Newly diagnosed and worried

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Glassgoblin

Glassgoblin

Member Since 2018
My Jaxa, a nine year old female, was just diagnosed this morning and given her first insulin shot by the vet. We have been seeing a vet since November and she was diagnosed with pancreatitis in December. The LIPA test today looked good though so the vet thought that the pancreatitis was not an issue at the moment.

So this is my concern. I had to bring her home and then go back to work, and when I came home she had been drinking but couldn't tell that she had eaten much. They sent us home with Royal Canin Glycobalance. The pieces of food are gigantic; Jaxa likes tiny pieces. She seemed hungry when I got home though, but wouldn't eat so I gave her half a tab of cerenia, and then her regular doses of ondansetron and cyproheptadine as the vet said to wean those slowly. So right now she seems hungry, but she won't eat, and every time she does try to eat she starts wheezing, gagging and has vomited up some of her food (then tried to eat it again). I gave her some wet Fancy Feast pate and the same thing happened with that food. I tried breaking the dry food into smaller pieces but it turns to dust instead of smaller chunks, so unfortunately that doesn't seem to be an option and she doesn't even want to try eating her regular Fancy Feast dry. I'm not sure what I'm supposed to do if I can't get her to eat when I am supposed to give her shot in the morning.

I left a msg with the vet's office, but of course this is Saturday night and after the last few months I cannot afford an emergency call unless it is an absolute emergency.
 
Welcome, sorry Jaxa is having trouble. Did the vet give her any other meds that she could be reacting to? Do you think she could have a blockage? How is she acting otherwise?
 
She has some of her meds from the pancreatitis, but nothing other than the insulin is new. She sounds a bit wheezy; not always unusual, though I was worried that she may have breathed in water since she lays with her head just above the bowl. I can't tell if there is a blockage, other than it isn't to her lungs. I did call the emergency line but am waiting for the on-call vet to get back to me. *The on-call was our old vet, and he only suggested feeding her less at one time, which is not so helpful as she wasn't trying to eat very much at any given moment,
 
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Maybe try mixing the fancy feast pate with some water. That is my regular feeding ritual for our kittehs. Mostly they get fancy feast stew for all their meals!

Also welcome to the forum.
 
One of the first things to do is get a meter and strips I guess? I am scared to ignore the vet directions but worried about how much she eats right now. She was acting as though she had something stuck in her throat, and I don't know if it was a piece of that giant dry royal cabin food or one of the pills for nausea and appetite she had, but she ate some canned without vomiting it back and still has trouble with the dry- maybe she continually is trying to swallow too large pieces? Drank several times also, so liquids are getting through. I put the dry food away for the moment, have several cans of Ff, Wellness, RC and misc grain free. It looks like the favorite seafood flavors are often higher carb so will have to explore a little on that Binky's List.

I like to add water to her pate too, usually a little warm water if it has been refrigerated or room temp water to keep it moist until she eats it all.

I've been keeping a food and med log for the pancreatitis so will continue that and note her behavior as well. But need the testing, am paranoid that I will give her insulin when she doesn't need it etc.
 
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Here’s the food chart we use. It has been recently updated, so info is good. Look for under 10 carbs. Yes take away the dry it’s not the best for her anyway. I think the Fancy Feast Classic seafood flavors are ok. As for the meter, yes, definitely. Many of us use a human meter. It will read lower than the vets, but is much more affordable. What insulin is she on?
 
Sharon14 said:
Here’s the food chart we use. It has been recently updated, so info is good. Look for under 10 carbs. Yes take away the dry it’s not the best for her anyway. I think the Fancy Feast Classic seafood flavors are ok. As for the meter, yes, definitely. Many of us use a human meter. It will read lower than the vets, but is much more affordable. What insulin is she on?
Click to expand...


They gave us prozinc insulin.

This is probably a weird observation,but her purring sounds different, I wonder if she didn't bruise the inside of her throat.
 
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She may have scratched or bruised it. Are you in the US? Many of us use the Relion micro or confirm meter from Walmart. It’s cheap and easy to use. As I said earlier it will read differently from your vets meter, but will tell you if Jaxa is to low for insulin.The vet meters (usually the Alphatrac) is more accurate for cats, but the strips are expensive, but a very good meter if affordable. Whichever you choose, be sure to get plenty test strips, and 26-28 gauge lancets.
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Prozinc is a good insulin. We have a prozinc forum if you have any specific questions about that insulin. Read the yellow stickies at the top of the page, they are full of useful info
http://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/
 
I just got back from Walmart, and got a Relion Confirm, test strips, lancets (33 gauge, and have been trying to figure this out but I have tried three times to get blood from her ear with no success so far. tiny bit of blood, not on the right place to test on the strip. We're both a little stressed now, but she taking a break to eat.

I need to learn what it means for the results I get; she is at 241 right now, which is high but she tested 424 at the vet's yesterday morning. I just don't know if it is high if that means she needs more insulin, to just follow the vet's guidelines so far (twice a day 10-12 hrs apart/2 units) and stay on schedule, to check her food, etc.. They didn't want to discuss home testing when I asked, and wanted to have me just bring her in after a couple days of shots. She did have her morning shot and was noticeably perkier about two hours later. My cousin is a Type I diabetic but we aren't close so I don't really know about asking him personal questions about testing/response. Will search the forums for more advise.

*Got more foods/wet that were listed with low carbs too*
 
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Do take a break. Are you warming her ear? Some use a rice sock warmed in the microwave, I just vigorously rub my cats ear. The larger gauge lancets would help too, but I started with the ones you have, so it can be done. Have you looked at the hometesting link I posted above? There are some videos as well as a pic of the sweet spot on the ear.
 
Glassgoblin said:
I just got back from Walmart, and got a Relion Confirm, test strips, lancets (33 gauge, and have been trying to figure this out but I have tried three times to get blood from her ear with no success so far. tiny bit of blood, not on the right place to test on the strip. We're both a little stressed now, but she taking a break to eat.
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At the beginning, thicker lancets make it easier to get blood - 26 to 28 gauge often labelled "for alternate site testing". Warming the ear first helps a lot.

Here's a helpful photo:

upload_2018-3-4_12-14-33.png
 
If you end up with the Alphatrak2 meter, you can use FreeStyle Lite strips. I get the strips from ebay for $0.33 apiece. Leo gets tested 3 or 4 times a day, so we figure ~$1.30 a day in testing.

For their Fancy Feast meals, we nuke the prepped meal until it is lukewarm. I test it with my finger. One of our cats drinks out all the gravy, so I usually monitor them eating, and add more water as they work thru it.
 
@Glassgoblin happy to see you here, you're getting good advice! Well done on getting the meter. Testing is tricky at first but you'll get used to it. Right now I'd say the priorities are:

- getting food into her
- figuring out the testing thing
- (note I put this third) how much insulin to give

Insulin doses are adjusted vary slowly, as its effect can be powerful. How much insulin did your vet instruct you to give? I understand the concern about getting conflicting advice from your vet and people on the internet. I've been there and it was very uncomfortable. The advantage of testing, in this situation, and being here is that you can gather the data and learn what you need to know to back up your decisions and explain to the vet why you did what you did.

In how many hours would your next shot be?

You might want to take a moment to read through this: http://www.felinediabetes.com/FDMB/...prozinc-pzi-insulin-for-diabetic-cats.164995/ -- a lot of info in it but come back to it, it will start making sense. Ask any questions you have if something is unclear for you.
 
Was told 2 units of insulin, twice a day; her doses are going to be about 6:50am and pm.

The food is a worry with the pancreatitis; I skipped her morning pills to see if she would eat well without, and because her throat still seemed sore, but she still hasn't finished her first can of wet food. We always had the wet food as more of a treat and she preferred small dry kibble types; she prefers crunchy, never chewy foods and treats so pate was always the only wet option. Tested her again an hour ago, and it hadn't changed too much. I think I need to give the ondansetron and cypro tonight, but maybe not the cerenia. She has never been a big eater (before the pancreatitis she ate about 1/2-2/3 c. daily even at 20 lbs.) She was 18lb on Saturday, down from 19.6 on January 24th, so the vet and I both want to see that slow loss continue, but now I worry that we need to find a balance of calories (she is willing to eat) and her glucose levels. I can't keep buying foods hoping she will like one. Why can't someone sell a sampler, lol?

Her drinking has already changed though- decreased. A few days ago she was eating about 350-400 calories per day and I haven't even wanted to count today though since I know it is low.
 
If she won’t eat enough canned food you can try THIS food. It is low carb dry and the kibbles are small. If you call them they will send a sample.
 
@JeffJ FYI-The freestyle strips in the AT2 meter don't produce the same numbers. I tested today and got 79 with AT2 strip and 103 with Freestyle strip. Not acceptable in my opinion.
 
That is quite a variation. One of our members did a side by side test over a year ago. The results were nearly equivalent. I have been using the FreeStyle Lite strips for over a year. You are using code 38 correct? The strips are not expired?
 

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JeffJ said:
That is quite a variation. One of our members did a side by side test over a year ago. The results were nearly equivalent. I have been using the FreeStyle Lite strips for over a year. You are using code 38 correct? The strips are not expired?
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Yeah, code 38. Strips expire 5/2018. I did other tests as well:

AT2 strip, At2 meter code 38 = 79
Freestyle strip, AT2 meter code 38 = 101
Code on Freestyle bottle is 16. 16 is not an option on AT2.
Freestyle strip, AT2 meter code 15 = 137
Freestyle strip, AT2 meter code 17 = 153

The one thing that confuses me is the vial says code 16, but the freestyle meter says no coding. I went out and bought a freestyle meter to use, but haven't yet because I need control solution for it.
 
I'm still using the AT2 meter. Keep the code at 38 on the AT2. Frankly I consider these test strips to be similar to ink cartridges. The strips are probably $0.01 to make and they upcharge a lot.
 
We are looking for consistency with testing. So a perfect test would be to use the same tester and same batch of strips - 10 strips on one drop of blood. They should all be within about 20%.
 
My last vial of AT2 strips, before this last one, was code 22 I believe. I'll try that code next time and see what it comes up with.
 
Have tested several times now and I think we've gotten the hang of it. Still having trouble coaxing her to eat more than 180-200 calories in a day. I let the vet office know she was vomiting the royal canin as she was eating it, but who knows if they will have an alternative. Jaxa wouldn't even try the can of wet food they sent with of glycobalance because it had chunks in it and she hates that. Running to specialty pet store after work I think to see if they have low carb dry or some treats I could use to tempt her with. She still we ts Friskies treats, anyone know if those are okay? It says 4.0% for carb listing on nutrition details,but I don't know how that equates basedon the food listings I've looked at. Have to go to work and hope for the best while I am gone.
 
Glassgoblin said:
Have tested several times now and I think we've gotten the hang of it. Still having trouble coaxing her to eat more than 180-200 calories in a day. I let the vet office know she was vomiting the royal canin as she was eating it, but who knows if they will have an alternative. Jaxa wouldn't even try the can of wet food they sent with of glycobalance because it had chunks in it and she hates that. Running to specialty pet store after work I think to see if they have low carb dry or some treats I could use to tempt her with. She still we ts Friskies treats, anyone know if those are okay? It says 4.0% for carb listing on nutrition details,but I don't know how that equates basedon the food listings I've looked at. Have to go to work and hope for the best while I am gone.
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Have you tried feeding her Fancy Feast or Friskies pate style foods? They're low enough in carbs and have a smooth texture she might prefer.

Re treats: you can buy freeze dried meat or fish treats (single ingredient) at most pet stores. Pure Bites is one common brand. Specialty pet stores will carry Orijen brand in several varieties. I use both brands.
 
Glassgoblin said:
One of the first things to do is get a meter and strips I guess? I am scared to ignore the vet directions but worried about how much she eats right now. She was acting as though she had something stuck in her throat, and I don't know if it was a piece of that giant dry royal cabin food or one of the pills for nausea and appetite she had, but she ate some canned without vomiting it back and still has trouble with the dry- maybe she continually is trying to swallow too large pieces? Drank several times also, so liquids are getting through. I put the dry food away for the moment, have several cans of Ff, Wellness, RC and misc grain free. It looks like the favorite seafood flavors are often higher carb so will have to explore a little on that Binky's List.

I like to add water to her pate too, usually a little warm water if it has been refrigerated or room temp water to keep it moist until she eats it all.

I've been keeping a food and med log for the pancreatitis so will continue that and note her behavior as well. But need the testing, am paranoid that I will give her insulin when she doesn't need it etc.
Click to expand...

Hi ... not sure if this helps but Maji previously was on UR food then had to go off that...so vet wanted supplemental water. Originally I tried mixing water with the pate... but Maji did not seem to like that...BUT this worked as follows... I get a small amount of filtered water like two teaspoons only into a clean bowl then I scoop out a fresh can of her pate and put it in the bowl right on top of the water so it’s like a little island in the middle... not too much water at all small amount and Maji just loves that she’ll bite away chunks of food then she begins lapping all around the food like it’s gravy but it’s not it’s the water... seems to work for me :) rather Maji!!!!
 
Have you checked out the food I linked above (post 17). It is dry, high calorie and low carb. We recommend wet food first, but she needs to eat and if she likes the Young Again you can use it to help transition her more easily. It and Dr Elsys Clean Protein are really the only low carb dry foods out there.
 
Glassgoblin said:
I just got back from Walmart, and got a Relion Confirm, test strips, lancets (33 gauge, and have been trying to figure this out but I have tried three times to get blood from her ear with no success so far. tiny bit of blood, not on the right place to test on the strip. We're both a little stressed now, but she taking a break to eat.

I need to learn what it means for the results I get; she is at 241 right now, which is high but she tested 424 at the vet's yesterday morning. I just don't know if it is high if that means she needs more insulin, to just follow the vet's guidelines so far (twice a day 10-12 hrs apart/2 units) and stay on schedule, to check her food, etc.. They didn't want to discuss home testing when I asked, and wanted to have me just bring her in after a couple days of shots. She did have her morning shot and was noticeably perkier about two hours later. My cousin is a Type I diabetic but we aren't close so I don't really know about asking him personal questions about testing/response. Will search the forums for more advise.

*Got more foods/wet that were listed with low carbs too*
Click to expand...
I test in my cats paws, just a thought, he won’t let me do ear
 
Kris & Teasel said:
Have you tried feeding her Fancy Feast or Friskies pate style foods? They're low enough in carbs and have a smooth texture she might prefer.

Re treats: you can buy freeze dried meat or fish treats (single ingredient) at most pet stores. Pure Bites is one common brand. Specialty pet stores will carry Orijen brand in several varieties. I use both brands.
Click to expand...

We usually have Fancy Feast and have tried a couple cans of Friskies recently. She just never wants to eat a whole can in a day, much less the three or more needed for her calories requirements. She sometimes will eat half if what is in her bowl, I mix in a little water or tuna water and she will eventually eat some of that, and so on until it has been out too many hours. The thing I like about dry is that she can get the same amount of calories in a fourth of a cup of dry as a can, but she is more likely to eat all of the dry.

I tried some others recently too; she hated the whole chunks of meat in weruva, but ate a whole can of Whole Earth Farms salmon pate. If it were not storming I would have gone to the specialty food store today,but roads are bad.

My other current concern is a question about the test/feed/shot schedule on the prozinc page, because I'm not sure if that means it is okay to test when I get home and then feed even though there is an hour before her shot. The two hours of no food is confusing me; two hours before testing for the shot, or just no food before the shot in general?
 
Sharon14 said:
Have you checked out the food I linked above (post 17). It is dry, high calorie and low carb. We recommend wet food first, but she needs to eat and if she likes the Young Again you can use it to help transition her more easily. It and Dr Elsys Clean Protein are really the only low carb dry foods out there.
Click to expand...

I did and bookmarked the page. I sent them a message about samples but am waiting to buy anything more online atm.
 
Glassgoblin said:
The two hours of no food is confusing me; two hours before testing for the shot, or just no food before the shot in general?
Click to expand...

It's two hours before the test. You want your pre-shot test to be "clean", ie not food-influenced. Then you want to feed, and then shoot. You feed before shooting because in the case where the cat doesn't eat, you don't want to be giving insulin, or maybe just a reduced dose. So you feed first to make sure you have an eating cat before you give insulin.
 
I didn't always manage to get clean preshot tests, however. I'd wake up in the morning, test, feed, shoot, but as Quintus is a grazer, I couldn't be sure he hadn't eaten during the last two hours when I was sleeping. Same when I got home from work, I'd test-feed-shoot as soon as I got back, so I just had to hope he hadn't eaten too much just before. If he'd remained on insulin any longer I'd have bought a bowl with a timer and different compartments, but I didn't have time!
 
She had her second appt with the vet today; glucose at 419 so the vet wants to go to 3 units in the insulin- she is at 18lbs still. My mother thinks she smells musty and the dog keeps smelling her too, though I don't know if it because Jaxa was away for hours. Third appt set for this Saturday.

I plan to stop at the petstore for food and Walmart for ketone strips after work tomorrow.

I feel like I'm crying all the time lately.
 
It will get better.:bighug: Feel free to come here and vent, we’ve all done it, and we’re good listeners
 
I'm of limited help right now, am on business travel until Friday pm.

Some people can smell the ketones, and I'm one of them. Leo had ketones before we got him first diagnosed. Like most everybody we felt horrible that he got in such bad shape before we figured out what was happening (almost 3 years ago). He looked all washed out and had lost about 20% of his weight. But you are in the right place now, and it's not too late. Many kittehs respond very well to insulin and there can be some drastic health improvements.

It looks like you are on 2 units, twice daily now. I probably wouldn't crank it to 3.0 units. But would probably do a dose increase to 2.25 or 2.5. If you get time, it would be very helpful to create and maintain a spreadsheet. Even just for a month. It would show the insulin response patterns and help you fine tune the dosage.
 
JeffJ said:
I'm of limited help right now, am on business travel until Friday pm.

Some people can smell the ketones, and I'm one of them. Leo had ketones before we got him first diagnosed. Like most everybody we felt horrible that he got in such bad shape before we figured out what was happening (almost 3 years ago). He looked all washed out and had lost about 20% of his weight. But you are in the right place now, and it's not too late. Many kittehs respond very well to insulin and there can be some drastic health improvements.

It looks like you are on 2 units, twice daily now. I probably wouldn't crank it to 3.0 units. But would probably do a dose increase to 2.25 or 2.5. If you get time, it would be very helpful to create and maintain a spreadsheet. Even just for a month. It would show the insulin response patterns and help you fine tune the dosage.
Click to expand...

I did give her three units last night, but that was before I saw this. She tested at 296 this morning, so I fed her and gave her 2.25 unit or as close to that as I could eyeball it. We are still struggling with some eating, though she had a few bites of both wet and dry this morning and always wants her Friskies treats.

I wonder about the Friskies treats but they list carbs at 4% and her Royal Canin dry is 6.8%. Does anyone else give those treats? I .looking for different ones but she does love them.
 
Glassgoblin said:
I wonder about the Friskies treats but they list carbs at 4% and her Royal Canin dry is 6.8%. Does anyone else give those treats? I .looking for different ones but she does love them.
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Where do did you get those figures from? I have a hard time believing that. Not to say you're wrong, but might be bad info.
 
Glassgoblin said:
I did give her three units last night
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That's probably fine. We are trying to avoid a hypo during these increases. Some cats respond vigorously with increased dosage. Here is the recent summary:
3/5 (and earlier) 2.0 units each dose
3/6 AMPS ? - 2.0 units
3/6 AMPS +3-6 hrs - BG 420
3/6 PMPS high - 3.0 units
3/7 AMPS 296 - 2.25 units

I will be offline probably until late tonight. I recommend staying at 2.25 for 6 doses and seeing where the AMPS and PMPS values are. Then raise it to 2.5 units/dose. While prozinc is not technically a depot insulin, there can be an overlap past the 12 hour mark. I still recommend a spreadsheet since it will help you and us - for dosing adjustments.
 
I encourage you to go over to the ProZinc forum where you can get insulin specific advice from folks who use or have used that insulin. Jeff is right: technically it's an in and out insulin but it can have a little bit of carryover into the next cycle for some kitties. Also, I second his advice to get a spreadsheet like the one we use here set up. It would make it so much easier for us to help, especially in a tense situation. :)
 
Sean & Rufus said:
Where do did you get those figures from? I have a hard time believing that. Not to say you're wrong, but might be bad info.
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I'm looking at the bags and trying to figure out how it equates to the numbers for the RC food listed on the spreadsheets, because they don't make sense to me. I don't know what fancy equations are used to convert those numbers but if the Friskies is lower than the RC it seemed like it might be okay. We got our two free samples from Young Again cat food and she gets to try that at shot time tonight. I didn't know it was a local company- I'm in MN too.
 
Glassgoblin said:
I'm looking at the bags and trying to figure out how it equates to the numbers for the RC food listed on the spreadsheets, because they don't make sense to me. I don't know what fancy equations are used to convert those numbers but if the Friskies is lower than the RC it seemed like it might be okay. We got our two free samples from Young Again cat food and she gets to try that at shot time tonight. I didn't know it was a local company- I'm in MN too.
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Yeah, they equations get me too. I usually call the company or look on chewy.com in the question section under the food, usually people have already asked what the carb % is.

Which friskies treats and which RC dry?
 
Sean & Rufus said:
Yeah, they equations get me too. I usually call the company or look on chewy.com in the question section under the food, usually people have already asked what the carb % is.

Which friskies treats and which RC dry?
Click to expand...

We have the Friskies party mix, and the vet gave us Royal Canin Glycobalance. I've been trying to get her to eat more canned but she seems to think of that as a treat instead of a meal.
 
FYI the Royal Canin Glycobalance is super high, it actually is 25.2% carbs! And I think the Friskies party mix is way more then that :(
 
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