Newly Diagnosed Cat - Appreciate any tips or advice.

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imjosh

imjosh

Member Since 2017
Hi all, my 10y.o. Nebelung Charlie was recently diagnosed today. Attached is a picture of him and his new brother Theo, a kitten we adopted about a month ago.

Blood test on 12/3 revealed Glucose at 425 (ref. value 75-175)
Urine test was negative for protein and ketones, but 3+ (1000mg/dL) for Glucose.

Did endocrinology test to confirm and got results today.
Total T4 was at 1.6 (ref value 0.8-4.7)
Hemolysis Index at 1+
Fructosamine at 649 (ref. value 191-349)

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The vet seemed surprised we didn't catch this sooner. My cat has always loved to drink water, so I did not notice any uptake in consumption. He has slowly lost weight over the years, down from a very overweight 25lbs when we first got him (adoption at age 5) and now at a healthy 17.5-18 lbs (he is a large cat). I hope he hasn't been dealing with this for many years... his other lab results were fine, it was just the glucose.

Anyway, vet has recommended a switch to all wet cat food (Purina DM), and 2 units twice daily of glargine (lantus). They also want us to get the alpha trak glucometer.

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I've started to do my research on this forum and useful website and this is what plan I have developed, and have presented to my vet. Wondering what you all think.


1. For diet, go with FF classic or alternate, rather than Purina DM, (thanks for this chart btw and web tool) as it is less expensive but just as effective. I will spend 50% less for something that may be only 99% as effective, that's just my viewpoint at least, as I don't think I can afford all of these "premium options" - though i still want the best for my cat (within reason).

2. For glucose checking, go with the Contour Next EZ (Meter, Lancets, Solution, Strips) for humans, since it is much less expensive than the alpha trak one, and the strips are much less expensive as well. Again, but just as effective. Anyone use this meter for their cats?

3. For Insulin, go with Marks Marine. I hope my vet will be ok with this. Also I found another Canadian supplier called PricePro Pharmacy - anyone ever used them? Anyways these seem to be a lot more reasonable. And I want to take your all's advice and go w/ the pens rather than vials. I found a syringe (CarePoint Vet U-100) at ADW that was recommended on here, will that work with the pens?

4. Do you think jumping straight to 2x2 doses a day is too extreme? Should I try to see if maybe going with just diet only first is more reasonable, or perhaps only 2x1 dosing? Or is 2x2 needed since my cat is larger... or is it because his readings are so high? I can share some other #s of his labs if you are interested

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Also, just wanted to say thanks to all of you who contribute to this website. Learning that my cat has diabetes has been overwhelming for sure, but I am not as stressed as I was initially because of all the valuable information that is on this website. I know that most of the answers are here if I just look hard enough!
 

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Welcome to you and your fur kids! You're doing great so far! Sounds like your vet isn't to bad either. I'm a relative newbie so mostly just welcome and soak up all you can. The people here are wonderful and caring and knowledgeable and they'll help you navigate this new journey. I will say though that dosing is going to significantly affected by the change to wet food. Hopefully a more senior person will welcome you soon and give you more guidelines on transitioning from dry to wet and lantus dosing. Love and hugs to your sugar cat for a speedy response to treatment.
 
Thanks! He has been on dry food for as long as we have had him, so I am definitely imagining the transition to wet cat food will prove to be a challenge (I did find this resource though which will hopefully prove useful). He loves deli ham and cheese though so I'm wondering/hoping I might be able to use those to trick him into transitioning to the wet stuff. Ham/cheese are both low caarb high fat/protein - so I'm guessing those would be o.k. to give to a diabetic cat? Please correct me on this if it's wrong! :D
 
Not necessarily. Every cat is different. I had financial issues so couldn't start with a lot of vet intervention. The first and only thing I did in the very beginning was switch the food. Both cats. Right away. Mine didn't seem to mind. You make a "mushy soup" with water for grazing. Others have a harder time. But they take their cues from us.... Hope it goes smooth. Was more concerned you get info on the fact that once switched your baby will likely need less insulin than if still eating dry. Good luck!
 
Oh I think I follow. So if for example 2x2 doses is what is needed to bring his current levels down to normal, but the low carb wet cat food diet gets him halfway there on its own, then maybe the 2x2 would be overkill at that point. That's why I was kind of hoping to just go with the diet option first. I'm a bit worried of overdosing or doing "too much too fast"
 
Welcome, your plan sounds like a good one. I would definitely start the switch to the low carb Fancy Feast Classic and see how he does after a few days. In the meantime you can begin testing. I’m not familiar with your meter, but as long as it takes a tiny amount of blood I’m sure it’s fine. I would also pick up some ketone test strips and test for ketones, especially while you transition the food. As far as insulin, Marks Marine is a great resource. The only problem you may have would be winter weather, so call them and if need be try the Supply Closet here. Usual starting dose is 1 unit twice a day, so I would start with that.
 
You're doing really well so far! :) I agree with the advice to work on the food switch for a few days before giving insulin. It'll give you some BG tesing practice and you can monitor the effect of the diet change before starting 2 units of Lantus twice a day - could be too high a dose.
 
Sharon14 said:
Welcome, your plan sounds like a good one. I would definitely start the switch to the low carb Fancy Feast Classic and see how he does after a few days. In the meantime you can begin testing. I’m not familiar with your meter, but as long as it takes a tiny amount of blood I’m sure it’s fine. I would also pick up some ketone test strips and test for ketones, especially while you transition the food. As far as insulin, Marks Marine is a great resource. The only problem you may have would be winter weather, so call them and if need be try the Supply Closet here. Usual starting dose is 1 unit twice a day, so I would start with that.
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Thank you. I have an order for the FF Classic that comes today, and I called Marks - they said they would deliver where I live, and weather is fine. Takes a week they said. Not bad! I picked the meter because I shop a lot on Amazon and noticed it has strips and all supplies in stock. I did a search on this forum and it looks like others have used it before as well - though the Relion meters seems to be a bit more popular. However I could not find Relion strips on Amazon for as good of price or as many in stock (I guess they are a Walmart product?)
 
imjosh said:
Thank you. I have an order for the FF Classic that comes today, and I called Marks - they said they would deliver where I live, and weather is fine. Takes a week they said. Not bad! I picked the meter because I shop a lot on Amazon and noticed it has strips and all supplies in stock. I did a search on this forum and it looks like others have used it before as well - though the Relion meters seems to be a bit more popular. However I could not find Relion strips on Amazon for as good of price or as many in stock (I guess they are a Walmart product?)
Click to expand...
Yes, ReliOn is Walmart's house brand. There are lots of us who can't get it. I'm in Canada and Walmart here doesn't carry them. I use a Freestyle Lite. Insulin is much cheaper here but test strips are $$$.
 
Gotcha. Yeah the Freestyle Lite strips on Amazon seemed to be like $0.60 a strip whereas the contour are about $0.30, or half the price. The Alpha Trak which my vet recommended are over $1/strip :eek:
 
Looking to start a spreadsheet - I noticed many of yours have many cells filled in for readings after the shots. Are you taking multiple samples after each shot? My vet has recommended to try to do one sample before, and then one sample 4 hours after, (2 shots a day), for as many days a week as we can manage. But I see your spreadsheets with multiple samples between shots and I get confused.
 
Welcome! Sounds like you have done your research and have a good plan in place to help your cat.

Some people test more frequently throughout the cycle. This allows you to see the insulin effect and how the cat responds to it. This is important in finding the nadir (the low point in the cycle) and comes in handy when adjusting doses based on glucose levels.

Testing every 2 hours (post shot) is known as a glucose curve. You will see if the cat is having a steep drop or a gradual drop in glucose levels.

I don’t have that kind of data because I started testing months after my cat’s diagnosis. Bad idea there...don’t do like me.

I’m hoping someone with more experience (especially with Your type of insulin) will chime in.
 
Remember that you need to use a different BG reference range if you use a human meter (they read lower than the Alphatrak). If you're going with Lantus there are a lot of very helpful 'sticky' posts at the top of the Lantus and Levemir support group's board.


Mogs
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My cat BG level is 35 (2nd test 40 right after) today after being 200 previously. What should I do? I gave him some honey. Chart in signature. I will check again in 15-30min I think.
 
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Below 50 is the "take action" point on a human meter. Now that he's at 59, you can back off food for a bit (it's ok if you fed him some more, though), and re-test in 30 mins. You want to see a couple of tests in the "safe zone" without food influence before really relaxing.

Whew! So glad you are testing!
 
While we have some breathing space: yes, I think 2 units may have been too much, and definitely today's numbers call for a reduction to at least 1.75U. The other thing I noticed is that you are not shooting on a 12-hr schedule according to the spreadsheet. The thing about that that you have to keep in mind is that when you shoot "early" (as this morning, when the 5:30am shot came only 9hrs after the 8:30pm shot last night) it can act as if you had increased the dose (and the opposite when you shoot "late").

With Lantus, it's best to stick as close to a 12-hr schedule as you can, but if your schedule doesn't permit that, and especially if you are sometimes going to be as much as 3hrs off as you were this morning, a more conservative dosing strategy is probably in order.
 
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