Newbie insulin help!

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Taylor & Carl

Member Since 2023
Hi, I'm Taylor and my cat is Carl. Carl is a 9 year old male who was just diagnosed yesterday. I took him to the vet after noticing an abnormal amount of urine in his litter box and frequent/long trips to the water dish. Otherwise he seems pretty much himself! After reading through quite a bit of information on here and the diabetes support group on FB, I'm feeling a lost about how to move forward with insulin and would love some thoughts. Here is the info:

Carl's glucose level was 323 the day he was diagnosed and his liver enzymes were slightly elevated (120 U/L). His vet gave me some insulin, told me to give him 2 units twice a day, had me buy a freestyle libre and then sent me on my way. Now after reading the information on this site I am wondering if I can just start with a diet change (he was eating kibble) or if I should use the insulin. My vet told me he needs the insulin and it's "too late" to just make a diet change, but she also didn't test for ketones. In this scenario, would you give the insulin to be on the safe side or try the diet change for a few days? Carl's glucose levels have continued to be in the 320-340 range today according to the freestyle libre.

Also as a side note- I plan to start at home testing now that I have learned more!

Thanks for any help on this long post!
 
Hi Taylor my name's Kyle. That's my boy Hendrick over there on the left :)

If you're going to withhold insulin while you change the diet, please please test for ketones at least twice a day. It is true that one should not both start insulin AND change the diet at the same time. A diet change can make a big difference in the amount of insulin a cat needs. You can use ketostix and dip them in a urine clump in the litter box, or some people catch some urine in a ladel or put plastic wrap under the litter to catch a puddle. There are also blood ketone meters.

How did the vet confirm the diagnosis, was it a blood test? Was a fructosomine test done?
 
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Hello Kyle and Hendrick, thank you so much for the reply! I will go get some of those strips today. That’s a great idea to put plastic wrap in the litter box. I had read about those but wasn’t sure I’d be to catch Carl mid pee. I have a baby and a 3 year old, so things are a bit crazy over here!

She just did a blood panel. I had them email over his results and this is all there is.
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sorry, mixed up your name and the cat's name haha.

edited and corrected, Taylor!


Also, to answer your question it is not likely that a diet change is all that is needed but it's not impossible. If/when you do start insulin therapy please start at only 1 unit. 2U is too high for a starting dose because without any data on how the insulin is affecting Carl, you have no idea what the right dose is. Some experts say to start at .5U! But here at the FDMB the recommendation is 1U to start.
 
Totally fine! I’m happy to respond to Taylor or Carl. Haha

Okay, I’ll make sure to start at 1U if/when I use the insulin. I switched his diet yesterday and I’m starting to see his BG trend down, but I’m not sure if that means much? Before switching his BG was 320-340 range. In the last 12 hours it has been in the 270’s.
 
that is a decent drop. Food change is probably impacting the BGs. Doubtful it will come all the way down to normal levels but who knows!

In order for the experts here to help you and Carl, they need to see the data on his Blood Glucose (I'm not one of them, just a regular guy who's cat was saved by these people so I try to pay it forward).

Please setup a spreadsheet and input the data from the libre as much as you can:

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



I would also strongly recommend you learn how to test Carl's BG with a handheld monitor like the Relion+. The libres are great but they only last two weeks, sometimes fall off, or malfunction. People here have had varying success with them, some people get rid of them pretty quickly due to so many issues. They also are known to be not-so-accurate at lower BG numbers.

Testing your cat's blood by using a lancet and getting a blood droplet from an ear is, believe it or not, pretty easy....after you've done it a thousand times maybe. But in the beginning it can be very difficult for some, others never have a problem. I thought it was impossible but if I can learn how, anyone can!

Folks here can provide a huge list of tips and tricks to help you.


Btw, Carl is adorable he looks just like our ASH rescue, Chester. :bighug:
 
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Since you haven’t started insulin yet, if and when you do, make sure to ask for Lantus or prozinc which are the best insulins for cat. Not Vetsulin, aka caninsulin.

With a diabetic cat you need:
  • A low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs
  • A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
  • We recommend hometesting the blood glucose with a human meter…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.
  • HELP US HELP YOU has information about the spreadsheet, signature and hypo box which you will need to be able to look after your beloved kitty properly

We are happy to help you with setting up the spreadsheet, sorting out what food to buy, how to transition safely to a low carb diet, how to learn to home test and much more.

FOOD CHART have a look on this chart and choose foods that are under 10%.

This is an excellent site for diabetic cats…it has been around for more than 25 years and has very experienced people to help you.

Keep asking lots of questions!
 
Good news! I got the ketone strips and there were no ketones present in his urine. Do I need to keep testing this? And if so, how often?

I have ordered all the gear for at home testing, and will start that when it arrives!
 
Good news! I got the ketone strips and there were no ketones present in his urine. Do I need to keep testing this? And if so, how often?

I have ordered all the gear for at home testing, and will start that when it arrives!

I'm thinking at least once, if not twice a day until you start insulin therapy. And then probably not a bad idea to still spot check every few days. Ketones can be deadly, they can build up in a cat that has been diabetic and not receiving insulin. Plenty of food and water also helps keep ketones at bay.

What are you feeding, how much and how often? My vet said only feed twice a day, very strict, only every 12 hours with the insulin shot! This, as it turns out, is very old and outdated thinking. Today we know that it is much better on a diabetic cat's pancreas to feed a main meal twice a day with the shot, but also feed 2-3 smaller meals in-between. The only caveat is to avoid giving food during the later half of the 12-hour insulin "cycle" as it is called. So for example we used to shoot insulin at 630am and pm. After the 630am shot and meal, he would get a 'snack' around 10am and around noon. Then food was withheld for the remainder of the cycle until the PM shot.

What insulin type was prescribed btw?
 
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