Newbie

[firedancergurl5]

Well I guess I'm not really sure where to start... My name is Hillary and my diabetic kitty's name is Benjamin.
I kinda feel like I've been ran over by a bus.... backed up and ran over again... especially since yesterday but I'll get to that in a minute.
Ben went to the vet in February 2012 for a normal vet check.. shots.. the usual... the vet said he was fine just a little over weight and to cut back his food from 2 soft cans
of fancy feast a day to a total of 1. [poor baby only has 3 teeth, he was a stray and the shelter had to have most of them pulled].
About the beginning of may I start to notice things with Benjamin that was reminding me waaay too much of my mother. He all of a sudden had the urge to drink his water almost constantly and urinate as much as a human being, with being in nursing school the first thing I thought was "oh my god, Ben is diabetic". I tried justifying what he was doing.. that it was getting hot out so he was drinking more... even knowing for sure with the polydipsia and polyuria he was definitely diabetic. 2 days later I made the dreaded call... he was scheduled to be seen that week. I went to the dreaded vet visit and quickly regretting going back to see this vet. He did everything in his power to try to convince me that Benjamin had kidney failure and that there was nothing that could be done for it. Thankfully my mother and boyfriend were also in the room with me. I very nicely advised him not to insult my intelligence and that I wanted a full panel of blood work taken, the results the next day and I would go from there. Low and behold my cell phone rings around noon the next day and it was the lovely vet calling to advise me that Benjamin's kidneys were indeed functioning properly [ya think?] and that he was definitely diabetic. I asked him the number and he said it was in the 430's... I almost fell over right then. That day he was started on 2 units of lantus. 2 weeks later I called to make an appointment for his glucose curve [Stressing that that vet was to NEVER be around Benjamin again!] The day of the glucose curve came... He was running in the low 400's and high 300's... lantus was upped to 4 units a day.... called back in one week spoke to Ben's new amazing vet there... she asked me what I thought, I told her there were no changes so she had me up his insulin to 6 units a day. He just went for another glucose curve yesterday... 45 mins after dropping him off the vet calls me to come get him... that his sugars aren't even registering on their glucometer that tops out at 550. I instantly started crying and left work to get him. I spoke with his vet and we were both kind of shocked.. especially considering he hasn't been acting any differently.The only good thing is that they did run a urinalysis and he does not have any ketones in his urine...thank you god! Some good news. She did up his insulin to 8 units a day and strongly suggested I get the Purina DM wet and dry food which I did.

Sooo there is my very short version to the insane past few months I've been going through.... if anyone has any suggestions on how to keep my sanity... or if anyone has ever experienced such crazy sugar fluctuations with their own cat I'd love to hear about it...


Thank you,
Hillary

 

[LynnLee + Mousie]

first, welcome to fdmb!

second, i hate to have to say this but unfortunately those vets aren't doing this right. they possibly started on too high of a dose to begin with and you never ever ever raise insulin doses that much at one time in a cat. cats usually only need very small doses, unless they have concurring conditions that make them need more, i.e. acromegaly, etc.....thus, doses in cats are often raised 1/4 to 1/2 a unit at a time.

soooooooooo, what i would suggest to start with is getting a glucose meter and start testing Benjamin yourself, at home, where stress isn't as likely to effect his levels. then you will get a truer idea as to his levels. i would also suggest lowering that dose back down but to what i hope others will chime in on. if you were feeding him a higher carb food before, the switch to the d/m might drop his glucose levels enough that that high dose could become dangerous. fwiw, don't be surprised too if he turns his nose up at the d/m in a few days. it's not unheard of in kitties. if he does, you can get some low carb wet fancy feast or friskies to start with.

also, you can test at home for ketones too which is always advisable in the beginning and if you do drop that dose back down too. you can get the ketostix in the pharmacy section of your local walmart, target, cvs, etc....along with your glucose meter. stay away from any meters with True in their name as they have been found to be unreliable. Walmart's Relion meters have been found to be reliable and the most economical.

i think if you can go back and start almost back at the beginning and do the dosing in a more controlled way, the wild numbers will go away

 

[hmjohnston]

Welcome to the Board Hillary and Benjamin!

Your new vet seems to be a very good one- but I think the board can give better advice as we deal with this kind of stuff all day long :lol: .

A few things are needed to combat FD:

While you have the correct insulin you probably don't have the correct dose. Most vets see high numbers and assume that it means the dose is low. They don't understand that the dose may be high, putting the BG's low and then the cat is bouncing like a rocket because of it. So I would suggest dropping- most cats only need .5u to 1.5u BID- while I think you are doing 3u BID.

The correct FOOD for a diabetic- since he is already on canned you've gotten a good start but you might be feeding too high of calories even with the canned- especially if it has gravy in it. here are two lists-
https://docs.google.com/spreadsheet/ccc ... hYXc#gid=0 (called Hobo's List)
http://binkyspage.tripod.com/canfood.html (called binky's list)

You want to look for canned food that is low carb. The two lists above are ones that we use- look for the %kcal/carbs- under 10 (5 is better) in both lists. Feed the best you can afford. Most do Fancy Feast, Friskies, 9-lives. This will also help with the UTI- dry food is, well, dry. Canned food has more moisture and when you add water to it the water content is increased- all the better to pee a lot. You do NOT need vet prescription food- it is overpriced, high carbs, and contains high quantities of liver- which most cats won't eat day in and day out. If you bought some just take it back and say your kitty stopped eating it. They should refund even if it is opened.

Home testing-
You need to get a glucometer to test your cat- a human one is fine and reliable to use. It reads different than the pet ones but all you really need is the consistency of the levels day in and day out. You might be able to get a free one- there is a spot just at the top of every page here that says home testing kits. Here is a link to what's inside:
viewtopic.php?f=28&t=60261

If you purchase one here is a list from Consumer Reports:
viewtopic.php?f=28&t=70140

You need to look at the ones that have the cheapest strips- not the cheapest meter. The meter you will buy once, the strips you will continue to purchase over and over again. A lot of people on the board use the Relion micro/confirm meters from Wal-mart because the strips are the cheapest around- $.36 each and usually easy to get (and you can get the strips even cheaper online through the ADW site). Bayer is another popular one. Stay away from the generic kinds that have the word TRUE in the name- those are inaccurate at higher #'s or don't go above 299- and another bad one is the Freestyle Light with the butterfly on the strips- both of these have led many pet owners to believe their cats were okay when they were really in trouble. And you can do your own curves at home when you hometest- that is cheaper than doing it at the vet.

To keep up with the BG #'s there is a spread sheet (SS) that we link to our signature line. Here is the link to set up:
viewtopic.php?f=6&t=18207

Incidentals-
- Because your little kitty's BG is so high, I would suggest getting ketosticks (found in the diabetic supply aisle) to test your kitty for ketones that lead to DKA- this is a very serious and deadly (and EXPENSIVE) illness. For $7 you get 50 strips- the best insurance against ketones possible. If you catch it early the easier it is to treat. This way you can keep track of them at home.
- Lancets- for your first box go for the lowest gauge you can find- 26 or 28. His ears won't bleed that much at the start. There are so many u-tube videos out there that can show you how to test the ear. You can either use the lancet pen or free-hand. I free-hand as I feel like I have more control over the pointy end. After the first box is used up you can switch to 31 gauge.
- TREATS! In the videos you see the cats eager to be tested. That is because they are shamelessly bribed into sitting still because of a yummy treat that is given after testing. Freeze-dried chicken, beef, shrimp are no carb treats and there are others out there that get used as well. Give this treat ONLY a poke time- tests or shots. Your cat might not care for treats, mine never did. She just knows it comes before her food :lol:

Good luck! I know others will chime in soon.

Edited broken links

 

[PeterDevonMocha]

Hi, I just wanted to welcome you to the board and give you a big hug!! We've all been where you are, scared, nervous, frustrated, worried .. it will get better, especially with the help of this board!

I agree that the lantus dose was upped to much, to fast .. Your vet very well may have missed benjamin's "perfect" dose, the dose that regulates him into very healthy numbers and keeps him safe .. Getting a home meter (we use relion micro from walmart, for 10.00 and strips from there as well, 20.00 for 50) There are lots of videos out there to help show you how to home test .. if you want, you can also post your address (city, state) here and someone might be nearby to come help you out ..

Take a deep breath, read over this site and know you'll find help here pretty much any time of the day!

 

[Julia & Bandit (GA)]

Welcome Hillary!

I want to make sure I got this right--you say Benjamin is currently on 8u a day. Is that 8u once a day, 4u twice a day, or 8u twice a day? Lantus needs to be dosed twice a day 12 hours apart, and dose increases need to be made slowly in .25-.5u increments based on the cat's nadir (the lowest number of the cycle). The only way to safely and effectively dose Lantus is to home test your cat daily. Raising the dose blindly in large increments like your vet has been doing is very dangerous for two reasons. First, blood glucose levels obtained via office testing at the vet are inaccurate--even non diabetic cats will show large spikes in blood glucose levels if they are stressed out. Bandit will shoot up into the 300-400 range just from a vet visit, and his numbers will go back down when we get home. You cannot base dosing decisions on these false high numbers. Second, this leads to chronic overdosing, which in turn leads to even higher extended blood glucose levels. This is because when a cat drops too low, its liver will release glucose into its bloodstream to counteract the low number as a survival mechanism. So cats that are overdosed will have even higher blood glucose levels than a cat that is not getting enough insulin. Unless you are home testing and seeing how the insulin is working mid-cycle, you have no way of knowing if the dose is too high.

Home testing seems difficult at first, but after a week or two most cats are perfectly ok with it. Bandit fought me the first week or so, but after he realized he gets a (low-carb) treat after each test, he now runs to me to get tested and starts purring. The ear pokes do not hurt them at all--cats have very few nerve endings in their ears. It's doing something new/startling to them that they dislike, and once they get used to it even very difficult cats are tolerate it just fine.

The Purina DM canned is ok to feed, but not the dry DM. The dry DM is too high in carbs for a diabetic cat, and will keep blood glucose levels too high and increase insulin need, so I would return that to your vet for a refund (if you say your cat won't eat it, they'll take back the opened bag). The Purina DM is 3% carbs and an ok food to feed, but it's pretty much the same/lower quality food as the low carb, grain free flavors of Fancy Feast, so you're paying a huge markup for just the prescription label. Compare the ingredients in the DM to something like Fancy Feast liver & chicken. They are pretty much identical foods.

However, and this is very important, do not change to a low carb diet unless you are testing and lowering the insulin dose. Switching to a low carb (less than 10%) diet can cause blood sugar levels to drop 100-300 points, and can even cause spontaneous remission in about 25% cats. That means if you're shooting a high insulin dose like you are now, a potentially deadly hypoglycemic incident could occur.

Here's some information for you to print out and bring to your vet. Here's the current AAHA guidelines that state home testing is ideal and strongly encouraged, as well the effects of chronic insulin overdose (p. 218): http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf. I've also attached an article about safe and effective treatment of cats with Lantus. When the guidelines in the article are followed (low carb canned diet and small dose adjustments via home testing), the majority of newly diagnosed cats go into diet-controlled remission. My own cat is in remission from following these treatment guidelines, and very healthy and happy!
. And here's a link to the dosing protocol that is outlined in the article: http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf.