Newly diagnosed baby girl

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asilem09

asilem09

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My baby girl Truly Scrumptious Boom Boom De-Lite was just diagnosed this past week with diabetes. Now being a nurse and a diabetic myself I thought I could handle this. Well after doing a little research and landing here in this forum, I'm finding myself crying my eyes out, feeling overwhelmed and just a little freaked out! The educational information like the carbs in canned food is invaluable, the personal stories (especially Gen Gen's) are inspiring/sad/informative, and the support I see is phenomenal! This is Scrump's first night home after the hospitalization so of course I'm watching her like a hawk. I was discouraged by my vet to do in-home testing but after reading that this is the apparent norm to do and watching the video on doing the testing, I'm definitely going to give it a try. He also was a little put off because of our not being able to pay everything today. This, along with his attitude towards home testing, has put me off of him a little bit. I do have a couple of questions for anyone as I'm finding conflicting info on several sites: 1) is all dry food bad and 2) is NPH insulin not effective? We have a follow up appointment on Tuesday for a lab draw and I want to give him the benefit of the doubt that he has ordered the best treatment for her but I would also like to go to that appointment armed with information. Thank you for any help.....
 
Well, let me tell you! Most of us felt just like you do, or maybe worse! The good news is that there are many very kind and experienced members on this board who are generous with their assistance. I'm not so experienced, but wanted to let you know that in not very long you will likely look back and be amazed at how easy and routine it all seems. You're not alone, and definitely in the right place to help your kitty.

Home testing is, in my opinion, the very most important thing to do for Scrump. I don't think that many human diabetics would inject insulin while having no idea of their bg, so I can't understand why some vets would think its a good idea with a cat. There may be a lowering of her bg # with a change to a low carb diet - yet another reason to home test.

You can use a human glucometer to test her - it's not hard at all as you have seen in the videos that you've already watched (good job!).

I'll leave comments on the insulin for others. They will probably want to know things like dose that was prescribed, and bg # that you have to share, type of food that Scrump is eating, was she checked for ketones - I think that's the usual.

You'll do fine. And welcome to the board.
 
Hi asilem09, and, of course, you too, sweet Scrump,

You can handle this! It's not always going to be easy because you know diabetes, right? But, it is immensely do-able.

Yes, all dry food is not good. And, yes, you still need Scrump's vet. Conflicting, I know...

Okay, so here's my humble suggestion... Start gently switching Scrump from dry food to low-carb wet -- s-l-o-w-l-y. I say slowly because that will most likely affect Scrump's BGs/blood glucose levels... And, it's so good you're a nurse, sadly diabetic, yet fearless! So, you will be able to get a bead of blood from Scrump's precious ear. And, that will start your knowledge as to how she's handling the juice, ie insulin.

There are other insulins out there that would probably be better for Scrump. Gentler, more cat friendly... But, for now, you have much on your plate. It's kind of like a dance, where we all learn one step at a time...

Welcome to the place you never wanted to be; but, will be blessed for having found, kind of hugs,
Deb and Nikki, my extra-sweet rescue -- and Giz, forever whispering in my heart...

PS: Tears are good. It means you're a wreck, and that's completely okay and expected... Extra hugs...
 
Good Morning and Welcome,

You are now in the best place you never wanted to be.

The fact that you are a nurse and a diabetic yourself gives you a leg up on all of this. First off you aren't afraid of needles or the sight of blood. Also being a diabetic yourself means you already know how important it is to check your blood before taking insulin. I'm sure you would never think of giving yourself an injection without first testing, same goes for Scrump.

You and Scrump can also share some of your supplies like your meter and test strips. You don't need anything fancy, just your plain old human meter will work just fine.

As far as food goes, almost all dry food is just too high in carbs for kitties. Binky's list is valuable to finding low carb wet that Scrump loves. I won't tell you the evils of dry but I will tell you what I have personally seen with my own cats. I have 10 but only one is a diabetic. But because of Max my diabetic we put all the cats on a canned only food. Everyone eats the same thing. Within just a few weeks of everyone's diet being changed Max went into remission, and the other 9 cats started shedding like crazy. Why? Because they were losing all their former course coats. Today a little over a month later I have 10 of the sleekest, shinest cats I have ever seen. They look professional groomed and ready for a show ring. Not only have all their coats improved, my guy with severe allergies, had his allergies disappear. My one that was just about a daily puker, quit. And all of their energy is greatly improved.

Now will not all kitties go into remission it is possible for a lot of them with a proper diet and a little insulin. The others at least can get regulation with the proper dosage of insulin. Now I adopted Max from this very board, after losing my first diabetic cat passed away. If this was something that was extremely difficult I certainly wouldn't volunteer to take on another one.

And as other's have said, we have all been there in the beginning, we completely understand the fear and the tears they are both perfectly normal. But very soon you will feel like an old pro. Just as you have questions or need to vent come back and post and we will be here to answer the questions and hold your hand/paw all the way along.

Mel, Max & The Fur Gang
 
Hello and welcome to FDMB.

Unfortunately a lot of us have gone through similar things with our vets. You do need your vet as a partner and sometimes it just means educating them. Most vets do not deal with the day to day care of diabetic cats and therefore go by the information they have learned in school. However, some of them also have not kept up with feline diabetes treatments either. :cry:

Yes, dry food is bad. You will not need to feed your cat prescription food either - no matter what your vet tells you. Many of us feed our cats foods like Fancy Feast and Friskies canned foods. On this page you will find information about nutrition http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=115. Janet and Binky's food list is a great resource http://binkyspage.tripod.com/canfood.html. Using both the old and new list, look for foods that are under 10 in the carbs column and a high number in the protein column.

There are better insulins than NPH. Many cats have great results with Lantus, Levemir, PZI and Prozinc. These are longer acting insulins and do not have the steep drops that NPH does. If you do decide to use Lantus or Levemir, get the prescription for the pens or cartridges. The initial cost is higher than the vial, but because you will not end up wasting any of the insulin because it expired, you will get about 5 times the amount of usage. One package of 5 pens will last almost a year vs a couple months with a vial. There us also a coupon for $25 off Lantus pens in the Supply Closet http://felinediabetes.com/FDMB/viewtopic.php?f=15&t=30098. It expires 12/31/10.

Also, if you have not started insulin yet, you want to start at a low dose - 1/2 or 1 unit twice a day. Insulin for cats is not dosed by weight and don't let your vet try to convince you otherwise. Start low and raise slow until your optimal dose is found. We will help you with that.

It's a scary dance to begin with, but you will soon find that caring for a diabetic cat is not difficult once you get into your routine. Many of us have been doing this for years and have even adopted diabetic cats. You can do this. :mrgreen:
 
Thank you all so much! I checked this forum first thing this morning and I'm so glad I did. I feel more ready to do this. It was a fitful night and I heard Scrump up drinking a couple of times but right now I'm so afraid of low bg that I found that more comforting than if she hadn't moved. Right now I am sitting here beside the bag of canned and dry food that I just bought yesterday prior to finding the information on this site and I'm checking the food against the lists. Amazing how I was drawn to all the WRONG stuff! I picked almost all foods with high carb content. I bought the Whiskas Purrfectly Chicken because I thought it would be more meat. Wrong on that one. She likes it but I'm going to slowly switch her back to the old classic stuff. I did pick up some Friskies because it happened to be on sale and did good there. One thing I've learned already--No matter how much I don't want to wear them, I NEED my glasses when I go to buy her food! LOL

Again, thank you all so much for responding. I did try to get a sample from her ear this morning and maybe I'm too timid or she was too chilly but it was a no-go. She also wanted her food and was getting tired of me messing around with her ear so I left it for later today when her insulin peaks. Wish me luck :-D
 
A couple of tricks to getting blood from those pretty ears. Warming the ear helps alot. There are several ways to do that, either by giving them a good vigorous rubbing, using a rice sock or a warm wash cloth in a plastic baggie. I found it was easier to use the lancet pen but to take the cap off. So you are about half free handing it, and half using the pen. I use the spring load feature to make sure I don't chicken out or go to lightly but without the cap so I can see where I'm pokng.

Now every cat is different but the best spot on Max's ears is right above that little double fold near the base of the ear. He also has one ear that bleeds better than the other one, so you may have to experiment at little until you find where exactly Scrump's sweet spot is. Make sure you have something firm backing the ear. I personally just use the rice sock to poke against. Also don't worry if you piece the ear (go all the way through). Poor Max had his ear pierced a couple of times before I got it down. But he never complained.

We will cross our fingers and paws that you will soon be another member of the vampire squad. =^..^=

Mel, Max & The Fur Gang
 
Let me ask you this: if your own dr told you that you don't need to test your BG before giving yourself insulin, what would you say? Exactly; you would be looking for another dr, to be sure, because it's very important for you to know your BG when it comes your shots, your dose and also your diet.

The same can be said for your cat, but most vets don't know that much about FD and you may have problems finding a vet who is great with FD info and also good in all other aspects of vet med. The vet office where I take my cats has no vet that knows much about FD at all but there is one vet who is incredible with the animals, is a fantastic diagnostician, and does all the dentals, plus is willing to work with me and does research to educate herself. She freely admitted that she knew nothing about FD but started us on Caninsulin. When I asked about trying Lantus, she said sure, but I don't know anything about it. It's a human insulin so how can I expect her to know all. She's done well by us in all other areas so I stay put for now. See how flexible your vet is - tracking BG for your cat is important and so is feeding good low carb wet food.

I can say that both Lantus and Levemir are great long lasting insulins, but I think I would suggest Levemir because both of my cats are doing well on it, and one did not do as well on Lantus. I am sure you can relate to how it feels when your BG is good then goes really high, or how you feel if they go really low. I am sure the cats are no diff so the insulin being suggested by your vet is not long lasting and your cat is likely going to experience big drops in BG and then the insulin wears off and BG will go soaring high again until the next shot. If you put yourself in the cat's paws, you would know that's not a great way to be feeling every day. Going with a longer lasting insulin will feel better in your cat.

Food's very important as there are many cats who are diet-controlled cats and do not need insulin. Some have needed insulin for just a short period of time, and then once the diet is fixed up, their pancreas is ready to get back to work.
Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition

I know it's rough in the beginning, with all the new info, but in a very short time, the routine will be as commonplace as your own - just normal everyday stuff and you and your cat will be just fine.

Ask every single question you have; there will be someone here who can answer it or point you to the place to get the answer.
 
Welcome to you both! My cat Willie got his diagnosis on 4th and we got started the evening of the 7th, so I'm a couple weeks into all this, and I promise, it gets less overwhelming as you go! The rice sock and the kitty blanket burrito are very helpful tools as you're just starting out. Willie is still less than enthusiastic about ear pokes, but he tolerates them and we no longer need the sock to get a reading.

Personally, I would transition away from dry food if you are able. Most are higher in carbs (there are some exceptions). In my mind, the more important consideration is the moisture they lack. Kitties have to drink much more water in order to handle the dry food. Plus, wet food will often result in less litterbox waste as kitties aren't getting as many fillers they don't need. This is especially true if you go with a homemade diet (raw or cooked), which can be a surprisingly cost-effective option. My cats eat a ground-turkey based diet that works out to about $.87/serving including supplements to make their meals well-rounded.

I also echo the advice of others on the importance of home testing. I'm in the middle of a dosage change and I don't want to think how lost I'd feel trying to do this without it! One thing... when you're just starting out, I wouldn't get lancets thinner than a 30 guage. It was hard for me to get blood with a 31, but we are having success with a 30. Others use anywhere from a 26 and up.

You are in the right place! Good luck!
 
Wow! This site is such a blessing. I am reading all your posts and talking with my hubby about all your thoughts, suggestions and help. You are just an amazing group of people and pets. I am feeling much more reassured and am looking forward to the appointment on Tue to discuss with my vet what I've learned. I think he will be really interested in a lot of this info too! At least now I'm not looking at Scrumpy and bursting into tears :thumbup
 
One more thought - when you are about to do take blood from her ear, poke like you mean it! I imagine that with the nursing background, this might not be an issue, but the thought of poking those cute little ears is a bit intimidating. As said before, if you go through, its not really a problem. I use a cotton makeup removal pad and fold it over the ear and hold pressure for a few moments. It reduces bruising and it the lance has gone through, it gets both sides.

You and Scrump will be stars in no time!
 
whew! got a blood sample finally using my lancet pen with the cap off (thank you for that suggestion) and the inside of the ear (got that from somewhere, can't find it in this thread so must have been someone elses). BG was 367 prior to evening insulin dose of 3 units NPH. That's about the same level as when she was diagnosed last Wednesday but I admit, I gave in and fed her a little bit on her "old" schedule around 5PM because she was begging so that was more like a 3 hour postprandial sugar. Gave her a little more after the insulin along with some plain roast turkey. Noticed she's not eating her dry food (mix of Fancy Feast and the new food I bought that was "sugar free" and low grain called Katz N Flocken Solid Gold) so I think that is going to disappear. Now begins the work week but thankfully I work from home at this point so I can continue my watchful gaze. Everyone have a great night and I'll let you know how the vet appt goes Tue!
 
The recommended starting dose for cats is 1unit bid. Cats are not dosed by weight
and the BG at diagnosis is not a good indicator of what the dose for regulation will be.

Cats here have been in the 500's at diagnosis and eventually regulated at .5u to 1.5u bid.
Some even go OTJ (off the juice....no insulin), after proper diet adjustments.

The danger in starting too high with the dose is that the correct dose has been passed,
and you will get into rebound (Simogy effect). Not sure I spelled that correctly.

With that three units, you should try to get some mid-cycle BG tests, because
NPH hits hard and fast. And then poops out so no insulin is in the system at the
next pre-shot test.

In these early stages, it's important to learn where and how deep is the nadir.

You could get high pre-shot numbers and not be aware of how low the nadir is.
Being too low for a short time is way worse than being too high, as you probably know.

Also, as you introduce the low-carb food, BGs can drop dramatically....as much as 100 points
almost right away.

Are you, yourself, on insulin, and which one ?
 
Karen--thank you for the information. I will certainly discuss with the vet tomorrow. He is planning on increasing her dose to 4 or 5 units then per what he told us Saturday and I will try to get some in between BG levels before that so he has a better idea of what he is dealing with.

I am not on insulin myself. I take orals and Byetta which is another story in and of itself!
 
Please please please do not increase her insulin! 3 units is way too high of a starting dose even with dry food, and if you are altering her diet then it is even more serious. You run a real risk of overdosing her if you follow your vet....
 
I am so glad you are testing at home. This will give you the best information... better than the info your vet can get since the office is usually stressful on kitties and can disrupt their glucose readings.

If you have time, I would really suggest doing a curve at home... this means testing your sweet kitties BG every 2 hours. So once before her shot, then 2 hours later, etc. This will show you how the insulin is working in her system, and also let you know if she is going too low during the cycle (the time between shots). It sounds like she might be going too low and then rebounding, which means that her BG is going too low and her body is releasing its own glucose to survive. This happened with our kitty before we started testing midcycle, so his preshot numbers were high and made us think he needed more insulin when really he needed less. He is currently not on any insulin, is diet controlled, and we all have our fingers and paws crossed for him.

Lulu was on NPH, and this insulin brought him to his lowest BG between 4 to 6 hours after his shot... but it also acted really fast. I would suggest checking your kitty's BG at 4, 5, +6 hours after her shot and also read up on hypoglycemia. Having some gravy wet foods around can really help if your kitty's BG drops too low, as well as Karo syrup... the food will maintain higher BG's longer than the syrup which is a quick emergency fix.

Hang in there, you are doing great!
Amanda
 
to all---thank you, thank you, thank you! I've noticed today she is not ravenous and is not drinking much water. We have the wet food and Karo. I want to get some of the nutrient paste too in case there is a time she goes off her feed.

Testing is not going well though. She is extremely upset at the present time because I tried for a 2nd BG today just now and she is having none of it. She recognizes the testing equipment already and as soon as I went for an ear, she heard the click of the pen, and the claws came out. I fended them off and went for the stick and she took off! I know I read you can try the pads but because of being in the litter, that isn't best. Is there anywhere else to try?? I also need to look at the wrapping technique that was suggested. Just have to "stick" with it--oooo, that was a poor pun!
 
Interesting that she hates the click...was never an issue with mine.

I could never restrain Squeak so I would sit on the floor with him between my legs. I'd brush with my right hand, warm his ear with a warm rice filled sock in my left. Then grab the lancet pen and poke the ear with the rice sock 'in' it for support. Put the pen down and grab the tester and bam.

Consider getting her used to the pen sound. And if you are steady handed, consider free hand poking at an angle without the pen.

Jen
 
Hey there!
Getting alot of information from everyone of course!
Welcome to the forum!!

Also, my mowgli, he acutally learned to like the poke! I never thought he would, if you peek through some of my old posts we, both he and I were traumatized from the pokes!! Now I shake the strips in their container and to the poking spot he goes and purrrrrs....I never thought I would see the day!
Keep at it, good luck with everything and you are in the best place you could think of being for FD!!!
 
asilem09 said:
He is planning on increasing her dose to 4 or 5 units then per what he told us Saturday
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I rarely make any comments on this forum regarding insulin dosages unless I think that something dangerous is about to happen but please do not allow the dosage to be raised this quickly.

Also, I disagree with the use of NPH and the starting dose of 3 units BID. While NPH can work in some cats, it is certainly not my first choice of insulins for a cat...and definitely not at a starting dose of 3 units bid.
 
I am glad I mentioned the intended dosage increase! Thank you to all and in particular, Dr. Lisa. I know as a medical professional it is difficult to make comments against another provider's treatment plan so I totally respect your input. I plan on really discussing the choice of insulin and the rapid increase in dosing with my vet. I am anxious for tomorrow to get here. Did manage to get another BG on her around 3 PM when my husband got home to help and it was 417 :o(
 
asilem09 said:
I am glad I mentioned the intended dosage increase! Thank you to all and in particular, Dr. Lisa. I know as a medical professional it is difficult to make comments against another provider's treatment plan so I totally respect your input. I plan on really discussing the choice of insulin and the rapid increase in dosing with my vet. I am anxious for tomorrow to get here. Did manage to get another BG on her around 3 PM when my husband got home to help and it was 417 :o(
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Not surprising....last dose was in the morning, right ?

NPH has totally worn off by now.
 
asilem09 said:
. I know as a medical professional it is difficult to make comments against another provider's treatment plan so I totally respect your input
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Yes, it is hard. I picture your vet reading this and getting very upset with my straightforward comments but, sadly, so many of my colleagues are simply not keeping current with feline diabetes management.

Also, I am not sure if your vet recommended against home testing or not....I think he did.....but that REALLY upsets me.

This is also going to sound unprofessional, but you may have to consider your other options...ie....another vet if your current vet is not willing to work with you. Note that I said "may" because maybe he will be willing to learn *with/from* you because if you hang around on this board very long, your knowledge will quickly surpass his.
 
Thank you Dr. Pierson (sorry I didn't see your last name before when I referred to you as Dr. Lisa). I have printed off some material from the site and written down some insulin types to discuss. I plan on taking a nonthreatening approach to see what my vet's "experience has been with NPH" and go from there.

BG this morning was 166. Scrump is doing better with the testing if both hubby and myself are doing it--we consider it quality time :lol:
 
asilem09 said:
Thank you Dr. Pierson (sorry I didn't see your last name before when I referred to you as Dr. Lisa)
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Not to worry. Everyone here calls me Dr. Lisa. :-D

I second Jen's question about that pre-shot number....???
 
I am (was) giving Scrumpy 3 units BID (twice daily) so this morning before her shot her glucose was 166. She ate her breakfast but didn't seem too interested in any further feeding prior to leaving the house at 1:30 PM. She did take off when she saw the carrier and we had to coax her out of her hiding place by cooking bacon which she ate some of. At the vet's office her blood sugar was 108. I asked if we should feed her something prior to leaving there and starting the 1/2 hour drive back home. He asked if we wanted a can of food, which we said yes and they did give us one which Scrump ate 1/2 of in their parking lot. I did have a packet of honey from McDonald's with us in the car, in case. Anyway, here's the details:
1. they don't use any insulin other than NPH--"other practices do, we don't"
2. this was a different vet in the same practice as our 1st vet--however, he is a vet that Scrump saw 1x before and she bit him. That may have played a role today.
3. he had no interest in the material I printed from this website or in knowing the name of the website for that matter
4. he thought I was giving 2 units BID so was he looking at the card wrong or had we been told wrong?? good question.
5. we are not to increase at this point and she follows up next week for another sugar
6. he was somewhat suspicious when I said I was testing her sugars at home ("just HOW are you testing her sugar?") and then when I said with ear pricks and a glucometer he did admit that the results were helpful to him but there was no further discussion or interest

So.....like I said, I was giving her 3 units but I'm going to drop it to 2 units BID and keep testing while slowly changing her diet. From reading everyone's comments it seems that going down in dose as long as her sugars are ok is the "norm" or standard.

Question: He said they like the sugars to be between 120 - 180. Any thoughts?? Thanks again for all comments/opinions/suggestions!
 
asilem09 said:
("just HOW are you testing her sugar?")
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This makes me shake my head in utter frustration. There have been NUMEROUS articles in our vet journals for the past many years discussing the value of home testing. I would think that a colleague would have to be practicing on Mars to not be familiar with - and supportive of - home testing.

I'm going to drop it to 2 units
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You are heading into very dangerous territory with this insulin and that high of a dosage....
 
Dr. Pierson--I know this puts you in a bad position but I'm going to come right out and ask, since I'm not getting much assistance from my vet and there aren't many vets where I live (only 1 other within an hours drive of my house) to switch to, would it be appropriate to go lower, say 1/2 to 1 unit and see how she does until we can find someone local to help us??Or is it the type of insulin that concerns you more? If you do not wish to answer that, I understand. Thank you!!
 
Missy, I know that you are stuck in a difficult position but I have already said far more than I normally say here about dosing issues. I only jump in on this board (regarding dosage issues) if I see someone headed for a cliff. Any specific advice must be given via a two-way phone consultation. I do a lot of diabetes consultations with people from all over the world since so many of my colleagues are not well-versed in this area of medicine.

Please keep posting....*before* you give more insulin. You can get a lot of great help from the members here.
 
PS.....I do want to say that I feel awful for people in your situation.....and I wish that better veterinary health care was available in every part of the world. It hurts me to constantly see animals not getting the best care possible......
 
Dr. Pierson--thank you so much. I will keep reading (I just found the forum for Humulin N insulin) and learning as much as I can while monitoring my "babes"!
 
I am not a vet so I have no problem giving some advice :) Yes, I would totally suggest dropping that dose. Consider 200 as your give insulin/don't give insulin line until you have more 'data' and get spot checks inbetween shots to see how low she is going

Jen
 
Dale said:
May I ask, what insulin are you taking for yourself? N and Lantus/Glargine?

I am not on insulin but oral meds and byetta which is an injectable but not insulin. It works by causing gastroparesis so you feel full all the time and nauseous. If you eat, you puke; therefore, blood sugar comes down indirectly because you don't eat.

Thanks for the link, Dale. there is a lot of information out there so being directed helps!

Last night BG preshot was 389 so I gave her 2 units of NPH and her supper which was one of the higher carb content foods that we are using up. I heard her up in the middle of the night drinking quite a bit and she ate about a tablespoon of dry food which we are taking away from her but now I wonder if I should leave about 1 - 2 tbsp out in case she feels she needs it??? Although this morning sugar was 450 preshot. Gave her 2 units and her breakfast which was a can of lower carb food (3 grams) and I just tested a little bit ago and her sugar was 263. I know that at around 2:30 yesterday her sugar was 108. So I am about to wake her up and give her some lunch so she doesn't drop so low this afternoon.

Jen & Squeak said:
I am not a vet so I have no problem giving some advice :) Yes, I would totally suggest dropping that dose. Consider 200 as your give insulin/don't give insulin line until you have more 'data' and get spot checks inbetween shots to see how low she is going

Jen--thanks for the parameters.

And everyone, thanks again for the support, encouragement and suggestions. The testing is going much better and the last sugar I actually was able to get by myself without a lot of trauma for either me or Scrump!
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