Newbie Fofinha from Brazil

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bruna

bruna

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Hello everyone, please forgive the long text and my awkward English. My cat Fofinha, 12 y.o., was diagnosed with diabetes last month. There were almost no symptoms until suddenly in just a few days she got so bad we ran to the vet and she had to stay there a week to treat ketoacidosis. They really saved her.

She got better and has been getting stronger these last two weeks back home. For the first week we gave her 2 units of Lantus twice a day and, since she was completely refusing to go back to dry food (I'm still surprised about that since she ate kibble her whole life), we kept giving her tuna like we did during her stay at the vet along with some canned Whiskas, which is one of the few canned foods we can find over here.

Well, now we're suspecting that she might be going into remission AND I'm worried about hypoglycemia. We went back to the vet last Thursday afternoon (Fofinha had taken insulin 10 hours before and eaten just before we left) for her first BG test after the release and it measured 42/33, they had to give her some glucose then.

These last couple of days we've been home monitoring her BG before the usual insulin shots, 6 AM and 6 PM. The vet said to give one unit of insulin only if the BG is over 100. Yesterday morning it was 108 and we gave 1UI of Lantus, afternoon it was 56 so no insulin. This morning the BG was 112 and we gave her the insulin, and just now she tested 72. I'm not sure if I should be testing particularly before or right after she eats.

I'm just so worried about hypoglycemia that I try to make her eat as often as I can. She has been eating tuna and sardine with gusto but only takes a few bites of semi-cooked chicken (I haven't tried the homemade recipes yet but I will soon). I'm not sure if it's good for her to eat only fish but I don't want to push other foods and risk leaving her hungry. She is the laziest cat too and very nocturnal so it's extremely difficult to see any possible symptoms.

What would you say of her BG numbers, and should we keep feeding her like this? Any advice will be greatly appreciated.
Bruna and Fofinha.
 
Welcome! It's great you are home testing Fofinha. And your vet seems up to date because they prescribed Lantus, which is a great insulin. In case you didn't know, it's possible to give less than one unit. I'm sure someone using Lantus will be here soon to help with her BG numbers and suggestions.

PS: Your English is great!!
 
Good for you for taking such great care of her! and yes, your english is great!!!

you need to find some canned foods that will work or else have recipes for home-made low-carb canned food. just meats aren't a complete nutrition for a cat, although for temporary it's probably ok.

Extra Super Duper Kudos to you for hometesting!!!! that's really great.

You have some of the key points down. You must test a minimum of 3 times each day - right before each shot to make sure the numbers are high enough to shoot and a test around the middle of the cycle to see what the lowest point is that she's getting to. sometimes cats get lower at night, so ideally at least some tests at night are good too.

Here's a basic bit of info we give people on Lantus: Lantus & Levemir: New to Group? Start Here

On that page there is a link to low-carb canned foods - everything should be less than 10% carbs, ideally less than 5 or 6%. you want to have some higher carb food in case she goes below 50. if that happens, we give a teaspoon of the gravy from the high carb food, wait 20 minutes and retest again.

there are also directions on starting a spreadsheet. when we can see a spreadsheet we can tell what the insulin is doing and be able to give you good dosing advice.

There's a fair amount to learn and a cat going on Lantus can have her pancreas heal and can go off of insulin fairly quickly. that is very possible - and with those numbers she may be on her way already. it's critical to keep testing so that she stays safe - and adjusting her dose to match the numbers so she doesn't get too much/little insulin. your vet started you well with some very good advice and a good dose. the testing is going to let you adjust her dose so that she doesn't get more insulin than she needs. I'd encourage you to read that basic page i gave you - which is at the top of the Lantus Support Forum. Everyone on there is using Lantus or Levemir (which are similar insulins) and we help each other. Many of us post every day, especially while learning how to read your cat's responses to the insulin. You can have high numbers that are not from too much insulin, and it takes some practice to learn to read the numbers on a spreadsheet and know when to increase, when to decrease, and when to hold the dose. we would be more than happy to help you with that!!

welcome to the best site in the world for helping diabetic cats. some pretty nice people are here too! :-D
 
Welcome! With those numbers, you probably should consider shooting less than 1 unit, since those numbers over 100 ares still pretty close to 100.
Cedric was on lantus for a month. I changed his diet to grain free, high protein & low carb canned food (took the dry away) and he gets this 4 times per day. I still test him a couple times a week, in fact I meant to today....

I don't know anything about the food in Brazil that is of this type. I use a brand called Wellness, but you will most likely need to look into the canned cat food that is sold in your country and find out it's ingredients. Stay away from stuff that has grains and gravy, for starters.

My cousin is living in Porto Alegre for a year. Where are you located?

Ciao! (the only Portuguese I know...)
 
It's wonderful that you started hometesting! That's truly the only way to catch those low numbers so you know not to give insulin. You are doing great so far! I test at least 2x a day (once before each shot), and try my hardest to get at least one more test in somewhere throughout the day, either in the middle of the day, or before i go to bed. My only suggestion otherwise is to be cautious just feeding tuna and sardines. Fish like that which is meant for human consumption is lacking in key nutritional components (among those is taurine). There are ways to safely make your own food on this website: http://catinfo.org/?link=makingcatfood. Lots of good feeding info on that site. Also, here is a link to non-US cat foods and their carb contents: http://binkyspage.tripod.com/nonusfd.html I have no idea if any of these brands are available in Brazil, though. We generally advise to keep the carb count below 10%. I have nothing more to add, except to welcome you to the site! There is a wealth of knowledge here, and the people are wonderful!
 
Thank you so much everyone, I fell very welcome! ^__^

Thanks for the input about the food. Claudia I've been looking for canned foods but so far have only found Whiskas, Sabor e Vida and Three Cats. I can't say I understand the labels very well to guess the carbohydrate quantities of those two last ones. But I'm planning to try and make some food myself from the online recipes and see if she likes it.

Julie, thanks for the Lantus page link! It's very helpful and some things about the handling of it are actually different from what the vet (and youtube) told me to do.

Actually it raised some new questions: If she tests below 150 is it ok to not give the insulin or is it best to just lower the dose? Also CAN she become hypoglycemic if she hasn't taken her last shot? And should I test her during that period too? Like, today I only gave her the morning shot, do I need that one more test tonight?

Doombuggy, it's great to know Cedric had such a fast remission, and it brings us even more hope! And I'm reading now about lowering her dose. :D Oh, we live in Rio de Janeiro, tchau! (lol it's spelled really weird like that, ciao is more Italian I think) ;)
 
I just wanted to say "Welcome!" I know Brazil well as I travel there on business often. It is such a beautiful country. I have had the pleasure of being in Rio during Carnival.

I do not use Lantus, so I am no help! But, Good Luck!
 
bruna said:
Thank you so much everyone, I fell very welcome! ^__^

Doombuggy, it's great to know Cedric had such a fast remission, and it brings us even more hope! And I'm reading now about lowering her dose. :D Oh, we live in Rio de Janeiro, tchau! (lol it's spelled really weird like that, ciao is more Italian I think) ;)
Click to expand...

To be honest, I've only ever said the word, as we get many Brazilians here at Walt Disney World. One year I said it to a little girl and she asked me why I was speaking to her in Italian and her dad said that was a Portugese word too! :lol: I should have called my other cousin Katie to gets some spelling - she lives in Arizona but spent her junior yr of high school in brazil and still speaks it well (she goes back to visit friends every few years).

You are doing great! You'll find a routine with the food, etc, and hopefully can get your cat into remission. Those low numbers are great!
 
good morning!

Julie, thanks for the Lantus page link! It's very helpful and some things about the handling of it are actually different from what the vet (and youtube) told me to do.

Actually it raised some new questions: If she tests below 150 is it ok to not give the insulin or is it best to just lower the dose? Also CAN she become hypoglycemic if she hasn't taken her last shot? And should I test her during that period too? Like, today I only gave her the morning shot, do I need that one more test tonight?
Click to expand...

glad it was helpful.

we don't adjust the dose based upon the preshot numbers - those test numbers just tell us if it's safe to shoot.

the answer to your question on "if she tests below 150 is it safe to shoot?" is complex. there's actually another link on that question that also tells you what to do if she gets too low (below 50) Shooting & Handling Low Numbers.

the basic answer is that in order to go off of insulin, we all bite the bullet and learn to shoot low numbers. the goal is to keep them in the range of 50-100 - and to do that you have to shoot low. BUT, before you get to that point you have to be willing to monitor your cat to make sure that you are there to keep them from becoming hypoglycemic. in general, new people skip shots if their cat is less than 150. if you do that, you go right back to the same dose at the next shot time.

if you're going to shoot a lower number, you must be committed to checking the cat over the next several hours, you must have enough test strips that you won't run out, and you must have high carb kitty food and/or karo syrup type of something to be able to pull up Fofinha.

we only lower the dose if the nadir falls below 50. if you're too scared to shoot a full dose you can just give a token dose, say 1/2, but in the long run of the whole process, we learn to shoot the whole dose.

i'd encourage you to start posting in the lantus forum so that other lantus users besides just me can help you learn all the little things that will make you more successful at this.

if you shot insulin, you're committed to testing until you've seen the cat pass her nadir - meaning that if you shot insulin this morning, the nadir is going to be somewhere 6ish hours later - although cats can have nadirs anywhere from 4-9 hours after the shot. past about 9 hours and you've likely passed the low point and the lantus effect is going to be waning. so if you skip a shot - say it's 15 hours past your last shot, you don't have to test because the insulin isn't going to be very strong at that point.

BUT - always special circumstances where a cat with some other medical thing going on might continue to have falling blood sugar, for example from anesthesia or other special somethings. so i don't want to blanket say don't test. but if you haven't shot insulin into her body, she can't go hypoglycemic.

i tested a non-diabetic cat last weekend and his BG was 46. we start giving a tiny bit of high carb gravy or karo when they fall below 50, but they aren't in danger until 30's or below.

re the food - you're looking for the pate style of canned cat food - the traditional "comes out of the can in a big chunk with a little broth around it" kind. those are the old-fashioned kind that seem to be the low-carb. i don't know that all pate style is low-carb, but i think everything fancier is mostly not low-carb.
 
Julie, thanks again! I understand what you said, we aim to keep the blood sugar in a low range but have to watch closely for it to not go too low.I haven't shot her yesterday because her numbers were below 100 and today I ran out of test strips. I really have no idea how the insulin is acting on her, though I guess it's working well since she got so much better. Anyway, I'm gonna buy more strips and take the time to do a curve. I think I'm gonna do a curve with and one without insulin to have a better idea of how she is doing and post the results to the Lantus forum... and I think we got he hang of home testing. At first it was more difficult than the insulin shots!

I was just so scared when she tested 30s at the vet, about 10 hours after the shot and under stress. It's good to know she wont go hypo when I'm away when she doesn't take insulin. Also, I bought two cans of cat food, the Whiskas one is pate and doesn't mention any flour in it's ingredients but the Sabor e Vida has cassava starch. Oh well, I'll get only Whiskas pate from now on.

Kse, thanks! I feel very welcome, it's great you've been over here and liked it, I agree it's a beautiful country. ^_^

Doombuggy, wow, you work at Disney or something?! It's a dream to go there someday. : D And you can say "Oi" too, (but I think the British say that too, not sure...) it means "hi"!
 
i also thought the testing was harder than shooting the insulin, although when i first started shooting the insulin i'm a bit needlephobic and i thought that was hard enough. but the testing has more steps and at first it takes longer to manage all of it.

you've done great getting that down!

i can understand why a 30 at the vet's would be scary - that's too low. if you ever see that at home, give a teaspoon of the gravy from high carb food and retest again in about 20 minutes. you could also post here and someone would help you.
 
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