Newly diagnosed and overwhelmed.

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scrappykendra

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Hello, My kitty was just diagnosed a week ago with Diabetes and I am a little freaked out. We went back this past Tuesday and the vet showed me how to give the shot and I have been doing it and I think I am doing it right. We are supposed to go back next Thursday for the blood glucose curve but my husband is giving me a hard time over the bills. Walmart wants $110 for the insulin called Glargive. Apparently there is no generic. I don't know how long it will last and I can't afford $110 dollars a month. The needles weren't so bad. They were 13.99 for a box of 100. I went on my local freecycle message board and was able to get a glucometer with test strips, but don't know how to use it. Can I even use a human one on cats? My uncle has a diabetic dog and he paid $150 for his. I read the food list by Dr. Lynne and started giving Smokey '"safe" fancy feast, but I am not sure what kind of dry to let him munch on. Should I let him munch? or not? Help!! Sorry I am rambling, I just feel like I have one foot nailed to the floor and I am running around in circles.

Kendra
 
Hi Kendra! First of all, welcome to the board! Try not to feel so overwhelmed, we will walk you through this.
First, I can't really answer your question about your insulin since I have experience with only Humulin N and Lev. I believe you are using Lantus, right? And I'm going to assume that you are using a vial and not pens?
The meter and test strips I use are from Walmart, the Relion brand. They are the least expensive of strips. I use the Relion Mico meter, costs about $11 and the strips cost a little less than $20 for 50. You can use human meters....blood is blood.

How much insulin are you administering daily?
 
Hello and thank you for the warm welcome. Currently he is getting 1 unit in the morning after he eats and 1 at night. What is the normal level when I start to test? Should I wait for the vet or can I be brave enough to try?
 
Be Brave! I remember when I decided to home test Spot....I looked at the videos on line and on a Friday I called my vet to make an appointment for them to show me how. They could get me in on the following Monday. Saturday I went out and bought my meter and strips and watched videos on the net. Sunday, I took the dive and tried to test. I wasn't very successful my first try, but I did get it on my second. It is scary, but you just have to relax and try.
 
Hi Kendra,

Let's take it one issue at a time:

1) glargine or lantus is an excellent insulin - you don't have to purchase the vial which is $110 and expensive, rather we recommend purchasing the pens - they are more cost effective and you won't waste any product. While the initial cost for pens (box of 5) are a more than $110, overall it will come out to less monies. You may even be able to purchase one or two pens at a time.

And don't worry, you will use the syringes you bought with the pens - just pretend it's a small vial.

2) regarding food - sadly there is NO dry food that you can safely give your cat to eat. All dry food is really bad - read about the reasons here: www.catinfo.org

The good news is you can feed fancy feast - look for the ones that are classic pate varieties - such as beef feast, turkey & giblet feast, chicken feast, beef & liver feast, etc.

Now there are safe dry treats that you can use - such as purebites or halo liv a littles - these are freeze dried pure chicken or beef, nothing else, it's dry, crunchy and cats love it. I also recently discovered stella & chewy's freeze dried cat food dinner - http://www.petfooddirect.com/Product/50 ... -for-Cats-

My cat's love this and while I don't know how many carbs are in it, reading the ingredient list, to me it appears safe for diabetics. You can serve it dry or wet, mine prefer dry.

3) yes you can use a human meter for your cat.

If you tell us where you are located, there may be someone close by who can provide in person support and show you how to test with the meter.

How much insulin are you giving?

Here is what I typically write to newbies, you may find the information and links helpful.


WELCOME, this forum is a great place to gain knowledge and really learn how to manage feline diabetes. By doing just a few things each day (that really won't take up much of your time at all), you won't need to worry about losing your precious cat, not where feline diabetes is concerned.

There are three key factors to managing diabetes: food/nutrition, home testing and insulin

1) Feline Nutrition: Now, as far as diet - definitely dump the dry food (if you are feeding any) and if the vet recommends purchasing prescription food like DM just say "no thank you". ALL cats, and especially those with diabetes, do best on a species appropriate diet that is high in protein and low in carbs. Dry food DOES NOT fit that bill and DM food, even canned, just really isn't that great as far as quality. Most here on FDMB feed low carb/high protein canned, raw bought from a pet store or they make there own.

Here great links, one is to a food chart put together by one of our board members that breaks down the carb % and protein % of most of the commercial brand foods. You want to keep the carb % below 10% and around 7% is great. The other link is to a site by a vet "Dr. Lisa DVM" ... who also posts on this board from time to time ... there is in-depth info. there about many things, including nutrition and how to make raw food.
Nutrition/food info

The good thing with feeding your diabetic cat this way, is that it is ALSO good for any non-diabetic cat too. All your cats can safely eat the same food without worry and it may save you some costs and headaches of having to do separate feedings and keeping track of what they are eating.


2. Home testing: It is impossible to convey the value of testing your cat's BG (blood glucose) level at home. Some vets will "suggest" this, but most won't even mention it. They will send you home with insulin and an amount to shoot and maybe some instructions about hypoglycemia (blood sugar dropping to a dangerously low level).

Well, the thing is, human diabetics don't EVER give themselves insulin without checking there BG to make sure it is safe to do so, so why shouldn't it be the same for our kitties. Here on FDMB it is. You will notice that the vast majority of people here test their cat's BG at least 2x/day (before giving each shot to make sure the level is safe enough) and periodically at other times to see how the cat is responding to the current dose. We use a human glucometer, test strips and lancets - which are all very readily available and easy to use.

Our kitties get lots of love and treats for "putting up" with this and most of them actually come out to be tested on their own 'cause they want those treats . Here is a collection of great links that "Carolyn and Spot" pulled together about hometesting. See what you think ... it truly is the best way to not only keep Your cat safe but also really get a handle on this disease and help him to live a healthy life with FD (feline diabetes).

Home testing Links

3. Insulin: There are several types of insulin available. Many people, myself included use Lantus or Levimer both of which are great insulins. They are gentle insulin and given twice (BID) per day in 12 hour increments. Or you could also choose PZI or the new version called Prozinc.

Please read up on the insulins available, here is a link to the Insulin Support Groups:

Insulin Support Groups


However, one caveat and again this shows how these three things are inter-related:

If you are feeding dry food or even a high carb food, BEFORE removing these foods, please make sure of your insulin dose as it will most likely need to be reduced, so as to avoid a possible hypoglycemic situation due to the removal of the dry/high carb foods that will lower the BG’s and reduce the amount of insulin required. Again, another reason why home testing is important.


I know this all seems like a lot, and that's because it is ... there is a learning curve here. But as long as you are determined and keep at it, you will have it down before you know it and you'll be seeing the results in Your cat' overall health and happiness. Ask all the questions you can think of - that's why we are here!
 
Hillary, Thanks for all the great info. It looks like I have a lot of reading to do LOL! but my smokey is totally worth it! I was just wondering about the numbers. Is there a site that will tell me what the numbers should look like? When to adjust levels? When to panic? Etc?
 
Kendra,

You most definitely can use a human meter in fact most of us here do exactly that. You will find lots of tips and videos here that will show you how to use your meter to test kitty at home. http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=287. Not only is testing at home one of the best ways to keep kitty safe while he is on insulin, but it will keep a bunch of money in your wallet. Because you won't be dragging her to the vet every couple of weeks for testing, and paying them to do curves that really are pretty much worthless because her numbers are going to be elevated by stress. Almost all cats are stressed out at the vet's (strange smells, barking dogs, people that aren't the mommy, etc). You can do them yourself at home and then either phone, fax or email your numbers to you vet, that way they will have truer numbers to work off of to help you figure the best way to care for him together. You will also always know right where his blood sugars are before giving him his shots, or tell if he is going to low. For me, hometesting let me be in control of how well my cats are doing and decide how to adjust their dose accordingly. In fact, neither of my diabetic have been to the vet other than Musette once for an ear infection. There has been no really to take them.

You have already figured out the diet...except for the dry thing, there really isn't a good dry food for a diabetic can munch on, but the Fancy Feast Classic are a great food for Kitty, so if she likes them and they fit into the budget, then let him eat all he wants of it. However if you need a cheaper option to keep your husband appeased then many of us use the pate-style of either Friskies, 9-lives, or even Walmart's Special Kitty...Both Friskies and Special Kitty that I know of come in big 13 oz cans for right around a dollar. If he is your only cat one can should feed him for a couple of days...Around here I feed 13 cats (2 diabetics) on 6-8 cans a day.

Your vet also started on a really good insulin...Another way to save money is when you vial you have now goes bad, have your vet write the refill for the Solostar pens. They are more expensive up front, but you get 5 pens with a smaller amount of insulin in them, so you can use them up completely, whereas you will end up throwing a lot of that vial away because it has lost its punch. So the pens will end up lasting you for almost a year if you handle it correctly.

And lasty you have found us!!! Ask all the questions you want someone will have an answer, we can teach you to test at home, understand what those numbers mean and hold your hand and paw every step of the way.

Welcome to the FDMB Family!!!

Mel, Maxwell, Musette & The Fur Gang
 
scrappykendra said:
Is there a site that will tell me what the numbers should look like? When to adjust levels? When to panic? Etc?


The main web site http://felinediabetes.com has all that and more.

Normal non-diabetic blood glucose levels are roughly 60 to 150 mg/dl. Ideally you want your diabetic cat to stay in this range for as much as the time as possible with diet and insulin, and maybe one day, on diet alone. Anything over 200 mg/dl is considered diabetic.

Insulin dose is adjusted based on blood glucose curves that you do at home. We can help you with that once you get started with testing :smile:

Panic if your cat becomes hypoglycemic and shows symptoms. Some cats start showing symptoms around 60, other cats don't show symptoms until the level drops very very low. You just have to know your cat. If you think your cat is acting odd and isn't sure if it's a hypo or not, test the bg to check.

Here's the hypo reference sheet: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=1122 Print it out and keep it easily accessible. And print out the list of supplies you'll need to treat a hypo: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=2354
 
This link should help: http://petdiabetes.wikia.com/wiki/Blood ... guidelines

Please keep in mind that while you are giving insulin and once you learn to home test, you may see high and low numbers throughout the day. When this happens, first don't panic, if the numbers go too low, get your hypo kit ready as you may need to use it: http://www.felinediabetes.com/phorum5/r ... ?8,1700444

One item to include in the hypo kit is the fancy feast gravy lover's product - it has lots more gravy which is all high carb and can come in handy to raise the bg. So when you shop be sure to pick up a few of these cans. Make sure to keep these cans separate from your regular feeding cans, so you don't mistakenly use it.
 
You have received much info from many, so, I will just say WELCOME and you are not alone and never ever will be! Isnt that just great????? ;-)

Welcome Smokey and his momma (bean - that is what you are now - lol)
 
Welcome, Kendra.

You've gotten some great information.

Most of us no longer go to our vets to have a curve done. Once you start testing and collecting all of that data, you will be easily able to do a curve yourself. That is a quick cost saver. The majority of us who post here regularly collect our test data on a spreadsheet. It keeps all of the information in one place and you can easily send the information to your vet. This is a link to the spreadsheet template along with instructions.

When purchasing Lantus, buying pens is cheaper in the long run. You may need to call around your area to find out if there are places where you can buy a single pen. In some places, Costco or other of the discount pharmacies will sell single pens but this isn't consistent across cities. Some outpatient hospital pharmacies will also sell single pens so remember to check there. Also, many people purchase their Lantus from Canada. As long as your vet will fax a prescription, the cost for purchasing across the border is about half of what it is in the U.S.

Kendra & Smokey said:
I was just wondering about the numbers. Is there a site that will tell me what the numbers should look like? When to adjust levels? When to panic? Etc?
There is, in fact, a dosing protocol used with Lantus. It's referred to as the Tight Regulation Protocol. I've linked the modified version that we use on the Lantus board. The sticky note also contains links to the more formal version of the protocol which you may want to share with your vet if your vet isn't already familiar with this very well researched method of dosing Lantus.

There is a huge volume of information for your use on the Lantus board. When you're ready (i.e., are reasonably comfortable with home testing, have your cat eating a low carb, canned food diet, have your spreadsheet up and running), you may want to take a look at the starred sticky notes that we use. Here's an overview and links to the information if you want to start reading. As others have said, the beginning of this process is overwhelming. We've all had that overwhelmed, my brain is melting feeling. You can do this! And we'll help!!
  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in Germany and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot/shed: This is an important concept for understanding how Lantus works.
  • Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.
 
Normal non-diabetic blood glucose levels are roughly 60 to 150 mg/dl. Ideally you want your diabetic cat to stay in this range for as much as the time as possible with diet and insulin, and maybe one day, on diet alone. Anything over 200 mg/dl is considered diabetic.

Insulin dose is adjusted based on blood glucose curves that you do at home. We can help you with that once you get started with testing

Panic if your cat becomes hypoglycemic and shows symptoms. Some cats start showing symptoms around 60, other cats don't show symptoms until the level drops very very low. You just have to know your cat. If you think your cat is acting odd and isn't sure if it's a hypo or not, test the bg to check.

just want to comment on the number 60 here - i think squeem is giving you numbers using a pet-calibrated meter such as an Alpha Track. On a human meter, which most but not all of us use, the numbers we generally refer to for non-diabetic cats/healthy cats are 50-120. i have tested non-diabetic cats who are in their 40's and i have seen many people with cats recently off of insulin posting 40's as well. that doesn't seem to be uncommon. a cat cannot become hypoglycemic if it isn't getting insulin shots. hypos ONLY happen with injected insulin.

and while we begin to give high carbs to a cat when they drop under 50, that's not cause for panic, rather cause to pop open a can of high carb cat food and give a teaspoon of the gravy or a little blop of karo syrup to pull up their numbers. the 40's are kind of a "buffer zone" telling us the cat's not in danger but needs action from us to keep him from getting lower. cats on Lantus (Glargine) don't seem to usually show hypo signs until they are in their 30's or lower. if i had a cat in the 60's showing hypo signs i would worry about some other cause.

so not to derail your conversation, but i just didn't want you to be alarmed if you see a number less than 60. if you're using an Alpha-Track, then yes, be concerned at 60. if you're using a human meter you are ok at that number. whenever you have a concern, you can post here and generally there is someone on who can give you advice fairly quickly. it's essential to print out the post on Shooting & Handling Low Numbers that was just posted so if it's a middle of the night or no one is available, you still know what to do.
 
Hi Kendra!

I don't have much advice, as I've only been at this for a couple of weeks myself. I just wanted to say hello and that this board is an amazing place. So many people have offered me so much help on many levels. I honestly don't know how I would have gotten through the last two weeks without everyone's advice!

Mikey is on Lantus too. From what I've read, the vial can last up to 6 months if you keep it in the refrigerator (I almost passed out at the amount, too, but spread over 3-6 months, $110 isn't quite so bad. I'm out of work, so believe me, $110 a month is way out of my budget!) as long as it is clear with no residue. If it does go bad, it will stop working, and you will notice that when you test, I think. The cheapest test strips are the Relion from Walmart, and the Relion Micro or Confirm meters are about $9.

I'm sure everyone else can give better advice than I can!
 
MikeysMom is right -- My Romeo's on Lantus and we've had the same vial since September. I keep it in the fridge and we "juice up" twice a day without issue. The pharmacist at Target and my local super market advised me that it can be kept in the fridge for up to a year. Just watch for it to get cloudy -- if it does, you'll need a new vial.

When I went away on vacation and my friends were taking care of my boy, I prefilled some syringes and left them out for them to use on him. My nurse friend says this is okay, as Lantus is good at room temperature for 30 days. So if you want to make sure the Lantus is room temp when you give the shot, you can prefil the evening dose when you give him the morning dose.

I might have missed it, but how are you giving the shot? When I changed vets, I originally was told to do the skin tent and insert the needle in the tent made by the skin. But the new vet says a shot straight down towards his hind quarters is best, because if you're trying to do the tenting, you might not get it where the insulin will actually get into your cat's system. Plus shooting further back (under the ribs, in front of the hips) will help with absorption. You'll see folks on here who administer differently depending on how quickly they want the insulin to take effect. Your Mileage May Vary.

Also, if you're doing glucose curves at the vet, those can be pricey. I know my vet charges $18 a draw (and on a curve, that's alotta draws!) plus an office visit. You might want to look into Purina's Glucose Test Strips. They are confetti looking squares you sprinkle in the litter box which react to sugar levels. For me, it's way easier and less stress on my boy than going to the vet. The only down side is if you have multiple cats -- you'll need to keep the others from using that litter box.

-Stacy
 
Yes, thanks! I also checked with two nurses and the pharmacist who both said that the less-than-48 hours that the insulin was out was fine, due to the rate of deterioration and the type of needle used -- especially given the circumstances. I set everything up Friday evening and the latest the insulin was used was Sunday am.

Routinely, I will take out the Lantus from the fridge and put it in the syringe. Bottle goes right back in the fridge and the Lantus can warm up in the syringe as I am making up the dishes. Gently rolling the syringe between my fingers is enough to warm it up so that Romeo doesn't get stung by cold insulin.

-Stacy
 
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