New to diabetes...looking for some answers

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pixiesmom

Member Since 2013
Just came back from the vets with my 10year old cat. Diagnosis...diabetes.
His white count was also extremely high, not sure why. They are going to redo the smear.
Anyway, my vet discussed giving Lantus Glargine.
Also discussed buying cheaper from online Canadian pharmacies which I need to look into as well.
Looking through the boards I see that people are giving pen like injections.
I didn't know this was an option as all my vet discussed was the regular needle injections in the neck area.
My concern is my cat is very sweet until you start poking around at him.
What are my options?
Hopefully someone can point me in the right direction.
Feeling very lost right now.
 
Looking through the boards I see that people are giving pen like injections.

People buy the pens because it is more economical to buy Lantus that way. But they don't inject straight from the pen. They use insulin syringes to draw the Lantus out of the pen and then shoot using the syringe. Pen injections don't offer the accuracy of a syringe, especially with doses measured in .25u increments.
 
If you have a kitty that's food motivated, giving an insulin injection when the cat's head is in his food bowl works well for most cats.

If you are planning on home testing, which I would strongly recommend, every time you test, no matter whether it's a successful test or not, reward your kitty with a treat. Many of us use freeze dried chicken or jerky-style treats. (Just make sure that you're not using jerky treats from China. Wellness makes a jerky treat that my guys love.)
 
Increased white count may be infection. If so, and if the infection is bacterial, an antibiotic may help.

Infection also raises glucose levels, so treatment may lower them.
 
A low carb canned food diet can also lower BG (Blood Glucose) levels. A lot of us feed the Fancy Feast classic pates, Friskies pates, or Wellness foods.

We use this food chart, and look for foods with <10% carbs.

If your cat is diabetic, has an infection (high white cell count) and appetite is less than normal, then ketone testing the urine would be a very good idea to prevent DKA, diabetic ketoacidosis. You can buy ketone urine test strips at your local pharmacy. Tips to catch urine. urine testing
 
I have no idea how I am going to test him. He does not like to be touched. Well, he is sweet when you are
petting him and is a good cat until you start poking at him, or try to groom him....he gets nasty.
But I will try. Can I use a human tester? Also, how do you test? From where?
My vet led me to believe that I would be bringing him in every 4 days to test until he was regulated.
He said I wouldn't need to test at home. But I have a diabetic father and husband and really am no stranger to diabetes.
Just strange to the feline version.
I actually have 4 pens in my fridge of Lantus that my husband no loner uses. I am worried that the vet is ok with him not getting any insulin until Monday.
(Office was out, I am way out in the country, 4th of July weekend, etc...)
I didn't realize at the time that the human Lantus was what he would be taking and now I can just kick myself.
I wish I knew what to do or what to give....I hope he will be ok.
Also the vet is redoing the blood smear to recheck his white count. He said something about it not being a bacterial infection and ketones being ok.
Why canned food as opposed to dry? I plan on switching to a grain fee food. vet said dry was fine. To feed 1/2 cup in am with insulin and 1/2 cup in evening with insulin.
Thanks for the responses...it helps knowing there is help out there.
 
Can I use a human tester? Also, how do you test? From where?

Yes a human glucometer is what most of us use. Test strip cost can be a factor. If you can use one of your husbands meters, that would save you some money. We have found that meters with True in the name and the Freestyle with the butterfly strips do not work well in cats at the higher numbers. They give false low readings. Many of us in the US use the Walmart Relion line of meters for their inexpensive test strip price.

Testing tips and videos are here: testing tips

How to make your cat more accepting of the process ear testing psychology

Read these two documents over, then ask questions. ;-)

If you can learn to home test, it can save you a lot of money in vet bills.

Here is a new member shopping list of supplies you should have on hand. You might have a lot of these already.

shopping list
 
Why canned food as opposed to dry?

1. Diabetic cats, while unregulated, will be peeing a lot. This can lead to dehydration which is not good. Wet food will provide more water.
2. Diabetic cats over the renal threshold, 230-280, excrete excess glucose in the urine. This sugar rich environment makes diabetic cats more prone to UTI's and kidney issues.
3. If your cat's BG (blood glucose) levels drop too low, the dry food takes too long to bring the numbers back up. Dry takes longer to digest. Wet or canned food works quicker.
4. Some cats, with a switch to low carb canned food (<10% carbs), never need insulin. The change in diet is enough to bring their BG numbers down.

I plan on switching to a grain free food. vet said dry was fine. To feed 1/2 cup in am with insulin and 1/2 cup in evening with insulin
Grain free food does not mean low carb. You want a low carb food with a low glycemic index to help keep those BG levels down.

My foster cat Wink was on grain free food at the advice of the vet. Then on Hill's w/d. Soon as I took him home, I started transitioning him to a low carb canned food diet. It did not take long to get him not only regulated, but in remission. This was after 4 and half months on the high carb food the vet advised and totally unregulated.

Vets differ in their opinions on dry vs wet for diabetic cats. You might want to read this vets take on Feline Diabetes and diet. Feline Diabetes Vet Dr. Lisa Pierson is a member of this message board.
 
I actually have 4 pens in my fridge of Lantus that my husband no loner uses. I am worried that the vet is ok with him not getting any insulin until Monday.
Yes, you will be using the Lantus human insulin. You will need to get insulin syringes to sue with the pens. The needle tips and the dial a dose feature do not work well with the small doses we need to give our tiny diabetic kitties.

You will want 3/10cc, 5/16" or 1/2" needle length, 29-31 gauge, 1/2 unit markings on the barrel of the syringe. Walmart Relion syringes are one option. Terumo is another with the 1/2 unit markings on the syringe barrel. B/D makes these also but they are prone to lots of hard to get out bubbles. It may not matter for a person, but those bubbles matter a lot for those tiny doses we give our kitties.

I would suggest you check the Lantus Solostar pens you have in your fridge to make sure they are still good. Not past expiration date, not cloudy, no particles in them. If they look alright, you should be able to use them just fine for your cat.

By the way, what is your name? I'm guessing your cat's name is Pixie.

If you could give us your country, state/province and city, there may be someone who lives close to you that could teach you to home test.

p.s. You are no longer lost, now that you have found this message board. ;-)
 
Reading a bit about the low-carb diet and seeing as Pixie is not starting Insulin until Monday, should I take advantage
of the next day or two and switch him to the low-carb diet now?
Today all he has had was tuna/chicken...no dry food at all.
He's a good eater and I shouldn't have a problem making the switch.
Is there any specific canned you recommend?
I am close to a feed store that carries the better brands.

Also, the insulin I have is fine. Will not expire until next year.

I think I'll be spending a lot of time doing some summer reading tomorrow.

Thank you again for the helpful links...
Lauri
(mom to 3 boys (humans) 17, 12 & 6)
(mom to 2 cats (Pixie-10) (Keegan-17) 2 Labs (Gertie-6) (Boo-6) a Blue & Gold Macaw (Lady -20) Guinea Pig (JJ-6)
and a various toads, frogs, caterpillars and bugs that make it through the front door with the help of my boys!
 
Yes, switching him to canned low carb before Monday is a great idea. It should lower his BG numbers quickly. It could mean the vet would prescribe a lower staring dose as well.
As far as which type of canned? The food chart Deb linked you to earlier is a great tool. Look for foods in the "% cal from carbs" with a number less than 10%. The lower the better, but you'll notice the lowest tend to be seafood flavors. Too much seafood isn't good. But there are plenty of poultry/beef flavors that are low.
I used fancy feast classics and friskees pates, like many people here do.
 
I am going to switch Pixie today over to Fancy Feast which shouldn't be hard.
He has been eating Keegan's FF (Tuna Feast Flaked) for a few weeks (along with his dry) and loves it.
My only question is how much to feed.....
A bit of history.....
He's a short stocky 1/2 manx cat....was about 18lbs. on average.
in May/June he dropped to 15lbs (at vets for sore paw)
now he is 13lbs.
He is used to eating whenever he wants.
The vet says to feed 1/2 cup of dry in am w/insulin and 1/2 cup in evening w/insulin. Limited treats.
What is the equivalent if I am feeding canned?

Also, what really concerns me is that as a kitten pixie had severe diarrhea issues. What finally worked was putting him on
Iams Weight Control/Hairball food. The high fiber content in that food keeps him from having loose stools.
Will eating all canned give him diarrhea?
 
Sudden food transitions can cause diarrhea. Gradual food transitions are less likely to do so.
Since you've been feeding both, GI upsets are less likely. You might change out 25% per day.

Adding some Forti Flora, or 1-2 teaspoons of plain yogurt with active cultures may help.
 
hello and welcome to the board! You are in the right place!

1. food - not every fancy feast is equal - you want the lower carb fancy feast classic pates or any on this list that are under 10% calories from carbs (column C):http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf . You can give about 3 cans a day for a cat his current weight based on him being regulated. While he isnt regulated you may need to feed more to keep his weight up - Weigh him every week or two (a human scale is fine - weigh yourself while holding him and subtract your weight without him) You can leave the food out so he grazes on it, or freeze it and let it defrost for later. No dry.

2. testing /insulin - you want to start testing asap to see what impact the food is changing and to keep him safe when you start the insulin. Here are testing tips https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

Wendy
 
Have him on the FF Savory Salmon Feast which is the lowest.
What is the issue with only feeding seafood?

Could you also point me to the link that does the formula to figure out how much insulin to give.
I am afraid my vet will want to start him out on too much.

He is 13lbs and his readings today were 299 and 323.
I am going to try to take it again now because I fed him after the 323 reading and I am curious what that did.
 
It's the mercury content.. Same issue as humans.

The formula is below but we usually start at 1unit even if the formula calls for more.


Using a weight based formula for determining a starting dose of Lantus or Levemir when following the Tight Regulation Protocol:
the formula is 0.25 unit per kg of the cat's ideal weight
 
If the cat is currently underweight, instead of at a healthy weight or obese, you use that value to calculate the initial dose.
 
Well, here is my Pixie update from the vets this morning.
Testing him over the weekend we had readings from 299-326
The vet was really happy with this and even happier to see that I was home testing. (Think he was quite impressed, actually)
He said at this point that we could keep doing the diet change (low carb now) for a few more days to see
what it does to his numbers or start him on Lantus.
I was more comfortable starting him on 1unit so we did.

Giving the shot will be a piece of cake. It's the testing that will still have me a bit nervous.

Can you tell me how long I should wait to do the curve?

I know I have seen so many links and info on this site and it is awesome, but I can't always find
what I was looking for. I would like the info on how to do the curve and read it. i know it is testing every 2hrs.

Thank you again for your help.

(Is there also a link how to add your signature at the bottom....think I may be a frequent flyer of these boards)
 
Signature info how to's

Would you please provide us with some more information and put this in your user control panel? It helps us to help you better. This will take about 5 minutes of your time.
Think of this as having some very useful information at our finger tips for those that are replying to your posts. One reason we like to see this information in your signature is because if there is ever an emergency situation like a possible hypoglycemic episode, we don’t have to ask a lot of questions like what meter you are using to give you the best advice. Doing this signature update is totally optional, but it does help us to help you better.
If you are willing to do this, would you please do those updates when you get a chance? Thanks.
Go to the upper left corner of your screen and click on the words, User Control Panel
On the next screen, a row of tabs is presented. Select the Profile tab
On the next screen, there are a number of choices along the left hand side. Select Edit Profile.
Go down to the location field and enter your country, state/province, and city if you are willing to share that info.
Click on submit to save this change.

Still in the User Control Panel, Profile tab, this time select Edit Signature from the left hand list of options.
A free form text box appears.
We like to see information like your name, your cats name age and sex, the diagnosis date for the diabetes like this (DX 4/30/13), what meter you are using for testing, what insulin you are using , what you are feeding (wet or dry, what brands/style of food), any complicating health issues your cat may have, any additional medications your cat is receiving. If you are using a pet specific meter like an Alphatrak or Ipet, please change the font size on that text from Normal to Large (using the drop down arrow list in the middle of the editing commands)

Click on submit to save this information. Now, this will appear at the end of every post you make. You can update the info when you need to.

There is an additional document you can create to provide even more information about your cat. This is also optional to create this google document and link it into your signature. The profile is in addition to the synopsis info in your signature. See this link on the how to's of profile creation. http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=79123
 
Can you tell me how long I should wait to do the curve?

I know I have seen so many links and info on this site and it is awesome, but I can't always find
what I was looking for. I would like the info on how to do the curve and read it. i know it is testing every 2hrs.

"General" Guidelines:
•Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
•Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
•Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.

From this topic in the ISG Lantus TR forum. Tight Regulation Protocol

How to do a curve - link from ISG TR Sticky New to the Group http://petdiabetes.wikia.com/wiki/Curve
 
So 4hrs. after Pixies 1 unit of Lantus he dropped from 326 to 254.
Is this about a normal decrease? I know I have to keep at this for 5-7 days and then adjust, but was
just wondering if this is about accurate or is every cat different?
I am sure his body need time to adjust as well.
He seems a little more alert and active where as before with his reading in the 400's he would just lay there.
Poor thing is breaking my heart I tell ya.
 
Lantus is a depot insulin, it takes a few days to build up in the cats system and before you really see the impact of the dose which is why you need to wait and see. That decrease sounds ok - nothing too drastic.
 
Still doing ok with the testing...it helps that he is "starving" and is more concerned with eating than worrying
about me poking at his ear.
I have given 1 unit yesterday am, pm and this am. His am BG before insulin was 281 so seems the Lantus is keeping
him steady so far.

Anyway, I have a food question and wanted to avoid making a new post.
Little backround....Pixie as a kitten had severe diarrhea. After $$hundreds$$ I found that all he needed was
a food change and found via online that a hairball formula would help.
So put him on IAMS Hairball and Weight Control. He has been on that for 10+years and no bowel problems.
(Once in awhile he munches on the dogs food...Nutri Source grain free lamb)
He is quite a pig and I am lucky to not have a picky eater.
Now I put him on FF Savory SAlmon Classic which he loves and his stool has been very soft. Not a drastic food change because for a few weeks
before his diagnosis he has been munching on mu other cats FF Tuna Feast Flaked here & there along with the IAMS.
Now he may need time to adjust, but I need to be proactive here in case I run into diarrhea from the FF.
Was it the fiber in the IAMS that kept him regular? It was only 6.5% fiber. Just checked the FF SAlmon and fiber is 1.5%.

Wondering if I should be ready to find a higher fiber food or if there is a way to add fiber if that is what would be causing the loose stool.
Of course it could be an adjustment and I will wait it out a bit.
Any thoughts appreciated....thanks
 
It might be worth trying to either give him canned pumpkin (not the pie filling) or adding metamucil to his food to increase the fibre if you are worried about diarrhea?

Any chance of that spreadsheet?

Wendy

Edited to remove "miralax" - that was a typo.
 
The miralax does not have fiber in it. It is an osmotic laxative that works to soften the stool by drawing water from other parts of the body. Miralax is good for constipation, not diarrhea.

The canned pumpkin works. I have added it to Wink's food when he does have diarrhea. About 1 teaspoon to start and increase to firm up the stools.

Diabetic cats are prone to infections, so sometimes we have to resort to metronidazole (Flagyl) to help with the diarrhea.
 
I know from personal experience that with Metamucil you need to make sure you drink enough
water with it.
I will try the pumpkin and keep it on hand if need be.
Should soft/mushy stools be ok and just treat should it be diarrhea?
 
When we changed our cats to all wet, he had loose stools for about 3 weeks in 3 out of 5 cats. They had all had the same dry Iams weight/hairball control that you used.

We changed over "cold turkey", though and that likely was the issue.

They all now have smaller, firm stools, as it cleared up on it's own.
 
Should soft/mushy stools be ok and just treat should it be diarrhea?
Depends upon how soft the stools are.

Thin pancake batter consistency?
Thick applesauce consistency?

Or watery and runny?

When watery and runny, I do a bit more pumpkin. When thin pancake batter consistency, I do a bit less pumpkin. When thick applesauce consistency, I take a wait and see approach.

I freeze the pumpkin in an ice cube tray, pop out and store in a Ziploc for later use as needed. They thaw out quickly.
 
Sometimes providing some FortiFlora or 1-2 teaspoons of yogurt with active cultures can help with GI upsets due to food transitions.

If the pooh is 1) large, 2) grayish, and 3) really foul smelling, you might check with your vet about exocrine pancreatic insufficiency. This (EPI) happens when the pancreas doesn't produce enough of the digestive enzymes needed to properly digest food.
 
My neighbors cat has Pancreatic Insufficiency....I actually diagnosed him before her vet and saved my friend from
putting him down. he was a sick little guy. He was only a year old and the vet never even suspected it...
...anyway,
with Pixie poop is still formed, just very soft. Hopefully it will just work itself out.
Taking the wait and see approach for now.
Think we are doing well with the testing and insulin for now.
Did have to leave my son's ball game to come home and take care of Pixie, though.

What do you all do when you go on vacation? Or don't you go?
I have a friend who will shoot, but not sure she will be able to test.
 
Some take the cat with them.
Some board the cat with a vet or kennel.
Some hire a pet-sitter.

I seldom went out of town when I had Spitzer although I had a friend who helped shoot nights I had rehearsals (Columbus Symphony Chorus). He wasn't a numbers person & one night, new syringes confused him. He gave Spitzer 10 units instead of 1 unit, requiring 2 days of hospitalization for the overdose.
 
Hi there,

I'm new here too...couple of weeks...just saw you used to feed the same Iams dry food I did. We switched cold turkey to the Friskies Classic Pates and noticed a good change in her stools. But that isn't why I'm writing. I wanted to give you a heads up that we did notice Lucy hacking up hairballs. She has never done that before being on the Iams so this was new to us. We did get some advice on here to either A. put some petroleum jelly on her paw or B. give them some coconut oil. You may notice with your food switch, some hairball issues. If not, then great. Just wanted to give you a heads up! ECID, every cat is different!

Welcome.

Becky
 
Ok...another poop question.
Since the switch to FF Savory Salmon also has had some Ocean whitefish mixed in Pixies poop is not
only soft, but ridiculously smelly. Is the food change to blame for the smelly poop?
He has had a couple firm movements, but mostly soft and formed, last night a bit like 1/2 formed, 1/2 applesauce.
It is beige in color (not grey)
I am hoping that the pumpkin will help which I plan to go get and start this evening.

Concerned about EPI, will he still exhibit EPI symptoms even with the pumpkin or will the pumpkin mask it?
He has always acted as if he was starving so that's not a good indicator and he has always had a flaky coat. He's not a very efficient groomer.

Wondering how long to give it to work itself out before I get a blood test for EPI.
 
Sudden food changes often disrupt the internal microbes.

Have you tried Forti Flora yet? It adds in some beneficial microbes in a tasty (for most cats) animal digest (smells like boullion).
 
I am coming up on vacation and I have a catsitter who will come twice a day to inject but not test. I will probably lower the dose a bit for those injections. The experts on this Board have offered to help me figure out how far to lower it in the few days leading up to my departure.
 
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