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Terrelle

Terrelle

Member Since 2015
Hi Guys, I'm new around here and it's been a rough week. My baby Terry who is 12 yrs old had enucleation surgery was diagnosed with type 1 diabetes. Apparently this is why her lens ruptured. Terry is finally home after a 4 day vet stay but now I have to adjust to giving her insulin, antibiotics and pain medication along with closely monitoring her glucose. At the moment her levels are about 11-14 in the mornings but fine in the evenings and she is getting 1 iu 2x a day. Any suggestions for a newbie?

I am going on vacation next week and am afraid to leave her but I have a friend who is a vet assistant who has agreed to come and feed and take care of her. Do you guys think I should cancel my trip?
 
There you are!

What kind of insulin are you using? Are you in Canada or Europe? (In the US, we use non metric numbers). What kind of numbers are you seeing? (It sounds like you are testing at home?). 11 would be 190 in US terms and would be a very pre shot number. (Multiply your number by 18 )We think a cat regulated if the kitty is in the lower 200s before the shot And double digits 5-7 hours after the shot, when they usually drop the lowest.

What kind of food? We suggest feeding wet low carb food. A vet explains why here: www.catinfo.org. BUT you don't want to change the diet without being careful monitoring - our cat dropped 100 points overnight when we switched from dry to wet.
 
Are you testing in mmol/L? If yes, perhaps you are in Canada, Europe, or Australia?

Generally, you want a dose that allows you to shoot every 12 hours, as no insulin lasts 24 hours in the cat.
 
I'm in canada and she's on Caninsulin, it measures in mmol/l The vet switched her to prescription diet w/d :)
 
If it's Hill's WD, it's 25% carbs on our food chart. We suggest feeding under 8%. It might make a big difference if you'd switch to a lower carb. But you might want to lower the dose before you'd change as her levels could drop quite a bit.
 
You might want to strongly consider changing insulins too. Caninsulin is a harsh, fast acting insulin that's much better for dogs than it is for cats (that's where it got it's name after "canine")

Since you're in Canada, you can buy insulin over the counter (and it's a lot cheaper than it is here in the US) Lantus and Levemir are both great insulins for cats that are milder and longer lasting than Caninsulin and you can get them at any human pharmacy.

Lantus has a proven and published protocol that was shown to get up to 84% of newly diagnosed cats into remission within 6 months, so it's worth seriously considering the change
 
Can your friend check Terry's blood sugar and adjust the dose as needed?

If not, I might postpone the trip if that's feasible. Terry has been through a lot in a short amount of time. She might be fine while you're gone but if you're going to be miserable and stressed then it might be worth postponing the trip if you can wait until she's further in the recovery process and when you know more about how she does on insulin.

Right now I'm out of town myself but I'm having a friend take my cat to the vet tomorrow because she was dehydrated this morning before I left. I've been tense and worried all day. I couldn't cancel this trip but I kinda wish I could have.

What were you feeding her before the switch? If she was on a high carb food, then even switching to W/D (which isn't as low carb as is preferable) might be enough to affect what her dose should be. If at all possible, I second the recommendation to switch insulins to one of the longer-acting ones (lantus or levemir), especially if you're going out of town.

Shane
 
Thanks guys, I wish I could postpone my trip but unfortunately it might be my last chance to go camping with my 95 year old grandfather so if possible I'd like to go... but I'm pretty sure my friend can monitor it as she does have experience and training working in a vet office.

Right now in the mornings before food she's about 11-14, at lunch she's at 6 ish, by the evenings she's at 11 and 2hrs after her evening insulin she's at about 5.

Any recommendations on how to ask my vet if I can change her insulin? I don't think in canada we can get the pork or beef based insulin over the counter.
 
Wow, sounds like Terry's been having a rough time; I'm sorry to hear that. If I were in your shoes, I'd postpone my trip. As big a drag as that may be to do, there are too many variables right now to leave that much responsibility in the hands of someone else, even a friend who is a vet assistant.
We generally need to monitor our newly diagnosed kitties closely in the beginning of treatment, and with all that Terry has been experiencing already (4 day stay at the vet, surgery, antibiotics/pain meds and now the need for insulin), my vote would be: stay home until she's better stabilized.

My cat went on Lantus when she was first diagnosed in 2013, and was off it and in remission within 8 weeks. If your vet is insistent on using a prescription diet, the Purina dm canned is very low carb (3%). No dry/kibble foods. Switching over to lower carbs makes it especially important to be closely monitoring blood glucose if Terry's already on insulin; as others have mentioned, it can drop her insulin dosage need considerably.

My vet had Bat on the w/d canned to start, too (while on Lantus), but when I realized how high the carbs were, I gradually switched her over to low-carb canned (the dm at that time) by reducing the w/d to dm ratio incrementally: 75% wd/25% dm, then 50/50, then 25% wd/75% dm, etc.
If the Purina Fancy Feast Classics (chicken or turkey with giblets) canned food is available in Canada, that's a good, much-less-expensive choice than the Purina dm canned; has only 4% carbs.
 
It's not ideal, but if it was me, I wouldn't miss seeing a 95 year-old grandfather. You may never get this opportunity again.

Your numbers are really not too bad. US equivalent of 192 pre-shot and 90-100 mid-cycle. Your vet-tech friend will be checking Terry's glucose, even getting a couple of mid cycle tests? Is there a glucose number that she will not give insulin? A plan should be made about what to do if Terry goes too low. If you are at all worried about Terry's glucose going too low (hypoglycemia), you could cut the dose a little while you are away, especially if Terry doesn't eat as well while you are gone.

If you are able to be in touch, I would have the pet sitter email, text or leave messages with Terry's condition and glucose readings. That will help you relax a bit on the trip.

Don't change anything so close to leaving, but when you get back do a little research on www.catinfo.com. A food with a lower carb content may get Terry off insulin.
 
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Thanks, yes I will be having her check her levels before each shot but she does already seem to have gone into a stable cycle. She probably won't be able to catch any mid cycle tests and I'm sure she'd be texting me with updates.
Are there any idea for help giving shots and taking tests from uncooperative cats? She's fine when I do them but she's a bit of a fraidy cat so I don't know how good she'll be for my friend

Thanks again everyone, your really helping me be at ease :)
 
Maggies Mom Debby said:
It's not ideal, but if it was me, I wouldn't miss seeing a 95 year-old grandfather. You may never get this opportunity again.
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Whoa, didn't realize this was a visit to a 95-year-old granddad. Changes the landscape considerably! (How did I miss that?)
When you say she's a 'fraidy cat/uncooperative ... how uncooperative is she? Can you paint us a clearer picture of how she behaves at test/shot time?
 
Terrelle said:
Thanks, yes I will be having her check her levels before each shot but she does already seem to have gone into a stable cycle. She probably won't be able to catch any mid cycle tests and I'm sure she'd be texting me with updates.
Are there any idea for help giving shots and taking tests from uncooperative cats? She's fine when I do them but she's a bit of a fraidy cat so I don't know how good she'll be for my friend

Thanks again everyone, your really helping me be at ease :)
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Treats are one way of ensuring cooperation. :) If you already have a testing routine, have the pet sitter try to follow it. Have the sitter come over a couple of times before you leave to get Terry used to her. Maybe have the sitter test her those times and give Terry treats. You may want to block hard to access hiding place, like under the bed, if you are afraid she might hide.

Good luck!
 
Well for me she behaves perfectly and puurs, when other people she doesn't know are around she hides and squrims to get away from them. She's never scratched or bit anyone on purpose, the only way i've ever gotten scratched is by her back paws pushing to get away from me if there is company or she is scared.

And I should say, I see my grand father very frequently this camping trip has just been a yearly family tradition for 13 years and this is proabably the last year they'll be able to come with us.
 
Hi there,

I agree with Debby - not a good idea to change anything before you go away. Hills' w/d is very carby - are you feeding dry or canned, btw? In spite of the carbs Terry's numbers aren't bad at all. (So sorry about his little eye. :( )

It's great that you're home testing BG. It's vital to be doing so before even attempting a food change from high to low carbs so as to keep a cat safe.As mentioned above, Caninsulin's quite a harsh insulin for kitties and you're feeding a high-carb food. It's highly likely that as soon as you start to transition Terry to a lower carb food (gradually, of course) his need for insulin will drop a lot, and drop fast. For example, when I moved my cat, Saoirse, from w/d dry to low carb wet food I had to repeatedly drop her Caninsulin dose and in less than a week I had to stop giving it to her because her numbers had improved so much and the Caninsulin was threatening to take her too low. And her numbers weren't anything like as good as Terry's.

I'd suggest getting as many pre-shot, +3, +6 and +9 readings as you can manage (daytime and evening cycles) before you go away. Knowing a bit more about Terry's BG pattern on Caninsulin will be a help to you and the vet assistant.
 
Terrelle said:
Right now in the mornings before food she's about 11-14, at lunch she's at 6 ish, by the evenings she's at 11 and 2hrs after her evening insulin she's at about 5.
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Hello, and welcome to FDMB!

A diagnosis of feline diabetes can be challenging, especially at first. But you will soon get the hang of things. Honestly! And we are here to support and help you in any way we can. :bighug:

Regarding the blood glucose numbers that you've given above; are these 'typical'? If they are then I think you may want to consider reducing the evening dose of insulin. If Terry is at '5' just two hours after the shot then there's a chance she could drop too low by the peak (lowest point) of the insulin cycle (with Caninsulin/Vetsulin that is often (but not always) between 4 - 5 hours after the insulin shot).

BTW, you are bound to see comments/info on the forum that say Caninsulin/Vetsulin isn't a great insulin for cats (and there are some sound reasons for those comments), but please don't be discouraged. Some cats do just fine on this insulin (and some have even gone into remission (ie become diet-controlled diabetics)). It's early days. And only 'time will tell' whether it's a good insulin for Terry.
Here is the link to the FDMB user guide to Vetsulin/Caninsulin, which may have some helpful info for you. If you have any questions at all please just ask. Vetsulin/Caninsulin user guide

Why did your vet think Terry has type 1 diabetes (type 2 is much more common) ...?

Eliz
 
For sure, if it's a trip with 95-year-old grandparents, that changes things! I totally agree with Debby and Aine, don't change plans and don't make changes to Terry's food before the trip (changing from W/D to something lower carb). And even though W/D ain't the best, my cat went OTJ while eating it. :) But now that I know more, I've switched her to other stuff.

Have your sitter come over and do some tests while you're there. Maybe that way Terry will get comfortable with the sitter handling her. And barricade any hiding spots that will be hard for the sitter to reach her. My Marshmallow likes to sleep under the bed but I cut lengths of cardboard, taped them together to make a 6-foot-long piece of cardboard, and taped it to the bottom of the bed. That way she can't get under there while I'm away. :) It's far from gorgeous, but it did the trick!

When do you leave for the trip? Try to get as many readings as possible before you go so you can feel confident about her dose before you go.

Good luck, post questions if you have them, and breathe. Terry will be okay. It's hard to leave her right now, but she will be cared for while you're gone.:cat:
 
granadilla said:
don't make changes to Terry's food before the trip (changing from W/D to something lower carb). And even though W/D ain't the best, my cat went OTJ while eating it.
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Definitely agree about not trying to change from the w/d to another lower-carb formula before your trip. That's something you can do later on. And I looked closely at my old notes from when Bat was treated with Lantus while on w/d: She didn't get transitioned off the w/d canned until close to the end of her treatment (like, just 2 weeks before she went OTJ) so I wouldn't worry about that right now.

Shane, those are some great suggestions re: getting Terry more comfortable with the sitter & barricading hiding spots! :)
 
Thanks for your support guys, it really is helping me stay calm about this. I was bullied a lot as a kid and terry was kind of my only friend who just turned up at my dad's school when I needed someone so I care about her so much it's verging on unhealthy (but I'm sure all you guys know what that feels like). I've been taking 4 readings a day and so far the highest her levels have gone is 14.7 which is 252 and that was only once, other than that it's ranged mostly from 4.7 (84.6) to 11.4 (205.2).

Do you guys know at what level does it start to become concerningly high? is 14 an ok reading for right before administoring insulin?
 
Terrelle said:
I was bullied a lot as a kid and terry was kind of my only friend who just turned up at my dad's school when I needed someone so I care about her so much it's verging on unhealthy ... (
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Not unhealthy at all. I've been bullied by people, but never by any cat. Probably why I think more of cats than I do of a lot of humans. ;) I'm glad that you and Terry found each other and that she is such a good friend to you. :bighug: (I owe Terry an apology - I erroneously reassigned her gender in my earlier post. :oops:)

You're doing great with the home testing. Has anyone here asked you to set up a spreadsheet to start recording Terry's test results? In case they haven't, here's a link to instructions on how to set one up:

http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

If you can get the doses and BG readings into a spreadsheet for Terry, it will help members better advise you on doses. What is the meter you're using? Is it a pet meter or a human meter?
 
Thanks, I'll try to set that up, and we're using a human meter, does that make a difference, and also she's called a boy all the time. :P I don't think she takes it personally ;)
 
The spreadsheets are a great help for learning your kitty's pattern and trends.

Human meters read a little lower than pet-calibrated ones. Because of that different reference ranges are used for the different meter types. The most important number to get your head around at the moment is the hypo threshold. It's 2.8mmol/L / 50mg/dL on a human meter (3.8 /80 on a pet meter). Members responding to your posts will need to know your meter type so that they can properly understand Terry's BG numbers. It'd be great if you could add the meter type and insulin type to your signature (I see you're already on the case with your spreadsheet - good stuff!).
 
Thanks, I added it I think... If you guys don't mind can you look at her chart, I think I did it correctly...
 
That looks great! You see all the blue and some green numbers? A lot of people here would do the happy dance to see numbers like those. You are doing great!
 
Thank you guys :) Terry is the tortie and winnifred is the ginger, She has one less eye now then she does in the pic but she's still pretty beautiful. I'll post a pirate pic when she's all healed up, right now she's still in the cone and stitches.

Wow I didn't know that those numbers were pretty good, I'm surprised she had eye complications then if her glucose levels aren't so bad
 
Terrelle said:
Thank you guys :) Terry is the tortie and winnifred is the ginger, She has one less eye now then she does in the pic but she's still pretty beautiful. Wow I didn't know that those numbers were pretty good, I'm surprised she had eye complications then if her glucose levels aren't so bad
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Your two kitties are just beautiful! :cat: And so are Terry's numbers. That's truly amazing, considering how much she's been through just recently.
Great job on getting that spreadsheet up & running! (P.S. Your grandfather sounds like a real pip - how great!)
 
Terrelle said:
Wow I didn't know that those numbers were pretty good, I'm surprised she had eye complications then if her glucose levels aren't so bad
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Well, Terry's getting insulin now and she wasn't before she lost her eye. At this point it's hard to know how high she was running before or how long her glucose was high.
 
\
Critter Mom said:
@Maggies Mom Debby -

Debby, I was wondering about that. Also, do you think the resolution of the eye problem (sad as it is :( ) might have had a positive impact on Terry's BG?
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It's defs had a positive effect on her behaviour, she was so lethargic and sad before and now she's behaving more like herself.

Also, do you guys know if bloated abdomen is a symptom of diabetes?
I've seen some cases online where it seems to be associated with it but I can't find a definative answer.

Her abdomen has felt kind of bloated on the sides, I think it's getting better but it's still pretty solid feeling
 
Saoirse's abdomen was bloated at diagnosis. The abdominal bloating pretty much disappeared by the time she went into diet-controlled remission. Sadly since cessation of her Lantus therapy, the abdominal distension has returned with a vengeance.

Saoirse has had low thyroid test results (not a complete panel - can't remember the specific value the test was for offhand, poss total T4??) and she's showing umpteen clinical signs of hypothyroidism (rusting fur, low mood, low energy, weight gain, alopecia/shedding). The specialist she saw said it was related to her pancreatitis, and I've been trying to find out a bit about Euthyroid Sick Syndrome. Apparently ascites can be a symptom of hypothyroidism. Don't know much about it at the moment.

There are other conditions that have abdominal bloating as a symptom. Cushings is one, but apparently it's quite rare.

Definitely something to ask your vetty bean about.


EDITED TO ADD:

Try to note whether there is any variation in the bloating. In particular, try to see if there's any reduction after a period of fasting, and also whether the bloating reduces after Terry has visited the litter box (Saoirse seems less bloated in the aforementioned circumstances). Let your vetty bean know about any variations.
 
Thanks, so far I have only noticed a bit of a reduction since she started insulin. SHe is going to the bathroom just fine and hasn't thrown up at all. My Vet said that she figured it was just her diabetes and that she agrees that its gotten a bit better already
 
Elizabeth and Bertie said:
Hello, and welcome to FDMB!

A diagnosis of feline diabetes can be challenging, especially at first. But you will soon get the hang of things. Honestly! And we are here to support and help you in any way we can. :bighug:

Regarding the blood glucose numbers that you've given above; are these 'typical'? If they are then I think you may want to consider reducing the evening dose of insulin. If Terry is at '5' just two hours after the shot then there's a chance she could drop too low by the peak (lowest point) of the insulin cycle (with Caninsulin/Vetsulin that is often (but not always) between 4 - 5 hours after the insulin shot).

BTW, you are bound to see comments/info on the forum that say Caninsulin/Vetsulin isn't a great insulin for cats (and there are some sound reasons for those comments), but please don't be discouraged. Some cats do just fine on this insulin (and some have even gone into remission (ie become diet-controlled diabetics)). It's early days. And only 'time will tell' whether it's a good insulin for Terry.
Here is the link to the FDMB user guide to Vetsulin/Caninsulin, which may have some helpful info for you. If you have any questions at all please just ask. Vetsulin/Caninsulin user guide

Why did your vet think Terry has type 1 diabetes (type 2 is much more common) ...?

Eliz
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I'm not sure but I'm pretty sure it was because of her eye complications and the did run several tests to diagnose it... I'm not completely sure though.
 
Too low (using human meter) is below 50. You're at 60 now @ +2 - if you have to go to bed soon, you might want to steer with a little canned food & recheck in the next hour to make sure kitty is rising more toward safe zone. (Which you're still in, btw, but you only have 10 more points to that cutoff #.
 
Did you get a preshot # right before you gave the insulin tonight? As didn't see one plugged into your spreadsheet.
 
If she drops below 50, that's when you want to get the High carb food out

What I usually do is pop the top off a can of Fancy Feast Gravy Lovers and then put it back on and "squeeze" the gravy out into another bowl

You definitely don't want to go to bed until she's stopped dropping and is staying in good numbers without having to have more food to "prop up" the numbers
 
Based on the numbers you were getting in the previous two cycles in pm that you had filled into the chart, she'll still be dropping by +4.
I've often set multiple alarms during to night when Bat's doing a low cycle, just to make sure I get in those tests at +4 & +6.
 
Actually, I'm thinking you might want to get a +3 - which would be soon, right?
And can you tell us your first name? Thanks! - Robin
 
Yah sorry, Her pre shot test was 118 and she's now up to 79 and I gave her a bit of her usual food after her innitial low reading.

Do you guys think it would be safe to tell my pet sitter if she's reading lower than 7 to give her .5 iu or not administor it at all? I'm only gone for a week and her numbers have never gone above 250. I would rather it be a little higher than too low while I'm gone

and my first name is Terrelle btw :)

Thanks again guys
 
Terrelle said:
Also please help, is 60 considered too low?
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Hi Terrelle,

A reading of 60/3.3 is fine (if on a human meter; it could be too low on an Alphatrak meter).

However, it's not just what the number is but also where it's headed.
If I got a 60/3.3 at the peak (lowest point) of Bertie's cycle that would be a very nice result for him. But if I got a 60/3.3 and there was still some time to go until the peak of the cycle then I would take some action to ensure that it didn't drop any further.

See this last paragraph from the FDMB general hypo info:
"Always keep in mind that with low blood glucose and no symptoms, the BG you get is not as important as where it is headed. In other words, if you get a BG of 100 mg/dL or 5.6 mmol/L or less and there are still several hours or more before the insulin peaks, your need to watch your cat (and the numbers) carefully and take appropriate steps. With very low numbers and NO SYMPTOMS, a cat can be fine one moment and seizing the next."
How to treat HYPOS - THEY CAN KILL! Print this Out!!
.
 
I didn't shoot below 200 (11.1), at the beginning of treatment (this was on ProZinc, btw). And you've been getting some pretty low numbers.
Was that 118 directly before her last dose (I'm looking at SS) --- so does this mean she was dosed at +10 in the cycle? I am not familiar with the type of insulin you're using (I'm assuming it's not long-acting like ProZinc ...)

Regardless, based on how low her #s were after tonight's dose, and that you'd mentioned in one of your earlier posts that your sitter won't be able to get many mid-cycle BG#s, I would rather see you have her err on the side of caution while you're out of town: meaning NOT have her shoot below 200 (11.1). And you're thinking along the right lines here: Better to be a little high than too low (and if your friend can't check a +3, +5, etc. regularly, how can you know if she's dropping too far?), than to risk a hypo event.

She's responding well to insulin therapy, btw - impressive, considering the trauma of her very-recent surgery. Terry is quite the little trooper!

Should have some of those more familiar with your particular insulin weigh in on this in the morning, too - so many good & wise people here!
You're doing a great job!
 
the 118 was right before her does and it was 12 hours after the morning dose, I just wrote it wrong. My vet said to administor it anyways because she's usually high in the morning.

My sitter will not be able to get any mid cycle readings unfortunately. The only reason I can is because I work ridiculously close to home

She's on Caninsulin which from what I've gathered drops quickly and climbs slowly
 
Terrelle said:
Do you guys think it would be safe to tell my pet sitter if she's reading lower than 7 to give her .5 iu or not administor it at all? I'm only gone for a week and her numbers have never gone above 250. I would rather it be a little higher than too low while I'm gone
Click to expand...

'7' is a normal blood glucose number number for a cat.
Normal blood glucose numbers are approximately 50 - 130/2.7 - 7.2 (although some cats will naturally read a tad lower or higher than this.)
It not advisable to give insulin at normal numbers (there are some exceptions to this rule, but they don't apply here).

The general advice here is that, for those new to dealing with diabetes, no shot is given if the blood glucose is below 200/11. That is to allow some buffer of safety while the caregiver gathers some data to work out how their kitty is responding to insulin.
And with shorter acting insulins like Caninsulin it is especially important to have an understanding of how the kitty responds to insulin before attempting shots at lower preshot numbers.

What exactly is Terry eating now?
If you are getting preshot numbers that are too low to shoot (and I think you are...) then you could try holding off on the insulin and switching Terry to low carb wet at this point.
The change in diet could make a considerable difference to her blood glucose levels. And it may be that she doesn't actually need insulin while you are away. She may be lucky and head into remission (ie. become diet-controlled).
Let's see what others think...

Eliz
 
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