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Courtney and Kismet

Member Since 2012
Hi everyone,

I made my username without realizing I was supposed to use my name and my cat's. Pennydreadful is my internet alias that I always use, referring to the 18th century British serial horror magazines that cost a penny. (I am a literature graduate student and teach College Composition, so forgive my overt literary nerdiness!)

My name is Courtney, and my sweet 3 year old male shorthair domestic is Kismet.

A little background info on my cat: Kismet has always been a healthy, active, sweetheart that I found and rescued when he was 2 months old. He is an only pet and lives exclusively indoors.

Case History:

In Late July, I took him to the emergency vet when I spotted a little bit of bright red blood in his vomit. Earlier that day, he'd had a serious coughing fit, what I'd thought was a hairball. He was acting normal, but thought I should get him checked out. The vet gave him a thorough physical exam, but didn't take any blood or do any x-rays because she didn't think it was necessary and was trying to spare me the exorbitant costs of such services. She said the blood was most likely the result of an irritated esophagus or stomach from hairballs. She prescribed Kismet Laxatone and sent him on his way.

I did a little bit of research on hairballs, and decided to switch him from science diet dry food to Wellness brand wet food. His retching episodes increased to between 3-4 xs a day and he wasn't producing any hairballs, but was eating and defecating normally. I was dosing him with Laxatone after every episode, up to 4xs a day. He started drinking excessive amounts of water and urinating a lot as well. After consulting my Cat Owner's Veterinary Handbook http://www.amazon.com/Owners-Veteri...ated/dp/047009530X/?tag=felinediabetesfdmb-20 two things occurred to me: 1) Perhaps he was having asthma attacks, not hairballs, and 2) The Laxatone was maybe making him Diabetic. I promptly stopped giving him Laxatone and his thirst and urination returned to normal. He continued to cough at unprecedented rates.

I also read that asthma could be the result of allergies. The only thing different in his lifestyle was his food. I discontinued feeding him Wellness right away and switched him back to his old food and scheduled an appt with the vet the next day.

They did an x-ray and couldn't find any evidence of severe asthma. At any rate, they prescribed a nebulizer with a mixture, oral prednisolone, and an antibiotic to give to him. His asthma attacks didn't decrease at all, in fact they increased, and additionally, he started drinking and urinating a lot again and became withdrawn and lethargic. Concerned, I phoned the vet and she told me to stop by to pick up a script for Theophylline 100mg.

The next week, I got a phone call and they told me he was diabetic. (Goes to explain the frequent urination.) She instructed me to stop all other medications and to start insulin. He now gets an injection of 3 units of Lanus 2x a day. I asked her if there was an alternative to the Theophylline as I'd read it was bad for diabetic cats, so she prescribed flovent 220mcg 1x120. We haven't received the Flovent yet as it was ordered from Canada and will take a few weeks to arrive. The vet instructed me to give the bronchiodilator pills if needed, but they haven't made any difference and only make his life (and mine) miserable. At this rate, I wonder if he even needs the asthma medication. He has had only one episode since he started receiving insulin. I asked the vet if coughing was a symptom of Diabetes and she said it wasn't, but I'm not so sure since there seems to be a strong correlation and his x-rays kept coming back negative.

I am hoping that both his asthma and diabetes are situational. I'm very suspicious that his glucose levels were high as a result of the Laxatone and maybe the Prednisolone. I mentioned this to the vet and she told me it was unlikely that he developed diabetes in a month, but it was her group that prescribed both medications and she may just be trying to cover her a**. Kismet is a big cat, but not obese according to his docs. He is a tall, long cat and weighs in at around 15 lbs.

I've read a lot of conflicting information on what to feed cats, especially diabetic/asthmatic ones. My vet insists organic, canned wet foods are just a fad, and says that he should stay on the Hills w/d dry because it is good for his teeth. wth? So I will get a toothbrush! It would be a small inconvenience and it seems far more important that I provide him with a better diet, right? At any rate, I will not be going back to Wellness since I suspect that may be what triggered the allergic asthma attacks, but was wondering if perhaps there is a better alternative out there. I read that dry foods are bad for diabetic cats because they are rich in carbohydrates, even those that claim to be low-fat, low-carb. I am planning on switching him over to a canned food such as EVO, Nature's variety or Fancy Feast as soon as I am able to consult with his vet. Raw diets are not feasible for me as I often work late and don't have time to prepare meals for him, let alone myself. And after all of these vet bills, I am on a strict Ramen diet! As far as treating his asthma, I've switched his litter to Feline Pine (a low dust, all natural litter.)

Overall, he seems to be doing much better now, more energetic and cuddly. We go back in 4 weeks for a check up. This is another thing that concerns me. She told us we don't need to do at home glucose testing, that she will do in the office when we go back. When he was initially diagnosed, she did not do a Glucose curve and based her prescription on two blood tests taken roughly a week apart. Both readings were around 450. I feel like this is negligent on her part and she may be putting my cat in danger. What if his levels were elevated due to stress? Are 3 units of insulin twice a day a good starting dosage? Why didn't she try to change his diet first? Furthermore, why did she instruct me to start administering insulin and have me start feeding Hills Prescription w/d dry at the same time? Isn't that change alone enough to potentially alter his levels? Most of these questions came to me after our visit to the vet once I started reading up on Diabetes over the past few days. I am worried that my vet is seriously out of touch when it comes to treatment based on some of her decisions and recommendations. Not to mention her gross oversight... In the span from July 27 to September 12 he went to the vet 3xs. We didn't finally get the diagnosis until the 12th and $1500 later!

I have scheduled an appointment with a specialist for Tuesday, hoping that she will be able to provide more insight and a draw up a more thorough treatment plan. If nothing else, I want a second opinion and permission to switch his diet asap. If there is a possibility I can regulate him to the point that he is off the insulin, I will literally cry tears of joy.

Any thoughts, recommendations, and/or support would be greatly appreciated. I love my kitty like he were my child, and I imagine all of you do to since you're on this board. It's nice to find a community here of aliurophiles who understand what it is like when you love your pets as though they were family members, and how emotionally taxing it can be to receive such horrible news that they are sick. I am especially concerned because my boy is so young, he's only three! I want to do everything possible to ensure that he has a long, healthy, and happy life... whatever it takes.

Thanks so much!

Courtney and Kismet
 

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Hi Courtney and Mr. Handsome boy, Kismet. Welcome to the board, lots of people call it the best place that you never wanted to be. Everyone here is so nice, and very helpful, so keep visiting, and asking questions.

It sounds like you have great instincts, and I am glad that you are taking Kismet for a second opinion. In the meantime, you don't need your vets approval to start doing home blood glucose testing. It is really important to test before every shot to make sure it is safe to do so. Another thing often said here is that you wouldn't give insulin to your 2 legged child without making sure it was safe to do so, same goes for your sweet little boy, Kismet. You don't need an expensive glucometer though, so don't let anyone tell you that you need a pet meter such as the Alpha Trak.... It is very expensive, as are the test strips. If you have a Walmart near, the Relion brand meters are what a lot of people here use - the meters are inexpensive as are the test strips, which is important if you test a lot.

If you need help with home testing, please come back and reach out. You can also search YouTube, there are a bunch of really good demos of people testing their cats. I am a visual person, so it was really helpful for me to watch someone else doing the test first before I tried it (our vet didn't even talk to us about testing, I found out how important it was by coming here).

As for the food - all dry food is bad for diabetics, too many carbs. You don't need the vets approval to switch the food either. If you do a search for Binky's food list, you can choose any of the canned foods that are low in carbs. Many people here feed the Fancy Feast Classics (make sure it is the classics as the others are higher in carbs). I would caution you however to start blood glucose testing before switching foods. You were right when you said that sometimes the switch in food alone can help to regulate the BG level.

Lantus is a good insulin, but 3units to start out with is pretty high, especially based on only a couple of tests at the vets office. As you mentioned, the stress of just being There can cause spikes. I would urge you to go out and buy a glucometer as soon as you can, and start testing. You want to make sure it is safe to give that much insulin. You can also visit the Lantus boards for dosing advice.

Good luck, and again, welcome to the board. There is a ton of really good info here, and the collective knowledge is amazing. Feel free to ask any questions that you may have.

Kathie
 
Let us know what the second opinion says...Severe coughing "could" be a sign of heart problems, especially if an xray showed no signs of asthma. I could be wrong but this will bump up your thread for more eyes to see.

WELCOME to the best sight on the planet to help you help your kitty

jeanne

ETA: You dont need permission to home test YOUR kitty. Sure your Vet will do it for you and I bet she charges you plenty for it. Would you shoot insulin into your body without testing your BS first? I BET your Vet wouldnt either. ;) Many here have gone through the same with their Vets. There is wealth of information here...Please keep us updated.
j.
 
Hi Kathie and Jeanne,

Thank you both so much for the warm welcome and all of the information. I decided to heed your advice and went out to Walgreens and bought the True2Go test meter. I read up on the process and watched a few instructional videos. Kismet is such an angel, he is the most laid back, cooperative cat ever. I had to stick his ear 5 times before I finally got blood. I was afraid the release of the lancet might frighten him, so I tried sticking him manually. When I failed the first 4xs, I figured I'd give the release a go and voila! I got a perfect blood drop. Kis LOVES having his ears cleaned, and I gently massaged the inside of his ear with the cotton ball through the whole process and he purred and purred. He didn't even jump up to get away once I was finished.

So I took the first sample at 3 pm (roughly 6 hours after his morning injection) and the reading was 241. I have no idea what this means. My vet literally told me nothing about levels and when to test.

He gets fed 2x a day and gets his insulin shots immediately after he eats. We feed him just shy of 1/2 cup of food at 9 am and another 1/2 cup at 9 pm. I've read that target ranges are between 100-300. Is this right? When should I be testing him? Before he eats and gets the shot? When should I be concerned about his levels? When would I NOT want to give insulin? Also, should I try doing a Glucose curve? What is that process? Do I test every 2 hours?

Thank you all so much for all your help. I really appreciate it! I would be at a total loss if it weren't for this site!
 
Ahh, I posted prematurely. I found the FAQ section and it has answered a lot of my questions.

Also, Jeanne, on possible heart issues... thanks for suggesting this! I will definitely ask the specialist. My regular vet tested for heartworms and lungworms and he tested parasite free. They said his heart sounds fine, but it won't hurt to check it out. That said, I am fairly convinced the coughing has something to do with the diabetes. We are four days into insulin treatment, and he has only had one minor attack! This is a cat that was having between 3-4 a day on average, sometimes more. We stopped all asthma medications, too. As I mentioned before, we ordered his Flovent inhaler which has yet to arrive, but I really don't even think it is necessary at this point.
 
:!: Ok sorry for all of the posts, but I am a little confused about when to test. Do I test before he eats or after he eats? Someone please answer asap so I know what to do tonight! Thanks.
 
Hi Courtney,

Test..."shoot"...feed. You can also shoot while he's eating (after the BG test). If you test after Kismet eats, his BG will be food elevated, which will not tell you if it's safe to shoot his insulin. This is why we don't feed for at least 2-hours before testing and shot time. The pre-shot BG is the number you will use to make all of your dosing decisions. Since you are new to this "dance", if your pre-shot BG is under 200, please ask for advice on the boards before proceeding. A pre-shot under 200, that is 12-hours since his last shot, could mean that 3u is too high of a dose. We usually start dosing at 0.5u to 1.0...and take it from there.

Deb
 
pennydreadful said:
I decided to heed your advice and went out to Walgreens and bought the True2Go test meter.

Actually that meter, and any generic one with True or Tru in the name, gives inaccurate readings. They are inexpensive to buy but you know what they say: you get what you pay for. Please buy another meter to use. Avoid the Ffreestyle brand. That brand also gives inaccurate readings. Do you have a Wal Mart? Wal Mart's Relion brand of meters is good to use and inexpensive.

So I took the first sample at 3 pm (roughly 6 hours after his morning injection) and the reading was 241. I have no idea what this means. My vet literally told me nothing about levels and when to test.

One test does't tell much. 241 is definitely a diabetic number. Once you get more and more numbres from testing, you'll see how well your cat's diabetes is being manged. Most people here keep track of blood glucose numbers with an online spreadsheet that they can share with members of this board and even with their vet. Here are the instructions: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=50130


He gets fed 2x a day and gets his insulin shots immediately after he eats. We feed him just shy of 1/2 cup of food at 9 am and another 1/2 cup at 9 pm.

Dry food is the worst you can feed your diabetic cat, much like a Human diabetic eating potato chips, candy, and other high sugar foods. The right diet is important. Even the perscription dry food the vet may insist that you feed isn't good for your cat.

Low carb canned food or raw food is best. There are many commerical brands of food you can feed: Fancy Feast, Friskies, Wellness, etc. A raw diet is doable. There are commercial brands of frozen raw pet foods you can feed. Nature's Variety is one brand. Just take a couple frozen raw nuggets out to thaw in the fridge about a day and a half a head of time and feed when they are completely thawed. Nature's Variety even has a new frozen raw food that defrosts in just minutes at room temperature, called Raw Bites.

Here are the food charts that we use:

Binky's canned food charts
Pet Food Nutritional Values list
Hobo's Guide To Nutritional Values
Dr. Lynne's Wet Food list
List of low carb gluten free Fancy Feast

On Binky's charts, stick with foods that have a number 10 or less in the carbs colum. On the Pet Food Nutritional Values Chart and Hobo's Guide, look at the %kcal from carbs column and choose foods that have a number 10 or less.

BUT... because you are giving 3 units BID of insulin (Lantus) do not change the diet cold turkey because it will impact your cat's blood glucose levels and 3 units may become too much insulin resulting in hypoglycemia. I suggest learning how to test your cat's blood glucose levels first and then slowly change the diet.


I've read that target ranges are between 100-300. Is this right?

Normal non-diabetic levels are roughly 6o to 150 mg/dl. Ideally your diabetic cat should stay in this range with diet and insulin.

When should I be testing him? Before he eats and gets the shot?

Always always test before giving the insulin shot. Even if you are running late and must leave the house, take the few minutes to test the blood gluocse level before giving the insulin. It's better to be late for something than to blindly give insulin and end up with a hypoglycemic cat in a matter of hours.

Random blood glucose checks can be done whenever you have the time. A few times daily is ideal. You can do it in the evening if you can't do it during the day.

When should I be concerned about his levels? When would I NOT want to give insulin?

Do not give insulin if the blood glucose level is under 200 mg/dl.

Hypoglycemia is roughly around 60mg/dl and below or so starting around a few hours after the insulin has been given. A cat who may test well over 200 and given the usual amount of insulin can become hypoglycemic for some reason a few hours later. It just happens sometime.

Please print out the hypo treatment sheet and the list of supplies to keep on hand to use: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=2354 and http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=1122

Also, should I try doing a Glucose curve? What is that process? Do I test every 2 hours?

Do a curve when you have a day available, like a weekend. You test approxiately every 2 hours starting from just before the morning insulin shot to the evening insulin shot. If your cat won't cooperate, just get as many tests done as you can.

Have you read the Lantus stickies? There is a lot of info there on how Lantus works for cats: http://felinediabetes.com/FDMB/viewforum.php?f=9
 
Hi Courtney,

I would recommend testing, feeding and then give the shot....or you can give the shot while Kismet is eating. I don't normally have a problem with Zeus eating, but the only time I shot before he ate, he wouldn't eat. It was a little stressful begging him to eat - once the insulin is in, you can't get it back out. It can be very dangerous to give insulin on an empty stomach.

I am so happy that you had an easy time with testing. Congratulations!!! So, test before every shot, and then it is also a good idea to get a mid-cycle test too if possible. Lantus usually peaks somewhere between +5 and +7, this is the nadir (the lowest number of the cycle), but it can and does shift from day to day, and every cat is different. I have seen Zeus' nadir at +3, +5 and the other day it was +8 (the number of hours after the shot).

The normal BG range is somewhere between 60 and 120, but I have seen the range quoted as 40 to 120 or 50 to 120 as well. For newbies, without much data, the recommendation is to not give insulin if the pre-shot number is below 200. This number will chage as you accumulate more data, you will be able to see if it is safe to shoot at a lower number.

It would be a good idea to do a curve when you can. That is testing every 2 hours for an entire cycle while keeping everything the same - feedings, shot, treats, etc. Dosing advice (to increase, decrease or stay the same) is usually based on the nadir, so it would be helpful to have that data.

Also, have you noticed in people's signature, it refers to a spreadsheet? Mine has Zeus' SS. If you click on it, it will open up a sheet where we record BG tests, insulin given and anything else that we may want to note. This is really helpful to others when asking for dosing advice. I will look for the link/instructions for setting one up, and will send it to you.

One last thing, your meter. I don't have any experience with it, so I can't confirm, but I have seen the experts here discourage anyone from using a meter with True or Tru in the name, as it can be inaccurate with cats. You may want to do a search here to see what they have said, as I didn't pay that much attention since I wasn't using it.

Kathie
 
Oh good, looks like you were given the spreadsheet instructions while I was typing. If you have any trouble setting it up. Come back and post, someone will be able to walk you through it.

And, let's know if you have any other questions.
Good luck,
Kathie
 
Hi Courtney,

I think many, if not most, folks use Walmart's Relion meters for testing, due to their accuracy and cost effectiveness. You can get a Relion Confirm (pink or blue) for $15 (currently) at Walmart. I'm starting to sound like a Relion Confirm salesperson...but...I love this meter! I use the pink meter for Marilyn, and the blue for Clark. :-D I've never had any problems with either of mine, and rarely (almost never) get a bad reading, or an error code. On the rare occasion that I do get an error code, it's typically due to "user error"...either I didn't have enough of a blood drop...or I stuck the strip right smack into a large blood drop ('cause I didn't have my glasses on); as opposed to "sipping/sucking/wicking" from the edge of the blood drop. You also have to consider the ongoing cost of test strips, and this meter is one of the most cost effective (along with the Relion Micro). Both of these meters use the same test strips, and require just a tiny blood sample (0.3 micro-liter).

http://www.walmart.com/ip/RELION-CONFIRM-METER-BLUE/13863716#Q&A+Exchange

I hope this helps.

Deb
 
Deb, Squeem, Kathie --- thank you all so much! I really appreciate all of your guidance and your patience in answering all of my questions. I've read scores of information, I think I am a bit overwhelmed and need to slow down and focus on one thing at a time. My learning curve is high, though, and I have fact sheets stuck all over the house. I've made an emergency kit with honey and an oral syringe and am teaching my husband everything I learn.

I wish I hadn't already paid $60 for the meter and the strips. I'm a poor student and have dropped $1,500+ already on all the vet trips and medications. I'd read a note from Rebecca the webmaster about getting free kits, and underneath, she recommended the Walgreens one which is why I got it. I may have to wait awhile before I can get the relion. Fortunately, I also bought keto-diastix strips to check his urine. My vet never checked for ketones, so I figured that one something I should do asap. I've already had one successful catch (my first time!) using a spoon and he tested negative!

I tested his blood right before dinner (242) and as soon as I put down his food, he went to urinate. I got the reading within 5 minutes of doing the blood test and since the glucose results were analogous I think my meter is okay. I will purchase the relion as soon as I refresh my funds, though, just to be on the safe side.

I plan on staying home all day long to do a curve and will test him with the urine strips too, as a precaution.We go see the specialist on Tuesday, and I have to work on Monday so I figured it would be a good idea to bring in the results, even if they're slightly off. Thanks very much for the spreadsheet tip. I will definitely use it. I also got in touch with a friend who's sister is a vet tech at a clinic in my relative area which I plan on switching to. Her vet focuses on nutrition and also encourages holistic practices. This is the passionate and informative response she wrote to my friend when he told her my situation. I thought I'd share here as it may be helpful for others.

Just as a warning, she uses some strong language.
Ok, first off, do NOT give your animals Hills food. It is ABSURD that any clinic would prescribe a food of that quality to any animal, healthy or sick.

A diabetic cat needs good quality protein, and no carbs. Carbs are converted into sugar. Fiber is fine, and can be easily added into a diet if you grind up a small chunk of any vegetable (broccoli, carrots, etc.) Cats should be on a wet food diet as they typically are not big drinkers. This can be supported by the fact that in the wild they would be getting their daily water consumption through the prey they eat, as most animals are 75 - 98% water.
Back to why Hills Rx diets are an abomination to animal medicine. All ingredients in foods are listed in the order of highest quantity to lowest. Want to see the ingredients for Hills w/d? The very same diet that vet was recommending to a DIABETIC cat? Here...

Brewers Rice, Corn Gluten Meal, Chicken By-Product Meal, Powdered Cellulose, Chicken, Chicken Liver Flavor, Soybean Oil, Calcium Sulfate, Lactic Acid, Potassium Chloride, Choline Chloride, DL-Methionine, Vitamin E Supplement, vitamins (L-Ascorbyl-2-Polyphosphate (source of vitamin C), Vitamin E Supplement, Niacin, Thiamine Mononitrate, Vitamin A Supplement, Calcium Pantothenate, Riboflavin, Biotin, Vitamin B12 Supplement, Pyridoxine Hydrochloride, Folic Acid, Vitamin D3 Supplement), Iodized Salt, Taurine, minerals (Ferrous Sulfate, Zinc Oxide, Copper Sulfate, Manganous Oxide, Calcium Iodate, Sodium Selenite), L-Carnitine, preserved with Mixed Tocopherols and Citric Acid, Beta-Carotene, Rosemary Extract.

So the first ingredient is a waste product from rice factories. Not only is it shitty quality, its a grain, and it is the dominating ingredient in this food. Way to go there, doc. Second is corn gluten meal..... really?? A cat needs that? Humans don't even need that. Oh the third ingredient is a protein but wait, its a by-product meal. Then powdered cellulose to have some sorry excuse for fiber. THEN you have chicken, the FIFTH ingredient. But look further, soybean oil??? Why? What is the reason? There are much better quality oils with much more stable molecules and lower cholesterol to use for a source of fatty acids. Then the rest are your vitamins and minerals.
Hills sponsors and pays for a lot of ****. That's why they are invading clinics everywhere. Its one of those huge, out-of-control, brain washing industries that is out for money, and not the quality of their product. Why do they add all that filler crap like rice, corn meal, and soybean oil? Because its cheap, and it will make your pet feel full.
Your friend's best bet is to either go BARF diet (the biologically appropriate raw food diet), or getting a good quality, grain-free, canned food. They can always add ingredients to it to ensure that their kitty is getting all the necessary nutritional needs.

Always always always read the ingredients label.

Things to look for: Your meat being the FIRST ingredient of the product. A label claiming it to be grain-free, and an ingredient list that backs that up.

Things to stay away from: fruit (you might find this in a good quality canned food, but diabetic kitty doesn't need this), corn, corn meal, any starches, by-products, shitty oils like canola or soybean (good ones are cod liver, coconut, flax, salmon), smoked flavored (its carcinogenic), and "natural flavors" are also questionable.
Some good food companies I'm personally familiar with and that are grain-free are: Instinct (by Nature's Variety), EVO, Wellness, and Nature's Logic.

Instinct and Nature's Logic also carry raw food. Another good raw food company is Primal, but Primal adds veggies and things to their food so be careful to read the labels on that one to make sure there isn't any grains or fruits.

So that's my input. And you can let your friend know that my clinic's primary focus is on proper nutrition and client education. And I'm the one who manages all the food orders for the entire clinic ;) Just sayin' ;)
Also, is his/her cat fat? Weight loss will help with both diabetes and asthma. If hairballs are a problem, grind up some chia seeds and add it to the food.
I hope this helps!

Again, thank you all so very much. You've made this acclimation process a little less daunting for me, and ultimately for Kismet.
 
Courtney,

Love the vet correspondence. :lol:

Good job on the ketone testing. Not to overwhelm you with info, but for future reference, blood ketones are "real-time", whereas, urine ketone testing is approximately 2 to 4 hours after the fact. So your two tests told you: 1) Kismet's current blood glucose, and 2) Kismet's ketone status a few hours prior.

I think most folks test for urine ketones...but for me?...a blood ketone meter was the way to go. I can't follow kitties to the litter box and live to tell about it. My ex barn cats aren't as compliant as Kismet. However, if ketones do become an issue, you may want to invest in a meter (not very expensive), and blood ketone testing strips (expensive)...so hopefully you won't need to go that route.

You and Kismet are doing a great job!
 
Hi Deb,

Thanks for the encouragement and support! Yes, I have a very cooperative cat, luckily. I can't imagine doing any of this with any of my past feline friends. Kismet is a cool guy, I've never heard him hiss, EVER. Nothing much fazes him!

Also, thanks for letting me know about the ketones! I don't intend on following him to the litterbox with a spoon every time he needs to pee, LOL but I will do it tomorrow just so I can include it as supplementary data for the curve.

I've spent the past hour making links for my signature after all of you suggested it! I got a SS up and a little bio. I'm going to go through and read everyone else's now. This site is just the coolest place ever. <3
 
Nice job! I don't know where you're at in the cycle, but if you could sneak-in a +7, it could be interesting. He's in beautiful "blues" right now...but yesterday's +7 was a yucky 344. Also, do you have an AMPS for today? AMPS is your AM Pre-Shot number...or did you shoot without testing?

It's so cool that he's in the blues! Good kitty, good kitty! Now give him a big ol' smooch on the noggin.
 
I've sent Courtney and Kismet and AccuChek compact with plenty of test strips and the other goodies in the home test kit.

The Walgreens meter, at least the ones in the last year, have proven to be very reliable and accurate by independent test groups. It will be interesting to see how the two meters compare.

_Rebecca
 
Your friend's sister gave you great food advice in her email. W/D is one of the worst foods a diabetic cat can eat--and no, dry food does nothing to help a cat's teeth. Check out this vet's article on the subject: http://www.littlebigcat.com/health/does-dry-food-clean-the-teeth/.

There is no Hills food appropriate for ANY cat. That stuff is some of the worst cat food on the market, and it's more insidious than other bad cat foods because they spend a ton of money marketing their foods to vets, banking on the fact that most vets aren't well versed in feline nutrition. Return it to your vet for a refund, definitely.

The "classic" flavors of Fancy Feast are pretty popular here because they are easy to find and most cats love them. If you want to feed a food without byproducts, Wellness, Merricks, EVO, and Nature's Variety Instinct are some popular premium brands that have many low carb options. Check out the food charts above for the carb content. Here's a great article written by a vet that explains the connection between diabetes and diet: http://catinfo.org/?link=felinediabetes.

If you want to bring research to your vet that supports low carb, canned diets for diabetics so that you can show her it's not "just a fad," check out the diet/diabetes article links in this thread to give to your vet: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=79087.

You may also want to bring her a copy of the AAHA diabetes guidelines: http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf. Note on p. 218 where it states that home monitoring is ideal and should be encouraged. Also, 3u is too high a starting dose for any insulin so please do not start that high especially if you're feeding low carb canned food. The Lantus starting dose formula is .25u per kg of ideal weight, per the Lantus dosing protocol: http://felinediabetes.com/Roomp_Rand_2008 dosing_testing protocol.pdf. This works out to be usually about 1u for most cats. Also, I've attached an article that demonstrates the very high remission rates associated with Lantus and a low carb canned diet, and dose adjustments via home monitoring.
 

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Thank you everyone for the kind welcome! Thank you Julia and Bandit for all of the helpful links! Kismet is now on a canned food only diet of Purina DM and Fancy Feast Classics.

I also wanted to say a big thank you to Rebecca for the special kit she sent.
Click here for a special message from Kismet. :D
 
First Night OTJ!!! His BG was 47 at 7pm and then 49 at 9pm right before dinner. This is the first time I am holding an injection. So excited! I am going to test him again in 30 minutes and probably once more before bed. I haven't been testing him the past few days as per my vet's instructions. She advised me to test his urine with keto-disatix strips and for every two consecutive days of negative readings reduce his insulin half a unit. He has been drinking and urinating far, far less so I've only been able to get one reading and decided I needed to resume blood testing. So glad I did as his levels are so low. :shock: Really wasn't expecting this! He has been doing really, really great! Running around like a maniac and playing hard like he used to. This is the most active my boy has been in weeks!

Keep your fingers and paws crossed for us! I hope we see these levels tomorrow morning before breakfast.
 
Hi Courteney-
I responded to your other thread and have been wondering how you've been. I thought you may have been upset with what I said in the other post.

You are doing a great job! Kismet is already showing huge signs of improvement. Can you imagine what would have happened if you shot on a 47 or 49? The very same situation happened to my mother's cat. Her vet told her to give him 2 units of lantus and NOT test him! If she hadn't tested him she wouldn't have known he didn't need insulin and would have faced a serious hypo or death.

Testing Kismet's urine has nothing to do with the process of deciding when to lower a dose....your vet does not know how lantus works. I'd jump pver to the lantus board and read the stickies over there and post there for dosing advice. It sounds like the changes you've made in diet are kicking in making it more risky to shoot the wrong amount of insulin. My mom went through a 12 hour hypo with her cat - it's not fun....very scary and stressful.

Congrats on getting the spread sheet going. Good work.
 
Whoa Courteney! I just looked at his spread sheet!!! Shooting 2 units at this point seems very dangerous! His numbers have not been "diabetic numbers" in days. Why did you stop testing him over the last week? You are very lucky that he didn't have a hypo!!! nailbite_smile nailbite_smile nailbite_smile
I think you may have "broken" him....meaning there's a good chance that he may be off insulin soon.
Before shooting any more insulin I'd find out the lantus protocol for lowering the dose according to what his numbers are. I'm going cross post this thread on the lantus board.
 
Hi Traci,

I actually replied to your post a short while ago. I've been off the board for a few days because I've been so busy with work. My students turned in their first batch of papers so I had 40 5-7 pg essays to read and grade in addition to my own school work. But please rest assured, I'm not upset at all! Quite the opposite! I really, really appreciate your advice and all of the great advice I've received from people here on the board. I realize that all of you have a wealth of experience and deal with DM cats on a daily basis. My vet, as wonderful as she may be, does not. I am finding it's a balance of working with them and trying to monitor him myself.
Yes, I am really glad that I tested tonight, too. I've been testing pre-shots for the past few days just to err on the side of caution. It would've been awful if I shot him with levels that low. I just tested him an hour after eating and he is only at 56. I will try to get one more reading before I turn in for the night.

Thanks again for everything.

Courtney
 
Oh, okay! I wasn't planning on shooting at all if he was below 100. His numbers had been so high before and then I didn't test for a few days because the vet told me not to (stupid, I know!) I realize now how quickly things can change with a different diet. I am going to call the vet tomorrow and give her his numbers and see what she advises. I imagine we will want to adjust his dose way down if I shoot him at all.

Thanks again.
 
Hello.
Welcome to the best place you could ever find to help your sugarbaby.

I'm so glad to see you held off.
There will be some others coming as they are able to help advise you.

Those were some very nice numbers and low.
It takes experience and data before shooting that low.

So please keep checking back here for replies.
 
HI Rhiannon,

Thanks for the welcome and the concern! I just posted in the lantus forum (I finally found it d'oh). I will be checking in regularly for replies. I don't plan on shooting at all tonight and will test tomorrow and call the vet.

Thanks,

Courtney
 
Courtney:

I think when Traci and other were suggesting you post on the Lantus board, they were suggesting you post on the Lantus Tight Regulation board. The TR board is very active and there's usually someone around close to 24/7.

I had mentioned in one of your previous threads that urine glucose testing is unreliable. I suspect your vet suggested it because many people won't do blood glucose testing. With Kismet being in such good numbers, it is actually dangerous to use urine glucose testing. The strips do not register anything below a BG of 150 -- a BG of 20 reads the same as a BG of 145 and you can't keep Kismet safe with this kind of reading.

With Lantus, we do encourage shooting low (although not shooting in the 40s). You do not have sufficient data to shoot low number, though. For now, skipping tonight's shot was a good idea. To be honest, with the numbers you're seeing, not getting a pre-shot test and at LEAST one additional test during both the AM and PM cycle is potentially dangerous. If Kismet were my cat, I'd be nervous about shooting 2.0u. With numbers in the 40s, typically a cat's dose is reduced. The question is how many times has Kismet dropped below 40. I would probably want to drop his dose to 1.0u and monitor with more regularity.
 
Hi Sienne,

I just saw your other post tonight and replied to it a few hours ago. Someone else on the lantus thread also recommended shooting 1u tomorrow if he is over 200. This sounds very reasonable to me. He was in the 40s before dinner and now he is in the mid 50s. I will check him again in the morning and I will come here and see if anyone has any recommendations based on whatever his readings are. I have no idea how low his levels have been dropping, but thankfully he is okay and doesn't seem to be any worse for it. I will definitely be checking him more regularly, before every shot and then several times throughout the day my schedule providing. I realize how important it is, and now realize that I've not been monitoring him as closely as I should. I thought I could trust the vet's advice and then didn't check back here for a few days. I think from now on the board will be my go to for all advice diabetes and shooting!

Thanks very much for your insight and the concern.

Courtney
 
WOW!!! First day of OTJ trial!!!

That is exciting! It is good that you decided to test again and caught a low dose. Here is hoping you get some tunatini's in your future!
 
Hi Heather,

Thank you! I may be a bit premature in celebrating OTJ lol, Sienne and Marje have been coaching me over in the Lantus forum. His dose was apparently too high so we may not be in the clear yet as these numbers might be the result of depot action. I am keeping my paws crossed though. So far we have had all green numbers today and I am hoping it will stay that way! We are actually dipping now a few hours after breakfast. I wonder how low he will go!

I will buy a round of tunatinis for everyone if we really do get OTJ!
 
Okay... how about regulation?

I was excited that we finally got that far after 9 months :lol: With her being acro and delving into dry food at one point in time I was fearing that would never happen.
 
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