Newly Diagnosed Cat

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ChEMom

ChEMom

Member Since 2014
My sweet boy, Dimitri, turned 15 yesterday and also was diagnosed with diabetes and a UTI. For the last week he has been having litter box accidents 4-5 times a day, plus drinking lots of cold water. And he wasn't acting like his usual happy self, so I knew something was wrong.

The vet told me to put him on "Kitty Atkins" and see if we can control his blood sugar that way because he doesn't think an old cat wants to be poked. Fair enough. But I'm not sure how to change his diet. I bought a case of the canned "m/d" diet and am feeding Dimitri 4 times a day. So far he loves it. But I read over on Lisa Pierson's site that the "m/d" diet is really too high in carbs. If I go her route of making my own food I'm thinking I'll have to get a meat grinder, for grinding up the bones, and then I'll have to find a source for rabbit, because I think Dimitri will get sick of eating just chicken. So it seems a bit overwhelming. Any suggestions would be welcome.

Also, I have 5 other "civilians" in the house - Tora and Kiri are sisters that are 6, then there are the "kittens" that turned up on our doorstep last June (Finn, Maisie and Fiona.) Plus we have a 12 year old Shih Tzu, Kirby, and a 4 year old rabbit, Truffles.

I am so relieved to have found this site and look forward to getting to know y'all.

- Janet B.
 
Hi Janet, My 11 year old cat Sweetie was also just diagnosed 5 days ago. I feel your pain! I have learned a lot through this message board from others!!! Please do your research about feline diabetes and listen to others on here, this site has been great for me!
I have switched Sweetie to Friskies Pate can wet food (it cannot be the gravy ones). These Pate Friskies are low in carbs and cheaper than the vet. sold wet can food and you do not have to do all the work of making your own. My Vet actually sent me home with a bag of Purina DM dry food that is $49.00 a bag and I just took it back yesterday for a refund after learning I should stay away from dry completely and Friskies is a lot cheaper. I know you can also do some Fancy Feast can wet food as well (has to be the classic ones) but my cat's do not seem to like those as much as Friskies. I would offer more advice other than the food but I am also getting adjusted to all of this so I'll let the experts weigh in now. :smile: ~Stacy
 
Oh, that's good news on the food. whew. Sorry about your cat. It is an adjustment.

- Janet B.
 
Hello Janet and Dimitri, and welcome to FDMB!
(Sounds like you have quite a household there!)

A diagnosis of feline diabetes certainly can feel overwhelming at first. But everyone here has been where you are now, and I promise you it will get easier.

Did the vet test Dimitri's blood glucose yesterday? And do you remember what the result was? (No probs if not, just thought I'd ask).
It's quite likely too that the stress of the vet visit, coupled with the UTI, may have further raised Dimitri's blood glucose level (possibly quite a bit).

May I ask what you have been feeding Dimitri prior to his diagnosis. Has he been on dry food?

Eliz
 
Hi Janet and Dimitri and welcome to the message board!

We've all been where you are now, dealing with a new diabetic cat. There is lots of experience here to help you with the many aspects of treating feline diabetes. It's possible that the BG (blood glucose) levels were elevated by the infection and by the phenomena known as vet stress.

A change to a low carb canned food diet can drop the BG levels up to 100 points very quickly and will help with the UTI also with the extra water in the wet food. We use this food chart, by vet Dr. Lisa Pierson, for folks in the US and Canada. Look in the 3rd column of numbers, under % calories, for foods that are =<10% carbs. Fancy Feast pate style, Friskies pate style, Wellness Grain Free are 3 of the choices most often mentioned here, because of their ready availability most places in the country and their lower price makes them affordable for all your cats. I feed my 3 the Fancy Feast pate, Friskies pate, and Friskies Special Diet pates.

No high carb treats anymore like Temptations or any high carb dry food could lead to a quick turnaround in Dimitri's condition.

Most diabetic cats seem to do well on those foods and it's a good starting point, to change the food first before starting insulin. You may be lucky and never need to start Dimitri on insulin.

Thanks for having your location, Florida, in your user profile, so we know which references to point you to.
 
Deb & Wink said:
We use this food chart, by vet Dr. Lisa Pierson, for folks in the US and Canada. Look in the 3rd column of numbers, under % calories, for foods that are =<10% carbs.
Click to expand...

Here's the link to the food chart that I'm sure Deb meant to include. ;-)
 
Thanks for the link. I had just bought a case of the Friskies gravy-style yesterday, because the kitten trio loves gravy, but I took it back today and got Pate-style instead so they can ALL share.

Back in January, Dimitri got sick and when I took him in he had a fever. The vet tried to draw blood, but Dimitri wouldn't cooperate, so he stayed at the vet for the rest of the day and got sedated so they
could draw blood and hook up an IV. At that time, his blood glucose was about 325, along with an elevated white count. The vet never did figure out exactly what type of infection he had, but he put
him on antibiotics, and in a few days he was feeling great. The vet and I both just assumed the elevated glucose was due to Dimitri being sick. Now I'm not completely sure. Yesterday the vet just did
a urinalysis on him only and his glucose hit the top of the scale, which was 1000 (didn't catch the units.) Today I went to Walmart and bought a Relion Mini meter so I can start testing his BG myself. But
I'm wondering if I should wait a few more days for his antibiotic to kick in, in case his sugar is still up from the infection? When I do start testing, I assume I start with a fasting BG first thing in the morning?

My dh has had type 2 diabetes for about 10 years, but I've never really paid a whole lot of attention to the times of day he tests other than first thing in the morning.

Thanks for all the help.

Forgot to answer a question from above: prior to this, Dimitri ate mostly Purina ONE dry food (occasionally he ate some of the Friskies with gravy too.) But since starting the m/d food, he is really loving it.
Before he got sick in January, his normal weight was 14 lbs (he's a Maine Coon), but in January he dropped down to 10 lbs. Yesterday at the vet he was back up to 11.
 
Today I went to Walmart and bought a Relion Mini meter so I can start testing his BG myself. But
I'm wondering if I should wait a few more days for his antibiotic to kick in, in case his sugar is still up from the infection?
Click to expand...

It takes time to become proficient at the home testing, so even if the BG (blood glucose) readings are still a bit elevated from the infection/inflammation, it's a good idea to start the home testing now.

Here are 2 documents for you on home testing.
1. The how to's of ear testing
2. how to get your cat to accept the process

The keys are for you and your cat to be as relaxed as possible, warm the cats ear, confident ear poke and a low carb treat at the end like freeze dried chicken or anything else pure protein.

Break it down into little steps. Get Dimitri used to having his ears touched first. Then try warming them with the rice sock or by rubbing them. Then a pretend poke. Then a real poke. Do 3 tries at getting blood and then stop. Come back to try again later. Give your cat a treat, successful test or not and maybe a human type treat for you. I highly recommend a bit of chocolate for you! ;-)

When I do start testing, I assume I start with a fasting BG first thing in the morning?
Click to expand...
We recommend the BG readings before you give the insulin be fasting, 2 hours without food before that test if you can manage it. Other tests during the cycle will be food influenced and we expect that.
 
That wasn't too hard. From now on, I need to eat before testing Dimitri first thing in the morning, my hands were shaking so bad, but he did great. It took 3 tries on the prick, but I got it. His reading unfortunately was 379 :sad: so we've got work to do. But he's only been on his new diet for a day-and-a-half and he's still taking antibiotic.
 
ChEMom said:
...From now on, I need to eat before testing Dimitri first thing in the morning, my hands were shaking so bad, but he did great. ...
Click to expand...

Having a little hypoglycemia yourself?

Breathe, too. Slowly exhale. Pause. Slowly inhale. Pause. Repeat.
 
Yes, in fact, one of these days I want to check my own BG when I'm fasting.

:?: : where can I find a chart showing me what a cat's BG should be at different times of the day (fasting, 2 hours after eating, etc.)? Thank you.
 
Another question: can someone please point me towards the basic spreadsheet I can use for tracking Dimitri's BG? And are there instructions on how to set it up and a key to the meaning of the colors too?

Thank you.
 
Glucose curve has a pattern somewhat like this when ideal:
highest is usually at the pre-shot numbers
+1 a touch lower
+2 may be up a bit from food
+3 lowering
+4 lowering
+5 to +7 somewhere in here is often the nadir, or lowest point for Lantus, ProZinc, PZI; Levemir often nadirs later
+5 to next pre-shot - rising.

The following is not exactly what you asked for, but important.

Comparing a human glucometer to a pet-specific glucometer is like reading temperature in Celsius vs Fahrenheit. Both are correct. You just need to know the reference ranges to interpret what the numbers mean.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]


* * * * * * * * * * * * * * *​
Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
Thank you for the info. I'm still not sure what the colors are for.

I'm assuming "0" is when the insulin shot is given, and then "+1" is one hour after the shot? I assume insulin is given before breakfast is eaten?
But I'm confused about the nadir being past the 5 hour mark, because Dimitri eats every 4-5 hours, so wouldn't his sugar go back up then?

His morning BG's for the last 3 days have been: 375, 379, 383. He still has 2 more days of antibiotic left. Do I wait until he's done with that
to see if his BG might come down some, before taking him back to the vet to ask for insulin? Since it's Friday anyway, I'll just see how the weekend
goes and then make him a vet appt. on Monday. Thanks for all the help.
 
BJM wrote this great explanation of what the columns mean on the spreadsheet (SS).

BJM said:
Then, once you start testing, you record the data on our spreadsheet - a grid for storing the numbers. Instructions are here.

Understanding the spreadsheet/grid:

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.
Click to expand...

The colors on the SS are to group ranges of BG values. It helps us to see values over time.
 
ChEMom said:
I'm assuming "0" is when the insulin shot is given, and then "+1" is one hour after the shot? I assume insulin is given before breakfast is eaten?
Click to expand...
Which insulin you use depends on weather you need to feed first and wait 30-45 minutes before you shoot, like with a NPH insulin such as Humulin N or can test, feed and shoot all within a 15 minute timeframe like with Lantus, Levimir or Prozinc.

But I'm confused about the nadir being past the 5 hour mark, because Dimitri eats every 4-5 hours, so wouldn't his sugar go back up then?
Click to expand...
Depending on which insulin you use, and how your cat reacts, the nadir or peak action varies. With Lantus of Levimir, think of the action as a nice shallow smile or very flattened out U shape. Lantus and Levimir have a long duration, usually 12-16 hours so they will keep working a little bit throughout the 12 hour insulin cycle. Yes, the food will raise the numbers up a bit, but most people only see a 30-50 point jump up in the BG readings after food. Remember, even if Dimitri eats at +4, the long lasting insulin is still working and trying to bring those numbers back down.

His morning BG's for the last 3 days have been: 375, 379, 383. He still has 2 more days of antibiotic left. Do I wait until he's done with that to see if his BG might come down some, before taking him back to the vet to ask for insulin? Since it's Friday anyway, I'll just see how the weekend goes and then make him a vet appt. on Monday.
Click to expand...

With those BG readings still in the high 300's Dimitri definitely needs some insulin. I doubt you will see any significant improvement with 2 more days of antibiotics. We want to see numbers under 100 and that doesn't look like it's going to happen. I'd make that appointment now for next Monday. Better to get Dimitri started on insulin and bring those numbers down and help his pancreas to heal. The sooner the better as the first 2 months are the most important in treatment.
 
I took Dimitri to the vet this morning. I did not tell him I had ordered a set of Lantus pens last night from Canada cause I wasn't sure how he'd feel about that. So the vet started him on ProZinc and gave him a shot in the office. Is it safe/o.k., to start Dimitri on the PZ, but then switch him to Lantus in about a week?

Thank you.
 
Is it normal for the first shot of insulin to have NO effect? Dimitri's +6 reading was 378. He was 344 fasting this morning.

Also, how exactly do you give a shot to a long-haired cat? I watched the vet do it this morning, and he barely "tented" at all; just pulled up the skin a bit on Dimitri's flank and boom, he was done.
Tonight, I did basically the same thing, but I couldn't see the needle for all the fur, so I'm wondering if I did a "fur" shot by mistake. How would I know? I felt his fur afterwards to see if it was
wet, but it's such a teensy bit of insulin, that I doubt I'd feel it on his fur even if I did miss.
 
He may have hit his lowest point - nadir - before you tested and been rising back up.
Or, he could have dropped fast enough that it triggered compensatory hormones to raise his glucose level.
Or, this really isn't the best insulin for him.
Or, you had a fur shot.
Or, he needs a different dose.

If you smell a "band aid" kind of smell, that is the insulin. If you feel wetness, that is the insulin.

You might try using a wide toothed comb to part the fur so you can see a bit better. You could even trim the area(s) where you want to shoot.
 
Thanks. I'll try to be patient and just keep collecting data and watching him. Lantus is on order and will hopefully be here in a week.
 
Try and get a few spot checks at various points as you really need to check how well this dose is working...

Also I usually recommend 3-4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low the cat’s blood sugar is going. The low point "nadir" is what you base dose changes on since you don't want the cat dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what the cat's overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.


Wendy
 
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