New to Forum...treated diabetic cat for 7 yrs

Status
Not open for further replies.
D

dm2kittys

Member Since 2013
Hi everyone
Just looking for advice for my 16 1/2 yr old Angel...she was diagnosed at age 9 and we have treated her with Lantus since then. She has been difficult to control but we have done home testing, fructosamine monitoring, regular bloodwork, and she has been on as high as 3 u per day, but usually tapers off to 1.0 to 1.5 u per day. She had good labs and was eating well until the past 6 months. She had several UTI's--treated with Orbax, and developed diarrhea...IBS and pancreatitis per her vet (who is very supportive). We have tried steroids, cerenia, and I changed her food from RD to DM to low carb fancy feast, pro plan, wellness and nature's variety (she was eating a mix of this very well up to the last few days). She has only about 25% formed stools, and blood sugars are running 400-500. She only weighs about 5 lbs. And today she is wobbly again and having difficulty walking. The vet seems to think that she has developed complications due to age and diabetes... and they are not sure what else can be done. I guess I just want to to the best for her and maintain a quality of life. Up until the past few days she was walking slowly but okay, using the litterbox with occasional diarrhea outside of the box, eating well, and snuggling/keeping her usual daily routine. I will check her blood sugars to be sure she is getting right insulin dose due to decreased food intake. I have given her syringes of food shakes yesterday and today. She didn't even eat her tuna! She is drinking a lot though. I told her vet I will know when it's time. Tx, Angel's mom
 
Hi and welcome to the group!

A few questions for you -

1) are you testing her glucose numbers at home or just at the vet's office?
2) how are you determining when to change the insulin dose and how much do you change it each time?
3) how often are you giving insulin? how many times a day and how many hours apart?
4) do you have a record of the insulin amount you are giving and the glucose numbers?
5) what foods are you currently feeding?

There are three key factors to managing diabetes: food/nutrition, home testing and insulin

1) Feline Nutrition: Now, as far as diet - definitely dump the dry food (if you are feeding any) and if the vet recommends purchasing prescription food like DM just say "no thank you". ALL cats, and especially those with diabetes, do best on a species appropriate diet that is high in protein and low in carbs. Dry food DOES NOT fit that bill and DM food, even canned, just really isn't that great as far as quality and is higher in carb content than we would like to feed. Most here on FDMB feed low carb/high protein canned, raw bought from a pet store or they make there own.

Here is a link to a site by a vet "Dr. Lisa DVM" ... who also posts on this board from time to time ... http://www.catinfo.org

If you look on the right side of her site, she has a food comparison chart to help you figure out what food you want to get based on the carb %.

You want to keep the carb % below 10% and around 7% is great. (Personally, I stay between 0-6% carbs.)

While on her site, you can read about in-depth info. on nutrition and how to make raw food, etc.

Here is another link that will give more information about food/nutrition

Nutrition/food info

The good thing with feeding your diabetic cat this way, is that it is ALSO good for any non-diabetic cat too. All your cats can safely eat the same food without worry and it may save you some costs and headaches of having to do separate feedings and keeping track of what they are eating.


2. Home testing: It is impossible to convey the value of testing your cat's BG (blood glucose) level at home. Some vets will "suggest" this, but most won't even mention it. They will send you home with insulin and an amount to shoot and maybe some instructions about hypoglycemia (blood sugar dropping to a dangerously low level).

Well, the thing is, human diabetics don't EVER give themselves insulin without checking there BG to make sure it is safe to do so, so why shouldn't it be the same for our kitties. Here on FDMB it is. You will notice that the vast majority of people here test their cat's BG at least 2x/day (before giving each shot to make sure the level is safe enough) and periodically at other times to see how the cat is responding to the current dose. We use a human glucometer, test strips and lancets - which are all very readily available and easy to use.

Our kitties get lots of love and treats for "putting up" with this and most of them actually come out to be tested on their own 'cause they want those treats . Here is a collection of great links that "Carolyn and Spot" pulled together about hometesting. See what you think ... it truly is the best way to not only keep Your cat safe but also really get a handle on this disease and help him to live a healthy life with FD (feline diabetes).

Home testing Links

3. Insulin: As you are already using Lantus, which is an excellent insulin, I don't need to discuss this area.

However, one caveat and again this shows how these three things are inter-related:

If you are feeding dry food or even a high carb food, BEFORE removing these foods, please make sure of your insulin dose as it will most likely need to be reduced, so as to avoid a possible hypoglycemic situation due to the removal of the dry/high carb foods that will lower the BG’s and reduce the amount of insulin required. Again, another reason why home testing is important.

You also mentioned that she is having trouble walking. That could be diabetic neuropathy. The way to treat this is using insulin AND using Methylcobalamin B12. It needs to be this type of B12. You can purchase the cat brand zobaline or buy a human brand. The key is you don't want it to have added sugar or xylitol.

Here is a link for zobaline - http://www.ilifelink.com/zobaline-for_d ... blets.html

And here is the human form I used - http://www.vitacost.com/vitacost-vitami ... 0-capsules

It is easy to use:

Empty one capsule or melt 1 tablet in water
add to wet food, mix and serve

3-5 mg once a day is fine to give - what the body doesn't absorb, it will pee out.
 
1) are you testing her glucose numbers at home or just at the vet's office?
2) how are you determining when to change the insulin dose and how much do you change it each time?
3) how often are you giving insulin? how many times a day and how many hours apart?
4) do you have a record of the insulin amount you are giving and the glucose numbers?
5) what foods are you currently feeding?

We do home testing and Angel gets insulin twice a day 12 hrs apart. Have been checking evening blood sugar prior to insulin for maintenance comparison...and have tried to maintain consistent dosing after reviewing the info on the forum--generally dose is 1.5 in the morning and 1.0 at night. It has seemed she eventually goes too low with the occasional hypoglycemic episode if 1.5 units twice a day is maintained too long, so we have switched back and forth for a while. I keep a daily list of food eaten--usually by Tablespoon since she eats small meals throughout the day of a mix of wellness, nature's variety, fancy feast, and proplan canned--all from the under 10% list. I also keep a list of glucose and insulin. I usually change doses by .5 increments, but have switched by .25 when she starts to get too low. I guess the biggest concerns are the IBS symptoms and the not eating...only syringes today. She has had one b12 injection and I could do more at home.
 
Due you test for ketones?

Wobbly, difficulty walking and not eating have me concerned. Any chance of getting her to the vet? I'm wondering if electrolytes are off, in particular potassium loss from the soft stool. Also check for dehydration.

Not eating her tuna? I'm guessing your kitty is like mine and that's a pretty huge deal.

Is 5 pounds her normal weight or has she been losing weight recently?
 
One problem I see is that you give a different dose AM and PM. With lantus, it is best to be consistent and not give different amounts AM/PM.

Have you visited the Lantus forum and read the starred/sticky information there?

Here is an excerpt from that: viewtopic.php?f=9&t=1581

Many Lantus and Levemir users in this forum have been successful following a somewhat modified version of this Tight Regulation Protocol for the last few years. These "general" guidelines are based on anecdotal evidence and personal experiences of laypersons frequenting the forum.

"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.


Increasing the dose:

Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.

After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.


Reducing the dose:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

If an attempted reduction fails, go right back up to the last good dose.

Try to go from 0.25u to 0.1u before stopping insulin completely.


Random Notes:

Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.

A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.

Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.


viewtopic.php?f=9&t=150


Have you ever wondered why, when you are giving the same amount of insulin every time, the response is different in each cycle? Sometimes the numbers go up for the whole cycle, sometimes they go down, sometimes they stay flat, and sometimes they actually “curve.” The answer often lies in the depot. Did you skip a shot or give a partial shot at some time in the past few days? That can result in higher numbers for several days as the depot replenishes some of its lost stores. Did you increase the dose? This can result in a change in the size of the depot and can lead to a temporary adjustment in the amount of insulin available for use. Did you decrease the dose recently? A dose reduction will usually result in a need for less stored insulin. The excess may be released into the bloodstream faster than usual, especially if several dose reductions are done back-to-back.
 
Some possibilities to check with your vet:

The various antibiotics may have thrown off the gut bacteria which help digest food; ask your vet if Forti Flora might be helpful with this. It is available online for less than most vets sell it.

A somewhat common co-ocurring condition is inflammatory bowel disease (IBD). It can provoke serious diarrhea which may alter the biochemical balance in the cat, with difficulty standing and walking, plus weight loss. Vets may try metronidazole or steroids to treat this. If steroids are needed, you adjust the required insulin around that.

When the pancreas is inflammed, it may reduce the amount of digestive enzymes it produces, this is call exocrine pancreatic insufficiency (EPI). You get grayish pudding poo and lots of it. Over the counter or prescription digestive enzymes may help with this.

If the diabetes control hasn't been enough, fat may breakdown. This may overwhelm the liver and cause hepatic lipidosis. Look for signs of yellowing in the whites of the eyes and in the skin. THis condition totally disrupts the digestive system and subsequent metabolism.
 
Thanks for all of the good advice...I had wondered about the Fortiflora. Her blood sugars registered HI so gave her 1.5u. She threw up a runny mess--from the syringes. Will try the cerenia with the next one to help with nausea. My vet and I have talked about non invasive interventions so will talk to her tomorrow a.m. My vet says she is like a little old lady--she is the sweetest kitty. She had pancreatitis about 2 months ago and we treated with hospitalization. She recovered well--was eating great but still had the IBD symptoms. She has maintained 5 lbs for about 2 months but that is low for her. I really am willing to try anything--her brother Tiger lived until 20 1/2 with kidney issues so we have lots of experience.
 
Can you do a spreadsheet for us and get some more tests in.. I want to see how the lantus is working.. Especially how low she is going when the insulin reaches its peak.

Do you have any other tests besides preshot you could share? I would like to see a few days worth of the following tests... preshots, mid cycle (5-7hours after shot) and before bed. Can you do that for us? It will tell us a lot of what's going on...


Setting up a sheet..http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
 
Status
Not open for further replies.
Back
Top