UGH! I had a glass of wine tonight...maybe I should stick to chocolate! haha! Thank you again and I'll update tomorrow.
 
I know that a lot of the hairball meds contain molasses, which is very high in carbs, which is why I wanted to let you know to make sure that Shasta also got high protein foods in addition to the high carb stuff.

You did great tonight! Chocolate or wine as a treat after you deal with things like tonight is your choice...whatever makes you feel better quickly! (((HUGS)))

Since you took away Shasta's carbs this past weekend, did you also adjust her insulin dose down? Sorry, I don't have your SS up anymore and now that I'm in "reply" mode, the url to the SS doesn't appear. But I already know that you are doing a dose decrease in the morning, so that should help.

If you are worried about Shasta having hairball problems, you can try feeding her Vaseline regularly (my GA Killer, who was a domestic long hair, thought Vaseline was akin to Beluga caviar), or just put some extra virgin olive oil in Shasta's canned food 2X per day. My cats are now getting the EVOO and that has really helped preventing the fur ball problems and the barfing.

Shasta is in very good hands. That I know for sure!

Suze
 
hi Deborah & Shasta!

I just read through your condo and wanted to say well done!! Good for you, taking Shasta's care and testing into your hands. Just like with our own care, noone cares quite as much about yourself (or your cat) as you do!

I'm pretty new at this experience too (looks like we've been home testing for about the same amount of time). I think you did a great job handling the big drop down to 39 calmly and appropriately. When Cleo had a big drop I went a little crazy with getting sugar and food into her, so I sympathize entirely. Glad to see Shasta's on the rise again.

I think I'm too new to have any useful advice for you, but I just wanted to give some encouragement!
 
Welcome, Deborah and Shasta!

Quite a start you guys had. Best of luck for the well-earned new dose of 0.75! I'm glad you had such great LL'ers helping you through Shasta's last cycle :smile: We live in South Africa, so out timing is sometimes not so great for helping out on normal-hours stuff. I'm glad to see how well you came through it!

Excited to see your next condo!
Jane
 
Good morning and welcome to LL, Deborah! I'm a little late in arriving to the party, I see, but you handled that low number well and had a lot of really good people to help you out.
As you already have found out, LL is a super place to be if you have a diabetic kitty. Lot's of good stuff to learn for sure, so it may take a little bit of time to really get into the swing of things.
Good luck in this sugar dance!
 
Welcome to Lantus Land!

It seems like you had a bit of excitement upon your arrival. You did great last night!

Suze & Pumbaa said:
Don't hold back food at this point...give Shasta all the low carb, high protein food she can consume. And limit the amount of high carb foods you are feeding, to prevent huge bounces. Just use enough to bring her numbers up out of the dangerous level, quickly, then use the high protein, low carb foods to keep her out of the dangerous levels.
The above is not entirely correct, at least not unless you want a very rotund kitty. I'm linking a post that discusses whether to feed your cat as much as she wants. The short answer is that it's not such a great idea unless your cat is dramatically underweight.

Frankly, high carb, no matter how little or how much, will not influence to what degree your cat bounces. The underlying mechanism of a bounce is what Marje described. Either a cat drops into lower numbers than his/her body is used to or there is a fast drop in numbers (not necessarily to a low range). As a result, the liver "panics" and releases a stored form of glucose along with counterregulatory hormones. These act to cause a rise in blood glucose (BG) levels. We use high carb (HC) food to get the numbers out of the lower ranges more quickly. This strategy allows you to have better control over the numbers. Using a combination of the gravy from HC food along with a bit of low carb (LC) food can be helpful but feeding just HC is fine. What you feed depends on how carb sensistive your cat is. The only way you'll be able to figure that out is trial and error. As in most things, every cat is different (ECID).
 
Good morning everyone!

I was awoken, about 5 minutes before my alarm, by a very sassy Shasta! As she borrowed my hand for scratching her head and neck, it also became her chew toy...ok, more like nibble toy! Her amps was 256; she ate 1/2+ FF wet; .75u morning shot; and now resting comfortable by my side. I'm about to test her BG at +1 (hyper vigilant after last night.)

Suze - I did drop her dosage this weekend(1.5u → 1u) when I took her off of dry food and switched her over to low carb wet. I had a freak out moment on Saturday and moved her back to her previous dosage (1.5u) but got my head together and have been consistent with 1u since...until this morning.

I usually don't worry about hairballs with Shasta...she's not an avid cleaner. However, I just replaced her calm collar which means that she has been cleaning more often, as of late. The only REAL reason I have the hairball treats is because they are her favorite treat! They are soft and she loves them. I was actually going to throw them out this past weekend when I switched her over to high protein/low carb because I know they're not good for her, "nutritionally" speaking! Kind of glad I held on to them. :YMSIGH:

Thank you, everyone, for your support and encouragement! I think the worse feeling for me, right now, is realizing that I have been injecting her for 1+ year and not really knowing what has going on with her system. :sad: Who knows how many times she had extreme BG numbers. Ok, I'm going to poke her and start working on her profile. Thank you, again and I'll be back with updates!

Deborah & Shasta
 
Deborah:

I think most of us have been in those shoes. Gabby was on insulin for a few months before I found FDMB.

When you provide an update, could you start a new thread? (We call them "condos.") We use a format so for those of us to keep an eye on the board, we can tell if you're running into a tense situation or if we think some additional information would be helpful. the format is:

date -- kitty's name --- AMPS-#, +time-#, etc.​
 
Sienne and Gabby said:
When you provide an update, could you start a new thread? (We call them "condos.") We use a format so for those of us to keep an eye on the board, we can tell if you're running into a tense situation or if we think some additional information would be helpful. the format is:

date -- kitty's name --- AMPS-#, +time-#, etc.​

Thank you for the clarification. Haven't spent enough time on these boards to know the protocol. Will update, on new thread, soon! Thanks!
 
Sienne and Gabby said:
Suze & Pumbaa said:
Don't hold back food at this point...give Shasta all the low carb, high protein food she can consume. And limit the amount of high carb foods you are feeding, to prevent huge bounces. Just use enough to bring her numbers up out of the dangerous level, quickly, then use the high protein, low carb foods to keep her out of the dangerous levels.
The above is not entirely correct, at least not unless you want a very rotund kitty. I'm linking a post that discusses whether to feed your cat as much as she wants. The short answer is that it's not such a great idea unless your cat is dramatically underweight.

Thank you for the link, Sienne. I guess I wasn't clear above, as I meant during the very low BG levels, not in general. I know when Pumbaa has taken a dive to very low numbers, he seems to instinctively know to eat more right then to give the insulin something to work on and bring his numbers up.

Suze
 
WOW...talk about being thrown in from the get-go!!! Wonderful job with those 30s.

You've gotten tons of fabulous info, so I'm just stopping in to say "Welcome!" Lantus Land is a very special place, and we're glad to have you with us!

We also shot Trixie for the first month or so without consistently testing - under the advice of our vet. I can't tell you how glad we were to find this place, too!

Again, welcome, and we look forward to seeing more of you guys around here!
 
Question/concern: In the past, Shasta has had a small bout with vomiting/regurg. and I have been able to contact my vet and they have suggested FortiFlora and she is typically fine. Last night (7/17) was a hairball due to excessive grooming with new calm collar. Within past 15 minutes, Shasta vomited/regurg. (yes, I have pictures...and yes, it is in a plastic bag now.)

My concern is over "what" is causing her to do this and they way she did it. Normally, she would do her typical "hacking" sounds and body "convulsions". This time, I swear I thought she was seizing, at first, but then she threw up, sat there for a second and walked over to her food bowl (empty) and looked at me for more. By the way, to my knowledge, she has never seized. (knocking on wood)

Because of this reaction, I just tested her AM +9 a bit early and it was 246. Am I crazy for being concerned? My suspicion is that the Purebites (which she loves) are not sitting well in her system; or she's not chewing them; or idk?!

Advice? Opinions?

(I have reposted this in the Lantus group, as well)
 
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