New to boards! Couple questions....

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Digitalvynil

Member Since 2013
Hey guys...lots of good information on here...here is my story...

My cat is getting older(roughly 13-15) years of age....he was recently diagnosed as having diabetes...the vet kept him approx 3 days to regulate him because he tested very high(400) when tested. He has no other ailments other than asthma which he receives a shot for every 3-4 months. The doctor had me giving him 5 units of Pro Zinc every 12 hours when he first got home approx. 2 weeks ago. After bringing him in..and them testing his blood...it was like in the 50's. He has had no signs of Hypo at all. My Vet told me to reduce the dosage to 4(the #4 line on the needle)...so I went ahead and just gave him less thinking that less would be better. So I have been giving him about 3 units for the past 3 days. I went ahead and took my own blood reading(which was not fun for either of us, but proud I was able to do it without throwing up)...and when I took it was at 48. My cat is fine and shows no sign of hypo at all. The frequency of injection is just down now to once in the morning.

She told me to take his reading 4 hours after I inject.

Should I revise something here...I dont want to kill my cat.

Does my vet not know what she is doing?

Please help!

PS. I was told not to alter his feeding or diet in any way. He has been receiving insulin now for a few weeks...and he eats what he wants whenever. I leave his Purina 1 urinary tract dry food out for him..and give him wet food once in the morning and again 8 hours later. Hope this helps!


Thanks

Justin
 
When did you get that 48? if it was around +5 hours after his insulin, a slight reduction in ProZinc dose actually may be prudent to keep him from becoming hypoglycemic.

We've got lots to read here and could easily overwhelm you with TMI all at once.

It seems like you're starting to get home testing under your belt, so before you venture into diet info and possible alterations, what questions do you have about home testing?

There are some Secondary Monitoring Tools in my signature links that are also helpful.

When you're ready to do some reading on feline nutrition, go to Cat Info
 
Hi BJM....

Thanks for responding so quickly. Yes...it has been approx. 5 hours since last injection. I feel like I am not sure who to listen to anymore...people on here or my Vet. I am sure she is knowledgeable....but I worry....

I am pretty damn sure we now need to lower the dosage substantially....his numbers shouldnt fall below 100...right?

Is it optimal to take the reading 4-5 hours after injection.

I cant check his blood everyday....and I just want to make sure the does I give him is not going to kill him. What if I have to leave to go somewhere and the cat is home alone....

That would not be good.

Thanks

Justin
 
If you are using a human glucometer, you don't want it below 50 mg/dL; if using an AlphaTrak, you don't want it below 80 mg/dL.

Which are you using?

If the AlphaTrak, reduce the dose by 0.25 to 0.5 units and yes, you may have to eyeball it because syringes don't mark 0.25, and some don't makr 0.5 units.

Have you got a hypo kit set up? Read here for more info on Hypos

For a basic veterinary overview of Feline Diabetes Management, read and maybe print for sharing the AAHA guidelines
 
BJM...

I am using a Walgreens True REsult...I think it is for humans...because my mother has diabetes...and she gave it to me to help with costs.

What should I do now....he is right in front of me..and looks good. Should I watch him for the next few hours?

When should I check his BG again?

Should I check it tonight? Tomorrow morning? Do I not have to give insulin at all if his numbers come within a certain range? I will ask my vet..but his numbers seem low...and I dont want to kill him.

I am ready to test his blood...and need to know what to do to keep my cat purring.

Thanks guys

Justin
 
Digitalvynil said:
...I am using a Walgreens True Result...I think it is for humans...because my mother has diabetes...and she gave it to me to help with costs.
Click to expand...

We've had some issues with this not representing high numbers very well; low numbers were OK, I think. (someone should chime in if that isn't true)

Digitalvynil said:
...What should I do now....he is right in front of me..and looks good. Should I watch him for the next few hours?
When should I check his BG again?
Click to expand...

When was the test? about 5 hours after the shot?
If that was the test right before the shot, you need to test asap. If it was about 5-7 hours after the shot, just watch him for signs of hypo.

Normally, we test before all shots, to make sure it is safe, and around the expected low point - nadir - between shots to make sure the glucose is not too low.

Digitalvynil said:
...Should I check it tonight? Tomorrow morning? Do I not have to give insulin at all if his numbers come within a certain range? I will ask my vet..but his numbers seem low...and I dont want to kill him. Justin
Click to expand...

Just starting out, we suggest you not give insulin if the pre-shot test is below 200 mg/dL.
 
BJM... I love you!

OK just got off the phone with the VET. Because the cat had a buttload of dry treats 5+ hours after injection...she said I didnt have to give honey and to just watch him for a bit to check for signs of hypo. She said to check BG in the AM before injection. If it is over 180...go to 2 units. If it is below...do not inject..and to call her.

Im sure he will be good....and she said all animals react differently to the effects of insulin...apparantely....he was hard to get his BG down initially...and they had to give quite a bit. So maybe it just built up.

I should have checked his BG this morning...but I am new and learning..and all mistakes were made on my own.

Thanks for all the help BJM. I think I will make a donation to this website now. What a great place.

Thanks so much

Justin
 
Hi Justin, Welcome to the FDMB, the best place you never expected to be. BJM has been giving you some great info.

Don't want to say too much and overload you right now but I did want to welcome you and let you know we have a wide range of experience with managing feline diabetes, 24/7 so we know a lot about the day to day management of this disease.

Let us know how else we can help.
 
A little infobit to remember - many cats are stressed at the vet and may have glucose elevations of 100-180 mg/dL above the normal for them.
 
Hello and welcome!

I am glad you reduced the dose, that was very high. We do need to work on his food though, does he have urinary tract issues which is why he is getting that food?

Also for future reference, dry treats aren't that great for bringing the blood sugar up.. They aren't absorbed evenly or fast enough in many cases. It's safer to give syrup or a high carb wet food

Wendy
 
If you're feeling somewhat comfortable with home testing, your next task is to do some reading on feline nutrition. Our favorite reference is Cat Info. You'll be particularly interested in the section on urinary tract health.

Generally, we aim for canned or raw food with no more than 10% of the calories from carbohydrates. Wet foods provide more water for the renal system, which may help reduce the risk of kidney or bladder stones. A cat eating a dry food diet does not drink enough water to compensate for the dry food.
 
Thanks guys...I will read up on the nutrition...I am just afraid of pulling his favorite food while I don't really know what is going on with his BG. Hopefully with some time an practice...I can get a grip on the right dosage for his insulin.


Baxter has had a urinary tract infection when younger...and her has been eating that urinary tract formula for like ever. I know he likes it....not sure if he would want to kill me if I took it away from him.

I also did not know that about the dry treats...I thought they were high in carbs. I will def. give him some of the things recommended.

I just figured any food will raise his BG.

Thanks for everything guys..

I will post his BG tomorrow...to hopefully get some more instructions from you. I have included my vet in this loop as well.

Justin
 
Many of us here feed freeze dried chicken, or liver treats and cats love them for the most part. They are zero carb.

Wet canned food should help with urinary tract issues too. However that reminds me that a UTI (any infection) can spike cortisol levels and cause high blood glucose and diabetes. Has he been checked for that recently?

Wendy
 
Dry treats do raise blood sugar for sure as they are high carb. My point was that to stop a cat dropping into hypo, you are better off with syrup or a high carb gravy food as they get absorbed faster and better. However hopefully now the dose is lowered you wont need them!
 
Digitalvynil said:
He has no other ailments other than asthma which he receives a shot for every 3-4 months.
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I assume you mean a steroid shot, in which case your cat could be a steroid-induced diabetic. It seems to me that diabetes often has a trigger -- an "offending" element, so to speak, be it a lifetime of high-carb food that the body can no longer handle (just like our own bodies become "less forgiving" as we age), or steroids, or something else. I personally think it's important to try to understand what is adversely affecting YOUR cat and try to address the underlying cause, if possible.

For example, your cat's diabetes could have been triggered by the steroid shots. Has your vet talked to you about the option of treating with inhaled meds rather than shots? In most cases, it's a much better option, especially in diabetics, as the inhaled meds don't typically impact BG values (meaning your cat might not need insulin shots). Google "Aerokat inhaler" and also check out http://www.fritzthebrave.com for great information about feline asthma. I have an asthmatic cat and use the Aerokat inhaler with Flovent. I personally wouldn't use steroid shots or pills unless absolutely necessary.

And it's important to recognize that your cat's insulin needs might reduce as the steroid wears off. Thus it's even more important that you test his BG at home, so you can catch any changes. My Charlie was steroid-induced and each time he went on steroids, his BG spiked; as he weaned off, I had to lower his insulin dose until he no longer needed shots.

Low carb food is a good idea for all cats, not just diabetics. And for most cats, the carb load makes a big difference in BG numbers. Chip was super carb sensitive and even a few bites of medium or high carb food would spike him. Charlie's nemesis, on the other hand, was steroids -- the carb content of food never affected him much. So although a low-carb food might make a great difference in the BG numbers, if the catalyst for your cat was steroids, it might not. Regardless, I fed Charlie low-carb just the same.

Digitalvynil said:
The doctor had me giving him 5 units of Pro Zinc every 12 hours when he first got home approx. 2 weeks ago. ... The frequency of injection is just down now to once in the morning.
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I'm sure you've already been told this, but that's an extremely high starting dose, especially for a cat who is potentially steroid-induced. I know you've reduced the dose, and perhaps the higher carb food is keeping him safe, but I'd do serious BG monitoring. Even though a cat isn't showing clinical "signs" of hypoglycemia, that doesn't mean the cat isn't hypoglycemic. I've seen hypoglycemic seizures and I don't care to experience that again. Better too high for a day than too low for a moment. Also (and I'm sure you've read or been told this, too), cats metabolize insulin twice as fast as humans, so they typically do best on two shots a day (i.e., take your current dose and split it in half).

Digitalvynil said:
I was told not to alter his feeding or diet in any way. He has been receiving insulin now for a few weeks...and he eats what he wants whenever. I leave his Purina 1 urinary tract dry food out for him..and give him wet food once in the morning and again 8 hours later.
Click to expand...
Well, until you lower that insulin dose -- I tend to agree. At your current dose, your cat might need the higher carb to keep him safe, and he might need free access to eat if he feels his BG going low (cats often "know"). There's a lot of discussion about food around here, and how much to feed, and when, etc. Some vets advise strictly feeding only twice a day. Others recommend small meals more frequently. It made sense to me that smaller amounts more frequently were less likely to overwhelm an already impaired pancreas. I tinkered around with the food and collected data and figured out what worked best -- both of my diabetics free-fed on low-carb canned food and we did well that way. However, it is probably better that a cat doesn't eat within a few hours before their shot because the insulin is waning in effectiveness so the food is hitting a system that's more vulnerable to the impact. In general, low-carb canned food is going to serve your cat well, but again, you need to carefully monitor BG and be prepared to lower the insulin dose accordingly if you move away from the higher-carb dry food.
 
Any food changes should be done gradually to avoid upsetting the GI tract. Fast food changes may result in diarrhea and/or vomiting, and sometimes, inappetance/not eating.

Thus, if you decide to ditch the dry, maybe start by offering a canned food such as Fancy Feast Classics at the same time. Gradually drop a teaspoon or two of the dry each meal. A little bit of hunger is OK as it may prompt trying the new food. If he won't eat, increase the dry back a bit. This may go like hotcakes in some cats or like dragging a resistant mule in others. Do what works for him, and monitor his glucose levels to observe the effect.

Note - if you get a glucose level below 50 mg/dL, treat it like a hypoglycemic episode by following these instructions If that is a pre-shot glucose level, it is unsafe to give insulin.

Edited to add: the hypoglycemic treatment is only if the cat is on insulin. Otherwise, it is a perfectly non-diabetic number!
 
Dry food = prone to dehydration
diabetes = sugar rich urine = prone to bacterial infections in urinary tract.
diabetes = excess urination = dehydration = more prone to urinary tract issues
 
OK...so I realized that my strips were expired. I went down to walgreens...and made sure to get the right strips.

So...the cat ate some food at about 10am. about 2 hours later at noon I checked his blood...and it was 52. I have not given him any injection since yesterday morning. WTF!

What is going on.

Should I start rubbing honey on his lips now? The vet says to recheck tomorrow morning. The cat is just resting now...and looks has happy as a clam.

I'm not really happy right now.

Any insight?

Thanks guys

Justin
 
If no insulin since yesterday morning, 6/20, no chance of hypo in your cat. You do not need to feed any simple sugars, like honey or karo.

Im sure he will be good....and she said all animals react differently to the effects of insulin...apparantely....he was hard to get his BG down initially...and they had to give quite a bit. So maybe it just built up.
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There is no depot effect with Prozinc insulin. It is what we refer to as an "in and out" or intermediate duration insulin. It lasts usually between 10-14 hours in most cats.

I would take another test this evening, before your regularly scheduled shot time and post here if the number is <200.
 
thanks Deb!

His shot is scheduled for tomorrow morning...so I guess I will just check it then.

Will report back tomorrow.

Thanks so much

Justin
 
Normal glucose levels in a non-diabetic cat may run from roughly 50 - 130 mg/dL.

The renal threshold - the glucose level which starts spilling into urine - may be from 180 to 280 mg/dL, depending on the reference used. When you exceed the renal threshold, glucose may be damaging internal organs. The cat's renal health may affect the threshold value.

Ketones are produce as a byproduct of fat breakdown for calories (ie not enough insulin, or starvation). Too many ketones in a cat with diabetes may indicate diabetic ketoacidosis (DKA), a potentially fatal, expensive to treat, complication of diabetes. You can home monitor for ketones in the urine (inexpensive test strips) or blood (expensive test strips and special meters). Those who have had a cat with DKA may opt for the more expensive meter.

There are tips on urine monitoring and some other supplemental observations in my signature link Secondary Monitoring Tools.
 
You may be wondering how the heck you'll keep track of all of this.

And guess what? We have an online spreadsheet/chart you may use to note your pre-shot test values (AMPS = morning, PMPS = evening), how much insulin was given, and if you do any other glucose tests, you can note them in the column reflecting how many hours since the shot - +1 hour since shot, +2 hours since shot, and so on. There is a Notes column where you jot down anything unusual you observe, or if on a medication, or feeding strategy, etc.

The instructions are here
 
My cat is asthmatic too. An asthma attack and trip to emergency vet clinic is when they discovered the diabetes. This was not his first asthma attack either.

The first one, he was given steroid injections while in the hospital, then oral steroids when I took him home. So, for me, it's possible that the steroids "helped" the diabetes along, but I also fed him that awful dry food. So, I had 2 culprits.

Inhaled steroids are much better in 2 ways. First, it's not injected, and second, he gets his daily treatment without expensive trips to the vet. You can order the Flovent (inhaled steroid) at Canadian drugstores online. I get mine from Universal Drugstore and they are MUCH cheaper than going to WalMart...I paid over $150.00 for the Flovent because there is no generic equivalent.

Poe is also on a rescue inhaler, albuterol, which again, you can purchase from Universal Drugstore and AGAIN is MUCH cheaper, even though albuterol does have generic equivalents.

There is a feline asthma yahoo group, which I got some info from, but I have trouble following yahoo groups. I did manage to save a document on making your own in home oxygen tank. I am seriously thinking of doing that. It's not hard, and is very inexpensive...only snag might be getting an oxygen tank for personal use, but talk to your vet, it might be possible.

Talk to your vet about the inhaled steroids. It gives you a much better handle on that condition also since you are not dependent on shots once every 3-4 months and you will have what you need in case you see the symptoms of a pending attack.
 
THANKS GUYS!!!

Took Baxter's readings this morning.....I haven't given him an injection in 48 hours...and his readings were only 72 this morning. What is going on here. Is he not diabetic?

Any insight?

Thanks again

Justin
 
Thoughts

1.Steroid induced diabetes has been resolved with a short course of insulin.
2. High numbers were due to vet stress
3.Your cat may be in remission for now. Any furthur steroid shots may bring the diabetes back
4. Many cats drop low overnight. Test in AM and PM to verify the numbers are low at both times.
5. Your cat was never diabetic to begin with. High BG numbers were caused by something else. Infection, stress, etc.
6. The possible hypoglycemic episode on 6/20 kickstarted his pancreas.It happens sometimes.

If the testing AM and PM, shows numbers between 40-130 every day for 14 days, your cat would be considered to be in remission. Since many cats BG's drop lower overnight, have higher BG's during the day, you really should be testing twice a day.
 
Wow, this steroid thing has me freaked out a bit. He has been getting steroid injections for his asthma for almost his whole adult life...and no one has ever mentioned that it may cause side effects like Diabetes. I will get that flovent and Aerokat thing...it looks like it will pay for itself.....he only has injections quarterly.

This is all so crazy.

You guys are so cool.

Not sure why my vet didnt say anything about the asthma/prednisone ....do they not know about this?

Justin
 
When Poe had the first asthma attack, they did tell me that prolonged use of steroids did contribute to diabetes. The oral steroid he was on for only for the 2 week period, then no steroids until his most recent.

For me, I think it was the combination of oral steroids AND dry food, but for you, seeing how your kitty has been steadily getting these shots for a while, it might be a bigger factor than the diet.

Since Poe had a history of asthma, that may have been why they ran additional blood tests and found the diabetes.
 
ok guys, its been a few days. My cats blood sugar as of 8:30 tonight is only 48....how is this possible. Should I give this cat some honey...he looks fine. There is no way I am giving him insulin...and will be calling my vet tomorrow. I haven't given my cat insulin in like 4 days.

What the hell is going on?


Justin
 
If your cat has not had any insulin, there is no need to give honey. Normal non-diabetic BG (blood glucose) numbers are 40-130.

You cat may have had a quick remission from the steroid induced diabetes.

With steroid use, we can sometimes see a very quick return to normal BG numbers, with only a few days or weeks of insulin use. Weird I know but ECID (every cat is different) and every case is different.
Deb & Wink said:
Thoughts

1.Steroid induced diabetes has been resolved with a short course of insulin.
2. High numbers were due to vet stress
3.Your cat may be in remission for now. Any furthur steroid shots may bring the diabetes back
4. Many cats drop low overnight. Test in AM and PM to verify the numbers are low at both times.
5. Your cat was never diabetic to begin with. High BG numbers were caused by something else. Infection, stress, etc.
6. The possible hypoglycemic episode on 6/20 kickstarted his pancreas.It happens sometimes.

If the testing AM and PM, shows numbers between 40-130 every day for 14 days, your cat would be considered to be in remission. Since many cats BG's drop lower overnight, have higher BG's during the day, you really should be testing twice a day.
Click to expand...

So keep testing him 2 times a day, and if in another 10 days, the numbers are in normal range of 40-130. We throw a party and give you tips for keeping him OTJ.
 
DEB & WINK....you are too awesome. Thanks for everything. I will test him tomorrow. I haven't been able to test him twice per day...because he really doesn't like getting his ear pricked. I will make an attempt though.

Thanks for everything.

Justin
 
You're welcome! And be sure to keep us updated every couple of days at least. We worry about our FDMB family members and want to know how things are going.
 
So far so good - we want 14 days of 50-130 before we consider him OTJ.

Meanwhile I would test once a day at least. And give frequent mini meals to help supplement his pancreas.

Keep us updated

Wendy
 
Got a PM from Justin - Baxter is OTJ!!!

Wendy

Thanks for checking up...you are so awesome.

He was hovering in the 50's every time I checked him...he is officially OTJ...and I haven;t checked him since. I guess I should still be checking him.....it was quite hard for me to do it though.

Do you have to still check a cat that is not even diabetic?

Thanks

Justin
Click to expand...

My answer is yes because remission is so fragile and can easily be broken

Tips to stay OTJ

1. never feed dry - not even treats. If you change wet food types, be 100% sure the new food is also low carb. Don't feed if you aren't sure!
2. Weigh every 2 weeks to 1 month to watch for weight changes
3. Measure blood once a week, indefinitely. You want to catch a relapse quickly.
4. No steroids or oral meds with sugar - remind your vet whenever giving you any medication. Always double check.
5. Monitor food intake, peeing and drinking
6. Regular vet checks for infection such as dental , ear or UTI. And get them treated quick!

If he does fall out of remission you need to be more aggressive and resolve issues/ back on insulin as soon as possible as the window for a second remission is tight if any. Come onto the health board asap.


Good luck!
 
Justin, congratulations on getting Baxter OTJ!

Even though he does not need insulin right now, he is still a diabetic cat. He is simply diet controlled for now.

I test my diet controlled foster cat Wink, once a week. That is so I can catch any issues before they become bigger problems.

I encourage you to continue testing. Once a week, once every two weeks, once a month. You decide. The more frequently you test, the earlier you will catch any rises in the BG levels and can start up treatment again.
 
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