New to the Forum. Trying to remain hopeful...

BootsFolks

BootsFolks

Member
Hello All,

Our 14 year old cat, Boots, was just diagnosed with diabetes on Thursday. He has been presenting with diabetes-like symptoms for at least 6 months (lethargy, changes in gait, abdominal bloating, excessive urination/hunger/thirst). After several trips to the vet with no x-rays, blood/urine tests providing anything concrete, on Thursday, his glucose reading was 245 and we are now moving forward with the insulin injections We are starting with 1 unit of Lantus 100 twice per day. He has been lethargic for awhile but the last few days (since starting the Lantus) even moreso as well as unstable when walking and last night his eyes were glazed. This could be stress from the vet visit and Gabapentin but I want to make sure that I'm not missing signs of anything correlated to the Lantus.

I'm heartbroken to say that he just seems miserable and I am wondering if we got to this too late? Is there still hope? How soon after starting insulin should I see a change? And as aforementioned, am I missing any alarming signs or what should I be on the lookout for post Lantus injection?

This forum is a Godsend. Many thanks...
 
@BootsFolks
Welcome Boots Folks
You couldn't have found a better group to join
The experienced members here helped me get my cat into remission for over 3 years until he passed away from cancer.

I will tag some experienced members for you but first we need more information about Boots

I'm no expert at giving dose information but maybe the dose is too high

Here is the information we need for your signature
Just click on your name up top and then tap signature and add this information. It's at the end of everyone's post in gray letters
  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Bexacat or Senvelgo (if applicable) and dates
    • Acro, IAA, or Cushings (if applicable)
    • 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.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


Here is the link to our spreadsheet so you can record cats BG numbers , the link will also explain how to use it
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/


In your title to draw more attention to your post can you put in front of New to the Forum
PLEASE HELP
To do that tap on the word to the right that says Thread Tools then tap on Edit Title and add what I said then tap save

Meantime you can read all the yellow stickys here about Lantus

https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/


I hope you are home testing it's the only way to keep Boots safe

If not

Here is the link for the meter and test strips so you don't have to search for them. Most of us use human meters
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197
At least if you need more test strips you can run into Walmart and pick them up or if you're running low you can just order them from Walmart on line



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. Youcan 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
c2b8079a-b471-4fa6-ac36-9ac1c8d6dcca-jpeg.57072
fec17d29-5ab4-44a8-912b-3a91944c3954-jpeg.57073

6. As the ears get used to bleeding and grow more capillaries 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 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets any brand
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with

Try putting a thin layer of Vaseline on the ear so the blood will bead up


Here is a video one of our members made, just ignore when she has to code it, that's because she is using a pet meter ,with a human meter like the Relion no coding is needed
VIDEO: How to test your cat's blood sugar

How numbers are based on human meters


Are you using these syringes

Using syringes with a pen, cartridge, or vial:
  • U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus, Levemir, or the Biosimilars from vials, cartridges, and pens.
  • BD Ultra-Fine, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings.
  • Syringes come in 5/64 inch (6mm), ½ inch (8mm) or 5/16 inch (12.7mm) needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest)
  • Full and half-unit syringe scales:


Walmart, you can get U100 insulin syringes with half unit marks for $12.58/100.
You need to go into the store to get them

Either of these 2 boxes are the ones you want (with a purple stripe). You have to go into the store , can't buy them on line
upload_2024-4-22_23-37-23-jpeg.69946





This was posted by a member and copied it for you
If you're going to Walmart, ask for Relion 3/10ml, 31 or 30 gauge insulin syringes. (Don't mention half unit marks because this tends to confuse them and they think you don't know what you want and will try to convince you that you need 1/2ml syringes---you DON'T)

ALL of the 3/10ml Relion syringes at Walmart have half unit marks. Trust me on this. You will want one of these boxes of syringes (the difference is the needle length...blue box are shorter needles than white box but both work fine). As long as the box has the purple stripe, they are the correct syringes.
 
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BootsFolks said:
Hello All,

Our 14 year old cat, Boots, was just diagnosed with diabetes on Thursday. He has been presenting with diabetes-like symptoms for at least 6 months (lethargy, changes in gait, abdominal bloating, excessive urination/hunger/thirst). After several trips to the vet with no x-rays, blood/urine tests providing anything concrete, on Thursday, his glucose reading was 245 and we are now moving forward with the insulin injections We are starting with 1 unit of Lantus 100 twice per day. He has been lethargic for awhile but the last few days (since starting the Lantus) even moreso as well as unstable when walking and last night his eyes were glazed. This could be stress from the vet visit and Gabapentin but I want to make sure that I'm not missing signs of anything correlated to the Lantus.

I'm heartbroken to say that he just seems miserable and I am wondering if we got to this too late? Is there still hope? How soon after starting insulin should I see a change? And as aforementioned, am I missing any alarming signs or what should I be on the lookout for post Lantus injection?

This forum is a Godsend. Many thanks...
Click to expand...
@Bron and Sheba (GA)
@Sienne and Gabby (GA)
@tiffmaxee
@Angela & Cleo
@Wendy&Neko
 
Welcome to the forum. You have not caught this too late. That’s not that high a BG especially adding stress from being at the vet. Was this the first time the BG was out of range? Did tge get run a fructosamine, a test that gives you a range if tge BG over tge past two weeks? What are you feeding him? We’re gge rest of the labs in normal range? Are his kidney cakes at all elevated, the creatinine Phosphorus, Bun? Was a urinalysis run?
 
Thank you so much. I'm trying to understand these new medical references - please bear with me.

In July we wanted to rule out any medical issues that could have attributed to Boots peeing outside of his litterbox. The vet told us in December he was pre-diabetic and had us switch to glucobalance wet foot (no dry food). Boots has had a good appetite through all of this but his affect has been gradually declining every week. The vet did indicate that there might be something else going on (e.g., cancer) that x-rays and labs have not picked up. She has been a bit mystified by his dramatic presentation without corresponding labs. When we were there on Thursday to get the Fructosamine test, he was in such distress and the urine test was brown and I believe his glucose at 245 (or 345... I was panicky). We opted to not put him under further stress to undergo the Fructosamine test and moved forward with the Lantus starting with a small dose.

I've extracted some of the lab ranges:
2/27/25: Distix Test: Ketones - Negative/Glucose 1+/No bacterial growth
2/18/25: Phosphorus (60); BUN (27); Creatinine (1.4); Glucose (258); Lymphocytes (7); Absolute Neutrophils (8918); Absolute Lymphocytes (686).
12/8/24: BUN (27); Creatinine (1.3); Glucose (242); RBC (4.9); HGB (8.1); HCT (25); Platelet (92); Absolute Neutrophils (7298); Absolute Lymphocytes (656)/Glucose Strip 2+
7/10/24: Glucose (106)

I thank you for the information regarding test monitors, syringes, and test strips. We were told we would next to start testing him at home with o additional information regarding how or what to use to do so - so again. Thank you. We were sent home with VetriJec Insulin Syringes (1/2 inch/29G) for the Lantus.
 
The food you are feeding is about 14% carbs which we consider middle carbs. Low carbs is under 10%. There’s nothing magical about veterinary food and it costs more. Feeding low carbs will help bring down the bg. If the bg was 345 he’s likely diabetic. Do you know what the USG was in the urine?
 
Was Boots eating any wet food prior to his diabetes "diagnosis"? I say that because a one time high BG (blood glucose) can be from vet stress. Too bad about the fructosamine. It can rule out one time higher blood sugars as it's an average over a couple weeks.

The Glucobalance is too high in carbs for a diabetic cat. I know, go figure! It's 14% carbs and we want to feed below 10% carbs. There are some commercially available foods in this food chart, many of them under 10% carbs. At this point you may want to get in a selection to see if there is something he'd prefer to eat. Or close to what he was eating before hand.

Do your syringes have half unit markings? A low dose for us is a starting dose of 0.5 units.

Did the vet say anything about the HCT? That looks like he might be anaemic. Could you double check the phosphorus, that seems really high!

Here are some tips/videos on home testing. Let us know how we can help: Hometesting Links and Tips

As far as concerns after injections, here are some really important post, hopefully you'll never need them:
 
Thank you. Thank you.

We were feeding Boots dry food (can't remember/vet prescribed) and wet food (Fancy Feast) prior to the diagnosis. He's only had wet food since December. Interesting (and maddening) about the Glucobance... thanks for the other food recommendations. I have attached a jpg of the syringes I am using with it adjusted to the marker for the prescribed dose.

I only have the USG from the 12/10/24 labs and it was 1.026.

The 2/18/25 labs HCT was 29. And you are correct - I was looking at the Alk Phosphatase (60). I do not have the Phosphorous count

Thanks again.
 

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Looks like those syringes only have whole unit markings on them, not half unit, as per the picture Diane put in post #4. 1/2 unit marked syringes are much better, as we change doses by 0.25 units at a time (we eyeball that).

Many people feed the Fancy Feast Classic/Pate formulas, those are low carb.
 
Good to know abou the Fancy Feast. THe Disastix urine glucose test strip was completely brown on Thursday which I think is why the vet opted to not do the Fructosamine test. Could that color be attributed to stress alone?
 
Depends on how long he was at the vet. Glucose takes a couple hours to go from the blood stream to the urine.
 
You have landed in a great place! Lots of good information here, and the people aren’t so bad either :)

One point from me, and maybe you got this already, but very important to get those pre-shot blood glucose tests. Especially in your case with that number at diagnosis…
 
@BootsFolks
I agree with Wendy the pic of the syringes you are using look like whole units markings, not half inch.
We use the ones with half units markings because we adjust the dose by 0.25 units at a time and these make it easier to do

You can order the U-100 syringes with half unit markings from Amazon without a doctors script
https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO

What is the name of the LC wet food you are feeding ? If you switched to Fancy Feast please put it, only asking because you were feeding Glucobalance
Can you put DX in front of the date Boots was diagnosed in your signature

To make these changes tap on your name up top then tap on the word signature and make the changes then tap save :cat:
 
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Hi All,
I have ordered all of your recommendations and it all will be arriving today/tomorrow. I have to say that I'm a bit dismayed that the vet did not cover a lot of this with me. But again, grateful for this forum. In going through the records again, his glucose via meter was at 352 on 3/27 at the vet. I do have a few questions, however I understand if some of these questions cannot be answered without the home testing component:
  • What do I do about constipation? And is this typical?
  • I've been told to give him the Lantus every 12 hours but do you all give insulin based on testing or on a concrete schedule?
  • Is this typical to see my kitty appear to be in such duress? Can this all be attributed to diabetes? He is a bit disoriented and he is having difficulty walking (his back feet seem to be paining him). His abdomen is quite distended as well. He is (and has been) lethargic.
  • How long after starting Lantus should I expect to see changes?
It's killing me to see Boots like this. I appreciate all of the guidance.
 
BootsFolks said:
Hi All,
I have ordered all of your recommendations and it all will be arriving today/tomorrow. I have to say that I'm a bit dismayed that the vet did not cover a lot of this with me. But again, grateful for this forum. In going through the records again, his glucose via meter was at 352 on 3/27 at the vet. I do have a few questions, however I understand if some of these questions cannot be answered without the home testing component:
  • What do I do about constipation? And is this typical?
  • I've been told to give him the Lantus every 12 hours but do you all give insulin based on testing or on a concrete schedule?
  • Is this typical to see my kitty appear to be in such duress? Can this all be attributed to diabetes? He is a bit disoriented and he is having difficulty walking (his back feet seem to be paining him). His abdomen is quite distended as well. He is (and has been) lethargic.
  • How long after starting Lantus should I expect to see changes?
It's killing me to see Boots like this. I appreciate all of the guidance.
Click to expand...
Tagging Wendy for you
@Wendy&Neko
@tiffmaxee

By the way what about the syringes , are you going to get the ones with the half unit markings?
Have you read the yellow stickys about Lantus , especially the 2 dosing methods , When you decide on which one you want to follow you can add that to your signature and your spreadsheet when you get that set up
@BootsFolks
 
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BootsFolks said:
What do I do about constipation? And is this typical?
Click to expand...
He's probably drinking some more but peeing lots more, drying him out and contributing to constipation. If he's eating wet food, add a couple spoonfuls of water to it. Water helps make things go. More ideas here: https://www.felineconstipation.org/index.html
BootsFolks said:
I've been told to give him the Lantus every 12 hours but do you all give insulin based on testing or on a concrete schedule?
Click to expand...
For Lantus it is typically on a schedule. Pick a time when you'll be home that time for the AM and PM, and ideally one where you'll be able to get a test a couple hours after the shot as well. This is deciding based on your life style and schedule. We do test before giving insulin (shooting) because we want to make sure it's safe to give insulin.
BootsFolks said:
Is this typical to see my kitty appear to be in such duress? Can this all be attributed to diabetes? He is a bit disoriented and he is having difficulty walking (his back feet seem to be paining him). His abdomen is quite distended as well. He is (and has been) lethargic.
Click to expand...
The difficulty walking might be something called Neuropathy. More info here, including treatment Feline Diabetic Neuropathy, and go on Youtube and search for feline neuropathy to see what it looks like. The disorientation (unless his blood sugar is too low) is not usual. Have you considered home testing his blood sugars? Distended abdomen not usual, unless his GI system is having problems with new food transition.
BootsFolks said:
How long after starting Lantus should I expect to see changes?
Click to expand...
Lantus is a depot style insulin, it can take a few days before you start to see blood sugar numbers improve. But I can't say more without seeing how his blood sugars are doing. He also had to get to a good insulin dose before you see significant changes.
 
Thank you.

I have the half unit syringes arriving today along with the lancets.

This morning I fed him (Fancy Feast 3 oz can) at 7am and gave him the Lantus around 7:15. I just did the urine check up stix at 11:00am and it was ++++ (>56).

When you do the meter test prior to the insulin what level is safe?

Thanks again.
 
Those of us typically do the following sequence in about 15 or so minutes - test to make sure blood sugar is a safe level to shoot, feed, shoot insulin (often when kitty's head is in the food bowl). It's also good to test somewhere in the middle between shots. A "normal" Lantus cycle will have the numbers go down to approximately 6 hours after the shot, then go back up again, a "C" curve on it's side. Note, cat's cycles aren't always normal, especially in the beginning. Some cats like to nadir or have their lowest points earlier or later than 6 hours after the shot.
 
I have all of the equipment and did the blood glucose test on the ear (harrowing) and it was 286 at 7am. I fed him and gave him the Lantus.

Is 286 a safe level to give the Lantus?

My biggest concern is that he is just so lethargic. I could barely wake him last night and almost took him to the ER.

I called the vet yesterday but there were no doctors available. I spoke to the vet tech who advised me to stop the Lantus. I didn't because I wanted to get the glucose levels with the Lantus. I plan on testing him again at 10am.

Thanks again. Any and all advice appreciated.
 
In general, 256 is OK to give Lantus. We suggest to new members that they not shoot under 200 to start, unless kitty is showing ketones. However, I'd really like to see a spreadsheet showing his blood glucose numbers and dosing before I say anything about dose to give.

I'm concerned about the lethargy. Is he eating OK? Have you been testing him for ketones?
 
I'm concerned about the lethargy too. He is eating just fine. I have not tested for ketones. Is that a urine or blood test?

Thanks.
 
So, Boot's lethargy sent us to the ER on Tuesday. He had an overnight stay. He has pancreatitis. They monitored his curve overnight and were pleased with that. He came home yesterday and we are continuing with same dosage of Lantus and now he has an anti-nausea med and pain meds. All daunting and hard to see him so uncomfortable and logey. We were told he would be lethargic for a few weeks and if not better to return for a neurologic consult. Has anyone dealt with pancreatitis?
 
BootsFolks said:
So, Boot's lethargy sent us to the ER on Tuesday. He had an overnight stay. He has pancreatitis. They monitored his curve overnight and were pleased with that. He came home yesterday and we are continuing with same dosage of Lantus and now he has an anti-nausea med and pain meds. All daunting and hard to see him so uncomfortable and logey. We were told he would be lethargic for a few weeks and if not better to return for a neurologic consult. Has anyone dealt with pancreatitis?
Click to expand...
Tagging
@Wendy&Neko
 
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Thank you so very much. I am so grateful for this Forum and all of you who have provided support.

Right now, Boots still has a pretty good appetite but taking a little bit longer for him to get the 3 oz in at each meal. I am continuing with Lantus although his BG was 212 this morning before feeding and I was wondering if that was too low. We are giving him Cerenia once per day and still trying to figure out the sweet spot between the Bupe and/or Gaba. He is basically sleeping all day, gets up for his meal and then back to sleep until the next meal - is this normal?

I have seen on the Forum that some vets are not as equipped to treat feline diabetes/pancreatitis. After our experience, I am wondering if we should transition to someone new. We live in the Los Angeles area (near Los Feliz/Glendale). Does anyone have a vet in the area that they have had a good experience with?

Again, many thanks.
 
I would start a new thread asking about vets in your area. There is also a website for searching for feline veterinary practitioners (i.e., cat only clinics) that you can search for a vet in your area.

For new members, we suggest doing exactly what you're doing -- post and ask for help if you're concerned about whether numbers are too low to shoot. Numbers over 200 are safe to shoot. However, I would strongly suggest that you test 2 hours after a shot to see if numbers have made a change. Lantus typically doesn't begin to work until 2 hours after shot time.

Gabapentin tends to knock cats out. Bupe is a narcotic and may do the same. I don't think gaba does a great job with pain management for pancreatitis. Gabapentin is best used for nerve pain.

If you're feeding your cat 2 meals per day, it's also fine to allow him to graze. It may be a moot point since he's sleeping a lot but once his pancreatitis is better controlled, it will be fine to allow for frequent smaller meals.
 
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