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HopeforDuffie

HopeforDuffie

Member Since 2012
Hello, my cat Duff was just diagnosed today and I can home with all the supplies we need to get started. Gee, I think this is going to be very difficult!

How many out there have a cat with diabetes only 7 years old? And did anyone's cat ever go into full remission after initial treatment with insulin? I am really feeling overwhelmed right now and I just want Duff to get better ASAP or at least give him a better quality of life. Also I am supposed to bring him to the Vet office to spend the day next Friday to see if he is regulated but I am thinking the stress alone of being there will taint the readings. Has anyone ever collected blood via pin prick to the ear at home? My head is just spinning with all my worries and I am hoping that a few members with more experience can provide a word of encouragement for me .... and Duff!

Thanks!
 
Welcome!

Yes, we strongly suggest you home test. It is the only way to be sure the dose you are planning to give is safe and to see how the insulin is working. Here's how we do it: Video for hometesting

We don't see much value in having vets do a day of testing. As you know, cats are stressed there and stress raises blood glucose levels. So you can save money right there!

We have taught hundreds of people how to test over the internet and would be happy to teach you. Here is a shopping list:

A human glucometer. Any one that sips and takes a tiny sample is fine. We do stay away from any meter with True in the name and the Freestyle meters. They have proven to be very unreliable and read lower than other meters. The meters are often free at drug stores; it’s the strips that are expensive. You can, however, buy them on ebay at less than half the price of stores. Lots of people here also like the ReliOn from Walmart. It is an inexpensive meter and its strips are the cheapest around. Try the meter out on yourself or someone else before you try it on your cat. You want to be familiar with it before you poke the cat.

Lancets and a lancet device. Usually, until the ears “learn” to bleed, a 26-28 gauge is good. Any brand will work as long as the lancets match your device.

Ketone strips. (Ketostix) Just like human diabetics use. You will sometimes need to test urine if the numbers are high.

Rice sack. Make this out of thinnish sock, filled with raw rice or oatmeal and then knotted. You heat this in the microwave until very warm but not hot. Then heat the ears before poking. You can also use a prescription bottle filled with very warm water. It provides a good surface to poke against.

Also nice to have. Flashlight: so you can look at the ears and find the little capillaries that come off the vein running down the ear. Vaseline: Put a tiny smear where you want to poke. It will help the blood bead up.

And some lo carb treats to give your kitty, successful test or not Lo carb treats
 
I didn't see in Sue's post to you mentioning you will want to get rid of the dry food.
http://www.felinediabetes.com/diet.htm is a great place to start reading about why dry food is bad for all cats but especially diabetic cats. nailbite_smile

Most of the prescription diet stuff that everyone peddles is too high in carbs. And certainly all the rest are ridiculously high for cats.
You will want to switch to canned food only or even a raw diet ( my cat doesn't like raw).
And there are even some in the fancy feast cans and friskies and 9live on the list so you don't necessarily have to find a specialty store for all the new foods
that are available now. See the janet and binky food list for nutritional values. Pay attention to carbs first then look at the fat and other values as well.
http://binkyspage.tripod.com/CanFoodNew.html

The other thing that I'm sure others will follow and mention is sometimes just changing the diet to canned low carb food is enough to lower the numbers
and go into remission.
The advice given around here is go slow with the insulin. start at 1 unit , if it needs increasing, wait a week at least and then only go up 1/2 unit a week at
most. Especially if you have a dry food junkie, the change to canned makes quite a difference in their glucose numbers.
You will need to tell everyone what insulin so those with experience with what you have can help.
So welcome. You'll find lots of help here.
 
Hi there and welcome! I just wanted to let you know that my kitty was diagnosed at the young age of 4 1/2 so it does happen :-) in all honesty, back when Mousie was diagnosed, being diagnosed so young was quite a bit more rare than it is now. i remember most kitties being diagnosed at a much older age but nowadays it doesn't seem real uncommon to have 5, 6, 7, and 8 year olds diagnosed.

and as far as remission goes, yes, it happens all the time. it's not a guarantee though but it's definitely something to try for, or pray for. i do want to say though that it is also not uncommon for people to get very frustrated, upset, depressed or downright angry about this if they set their expectations too high or just obsess about obtaining remission. our cats didn't get diabetes overnight and it can't be fixed overnight. and the most important thing is to not let this consume you so that your cat becomes a number and not your cat. if your life becomes all about the numbers, you'll want to quit and quiting is kitty's life so no matter what, gotta remember kitty is kitty and as long as they are healthy and happy, you're doing good.

nearly every person on this board pricks their cat's ear and tests glucose levels before giving any insulin shot. it's the only way to know it's safe to do so. so yes to that question. and yes to the question about curving kitty at the clinic being stressful and tainting the numbers. along with the simple fact that regulation cannot be done in a week. it varies from cat to cat to cat and can take many many weeks.

don't worry, it does seem overwhelming in the beginning but seriously, in a few weeks you'll be telling someone else this very thing, it becomes a part of your daily routine and takes no longer than brushing your teeth or making your oatmeal in the morning. i now have two diabetics in my house as I am fostering the most awesome diabetic kitty ever for DCIN (Diabetic Cats In Need) and it takes me less than 5 minutes to test both of them and give them their shots in the morning and again in the evening.
 
Additional food charts and lists:

Pet Food Nutritional Values list
Hobo's Guide To Nutritional Values
Dr. Lynne's Wet Food list
List of low carb gluten free Fancy Feast

The right diet is important for a diabetic cat, just like it is for Human diabetics. Dry food = candy, soda, chips, etc. Low carb canned foods are best. You can even feed raw pet food, either a commerical brand or homemade using a recipie.

HopeforDuffie said:
Also I am supposed to bring him to the Vet office to spend the day next Friday to see if he is regulated
Click to expand...

Very few diabetic cats can be regulated in a week. Those that do go into remission were immediately put on a low carb diet which was enough to lower blood glucose levels to a more normal range. Many other cats need both diet and insulin to become regulated and that may take a few weeks to a few months or more to achieve.

Cindy + Mousie said:
and as far as remission goes, yes, it happens all the time. it's not a guarantee though but it's definitely something to try for, or pray for. i do want to say though that it is also not uncommon for people to get very frustrated, upset, depressed or downright angry about this if they set their expectations too high or just obsess about obtaining remission. our cats didn't get diabetes overnight and it can't be fixed overnight. and the most important thing is to not let this consume you so that your cat becomes a number and not your cat. if your life becomes all about the numbers, you'll want to quit and quiting is kitty's life so no matter what, gotta remember kitty is kitty and as long as they are healthy and happy, you're doing good.
Click to expand...

So true :smile:

Has anyone ever collected blood via pin prick to the ear at home?
Click to expand...

Nearly everyone here tests their cat's blood glucose levels at home. You're not using the ear vein, just the little capillaries between the vein and the edge of the ear. If you accidentally hit the vein, no big deal.

You can use a Human blood glucose meter. The vet may try to sell you a pet meter but it's no more accurate than a Human meter. Plus the pet meter supplies are expensive and not available at any store. Avoid the Human blood glucose meters with "Tru" in the name and the FreeStyle brands. These give inaccurate readings. Wal Mart's Relion brand of meters are inexpensive and what many people here use. I like the AccuChek Aviva. It's cat-friendly and easy to use but test strips are pricey. I always bought test strips cheaper online.

There's a lot of tips and videos here of how to test a cat: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=287
 
Welcome!

Dandy was 6 years and change when he was diagnosed a year ago. I remember having the same thought at the time..."but he's so young, with so much life ahead of him". I've learned a lot about what to do and what NOT to do in that time...(and am still learning!).

- Dry Food = Bad
- Home Test = Good (Crucial, even)(still trying to get the hang of this one)
- Prescription Food = An unnecessary drain on financial resources
- FDMB Users = Brilliant, and so generous. They make you feel good about asking questions!
- Injections = No sweat!

I only really have one piece of advice to add to what folks here have already told you about:

Find a backup BG tester / shot giver!

I'm in a long distance relationship (hopefully not for too much longer...the distance, not the relationship ;)) with a surgical resident, who was not able to manage Dandy's diabetes with her schedule. That said, I moved Dandy down here and I've been taking it on alone. The best thing I've done was find a back up person to give shots when I have a conflict (or want to go on vacation). Though I don't call upon her often, it's so helpful, and so much less expensive and/or stressful on sugarpuss than boarding. (Thanks Jan!!)
 
Thanks everyone so much for all the info. I am certainly hoping that managing Duff's disease becomes an everyday thing!! This morning I went out armed with all the facts and came home with everything we need to get started. Those test strips are crazy expensive! I told my husband we'll have to add Duff on his medical plan as a dependent!! lol

I watched the video on how to pinprick his ears (the cat didn't cry or anything!) and I am willing to try. I know that diabetes is not an automatic death sentence. I decided to do the testing and administering of insulin in the evening simply because the mornings can be quite hectic and I want it to be as peaceful as possible for him. Does anyone know if evening injections are OK or just as good as at any other time of the day? Also my vet suggested we not change his diet just yet. Duff gets half a can Halo wet food in the am and pm, and free feeding of Hill's dry food Healthy Advantage during the day and night. My vet is the owner of the clinic and has many many years (probably 40!) of experience. I don't want to contradict him but I see many posts about how bad dry food is for a diabetic cat. I'm wondering if I should just up the wet proportion?? So many questions, sorry!!

Well I can hardly wait until tonight to get Duff medicated and on his way to feeling better. Please everyone wish me luck!
 
Is your vet saying one injection daily? That does not work for cats. Their metabolism is faster than dogs and the insulin only lasts 12 hours. One dose a day means he will be in decent numbers for 12 hours and then very high for the next 12.
 
@ Sue and Oliver Thanks for the fast reply.....yes it was recommended to start with 2 units once a day, keep his food the same and bring him back to the clinic in one week for a full day stay. Should I be looking for a specialist vet????!!!! Thanks
 
It depends on how open your vet is. You can say you have done research (What insulin are you going to use? We should be able to find some vet articles about the wisdom of twice daily shots.) and you want to divide the dose and give it twice daily. If he will agree, I would think he is open and willing to learn. If not, I would look for another vet. (Twice daily dosing is pretty basic feline diabetes protocol) You may not need a specialist, just someone who agrees with your testing at home, is up on current insulins and willing to see you as the customer (and parent :-D )

Where do you live? (city and state) It may be that we have someone who has a good vet and lives in your city.
 
And the full day stay thing. If you are testing and can fax him your spreadsheet full of preshot and midcycle info, it should be all he needs. And hopefully he will realize that numbers from home are more likely to be accurate than numbers at the vet. (strange noises, animals and people who are not the mommy and daddy!) If he insists on the curve done in his office, then I would leave. It is only a money making adventure for him if you are already testing at home.
 
Hi!

Just a couple of things.
Like Sue said, shooting every twelve hours is best for cats because they metabolize insulin twice as fast as dogs or humans do. If your vet believe 2u per day is appropriate, then shooting 1u every twelve hours would be better than 2u all in one shot. It could be that your vet treats a lot of diabetic dogs rather than cats, so 1 shot a day makes sense to him?

The benefit to "keeping his food the same" would be that it might be the food that is causing the numbers to be inflated, and if you change the diet to a low carb diabetic appropriate diet, then the dose of insulin your vet recommended might be too much. Eating low carb, and ditching the dry Hills food will most likely cause a rapid improvement by lowering BG levels. If you switch the diet, you would also want to be monitoring closely to make sure that the dose is "right", and not too high. But as far as Hill's dry food goes.... there's no such thing as a "Healthy Advantage" to feeding a diabetic cat any dry food made by Hills. In general, prescription foods are a waste of your money.

bring him back to the clinic in one week for a full day stay
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Your vet most likely wants to keep him all day so that they can run a curve on his BG numbers. The good news is that if you are home testing, there's no need to bring him for a stress-filled all day field trip to the vet's office. You can run the curve yourself, get less stress-effected numbers in an environment that he is used to and feels safe in, and then you can call or email your vet with the numbers. It'll also save you a chunk of money!

Carl
 
Hi HopeforDuffy: Please post the type of insulin you are using and your vet's recommended starting dose. My cat uses Lantus and it must be administered twice a day (shots 12 hours apart), so evening-only shots will not work with that particular insulin. I do not know about other insulins, but the senior members here will chime in shortly on that. They will also tell you to eliminate the dry food and feed only wet food. Some cats do not need insulin at all, once dry food is removed. Dry food is typically high carbohydrate, which elevates blood sugar. Here is an excerpt from veterinarian Dr. Lisa Pierson's (a feline diabetes expert) excellent article on the subject (entire article can be found here: http://www.catinfo.org/?link=felinediabetes )
-----------------------------
"Many cats that are in a diabetic state no longer need any insulin when they are finally fed an appropriate low-carbohydrate diet. Others will always need some insulin but the amount necessary to maintain proper blood glucose levels is nearly always significantly reduced once the patient is on a low carbohydrate diet. Please re-read the previous two paragraphs carefully. If you change your diabetic cat's diet to one with lower carbohydrates, he will, in all probability, IMMEDIATELY (not days or weeks later) require a reduction in his insulin dosage. He may also immediately go into 'remission' and not need any insulin at all. If this warning is ignored, you may very well end up with a cat in a hypoglycemic crisis (dangerously low blood sugar) which can result in death, or brain damage.

Also from the same article:

"Unless the patient's clinical signs warrant immediate insulin administration, I try a diet change - with no insulin - for 5-7 days to see what impact the new diet will have on the blood glucose. In most cases, I do not agree with waiting much longer than a week to start insulin. This is because you will have the best chance of getting your cat into remission (cease needing insulin) if both diet and insulin are used very early on. The longer your cat's body is under the effects of glucose toxicity, the more his body will be damaged and the less chance of remission he will have."

---------------------------
Not trying to scare you, but you will hear this over and over and over again on this board - that dry food spikes blood sugar and should be eliminated. I can't tell you why some vets, even those with many, many years experience do not seem to know this, but it is not uncommon. As someone else pointed out in another post, vets are trained to treat everything from snakes to birds to lizards -- and can't be expert in every disease in every animal. For diabetes, I think that it helps to have a specialist -- or at least a vet who is up on current protocols. In the end, it is best to read all the research yourself and decide what makes the most sense to you.

The injections should be relatively easy to administer. They take all of 1 minute. The cat doesn't feel them (believe it or not), and within a day or two you will feel like a pro at this. It takes more time to brush my teeth than to give my cat an injection (I typically give them to her while she is eating, and she doesn't even look up). No kidding. My hands were shaking on the first couple shots, but my cat was busy eating. LOL!! On the other hand, the blood glucose testing (ear pricking) may well take practice and patience. It has taken a month for my cat to sit still for this, to where I am (most of the time) getting readings; though I think I am at the far extreme on this. Most people master it sooner than that. I don't think it hurts the cat much, but it does sting a little and they have to get used to it. The important thing is to keep trying, and for the cat to associate the ear prick with getting a treat. The best advice I got was to try a couple of times, treat and let the cat go -- so as not to traumatize them by sticking their ear over and over and over in one sitting. Others may have different approaches. Within a few weeks the cat's ear actually begins to bleed more readily -- those on the board say that the ear "learns how to bleed" by growing additional capillaries (?). I have found that to be true.

Best of luck to you! I am sure you and Duff will be fine, and within a month this will become an "everyday thing" for you. Post if you have additional questions.

Melanie
 
Hi everyone .... the support in this forum is awesome!

The name of the insulin in Glargine which is the same as Lantus (I think). The vet recommended one shot a day, 2u. It sounds like twice daily is more suitable for cats? I think he may treat more dogs so it is very possible he is unaware of this. I think he would be open to ideas but a little hurt too. Oh well, the aim is to get my cat better, not massage egos, am I right?!!! Of course I will make my suggestions with respect; he has been a wonderful vet for our family for many years. I am definitely thinking the day stay will not do Duff any kind of good and yes all of we cat people know how stressful it is for them to be out of the home environment!

As for the dry food, Duff was already eating it prior to being diagnosed yesterday. I guess the vet thinks changing too many things at once might be too stressful, but I think I will taper off the dry food after reading the posts here. He can eat the Halo and I also have canned Ziwi Peak too. I have yet to research these foods for carb values.

I live in Spruce Grove, Alberta, Canada which is a bedroom community of Edmonton, Alberta (think Edmonton Oilers hockey!). Hopefully we have all the best current meds and info etc available in our neck of the woods. Thanks again....
 
Yes, Glargine is correct, and Lantus is a brand name. Same stuff.

One thing that might help is you were to share this link with the vet. It is the American Animal Hosptial Association's page of guidelines for treating diabetes in dogs and cats.
http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf
If you scroll down to page 218, that is where you will see the dosing guidelines for cats:
Most cats are well regulated on insulin at 0.5 U/kg q 12 hours, with a range of 0.2 to 0.8 U/kg.
The panel recommends a starting dose of 0.25 U/kg q 12 hours, based on an estimate of the cat’s lean body weight. This equates to 1 U q 12 hours in an average cat. Even in a very large cat, the starting dose of insulin should not exceed 2 U per cat q 12 hours.
Click to expand...

That way, he'll know that it isn't just something you heard from a bunch of crazy cat people on the internet! :lol:

Carl
 
Our 4 year old Manx was just diagnosed at the beginning of July, so I know exactly how you feel. We were overwhelmed in those first days, scared, nervous. Just wanted to reassure you that the shots are easy, and even the ear pricks aren't too bad, though we do it with 2 people. He's done amazingly well just with the switch to wet food (Fancy Feast) and the other interesting thing is that the blood glucose curve we're doing at home today has WAY better numbers than the ones done at the vet a few days ago. And our vet charged $150 for that day of 5 blood glucose checks - unbelievable!

Our vet told us to start with 2 U of PZI twice a day, after finding this wonderful community I immediately made it 1 U twice a day. Now that he's responding so well, we're going to be dropping down to 0.5 U twice a day. I don't know if he'll be lucky enough to be able to stop insulin, but I know for sure that he'll never see dry food again. And the same for our other 3 cats.
Jane
 
Good morning,

I can't thank you all enough for your friendliness and responding to a real newbie here! I gave Duff his first needle last night and he didn't flinch, cry or show any reaction of any kind! I fretted about it all day but got more brave after reading the postings in here!! Of course I gave it to him while he was eating (I hope that was OK) so he had only one thing on his mind! lol He was very good. I am encouraged, so much so that I am planning to do the first ear test later today. And I have decided to do the 1u twice a day regime as recommended by everyone here in the forum; I just have to alert the vet office on Monday. Perhaps he was thinking if I can get her to do one needle I'll be lucky lol

So my next big hurdle will be the full day testing. Please, can anyone tell me how many times per day (5x?) I need to draw blood, and at what intervals? It is set to be done this Friday. Then I will fax my readings to the Vets' office and go from there. I really really don't want to leave him there the full day, I think the readings will be off and he will be so unhappy and I will be worried the entire time anyway. I think a more hands-on approach supplemented with vet support would be ideal and is my goal. Duff was a feral rescue and in the months it took me to socialize him I really have become very attached to him and I want the best possible outcome for him. Thanks again for all the tricks and tips and I'll be a frequent visitor I think!!

Natalie
 
Welcome Natalie and extra sweet Duff!

KT was 8 years old when he was dx'd - I truly believe he had it for quite some time even before that. We've been 'dancing' for over a year now - KT comes to the sound of the beep of his meter, the shake of the strip container or the zipper of his testing case. We test usually about 5 times a day...when we first get up, at shot time (an hour later or so), about 4 hours into cycle, roughly 8-9 hours into cycle and at PM shot time. If his numbers are decent, there are about 3 more tests - one about +3, +5, +7. If he's low, it's at least hourly starting at +2. Some days we do up to 10 but those are not 'normal' days. You'll figure out Duff's pattern and adjust your schedule accordingly.

BIG HUGE HUG! You've already got SO much headed the right direction!!! GOOD WORK!
 
Hi Natalie and Duff. Welcome to one of the most fantastic communities in the world. Yes I Know you really don't want to be here but believe you will be very glad that you found the FDMB. Never a better group of people have graced the planet. My Tori was diagnosed back in June 2005 when she was 8 years old. She managed to get off the juice for 2 years after a year on insulin. She went back on insulin in 2008 and stayed on it until she went to the Bridge last year. She died of Lymphoma - nothing to do with the Diabetes at all.

Anyway Sue asked me to drop by seeing I live in Edmonton in the west end. It looks like you have gotten great advise so far and congratulations on your first successful shot. Funny the one time Tori wouldn't let me do anything to her was when she was eating. If things don't work out with your vet my vet is wonderful. His name is Doug Heffelfinger and he is a partner at Crestwood Veterinary Center. He is very knowledgable and a very kind and caring guy. He saved Tori's life many many times. He was named Young Vet of the Year last year by the vet association.

If there is anything I can do for you please give me a call. I'll PM you my number. I won't be on line later today and tomorrow. We have to dismantle the living room. We're getting the windows replaced tomorrow. Great fun.

Take care and remember to breathe. In a few weeks you'll be an old pro.
 
Hi Natalie! Glad to hear that the injections are going well. Depending on the cat, sometimes the ear tests take more time and practice to master -- though some people are successful right away (unfortunately I was not one of those...LOL!). One thing that helped me regarding the curves is this article from the FDMB site, written for beginners: http://felinediabetes.com/dummies

It contains an enormous amount of information (I printed it off and am using it as reference material). Especially helpful to me was the paragraph about curves -- saying that if you have trouble getting multiple readings in the same day for your curve (as some of us newbies do), that you can spread the testing out over multiple days. So that, for example, you could get a +2 reading on Monday, a +4 reading on Tuesday, and a +6 reading on Wednesday, etc. The only stipulation is that the insulin amount given and the food have to remain constant during that period. Here is the link if you want to print and read for yourself:

http://felinediabetes.com/dummies

(excerpt from the article:
"Glucose curves don't have to be done all in one day. If the insulin and food are held constant, you can spread the testing over several days and wind up with just as accurate a picture -- possibly even more reliable than a day in which he got an ear stick every time he woke up. Also, you can start your curve at any time of day. For example, test at 7 pm and 9 pm Friday, 10 am and noon Saturday, and so on. When you have at least one test for every two-hour block, plot them all on one graph as if they were taken on a single day and in sequence. Keep in mind that you do not have to interpret blood glucose curves. If you want to do the tests, plot the curves, and take them to your vet for interpretation (some will let you fax the curves), that is just fine."





HopeforDuffie said:
Good morning,

I can't thank you all enough for your friendliness and responding to a real newbie here! I gave Duff his first needle last night and he didn't flinch, cry or show any reaction of any kind! I fretted about it all day but got more brave after reading the postings in here!! Of course I gave it to him while he was eating (I hope that was OK) so he had only one thing on his mind! lol He was very good. I am encouraged, so much so that I am planning to do the first ear test later today. And I have decided to do the 1u twice a day regime as recommended by everyone here in the forum; I just have to alert the vet office on Monday. Perhaps he was thinking if I can get her to do one needle I'll be lucky lol

So my next big hurdle will be the full day testing. Please, can anyone tell me how many times per day (5x?) I need to draw blood, and at what intervals? It is set to be done this Friday. Then I will fax my readings to the Vets' office and go from there. I really really don't want to leave him there the full day, I think the readings will be off and he will be so unhappy and I will be worried the entire time anyway. I think a more hands-on approach supplemented with vet support would be ideal and is my goal. Duff was a feral rescue and in the months it took me to socialize him I really have become very attached to him and I want the best possible outcome for him. Thanks again for all the tricks and tips and I'll be a frequent visitor I think!!

Natalie
Click to expand...
 
Hi Natalie & Duff, glad your hear and that Duff is on his way to feeling better. Generally speaking a curve is doing a blood glucose test before feeding and then at regular intervals until the next shot. So if you do your first pre-meal test at 8am, feed, then at 3 or 4 hour intervals do another blood glucose test (noting if you gave a snack during the day. So for me a curve would be 6am - blood glucose test, feed, 9am BG test, 12pm BG test & snack, 3pm BG test, 6pm BG test & feed. That is basically what they do at the vets office - when you do it its minus the stress. It also saves you lots of money - my vet charges $127 for a curve that I can do myself for about $5.00 in strips. Keep up the good work!!! Jan
 
Hi everyone,

I'd have to say I'm a little bummed out - I talked to my vet this morning who recommended that we NOT change the dose to 1u twice daily yet and to keep with the single daily dose of 2u. He said 30-40% of cats in his experience have done very well on this schedule and doesn't want to change anything in the first week. He said Duff may end up twice daily but still wants start off 1x per day. I don't want to become obsessive but on the other hand I want to be Duff's advocat too. Have to say ... it's a little frustrating because I think the people in here are so knowledgeable and I want to skip the regular protocol and go right to what will probably ending up working out the best anyway, what people in this forum say .... <sigh> I haven't worked up the courage yet to the ear stick, but I did take the flashlight and take a really good look at the vein (it really does look like a red string!) and get my landmarks all set. Anyone in my area want to come over and babysit me while I give it my first try? lol

So I will give the Vet the first week with some misgivings. Wish us luck and say a prayer that Duff will be in that magical 30-40% subsection of kitties who do well. And, I was right, I thought he recommended 1x daily partially due to convenience/compliance from the owner, and he did refer to that during our conversation this morning. I will clue him in that I am willing and able to do twice daily injection, now that I know Duff doesn't really bother about it.

Thanks, good people!
- Natalie
 
That is discouraging, but I understand that it is hard to go against your vet. One thing you could consider is to start testing and get numbers for the am cycle and the pm cycle to contrast. If your kitty is like 99.9% of the thousands of cats on this forum, the cycle after the insulin will be much lower than the cycle without an insulin shot. A few cycles like that should be pretty good evidence that the insulin is only lasting 12 hours or so......

I do wonder how many "cats he has in his experience"......And whether they ever were regulated or went into remission.......

I would concentrate on getting the test down. Do the basics first - try the meter on yourself so you are sure how it works, get the bigger lancets 25-28 gauge) set up the rice sack or pill bottle. Try it and see how it works. Don't be discouraged if you don't get blood on the first try - the majority of us tried quite a few times before getting a drop. Just give a treat and praise. Come on and describe your technique and we will bombard you with tips and advice.

Serously - what city do you live in? We might have a member who lives nearby who could come help.
 
Hi Natalie! I was scared to do the first ear stick myself. If you're too nervous to stick Duffie today, you could do some test runs to get him (and you) used to the protocol. You could warm his ear with the rice sock, put a test strip in the meter (you can put it back in the container once the test run is finished if you don't use it); take the EMPTY lancet pen, cock it, and thump it against his ear (so he can get used to the clicking sound), give him an "atta-boy" and a treat and let him go. You can do that several times today and he will start to associate the testing procedure with getting his favorite low-carb treat. PS: It would help if you could limit treats to only this testing activity -- so he knows that if he wants a treat, this is the only way he is going to get one.

Then once you feel comfortable with the procedure in general, you can insert an actual lancet into the device (26 or 28 gauge) and see how that goes. You might want to practice on the back of your hand first...and also practice sipping the blood off your hand. You probably will not get blood on the first try with Duffie, but that's ok. Just stick his ear once or twice and even if no blood -- treat him and let him go. You don't want to traumatize him by sticking him over and over and over again. That's my advice. As I tell everyone, I am the world's WORST bg tester -- it took me a LONG TIME to get this down, so I am passing along what worked for me after a lot of errors, crying, and trying. Also, know that it gets easier with time!
 
Then we had a couple people who lived by and posted to your thread. Send them a private message to see if they would be willing to help you home test. I think Barb and Tori sent you a pm with their info so you could contact them.
 
Hi! I hope no one is saying Oh not her again!! !

Well I made some progress on the ear testing tonight. I keep telling myself: baby steps, baby steps. Armed with my trusty sock full of rice and my automatic lancer I held Duff until he was pretty comfortable, then ran through some mock ear testing. Pet, he purrs, put the sock in the ear, he purrs and kneads, draw back the lancer button, he still purrs and kneads and voila! one quick flick of the finger and it is released!!! Duff keeps on purring and kneading while looking up to see what happened, and should it even concern him ... lol By the time I was finished praising him and petting him, my little dog wanted in on the ear action! lol Now, next step, actually load the lancer with the little lancet .... there's always tomorrow. On the up side, it seems he is drinking less water. But, without doing the testing and actually knowing his BG, I mean, really what is the use of making visual guesses???? I printed out a lot of information from the forum today, reference material, so important when you are just starting out.

Say, while I was practicing I had a thought - has anyone ever traced the ear vein with a Sharpie marker so you'd know exactly where to go??? It would probably last a fairly long time and be invaluable, wouldn't it??? It would probably cut down on a newbie's uncertainty about where to poke??? Does anyone think Sharpie markers are like totally toxic???

Thanks again. I'm saying prayers for all our precious felines afflicted by this insidious disease, and kudos to all the people trying to help them!!

- Natalie
 
Hi Natalie! Trust me, no one is saying "Oh not her again"....LOL! In fact I look for your posts each am and pm to see how things are going for you. Others probably feel the same way. We all know how hard it was for us in the beginning, and giving support to new-newbies (from the old-newbies...LOL!) is rewarding. You are right....baby steps. Sounds like the mock ear testing went well. Too bad you don't have more time to repeat this over and over until Duff associates the rice sock with "all that is good." LOL!! Don't be surprised if Duff is not as excited when when actual lancet hit's his ear. Just be ready with the "good boys," petting and treats -- and resist the urge to keep sticking and sticking and sticking if no blood is forthcoming. Who knows...you might get lucy!

Not sure if I or anyone already mentioned this, but it helps to put a tiny speck of Neosporin (the pain relief version) OINTMENT on the ear before testing. It MUST be the ointment, not the cream. It helps the blood drop to form rather than spreading out onto the ear hair, prevents infection, and has a pain relieving agent. So rubbing a touch of that on Duff's target ear could be part of the ritual.

I like the idea of using a sharpie to mark the ear -- though my cat is black so probably not so helpful. LOL!! Here is a great article I found from the New York Times health and science section supporting the use of sharpie's over surgical pens (yes, I was shocked to hear this too. Says there was a study done by infection control experts at the University of Alberta comparing the use of sharpies over surgical pens; and because the ink in the Sharpie is alcohol based, they said it killed bacteria better than the surgical pen. Here is the link if you want to read it yourself http://well.blogs.nytimes.com/2008/10/2 ... a-sharpie/

I will copy some of the pertinent text below:
---------
"In a controlled experiment, the tips of both kinds of pens were heavily contaminated with four types of bacteria that can cause surgical site infections, including two germ types that are resistant to antibiotics. The researchers recapped the markers and allowed them to sit for 24 hours.
Surprisingly, the sterile, one-use marker was still contaminated. But the Sharpies were not. As it turns out, the ink used in a Sharpie pen has an alcohol base, making it an unexpected germ fighter. The researchers, who will present their findings at an infectious disease conference later this month, noted that they used an unusually large number of germs on the markers to conduct the experiment. That suggests that in the real world, a Sharpie would be highly effective in preventing the spread of germs even after multiple uses.

“We went much further than what would happen in real life,” said Dr. Sarah Forgie, associate professor in the department of pediatrics, in a press release. Dr. Forgie noted that the pen itself should be cleaned with an alcohol swab between patients, just as is done with stethoscopes. However, she said the marking tip does not pose a risk of bacterial transmission and doesn’t need to be discarded after each use, potentially saving thousands of dollars in annual hospital costs."
--------
 
PS: One final comment, I believe you said you were going with your vets original recommendation of 2 units once a day (at least for this first week anyway), rather than 1 unit every twelve hours. Don't know if anyone here mentioned it, but 2 units once a day IS NOT the same thing as 1 unit twice a day. The Lantus wears off after 12 hours -- so basically you are giving a double dose up front and then nothing for the remaining 12 hours. Two units (given at one time) is not a recommended starting dose here on this forum or by the American Animal Hospital Association (AAHA). Most people here recommend starting LOWER, like 1 unit and building up or down, based on the mid-cycle blood glucose reading. So just wanted to emphasize that you are taking a greater risk of creating hypo in Duffie starting out this high -- particularly since you do not have blood glucose readings on him yet. I am not trying to scare you. My original vet recommended starting at 2 units too (we eventually settled on 1 until I could get better at home testing); so Duffie may be fine at that level -- but you should be monitoring Duffie for symptoms of hypo just in case: viewtopic.php?f=28&t=15887 . Here is the link from the AAHA which you can show your vet. They recommend starting at 1 unit twice a day for the average cat: https://www.aahanet.org/Library/DiabetesMgmt.aspx

Senior posters, please weigh in on this too. Thanks!!
 
@MelanieP amnd Ninja

Hi, thanks for the post! Yes, other members have cautioned about the efficacy of Lantus after the 12 hour mark. I called my Vet first thing yesterday to request that we switch to 2x/1U and he still wants me to do 1x/2U. What am I going to do? Short of totally contradicting him and going in armed with the printout of the link info you provided .... hmmmmmm...... that might be what I HAVE to do, for Duffie. I am usually non-confrontational but I really want to be totally involved in his care and well-being. I am scared of doing something wrong and creating a whole 'nother problem for Duffie and I think creating hypo would be horrible. Of course it will happen when I am at work and not there to help. I have printed out a lot of information about signs of hypo and I am watching him closely, but again, without BG results it's just a guessing game. So I very much so see the importance of at-home tesing, just like human diabetics. By the way, I did try a lancet on myself and I thought it hurt like heck so hopefully Duff is tougher than I!!

And the Sharpie idea, I had to laugh because I hadn't seen that before and now I see it is a good idea, especially for those of us somewhat freaked out about lancing our cat, and then discovering it was in the wrong place anyway. But now I think I will proceed with that plan! Also, I think I will be taking Thursday off from work, and I am itching to grow my at-home BG testing wings. So Thursday will be the big day. Again, sending good thoughts and prayers my way would be appreciated!

Natalie
 
I am definitely sending good thoughts and prayers your way. Like you, I tend not to be too confrontational -- but when the life of my "baby" is at stake, then I take a stand. One of the posters here gave me strength by saying to remember that I AM THE CUSTOMER -- and that I am paying the vet to guide me, not to dictate to me or ridicule me if I don't happen to agree with him; and also that vets are not "all knowing." Most vets are not expert in diabetes care.

My first vet was VERY INSISTENT we start NInja at 2 units, twice a day, but I just kept saying, "I don't feel comfortable with that, particularly since I don't know how to home test yet; so would prefer we start at 1 unit." And I did hand him printouts of the studies supporting this (which he glanced at and handed back to me within 2 seconds). He did not like it that I stood up to him, but finally he gave in (with an attitude!). I immediately proceeded to find myself a new vet -- one who was supportive of home testing (my first vet couldn't even show me how to do it, because he had never done it himself), and one who would let me call in my numbers rather than requiring me to bring Ninja in for expensive tests. It was the scariest thing I have ever done -- going against my original vet's recommendation and trying to find a new vet. But when I did, I felt like a huge weight had been lifted from my shoulders.

I hope it works out with your current vet, but please don't be afraid to switch if he is not willing to let you be a partner in Duffie's care. That is your right. Another alternative is to retain your current vet for routine care (checkups, etc), but transfer monitoring of Duffie's diabetes to a vet who is expert in that field (like you yourself might be referred to a medical specialist if you had a particular disease). That way, you don't have to offend your current vet altogether. This is totally your decision though!

Sending only good thoughts your way! :)
 
Hi and welcome to you both :) I'm next door to you in BC.

30-40% of cats may have "done well" on your vet's dosing, but Lantus studies showed an 84% remission rate when started on Lantus tight regulation protocol within 6 months of diagnosis. My cat Scooter was diagnosed with diabetes at only 5 and a half years old. After 7 months on Lantus tight regulation he is in day 11 of his OTJ trial. :smile: So yes, please dose every 12 hrs. Although Lantus lasts for 24 hrs in humans, cats have faster metabolisms than humans... about twice as fast, so the insulin lasts half as long. It would be obviously ineffective after a few days anyhow.

I would start with 1u every 12 hrs or even .5u every 12 hrs.
 
KK, so after much stewing, I decided it might be a good idea for me to take Duff over to the Vet office for the Vet to show me how to do the ear testing. While I am there, it may just behoove me to request we put Duff on the twice daily protocol. heh heh Is that too sneaky???
 
I assume your vet is open to hometesting? You might take along the meter you plan to use so you can compare it to his meter - same drop of blood. Be sure he takes blood from the ear, not from a vein in the leg or something. (yes, some do...)

Good luck. Paws crossed it will work.
 
Here are some documents for you to print out and give to your vet along with the AAHA guidelines.

http://www.uq.edu.au/ccah/docs/diabetesinfo/link5.pdf

Note where it states, "When SID dosing is desired or demanded (it is important to note that better glycemic control and
higher remission rates will be obtained with BID dosing. SID dosing only provides similar control and
remission rates to lente BID)."

Here is the Lantus dosing protocol: http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf

Note that the stated starting dose is 0.25 IU/kg of ideal weight BID.

If your vet still insists on the 2u once a day after bringing him this information, I would find a new vet. A vet that dismisses current veterinary treatment guidelines for whatever reason is not one that I would want to see my cat.

About 25% of cats go into spontaneous remission from the diet change alone, so that could be why your vet thinks that 2u once a day works with 30-40% of cats. However, those 25% of cats would go into remission no matter what insulin and dose they were on. More commonly 2u once a day leads to higher blood sugar levels--most cats on a low carb diet do not need much more than 1u, so 2u is usually too much insulin to start with. When a cat drops too low on too high a starting dose, their livers release glucose into their bloodstream to counteract the low number, leading to very high blood glucose levels. If you're not testing several times a day mid-cycle, it will appear from the preshot tests that the insulin dose is not working, when in fact it is working too much.
 
Hello everybody! Guess what! I made a minor victory!

I took Duff to the Vet this morning to discuss his treatment and so that I could have some hand-holding for my first ear test! Well, the good news is : we are changing his meds to 1u/2x daily and that the ear test IS no big deal at all! Duff did not even react to the lancet poke at all, he just purred through the entire ordeal! His regular Vet was in surgery so I had to see an associate Vet. Oddly enough, this vet had a diabetic cat of her own and yet she had to get a vet tech to be with me during the ear test because she wasn't comfortable doing it that way. She said she had always done her BG testing via leg vein. Strange, isn't it? However, I was satisfied with the change in administration of the Lantus. When I took the BG reading it was 20.9mml/l which is I understand a reading of about 376. So she did agree that the dosage is not working for him. I can't understand why neither vet has recommended withholding dry food, I just can't. I asked about it this morning and she said to just keep his food the same. I don't understand. So, she wanted me to give him 1u of Lantus when I got home from the appointment (already done that - no problem) and then 1u tonight. I think the Vets in this clinic prefer the slow and steady way of doing things whereas I am sorely tempted to stop the dry food altogether.

So, I now am able to do the insulin injections solo, the ear test solo, and I just can't thank everyone enough for the encouragement you sent my way. If it weren't for groups like this one, people like me (afraid of hurting her cat, afraid the needles will hurt soooo much!) would never find the courage and the mettle to step up and do what needs to be done. I know I am still in the early days of his treatment but it's so good to know you are all here for support!

Natalie
 
Hi again, one last thought ..... do you all think a newbie such as I can do a home BG curve as the next step in his care??? Is that a good sound and logical next step? I thought to try tomorrow, or with the change in administering the Lantus should I wait a few days?? Thanks again.
 
Hi Natalie! That is great, great news about the twice a day dosing of the Lantus and also about the BG testing success!! I am so happy to hear that. Though I would say again that the dry food your vet said to continue feeding is likely driving Duff's high BG numbers and may be a reason the dose of Lantus is not working for him.

It's kind of like diabetic cats are "allergic" to dry food -- and when they eat it, their blood sugar spikes very high. Like, if you were allergic to pollen, peanuts, strawberries or shellfish -- you are going to have a reaction whenever you are exposed to those things; and you can take medication to help you overcome this reaction (like antihistamines for pollen) but the real answer lies in eliminating or minimizing your contact with the items that are causing this reaction in the first place.

Same with dry cat food. You can continue increasing the insulin dosage to try to counteract the effect of the dry food "allergy" in the cat but the real answer lies in eliminating the dry food. Why do some vets not know this? I don't know -- but the medical studies all support this.

The other reason why the Lantus may not appear to be working thus far is the once daily dosing you have been instructed to give (until today). So the high reading at the vet could be from that too. Once you get consistent twice-daily dosing the BG should come down. I would also say as a reminder that you should give injections 12 hours apart. So if you give them at 7am then the next one shouldn't be until 7pm -- as the Lantus lasts approximately 12 hours.

But, great news about the move to twice daily dosing and BG testing!!!!! PROGRESS!!!

:)
 
Natalie,

First I want to applaud you for doing such a good job. Duff will (fingers crossed) pay you back with many more healthy years of snuggles and purrs.

I do want to remind you that at the end of the day, Duff is your cat. What you do with him is entirely your own decision. You know Duff better than your vet ever will. You do not have to follow your vet's rules if you don't' want to. Just like you don't have to follow ours either (lol). I'm just saying this to remind you that if they tell you to shoot once a day and you want to shoot twice a day, go ahead and do it. They can't stop you, and if they try to disown you for going against their advice.... well, things are probably better off that way!

On the other hand I know it's hard to go against the advice of a studied, practiced, and licensed vet sometimes. But you've seen first hand just how little vets really know about feline diabetes. In some ways, it's expected, because they have to know so many things about so many different animals. But us here on FDMB, we live and breathe feline diabetes every day of the week, 24/7/365. We have devoted our lives to it and we know it inside out. Thanks to the amazing advice of this forum, my Scooter will be celebrating his OTJ (off insulin!) party tomorrow. :-D
 
I thought I would weigh in on the vet issue.

You have all of us to use as a sounding board. If your vet is telling you something that doesn't sound right, ask them for their own personal
success percentages.
How many pets have they brought to remission from diabetes? Of course they aren't going to admit anything.

I was just talking to someone who used to work at our animal shelter and she told me that the biggest fiancial contributor to veterinary diabetes studies
is Hill's.
I'll have to go look up that statistic to verify it but....
it sure makes sense as to why none of them spend time to learn about proper diet for a cat.
And I don't think I've ever been in an office that didn't have it for sale on their shelves.

Everything said on Dr. Lisa Pierson's website www.catinfo.org

and the new vet I found http://www.2ndchance.info/diabetescat.htm makes sense.


Keep learning. Read what they both have to say. You will be able to defend your position with any medical person when you know more than they do.
And the reason you know more is because you have an investment in knowing. It's important to you and to all of us.
You will learn even more by reading other peoples questions and the answers that are given to them.


When you are ready to change the diet to canned low carb food, just make sure you also lower the dosage of insulin so that you
can observe how the diet change affects the bg.
the bg is likely to go down as much as 100 less, and that change affects how much insulin is needed right away.

It will change again in a week or so but I would call this approach a "Reset".

I never paid attention to diabetes before now.
But I have quickly come to this thought...
How can insulin do what it is supposed to do for the body ( human, dog, cat ) if the diet which caused the problem in the first place isn't addressed?

I should shut up.
 
Good Morning! Thank you for the links; there is a lot of great and thought provoking information in there. Already I have reams of printed reference sheets! lol I see where this diabetes is a very complicated situation.

So I have been able to get a blood glucose from Duffie this morning and it was pretty high again. I gave his 1u Lantus at 720am and at 825am his BG reading was 23.3, which is bad considering it should be in the 7 - 11 mark. Am I doing something wrong? Yesterday at 1249pm it was 24; he was given his insulin at 720am yesterday morning and at 720pm last night. I thought I would see lower numbers by now, maybe I am getting ahead of myself and I am being like when I was on a diet and weighed myself every day! lol On the up side he is really good about the ear testing so I hope that continues. He seems in good spirits though.

So I will continue with the Lantus and tomorrow is my day to do the full at-home BG curve. I will find the formula to convert the Metric readings by then. lol

Natalie
 
How to create a spreadsheet.


http://www.felinediabetes.com/FDMB/view ... =6&t=18207


It would help everyone advise better when they can see all your numbers.
I would start a new thread if you need to ask new questions.

It takes a few weeks for the patterns to emerge and certainly random bg tests.
Doing a curve will help you see how fast the insulin is working and when it is at it's peak and when it starts dropping. Every cat is different.

So don't get too focused on one number not going up or down the very next day.
The spreadsheet will help you see it clearer. If you push for results too early in the game, you risk a hypo situation.
Be patient !
Your cat didn't develop this overnight and as much as we want to.... We can't fix it quick either.

The fact that already the numbers have improved so much shows you are on the right track and your chances of remission are really good.
I have had to find patience as well.
 
Natalie: Are you still feeding the dry food the vet advised? If so, that is probably why the numbers continue to be high. You could always experiment for a couple of days -- try the wet food and see how the BG numbers react.
 
Hi there,

@ MelanieP and Ninja
Yes, he still has access to the dry food but I ended up switching to his other dry food, Halo Grain-free turkey. I have upped the amount of wet food and I haven't had any complaints so far! lol Oddly enough, he doesn't devour his regular Halo wet Lamb food but is now showing a definite preference for Ziwi Peak Rabbit canned. Not sure why; may mean nothing in the grand scheme of things. My long range plan is to eliminate the dry food altogether. Poor Duff! All these changes! If only I could tell him "it's for your own good" and "it's hurting me more than it's hurting you"! lol

@rhiannon and shadow
Thank you for that; I knew I had seen it in here somewhere. Hope I'm not showing my age but I actually made a graph today on real graph paper! I couldn't believe I actually found some for one thing. I have time of sample against BG reading, starting at 7am tomorrow and running every few hours until about 8pm. I'm very curious to see how it will turn out and if he will start running from me. I do have some really good treats that he loves so I sure hope that helps. I know he didn't get it overnight and I've been racking my brain for things I could have done to cause him to be diabetic. I used to give him some Greek yogourt (like just a little dab on his front paw) and I wonder if that kind of precipitated things. Guess a person can't start thinking like that though; you can drive yourself a little nutty!

@ Sue and Oliver
Great to have the Metric conversion formula, thank you! It sure helps when you are speaking the same language. I do remember the Imperial measurements but just the regulars such as gallon, pint, mile, etc etc. It gets a little fuzzy when you get down to the millimoles etc. I am anxious to find out how "Duff's First BG Curve" will pan out!! I'll be sure to post!!

Thanks again everyone from all over North America! Your input is invaluable!!!!

Natalie
 
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