New to managing diabetic cat

Hello there! I have a wonderful cat named Kitty. At the end of April 2021, I noticed she was starting to drink a lot of water. At first I didn't think much of it till the large urine clumps showed up. Off to the vet we went. Her blood work came back normal except her Retics were 102.8 K/ul (normal 3.0K/ul-50.0K/ul) and then her glucose was 534 - we diagnosed her diabetic. The vet I was seeing said let's try a diet change first. For 30 days I tried to feed her Young Again Zero Carb and wet cat food. She was dropping weight quickly. She typically averages 9 lbs but on May 5th she was around 8lbs. Everything kept getting more stressful. I didn't know what to do or how to manage this situation. I didn't even know I was foolish for thinking I could walk out of the vets office with a number of 534 and think that was normal and a diet change was the right choice. Regardless, 30 days passed as they recommended and we saw no change. We returned June 24th with the same high numbers. We started Vetsulin after that at 1 unit and slowly increased to 2. There was zero changes at all. We returned on July 1st to check her thyroid. The TT4 came back 1.4 ug/dL - normal. That's not the issue. The vet told me her kidney's were failing (without testing her blood and her blood work in May showed ZERO signs of kidney or any other type of failure) and our options were probably going to be euthanasia. My heart sank. I decided I was done with this vet as I had to told them what to test, what to do and I'm completely blind to this. Have no idea what I'm doing. I switched that Friday July 2nd to another vet who wouldn't let my cat leave till we lowered her numbers. She was at 400+ then. She went out on a whim and decided to try Novolin. Her numbers sank to 167! The lowest they have ever been. We went home and continued to give her insulin twice a day. I was not home testing at this time.
Out of nowhere about a week in, she became insulin resistant (at least that's what I'm told) so I did my research and found out that Lantus is the best for cats so we started that Sunday evening, July 18th. Her readings were 500+ and I found out that it was my fault more than likely. I was feeding her as much food as she wanted because she dropped down to a measly 5lbs and weighed 6lbs the week of July 12th. She also was eating Friskies shreds with gravy, her favorite and very high in carbs!
Last night, July 19th, I switched to FF classic pate and her numbers have been much better now! But they are still high. My question is, do I need to lower her insulin or raise her insulin? See attached spreadsheet as to where we are at. A few other things, yesterday she became much more active FINALLY! She peed outside the litter box between the hours of 6pm-12am but then before 7am used the litter box to pee. She didn't pee outside the litter box yesterday at all between 6am-6pm but did have 2 poop accidents but zero last night.

 

Hi Samantha
Here is the link to the spreadsheet we use
It will also explain how it works
If you have trouble setting it up , we have a member that will help you
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

 

https://felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Here is the link to set up your signature, it's at the end of everyone's post in gray

Look at mine
I'm glad you are home testing and Lantus is a good insulin
Once your signature and spreadsheet are set up and you read how the spreadsheet works you can fill in any BG numbers you have so members can give you some advice
I will also give you the link to read about Lantus

https://felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

 

Sorry for the late reply! Thank you for the information. I'm presently juggling raising my 5 month old son, a full time job from home and a diabetic cat! I will fill this out a little bit later and provide an update!!

 

OK I got the spreadsheet uploaded! I couldn't figure out how to add this information to my signature. It said it was too long.
Samantha and Kitty
DX: Date
Name of Insulin: Lantus
Name of your meter: ReliOn Prime
Diet: combo (wet food Fancy Feast classic pate and kibble Young Again Zero Carb)
Dosing: TR or SLGS or Custom (not quite set up yet)
DKA or other recent health issue - No health issues
Acro, IAA, or Cushings (if applicable) - NA
Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

 

Great job setting up your spreadsheet, I'll tag
@Bandit's Mom Bhooma to help you with your signature, she'll be on tonight
She'll probably sent you a private message so watch for it
I see he was Diagnosed 5-5 21 on your spreadsheet
See #6 Bhooma she might have enough info there for you to see
Thank you Bhooma

 

Hi Samantha you can delete that pic you have of that other spreadsheet in your post
#2. The number is on the right hand side

 

@Sienne and Gabby (GA)

@Marje and Gracie

Hi ladies can you please read about Samantha's kitty , she is asking about her cat ,her name is kitty, she has set up her SS but having trouble with her signature so I tagged @Bandit's Mom

Thank you

 

I PMd her about the signature block and can fix it for her. Thanks, Diane.

Samantha…we usually hold the starting dose on Lantus for 10-14 cycles but since she’s been on another insulin and is pretty high, we might want to increase her before then. I’d hold the dose through tonight and let’s see how she does….probably high.

Do you how many units of Normalin the vet gave her when it dropped? After that you were giving her 2u bid, correct?

 

I do not know how many units of Novolin but take a look at my SS! She is doing MUCH better today. No accidents in 24 hours now! Still drinking quite a bit of water but she also isn't eating like a maniac. She actually takes breaks and stops when she is full which is very new development He poops have finally became solid now as well which is great. Still large clumps of urine which is expected since she's still 200+ but she's finally starting to see a decline today. Let me know your guys thoughts!

 

Yes….better!

Actually, because she is still eating dry food, you will need to follow the Start Low Go Slow method of regulation as the other one has a prerequisite of no dry food. SLGS has you hold each dose for an entire week, unless the BG drops below 90, at which time you reduce by 0.25u. If she doesn’t drop below 90 during the week, you do a curve after the week and adjust the dose, if necessary.

 

Thank you Marje
@Marje and Gracie

 

You’re welcome!

 

If you check out my SS this morning, she is doing much better! We somehow are under 200 this morning! I cannot believe it! This is the lowest I've ever personally been able to get her! Question though, yesterday she pooped outside the litter box in our bathroom. I left from 9:30am-2pm and the accident happened during that time. Since she is so covered in poop on her paws right now and I don't want to stress her and bathe her daily, we have to close our bedroom at night. She jumps into bed with me and sleeps with me! It's so hard to lock her out but this morning she pooped in front of our door. Which sometimes I think it's behavioral but maybe it's just her glucose still. Does anyone happen to know when the accidents stop? I want to bathe her this weekend, mop the entire house, clean her litter box area with special cleaners but I want to ideally wait to do this till she stops having accidents.

Another thing, she keeps having spikes typically between 8pm-6am, does anyone happen to know why that is? Or is this completely normal to see? I'm going to slow down testing her I think. Now that her numbers are dropping, she's starting to get very angry at me and growl! She is not enjoying this anymore. I still plan to do prior to feeding/insulin and then an hour after. Unless you all think I should do this all differently! I'm learning so much about diabetes in such a short amount of time!

 

Hi Samantha great numbers today, I'm going to tag
@Marje and Gracie for you, Hi Marje
I would at least get a test @+3 and @+5 to see if she's dropping.
I know she's getting angry at you but you want to make sure she's not dropping too much , sorry can't help you out with the poop problem

 

I can handle that! I'm having a tricky time getting her to bleed enough on the first poke. Is that normal as she gets better and better? I feel so bad for her. I have to poke her a few times to get the right spot! Do you have any advice for that?

 

What size lancets are you using?
Look at the lancet ,you will see one side curves up, that's what you want to poke with, on an angle. Are you using a lancet device or free handing
It will get better

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming

 

I got them on Amazon - CareTouch Twist Top Lancets 30 Gauge and I use the lancet device mostly because I'm nervous, trying to hold her down and she doesn't mind the sound! Just hates that I can't successfully poke her the first try. I typically have to kind of move throughout her poor little ear and if I absolutely can't get enough blood (even with milking) I will try her pad on her paw which sometimes works better too!

 

Go to any pharmacy or CVS , Walmart , and get either 26 or 28 gauge lancets
The I are a little thicker, any brand , that's what we use in the beginning
The lower size lancets the thicker they are

 

Gotcha! I will have to try and swing out this weekend. If I lived in town it would be so much easier but I'm a half hour drive out and overloading myself a bit too much lately with too many things!

 

No problem

 

OK update! I just tried your method. I didn't use the lancet device, just to hold the needle. Poked the outside of the ear and boom! Easy peasy test! She even purred the whole time! I just tested which is about 6+ hours and she's at 50! What does that mean for tonights insulin?!

 

That's great news do you have syringes with half unit markings on them?


I see @Marje and Gracie mentioned this in her post #11
So tonight you would reduce by 0.25 units so shoot 1.75 units for tonight
The take action number on a human meter is 50 which means feed her some low carb food now and test again in 20-30 minutes to make sure he's coming up, then post it



Yes….better!

Actually, because she is still eating dry food, you will need to follow the Start Low Go Slow method of regulation as the other one has a prerequisite of no dry food. SLGS has you hold each dose for an entire week, unless the BG drops below 90, at which time you reduce by 0.25u. If she doesn’t drop below 90 during the week, you do a curve after the week and adjust the dose, if necessary.

 

Wait, do I decrease by .25 units or wait a week? I don't want her levels to dip too low but I also know a human meter is much different in numbers than a pet meter! She just picks at the dry food a little here and there. She eats about 2 cans give or take of FF pate a day. She actually gets full now and needs to quit eating!

 

Anytime she drops below 90 you reduce, doesn't matter if it's a human or pet meter
You have to try and get her to eat something ,you don't want her dropping any lower

 

@tiffmaxee
Hi Elise can you help me out, I don't want to give her the wrong info , her kitty just dropped to 50 @+6, see #11 and #24 and #25
Her kitty does eat some dry food

would you mind looking at Samantha's SS , I gave her some advice #15
Her kitty has been on 3 different insulin's , now on Lantus
There is a lot of info about her kitty #1

Tagging @Marje and Gracie

And
@Sienne and Gabby (GA)
@Chris & China (GA)





The dry isn't entirely helpful, it takes a while to hit the system and even longer to leave it.

 

@Samantha - Kitty
Did she eat anything? Have you tested her again?

 

She's been picking at her hard food this afternoon. I'll give her a half can of wet food! She's not over weight and never has been so that will keep her up

 

I have not tested again!

 

You don't want her to get full in case her numbers keep dropping, just give her a teaspoon of FF Pate, and test her in 20 minutes
For the future
The dry isn't entirely helpful, it takes a while to hit the system and even longer to leave it.
Just want to be sure you have med and high carb wet food and honey at home
Fancy Feast Gravy Lovers
Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs



Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy. 15% Med Carbs




Fancy Feast Gravy Lovers Turkey Feast in Gravy. 15% Med Carbs


Fancy Feast Gravy Lovers Chicken and Beef Feast in Gravy 15% Med Carbs

Or any other ones from the food chart, here is the link
@Samantha - Kitty

 

I gave her a half can of FF (didn't see your response before I fed her) but I still have some Friskies Shreds with gravy at home. I'll test her in 6 minutes here and let you know. If it's still low, I will just prepare to give her some Friskies Shreds instead! Thank you for the info on the hard food! I have Karo syrup in the cupboard!

 

I know she can get too low so I really appreciate the help! Seriously, you have no idea. My vet gave me her cell phone number and I texted her this morning and she said no more testing because my kitty wasn't liking it but I listened to you all instead and now we are hitting too low of numbers! So it's so helpful to have this group of people who have experience in this very unique illness in pets. To think just a month ago, another vet was telling me to put her down. What a crazy journey it's been already!

 

If it wasn't for the members here Tyler would not be in remission,

 

She's at 69 now!

 

Ok don't feed anything for now, but you have to test her in 30 minutes again
When wss that test @+ what?

 

I'm hoping for remission but we shall see! Right now all that matters is she is finally getting better. Now just to adjust her dosage!

 

When was that 69 done at @+ what
Just saw your SS 69 @+8

 

69 would be 8+ from her insulin shot this morning. I updated my SS.

 

You should also put in the remarks section of the spreadsheet what you fed and when for the further in case she drops low again, but always post for help

 

90 at 8.5+

 

OK don't feed anything now and test in 1 hour
What time do you test her PMPS how many more hours

 

I guess I'm not sure where the remarks section is but I will gladly update once I can locate it!

 

it's at the end your SS all the way to the right

 

She gets her insulin at 7pm MST which I usually test somewhere between 6pm-7pm before I give her insulin. Should I still do 1.75 or lower?

 

Found the remarks section!

 

Yes still shoot 1.75 units , I'm eastern time, I want to know how many more hours till PMPS
Samantha where you have the 69 @+8 tap on it . and add to the same cell or square 90 @+8.5 and color it manually if you have to dark green like it is now
@Samantha - Kitty

 

I think it would be a good idea if tomorrow morning you start posting on the
Lantus Forum, there are a lot of Lantus users there
I'll tell you how to do it
Go to the Lantus Forum then hit post new thread it's to the right
Put the Date 7-23 Kitty AMPS- her BG New Member

Then where you would start to write whatever you need to then link the post you did on the Health Forum , you would go all the way up to the of it , it's above the pic of the pic of the cat


You will copy that , then go to back to the Lantus Forum and paste it
That's so the members can go back to it and see what was going on

You can go back to your Title in the Lantus Forum and add the next test to it
Example
7-23 Kitty AMPS #/ @+2 BG/ @+6 BG/ PMPS BG etc
How to add to the Title to the Right hand side it says Thread Tools , then a drop down will appear hit Edit Title do what you want to add then hit save


Samantha just looked at your remarks , we live in all different time zones so putting the times you fed and tested don't help us

You have to put fed @+ whatever it was like +4 and so on
You don't need to put the BG when you tested we can see that on your spreadsheet

 

We recommend testing immediately before feeding/shooting with Lantus. So it's Test/Feed/Shoot. You Test to make sure she's high enough for insulin at all, Feed to make sure she's at least willing to eat, and Shoot, usually with their head in the bowl. The whole thing usually takes 5-10 minutes.

With Lantus, it doesn't usually start to "kick in" for 2-3 hours after it's given, so if Kitty wants to take her time with her main meal, it's OK...as long as you know she's willing to eat.

You definitely want to shoot a smaller dose tonight. I just scanned the other posts...do you have syringes with half unit marks?

You might want to grab a test at +11.5 (6:30pm) which will give us some time to think about what dose to go with tonight.

Also, you should know about stalling....if the Pre-shot is lower than you're used to, you can stall, don't feed and test again in 20-30 minutes. Use that time to post or update here. Usually, if the number goes up without food, it's OK to go ahead and shoot (remember, she'd be eating plus the shot won't be kicking in for awhile)

 

She is at 184 right now! She gets insulin in about 15 minutes or so. Sorry I'm not 30 mins early. Trying to also get my son ready for bed!

 

I guess I'm not quite sure what you mean here. If I should feed feed her or no?

 

Also yes I do have syringes!

 

Can you get 1 more quick test before you feed? It looks like she's heading up quickly but want to make sure

 

Also, for tonight.....do you have plenty of supplies (test strips, high and medium carb food, Karo/honey/syrup) and are you able to test as often (and as long) as might be necessary?

 

I wasn't sure what to do so I went ahead and fed her and gave her 1 unit. I didn't test her again before feeding her. I understand the grave importance of doing everything I can for her but I also have a son who's almost 6 months old and he needs me too. That being said, I've devoted a lot of time and energy into her.
I have over 50 test strips, Friskies shreds w/ gravy, Fancy Feast Classic Patte, I even have Iams hard cat food yet as that is what she was previously eating. I also have Karo syrup and I've been testing her an hour after she eats and then one more time before I go to bed. I can't test her throughout the night because I'm breast feeding solely and I truly need my sleep to also care for my son.
When I wake up in the morning between 5-6am, the first thing I do is go test her. I haven't been testing her right before she eats because I didn't think I needed to if I test her within an hour of giving her insulin. She doesn't love being tested so I try to only test her once or twice a day just to watch her and see what's going on. For her safety and so she can get better of course! I do all I can right now which is more than what most people I think would do! I'm really trying.

 

Absolutely!! You're already doing a lot more than most! I just figured you needed a quick answer so didn't have time to go back and see if there was more information about you available (like having a 6 month old....not sure which is harder...the baby or the sugarcat!)

I think the 1U was a good decision under the circumstances!

 

Thank you!!! Throughout this entire process I've felt like a failure at it. I wasted 2 months at a horrible vet that gave her a death sentence and then finally switched and found some hope. After the Novolin failed, I was so worried I would have to be putting my cat down this week. It was sounding like cancer and there wasn't going to be a lot of hope. Thankfully the Lantus is working and it's doing great! I'm so thankful things are finally moving in the right direction. I've shed far too many tears and been stressed beyond belief. Cleaning up the accidents, watching our cat deteriorate along with trying to take care of a young baby. It's been a wild ride! Thankfully our baby is very easy! He's given me so many hugs during this and let me cry into him. I've been lucky and thankful for him!

I believe the 1U was good too. I was too nervous to give her too much and I can't monitor her throughout the night so I don't want to be anxious and worried for her all night. Also thank you for being understanding! I do appreciate it!

 

241 - +1 after 1 can FF pate/1U

 

Looks like Kitty might be going off on a bounce! If she's higher at your "before bed" test, you should be able to relax and get a good night's sleep (if the baby will let you)

 

Is a bounce normal at this stage? Maybe it's because she eats dry food and it catches up with her at night? I'm almost entirely positive that at night she doesn't free feed. Just mostly sleeps till she tries to wake me up in the morning! Baby should sleep great! One can always hope lol

 

VERY normal. Bounces happen when 1. they drop too low, 2. they drop too fast, 3. they drop into numbers their body isn't used to anymore (or any combination of all 3).

The liver releases stored sugars and hormones to bring the blood glucose up ...it's kind of a leftover survival mechanism from when cats were wild and if they didn't have a kill for a long time, the liver's "release" would give them the energy to hopefully hunt and get some food.

In Kitty's case, she's most likely bouncing due to #3. By the time we see enough signs that our cats are sick and get them diagnosed, they've probably been diabetic for quite some time. Their body has gotten used to living in those higher numbers so now, even normal numbers cause Ms. L. to do her thing.

It can take up to 6 cycles for those sugars and hormones to clear out of the bloodstream but as she spends more time in normal numbers, the bounces usually don't bounce as high and clear out faster too.

It's all very normal....and very frustrating for us!

 

WOW! Thank you for the very detailed and thorough explanation! That totally makes sense actually! Because even though she's been hovering in "normal" numbers for herself. She still doesn't seem normal which is so frustrating!

Would you recommend I stick to 1U for the next however many cycles and see where we go from there?

 

If she's over 200 by AMPS, I'd go with the 1.75 reduced dose that she earned this morning. If it concerns you, you could try 1.5 but I wouldn't go lower until she earns the next reduction.

We talk about "earning" reductions because we want them to keep "earning" them until there's nowhere else to go and they're on zero!

 

Thank you for the advice! 1U tonight though is still OK right? Going to check her glucose shortly before heading to bed and then I will proceed with 1.75U tomorrow morning Looks like I got a few more days at least of lots of testing. Let's hope she just bonds with me instead of getting angry at me!

 

yes, you never shoot more. Once you make a decision, you go with it and learn from it for the next time you have to make a decision

Just make sure she gets something she really loves as a reward every time. Something special she doesn't get other than at test time. Cats do best with routine (same place) and reward (treat, brushing, cuddles..whatever is special to her).

You're going to learn more about her than you ever thought and your relationship is going to become even stronger. Unfortunately, when it is time for them to leave us, it hurts that much more too.

 

Thank you for the advice! I wish I had that advice Sunday night. I was texting with my vet who kept telling me to give her another unit each hour to get her down. I had these weird gut feeling I should not have done that and I shouldn't have started at 2U but rather 1U. Anyways, updated my SS. 1U was definitely not enough last night! We're sneaking back up into the 400 range. But we will get there! Gave her 1.75U this morning and she is still on the rise but I really like how you say "earn" their dosage. Funny thing is, she's acting more normal today again now that her numbers are a bit higher than she did yesterday with low numbers. Although she had a pee accident which I suppose is expected. Poor girl. I'm already so close with her that this is the hardest thing to put her through. I hope that in the future we become as close as we once were and if were even closer, that's OK too! She's 12 and I was really hoping to get 5 more years with her, at most. I want her to grow up with our son because she's so affectionate and loving. It's hard to not watch her be that way anymore.

 

I’m very sorry I’m late to the party but you were in good hands. It’s a good idea for you to move to the Lantus forum as the are more Lantus users there to help out. We post differently there but these Posting Guidelines will help you.

You are doing great with all you have on your plate! BTW, pooping outside the box is not FD related. It could definitely be behavioral but if it continues, it might be good to have the vet check her. Things that will not be behavioral but not medical are if she’s declawed, if there’s too much noise where her box is, if the box is not kept clean, etc. Medical might be constipation and it hurts her when she poops so she equates it with the box. Just ideas….

The other thing is many cats and their caregivers become more bonded during FD and you learn things you didn’t know about your kitty. As she starts to feel better and more regulated, you’ll see the old “her” coming out. I love this letter one member wrote to FD after her kitty went into remission.

See you in Lantus/Levemir Land!

 

No worries! I will seek that out today! Thank you also! And it never started till about a month or so ago. She never has had accidents before. So strange! But I'm going to get some enzyme cleaner today and see if that helps her out. Cross our fingers! We have been cleaning her box twice a day every day. Putting newspapers down for pee/poop accidents and somedays there will be zero accidents! Others there are 2 or 3. She's not declawed either and she poops once or twice a day everyday so I assume not constipated. She's been constipated in the past and I know those symptoms! She typically will not eat no matter what. I'm hoping a good cleaning with an enzyme cleaner helps her out!

I will have to check this letter out - thank you!! And she will eventually grow to trust me and learn that I'm helping her and not helping her. It's all a learning curve and we both will slowly get better at it!

 

Enzyme cleaner??? You mean for your carpet? The other thing is Dr. Elseys Cat Attract litter should help get her back using the box every time. I don’t know how but it does work. If she’s peeing outside the box, be sure she doesn’t have a UTI. These are uncommon in non diabetic cats but common in diabetic ones.

 

Totally expected! Not only did you give only 1U last night, she also got a flood of those hormones and sugars from Ms. Liver due to the lower numbers she got into yesterday morning. Just hold the dose at 1.75 and hang in there. It could take up to 6 cycles for the bounce to clear. You don't want to increase back to 2U due to the high "bounce" numbers

 

Yep...her body has gotten used to living in those higher numbers so when they drop back to what's supposed to be normal, she feels different. It's like if you were used to drinking a pot of coffee every day and then one day somebody started giving you a medication that blocked the caffeine....you'd feel pretty lethargic and icky too.

You can get puppy pee pads that would protect your carpets if she peed or pooped on them since they have a plastic barrier on the bottom to keep stuff from soaking in.

 

For the floors as well! She seems to be having accidents in repeat areas which I still think is her acting out a bit but also she can smell her previous potty issues. I definitely have thought about looking into a UTI!

 

I will definitely hang in there! Her numbers are back down to where I like to see them tonight. At least for her! They haven't went back to the 500s which I consider a huge achievement for her!

That comment totally makes sense! As much as I want her to just bounce back, I also know that's not how this works. I'm thankful every day that the insulin is working and I'm seeing small results. We'll get back to ourselves sometime soon!

I use newspapers in her litter box area and then just clean up the accidents throughout the house. I'm trying a special cleaner to see if that helps her not remember she went to the bathroom previously there.