New sugarcat with eating and lethargy issues, BG test not working atm

[Mia and Sped]

My cat Sped was diagnosed with Diabetes Mellitus yesterday. His glucose level was 515, everything else on a full panel came back normal. The vet prescribed 3u of Prozinc twice daily (I will be doing 1u per the advice of this forum). He also ordered me to do scheduled feedings because my cat was previously free fed (dry food currently, hoping to transition to wet food once we get the hang of this).


However, when I give Sped his allotted amount for his feeding he will only eat about 1/3 and then show complete disinterest. I didn't think this was enough food for his insulin shot. His first shot I gave him 2u after eating about 1/3 to 1/2 of his alloted amount and he seemed zombie-like. I gave him a couple treats that perked him up and now I am more cautious.

My vet instructed me to do the insulin for a week and come back to do a spot test for his glucose and he would teach me how to do testing at home. However, I am strongly considering going to Walmart to get a meter today, so that I have the peace of mind that I will not be sending him into hypoglycemia.

Any advice? On the feeding issue or otherwise?

 

[BooBoo]

Either lower the dose or don’t give the insulin… happened to me quite a few times at the start..

 

[Bron and Sheba (GA)]

Hi Mia and Sped and welcome.
Yes I would highly recommend you go out and buy a human meter today and start testing.
That will tell you what the blood glucose is doing with the dose and if it is the correct amount, too much or too little.
Buy lancets size 26 or 28 gauge to prick the ears.
While out getting the meter, I would buy a bottle of Ketostix from Walmart or a pharmacy so you can test the urine for ketones…..Important.

3 units twice a day is far too high a dose. 1 unit is the recommended starting dose..
****Don’t change over from the dry food to a low carb food until you are home testing as the low cat food will drop the BG up to 100 points.

With the food, it is recommended to give a meal before the shot and then a couple of snacks during the cycle (12 hours).
Do this for every cycle. Most cats won’t eat all their food at once.
As long as he is eating and you know he will eat, you can give the insulin as long as you keep offering snacks.
More information following

 

[Bron and Sheba (GA)]

I would not recommend skipping the dose unless you are testing for ketones.
HERE is a link to home testing links

HERE is a link to how you can help us help you

HERE is a link to using Prozinc

 

[BooBoo]

Yes - ok - check ketones first with wee strip - easy process compared to injecting

 

[Diane Tyler's Mom GA]

VIDEO: How to test your cat's blood sugar
Here is a video one of our members made
Even though she's using a pet meter the testing is still the same
At Walmart most of us use the Relion Prime 9 dollars or Relion Premier
17.88 for 100 test strips
Get 26 or 28 gauge lancets, we freehand with these some use the lancing device
I like to just use the lancet because I can see better where I'm poking
Get some cotton rounds ( ones you use to take make up off with
Put it behind the ear , poke then fold it over the ear to stop the bleeding for about 15-20 seconds press gently

 

[Diane Tyler's Mom GA]

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming

 

[Mia and Sped]

Thank you everyone for the great information. I am going to be picking up a meter and everything else I need right now.

 

[Sienne and Gabby (GA)]

One other point...

You do not have to change your method of feeding Sped. It can be difficult to get a cat that's used to grazing to switch to scheduled meals. Many of the people here leave food out or have a timed feeder so there is food around. Generally, we recommend that only time food should not be provided (unless your kitty is in low numbers) is 2 hours prior to shot time. You do not want the pre-shot test to be influenced by food. It's also helpful to not feed base the nadir (this is the point at which numbers start rising due to insulin wearing off).

Zombie-like behavior may mean your cat was in lower numbers. Testing and getting a spreadsheet set up will allow up to follow along with you and offer relevant suggestions.

 

[Diane Tyler's Mom GA]

Here is the link to set up your spreadsheet, it also explains how it works
If you have trouble setting it up just ask for help, we have 2 members who can help you.

https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

 

[Mia and Sped]

Got my spreadsheet set up and equipment ready, but couldn't test before his evening dose tonight. Testing will commence tomorrow for sure.

I gave him 1 unit of his Prozinc and he seems lethargic. Not quite zombie-like like he was with his first shot of 2 units, but still less active and responsive than usual. We're about 6 hours past his evening dose as I post this. Is it normal for a cat to have an adjustment period to insulin where they don't quite feel themselves or should the benefits come quickly?

I don't know how much of my observation is valid concern and how much is paranoia about him being hypo. He was very loving earlier and drinking water. He had a normal BM as well. This has been very overwhelming as it seems that he feels best when I leave him alone. Hoping for some peace of mind with the glucose testing tomorrow since I've come to realize its importance.

 

[Bron and Sheba (GA)]

If he seems lethargic please give him some food in case it is the low numbers that are causing the lethargy.
Did you buy the Ketostix to test the urine for ketones?
Was he lethargic before the shot?

 

[Mia and Sped]

I brought him a bowl of food that he seemed disinterested in. He has eaten a few treats happily. They are not great and high carb, but they are all I have at the moment. I can give him more of those if need be. I also set up a hypo toolkit with beechnut turkey and turkey broth baby food, as well as Karo syrup in case of emergency. I have also made food available that he can have at any time before the 2 hours prior to his AM shot, per advice on this thread.

They did not have Ketostix but I did buy the ReliOn brand of ketones strips. Are these ok? I am waiting for him to urinate so I can test.

He has seemed a bit off/more lethargic since I brought him home from the vet yesterday, I assumed because of the stress and the fact that he had not been for quite some time. He has been going to sleep under my bed which is new for him. However, he was definitely more energetic before the shot, talkative and willing to follow me around the house. I am continuing to watch him closely and will be attempting to test his glucose for the first time later in the AM.

 

[Bron and Sheba (GA)]

They did not have Ketostix but I did buy the ReliOn brand of ketones strips. Are these ok

Yes they are ok. Well done!

 

[Mia and Sped]

Sped was just up and more alert. Gave me some head rubs and ate a bit of food. Tried to catch him urinating but he was not happy about that. I had already taken the ketones test strip out of the bottle so I dunked it into a small puddle of urine at the back of the box. Not the correct way to do it and have no idea if it worked. In any case, it didn't change colors.

 

[Bron and Sheba (GA)]

Sped was just up and more alert. Gave me some head rubs and ate a bit of food. Tried to catch him urinating but he was not happy about that. I had already taken the ketones test strip out of the bottle so I dunked it into a small puddle of urine at the back of the box. Not the correct way to do it and have no idea if it worked. In any case, it didn't change colors.

I’m glad he is more alert. If the strip got into urine, it was probably OK…as you say, not the correct way…but sometimes you have to work with what you have. Next time try just putting a small container in his favourite spot in the litter box. Good no ketones.

 

[Mia and Sped]

Well we fought for a glucose test today and got blood. However, we messed up the order of operations with the meter so it gave us an E01 error which I believe means that we were using a used strip or the meter was having difficulties reading the blood. Poked the poor guy three times so don't want to put him through another one right now. Frustrating!! The insulin seems to make him feel worse than without it, so I'm anxious to know his levels.

Is it a good plan to give him his insulin now (his usual time) and try to get a glucose reading a few hours from now?

 

[Bron and Sheba (GA)]

Sorry no one answered you Mia. Next time, change the subject line to reflect your question. Eg write ‘unable to get BG, do I give dose?
what did you end up doing?

 

[Mia and Sped]

We gave him .5u and he seems to be doing alright at the moment (3 hours out). He still isn't eating enough, even with grazing available, which is why I lowered the dose as recommended earlier in the thread. I am going to call the vet tomorrow and ask about that, although since they recommended 3u of PZ without even mentioning the possibility of hypoglycemia, I am a bit skeptical.

I wonder if his lack of eating is because he has a dental issue or he is feeling nauseous from the insulin? I was under the impression that a lot of diabetic cats are ravenous but Sped has never been a huge eater and even less so now.

We tried practicing with the glucose meter using human blood, just as a diabetic would, to see if all the equipment was working and we were still getting errors. We got error E13, supposedly not enough blood, but it was a decent droplet, more than I think we could get from Sped. We then tried again with another decent droplet and it wouldn't even register that there was blood on it. Trying to figure this out.

 

[Bron and Sheba (GA)]

We tried practicing with the glucose meter using human blood, just as a diabetic would, to see if all the equipment was working and we were still getting errors. We got error E13, supposedly not enough blood, but it was a decent droplet, more than I think we could

Keep trying and read the instructions. If your hands are clean you could try getting the blood on your fingernail from the ear and see if that helps if he won’t keep still.
Otherwise take it back and say it isn’t working and ask for a new one.

We gave him .5u and he seems to be doing alright at the moment (3 hours out)

If you are reducing the dose, the one thing I would do is test every day for ketones in the urine. You can get a bottle of Ketostix from Walmart or a pharmacy.
As long as there are no ketones in the urine, I would stay with a lower dose until you get some BG readings.

wonder if his lack of eating is because he has a dental issue or he is feeling nauseous from the insulin? I was under the impression that a lot of diabetic cats are ravenous but Sped has never been a huge eater and even less so now.

He could well be nauseated. Does he sniff the food and walk away? Or smack his lips together?
I would ask the vet for some cerenia and ondansetron to try.
It could be because of his teeth. How bad are they?

 

[Mia and Sped]

He could well be nauseated. Does he sniff the food and walk away? Or smack his lips together?
I would ask the vet for some cerenia and ondansetron to try.
It could be because of his teeth. How bad are they?

He eats a few bites and then walks away. If I try to get him to eat more he'll ignore it completely or sniff and walk away. He revisits his food bowl a few times throughout the day and once again eats a few bites. He smacks his lips but only after eating, I think that's normal but perhaps he has been doing it more.

I am not sure the status of his teeth, they seem to be fine by appearance alone. The vet did not mention them during his physical exam. I'll ask about both possibilities tomorrow. I will also test for ketones again tonight. Also, thank you for all the help you have been giving me, it is greatly appreciated! I knew this would be a stressful journey in the beginning and that has proven to be more than true.

 

[Diane Tyler's Mom GA]

When you do get your meter working it's important to get some tests in during the night, .
You need to be getting in s few note tests after each pre shot to see how the insulin is working for Sped

 

[Bron and Sheba (GA)]

He eats a few bites and then walks away. If I try to get him to eat more he'll ignore it completely or sniff and walk away. He revisits his food bowl a few times throughout the day and once again eats a few bites. He smacks his lips but only after eating, I think that's normal but perhaps he has been doing it more.

That definitely sounds like nausea to me. Push for some cerenia or ondansetron. Ondansetron is often better for nausea.