New sugar baby mummy. Help!

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Anne

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My 2 1/2 yr old cat was diagnosed with diabetes yesterday and has just come home from the hospital tonight. His BG was 600 but he came home at 250 on 3 units Humulin twice a day. I was a nurse for 20 years so have a good grasp of 'human' diabetes but this is all new to me. He didn't eat while he was away being stabilized but has eaten really well in the last 2 hours. I have done extensive research on diet and have cooked his meal tonight based on my research. I am about to administer his first home insulin and his BG is 320. Should I stick with the 3 units or give him 4??? It seems I shouldn't mess with it so early but he is getting high again quickly as he is home and eating again. Any advise would be gratefully received. I don't want to go wrong at the first step!
 
Anne said:
My 2 1/2 yr old cat was diagnosed with diabetes yesterday and has just come home from the hospital tonight. His BG was 600 but he came home at 250 on 3 units Humulin twice a day. I was a nurse for 20 years so have a good grasp of 'human' diabetes but this is all new to me. He didn't eat while he was away being stabilized but has eaten really well in the last 2 hours. I have done extensive research on diet and have cooked his meal tonight based on my research. I am about to administer his first home insulin and his BG is 320. Should I stick with the 3 units or give him 4??? It seems I shouldn't mess with it so early but he is getting high again quickly as he is home and eating again. Any advise would be gratefully received. I don't want to go wrong at the first step!
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I would NOT go up, especially if he is eating low carb food, which it sounds like you may have done. The absolute BEST thing you can do, and since you are a nurse should have no trouble, is go get a human glucometer and strips and learn to home test. That is the absolute best way to learn what the insulin is doing and if you have changed the diet to low carb *imperative* because that alone can drop bg numbers dramatically and quickly. This is one of the best videos on how to do it.

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We like to start low and go slow, raising the dose as needed. We hometest so we know how the insulin is working. And we feed wet low carb food ( www.catinfo.org )

If it were my cat, I would start hometesting and feeding low carb before adding a low dose of insulin every 12 hours.
 
Hey Anne from Ann

We have a few simple "rules" here in how to get a regulated cat

1. Take away all high carb wet food and high carb dry food, and only feed low carb wet food and low carb dry food - that alone will lower the blood glucose levels without any insulin at all

2. Start to hometest the blood sugar, just like on a human, but instead in the ears or paws if ears fail or have injuries - that way YOU have to full control of what is going on with the bg's every day, and can see what the food change give in bg's before you even start with insulin.

2. Learn about ketones and get Ketos stix to measure ketones.

4. If you need insulin anyway in spite food changed, you start low and go slow with the insulin.

5. If Pre-shot bg is under 180, don't give any insulin.


I use long lasting Lantus insulin myself and have been doing it for some years (soon 6 years)

Now I understand you have such a youngster, but following steps 1 to 5 will show us how he works, and you can start up a spread sheet where you record all your numbers and other related info, so all others can see and give advice.
 
Thank you guys that was VERY helpful. I already had purchased a glucometer and that's how I got his preinsulin level. The video showing the best way to get the blood was invaluable as I took 3 attempts to draw blood initially. My baby didn't mind at all though and just purred all the time bless him. I am lucky as he is the most laid back cat I've ever known. I rescued him a year ago and always said 'he found me'. Now I think I know why. I will work so hard to get this under control for him and give him the best quality life I possibly can. Thank goodness I found this site. By the way I spent all afternoon cooking after extensive research and am very rewarded to see he loved it. My other 2 cats that are not diabetic (YET! after reading the literature on dry foods!!) are also being weaned onto a healthy meat diet that is low carb. Thank you all again.
 
Hi Anne,
Just wondering if you are in the United States. We don't see a lot of cats getting Humulin any more. Most people find that the longer lasting insulins (Lantus or Glargine and Levemir or Detemir) provide a more even dose over the 12 hours and result in a more stable bg. Now that you are testing, you can get several checks in a day and see how the Humulin acts in your cat's body. You can check into the insulin support groups on this message board and read the notes at the top of the forums that describe each of the insulins and their action.
 
I am in Texas but come from and practiced being a diabetic nurse in England and my first homework was on the type of insulin cats get. My last wish was Humulin but my vet had already started to stablaize Spookie on that insulin when I collected him tonight. I have strong reservations about that insulin and challenged my vet on his choice. He said after very many years he really didn't see very much difference in control between the insulins I had made note of versus Humulin. The last thing I want to do on day 2 of my cats diagnosis is alienate my vet (even if I don't agree with him) I have been on this for 2 days he has been on it for 30 years (which in itself maybe a problem I think) but I will ride this out for the first month to have his help and advise before I feel I should tell him I don't agree with him. I don't want to be looking for another vet 2 days into this process. He did make some suggestions about 'prescription dry food' that also made me know he is not the vet for me but again I am 2 days into this process, I need ALL the help I can get. Spookie's BG taken at home for the first time was 248 after his first home insulin ever and eating Mummy's hard researched home cooked food. I so appreciate all of your help. My husband (who is also diabetic) recognized the passion this has stirred in me and just smiled and said "I knew he found his Mummy".
 
In about a week, you can do a curve - test your kitty's bg before food and then every hour till his next shot. You will see how the insulin acts through the 12 hours. If there is a steep drop and sharp rise, you can tell your vet that you know from your own medical training that this is not healthy. It may be that the insulin will be fine in your cat - every one is a bit different. Data is very powerful.
 
Can I ask what is the cost efficacy of the various insulins versus the efficacy? My vet has prescribed Humulin but my cat is only into his third day of diagnosis and only my first day with him with this diagnosis (vet and cat in this new relationship) if I want to make a change I want it to be effective and for the right reason and don't want to alienate this vet yet.
 
Welcome to the FDMB family, Anne and Spooky! cat_pet_icon

I knew almost immediately the vet I had wasn't going to be the vet I needed for help handling Poopy's diabetes. It took me a bit, but I found the greatest vet for us. If you aren't comfortable with your vet, there is absolutely nothing wrong with shopping for another one. Your husband wouldn't hesitate to find a doctor he was comfortable with to help him with his diabetes, right? Same goes for our sugar kitties. :-D

Either way you go, you know you aren't alone as you've found the greatest place here, with all the super friendly and knowledgeable folks! :-D
 
Anne said:
Can I ask what is the cost efficacy of the various insulins versus the efficacy? My vet has prescribed Humulin but my cat is only into his third day of diagnosis and only my first day with him with this diagnosis (vet and cat in this new relationship) if I want to make a change I want it to be effective and for the right reason and don't want to alienate this vet yet.
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Though I do not think it is the best insulin for cats either, we have had some people, especially early caught diabetics, have success with that and changing food. It just doesn't generally last as long through a 12 hour cycle, with cats often hitting a nadir at +4 or even 3 hours in, so then they stay high longer. There is a very good primer on here if you want to continue to try using it. You won't really know how it is working until you get some curves. The insulins like lantus and my favorite, levemir, have a much more gentle drop and rise, in general and you get nadirs further out, like +7 or +8 even. They are insulins that build up a "shed" in the body and then begin to work so there is a more steady supply. They are pretty cost effective if you get prescriptions for the pen cartridges, particularly levemir, which I have never had poop out, like lantus did for us.
 
My vet started me out on Humulin but as soon as the first bottle was empty I insisted on PZI. THat was also when I started doing my own testing and curves.
 
I am still having trouble getting enough blood from the ear prick. Any tips would help. My cat is so patient with me but I really want to be better at doing it. His BG is still in the 400's despite going from 3 to 4 units twice a day. He is on an all meat diet now and I'm guessing that is part of the issue. I'm taking him back to the vet for another blood test to make sure my readings are accurate as I haven't had a comparison since he was diagnosed last week. Thank you for the help and advice so far. It's been a little overwhelming making the adjustments.
 
Anne-

Are you using a lancet pen? I found out I couldn't use it and free-hand the lancets. Or you could double poke- as have been suggested in other posts.

Plus it took me forever to poke enough so the capillaries filled out to that area- but she's a real bleeder now :lol: .

I'd say about a week of ear pokes- both sides before I started to get consistent blood from either. And I do anywhere from half an inch to an inch and a half on the outside.

What is your sugar baby's name?

Has Sue got you started on an SS chart to keep track? Here is the link or you can look in the Tech Support for it later.

viewtopic.php?f=6&t=18207

This is a lot to take in, I know.

Just take it a day at a time.
 
I am using a lancet pen. I'll try the double poke, thank you. His name is Spookie and he is a rescue cat about 2 1/2 years old. So still young. He is so mellow but it's me that gets worked up when I can't get him to bleed!
 
Anne said:
I am using a lancet pen. I'll try the double poke, thank you. His name is Spookie and he is a rescue cat about 2 1/2 years old. So still young. He is so mellow but it's me that gets worked up when I can't get him to bleed!
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I found that I was not warming the ear *enough* but adding about 10 seconds really helped and also, go for between that big vein and the edge of the ear. See http://i106.photobucket.com/albums/m267 ... etspot.jpg
 
the ears grow more capillaries as you poke them. it takes about 2 weeks for them to bleed pretty much every poke. until then, just be persistent. your poking helps grow new vessels. but if you or spookie are melting down, give each of you a treat and let it go. try again later. on this site we like to say "it's a marathon, not a sprint."

your vet is old school on the insulin. studies have shown that Lantus and Levemir provide long lasting control and are absolutely the best for cats. PZI is the next on the list. people change insulins without a problem - it shouldn't be a problem for spookie to change. but i understand your concern about the vet - you'll have to figure out what you want to do there. There is an excellent track record of cats who are put on the Rand/Roomp Protocol for dosing going off of insulin fairly quickly. that protocol is for Lantus or Levemir.

most newbies wouldn't want studies thrown at them, but if you're a nurse, perhaps you would. if you want it i'll post it for you.

funny how the universe works to bring us cats that are meant for us, isn't it? i think the same thing about my punkin. he got overlooked at the shelter for about 3 months, and i think he's the best cat ever. the new vet that i'm going to said maybe it was because of his diabetes - i said "but he wasn't diabetic then" and she said "but he would become diabetic." doo dee doo dee - but it's true - punkin is diabetic because of a tumor and probably most people wouldn't have gone to the lengths we've gone to for him. i'm just glad we have him.

so spookie is only 2.5 yrs old . . . has he recently been given steroids of any kind? that can cause diabetes. does he have any other health conditions? asthma?

i'm glad spookie found you. obviously you are just right for him!!!

edited to add: i just decided to get the link for you while i'm thinking of it. here ya go: Feline Diabetes: Which Insulin do i Choose and How do I adjust the Dose? The study was done by Jacquie Rand and Rhett Marshall, School of Vet Science, University of Queensland, Brisbane, Australia. It was published in 2006 and updated in 2008. i've collected a zillion articles on feline diabetes and related topics. if you want more, just say so.

that link does include a section on dosing with lente or NPH insulins - i *think* humulin is in that category but i'm not certain so you'll want to look into that before using these dosing guidelines.
 
Another tip on the lancets: I found that switching to a larger gauge lancet (smaller number) made all the difference. I'd been trying with the 30-gauge lancets, and it was taking me 6-7 pokes to get a bead of blood to come up. I switched to 26-gauge lancets, which are bigger, and now I almost always get enough blood on the first try. It actually hurts Atticus less to use bigger lancets because I don't have to do as many pokes.
 
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