Newly diagnosed cat

[BridgetBee]

Hello My boy 12 yr old kitty was diagnosed on Friday with FDM. His BG was greater than 700 so they could not get a true reading on him. We began 2u Lantus yesterday and then upped it to 3u today. His fasting BG was still over 700 this morning pre-injection. Has anyone had a cat with this high of a BG before? The doc said he had seen very few like this. We have him on Purina DM dry mixed with Purina DM wet but I think we are going to switch to solely wet because I have heard that it is much better. Is that right? I love my sweet boy and it saddens me that so many people think i should put him to sleep He doesn't deserve that...he deserves health which is what I intend to give him. The doc said that getting him to a 100 BG is not likely and that our goal is under 250 but we have to go very slowly. He has had a bit of kidney damage but the doc said it is minimal and we caught this early. I am praying that with diet and insulin we can get him to the point of remission eventually. So very glad to find this board and know I am not alone!!!!

 

[Blue]

Hello My boy 12 yr old kitty was diagnosed on Friday with FDM. His BG was greater than 700 so they could not get a true reading on him. We began 2u Lantus yesterday and then upped it to 3u today. His fasting BG was still over 700 this morning pre-injection. Has anyone had a cat with this high of a BG before? The doc said he had seen very few like this. We have him on Purina DM dry mixed with Purina DM wet but I think we are going to switch to solely wet because I have heard that it is much better. Is that right? I love my sweet boy and it saddens me that so many people think i should put him to sleep He doesn't deserve that...he deserves health which is what I intend to give him. The doc said that getting him to a 100 BG is not likely and that our goal is under 250 but we have to go very slowly. He has had a bit of kidney damage but the doc said it is minimal and we caught this early. I am praying that with diet and insulin we can get him to the point of remission eventually. So very glad to find this board and know I am not alone!!!!

First, welcome to the site.
Second, I don't know why a vet would say such a thing... "getting him to a 100 is not likely". Why would that not be likely?

Now, the dry food is VERY bad for diabetics. You can switch to all wet low carb foods like fancy feast pates or friskies pates... just stay away from any with gravies or with grilled or marinated in the names. There are a few lists, including Binky's list that will show you a wide choice of appropriate wet foods for diabetics.

Many BG meters don't register high numbers; the test result would be just HI. Most people use a normal human meter, like the Relion or Bayer meters that you can get at the pharmacy, and test their at home. You can also pick up a container of KETOSTIX at the pharmacy so that you can test your cat's urine for ketones.

Do you have some details on the sort of kidney damage he has? Many others here can help you with those issues as well.

When you change the food though, please reduce the insulin dose down to 1unit twice a day because he will not need near as much insulin once he's eating the low carb foods.

And don't worry about having to put him to sleep; once he's eating a proper diet and gets to a decent dose of insulin, you will have very nice low numbers in the 100s and maybe even lower.

 

[Marje and Gracie]

Welcome to FDMB.

What is your kitty's name?

Most of us in the Lantus Tight Regulation Insulin Support Group follow the Tight Regulation (TR) Protocol.

The TR protocol was developed based upon the premise that a cat's pancreas may be able to heal and return to producing insulin if the cat's BG is kept in a normal range, ie, 50-120. Caregivers following this protocol adjust insulin doses following the protocol guidelines, to aim for that range. Basic information on the TR is here TR Protocol. If you want to follow the TR protocol, we strongly encourage you to post daily in the Lantus TR insulin support forum for a while to learn more about how it all works. The starting dose for those following the TR protocol is .25u/kg of kitty's ideal weight. If kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight. Requisites for following a TR protocol with Lantus or Levemir include:

• Kitty should be monitored closely the first three days when starting Lantus or Levemir. Blood glucose levels should at least be checked at pre-shot, +3, +6, and +9. More monitoring may be needed.
• It will be necessary to test kitty's blood glucose levels multiple times per day.
• Learn the signs of and how to treat HYPOGLYCEMIA and prepare a HYPO TOOLBOX.
• Test regularly for ketones and know about DIABETIC KETOACIDOSIS (DKA).
• Use U-100 3/10cc syringes with half units marked on the barrel for fine dosing.
• Feed a high quality low carb canned or raw food diet.
• Feed small meals throughout the day. Some kitties adapt well to free feeding.

The Start Low Go Slow (SLGS) protocol has caregivers start with an initial dose based upon the BG at diagnosis and whether kitty has been transitioned to a wet low carb diet, hold that dose for a week or two while testing for ketones regularly, being consistent with food and shooting every 12 hours. Once a week a curve is done (test every 2 hours for one cycle) to check for the lowest point. the low number in that curve determines any dose change for the following week. Basic information on the SLGS protocol is here SLGS. If you want to follow the SLGS protocol, you can post for advice on the TR ISG, the Relaxed Lantus or Main health for guidance and support.

Generally, we do not raise doses by 1u at a time. Regardless of either protocol used, that is too much, too fast. It's easy to go over a kitty's "fitting" dose by going up that much. Our increases are much more conservative....typically .25u every six cycles unless kitty's nadirs are above 300. Then we would only increase, in general, by .5u every six cycles.

 

[Dyana]

What a gorgeous cat!
I love the picture

We will help you, and you are not alone. Post, with all your questions, and if you don't get them answered or don't yet understand, keep asking. We will help you.

Welcome!

 

[rhiannon and shadow (GA)]

Hello.
What a handsome boy.

My first question for you is how long did he spend at the vets and does it usually stress him out because stress can increase they bg number as I understand it as much as
200 higher.

I once had a dog with 700 in the numbers but it was 12 yrs ago and there wasn't all the new data of how to treat. They just gave us insulin and had us shoot twice a day
(7 units) . We never even heard of home monitoring then.
I think his number will be lower in a day or two. It might be in the 400's but that will be an improvement already.

It's great that you want to switch to canned food. It will make a difference in his quality of life for the rest of his life.

I have several web links to share to help introduce you to your new world.
http://www.catinfo.org/
http://www.2ndchance.info/diabetescat.htm (I just found this one today and I like it because it reinforces everything the first website says)


After you read thru the first one with Dr. Lisa Pierson.....
look at these lists to find the appropriate food. You want the one's that are lower than 10% carbs. The other nutritional info is there too in case you have needs about
fat content or phosphorus content .
Keep in mind that swtiching from a high carb diet to a hi protein , low carb diet will make him a little hungrier at first. That tapers off as they start getting the proper nutrition
that they have been starved for. It is best if you are able to feed smaller meals more often because it keeps their blood sugar more stable.
Feeding them only two big meals during the day creates a feast or famine and can cause their blood sugar to go up and down more.

IF you are changing the diet right away , you will likely see a quick decrease in his blood glucose. It can be 100 off his numbers in just a day or so.
You will definitely want to start at the 1 unit of insulin because of the food change and because you are just starting out.
You need time to learn a lot of stuff without putting your cat in danger with a higher dose.
Someone already posted about going up or down in small increments and you should keep asking questions .... even re-posting a new question when you have it.
Here are the binky canned food lists.
http://binkyspage.tripod.com/CanFoodNew.html
http://binkyspage.tripod.com/CanFoodOld.html

Some of the fancy feasts are on there but you want to stick to the classics. IF it has gravy on it, it's probably higher than 10% carbs.

Welcome.

 

[Sienne and Gabby (GA)]

Welcome to FDMB.

My initial reaction is that your cat would be best served at a vet hospital where they can monitor 24/7 and use both a basal insulin and a bolus insulin to bring the numbers down. Probably using an intermediate duration insulin like Humulin N along with a fast acting insulin, like Humulin R, will work to bring the numbers into a better range quickly and then you can then switch over to a long-acting insulin like Lantus. If your vet has seen very few cats with high numbers like this, then your cat is best served by being treated by a vet who has more experience with critical care.

Increasing the Lantus dose by 1.0u in one day is unlikely to give you the results you need.

 

[rhiannon and shadow (GA)]

I decided to go google "feline diabetes 700 blood sugar" and found this letter to a vet.
I am not great at computer stuff but I hope I have the letter part in blue to separate it out and help you see it. :YMSIGH:





the blue isn't showing up, so the article starts here :

Q: My cat has been diagnosed with insulin dependent diabetes. The vet measured his blood sugar at 700. When they measured my cat, he hadn't eaten yet and had not had his insulin yet.

I was wondering what levels his numbers should be, including what they should be just before he eats and gets his medication.

He has lost four pounds and had to be hospitalized for three days. He is not doing well, and I have tried two different types of insulin so far. Any ideas?

A: A normal cat has a blood sugar somewhere between 65 and 160 throughout the day. When a cat becomes diabetic, his pancreas can no longer tightly regulate the sugar levels. We have to do that for the cat by providing insulin from an outside source (i.e. twice daily injections).

Our goal is to try to maintain the blood sugar somewhere between 100 and 300 throughout the day. Typically, the blood sugar would be the highest in the morning, before the cat has had his morning meal. Ideally, it would be around 300. You would then administer the insulin, and four to six hours later, when the insulin exhibits its peak effect, the blood sugar would be around 100. It then would slowly rise, and about six hours later, we’d expect to see it again around 300, at which time you’d administer the evening dose. This would be the perfect scenario.

A morning blood glucose of 700 is frighteningly high. A number this high cannot be due to insulin deficiency alone. There has to be a significant amount of dehydration present for the blood sugar to become this elevated. There is a condition that is seen in some diabetic cats called nonketotic hyperosmolar diabetic syndrome (NKHDS).

Diabetic cats with this condition are very dehydrated and require hospitalization and intravenous fluid and insulin therapy for several days until they’re feeling better. Of course, without examining your cat, I cannot say if this is what is occurring.

Regardless, a blood sugar of 700 is a dangerous sign, and your cat will need to be hospitalized and monitored closely until your cat’s hydration status normalizes. Once that occurs, it will become easier to control your cat’s diabetes using the standard insulin preparations available for
cats.
article ends here.








It's only one opinion but it gives you something to ask your vet about.
I hope you have a good vet that is supportive to home testing .
I just read today how to test your cat for severe dehydration, you pull their skin out around their neck and if it doesn't go back in place quickly, just hangs there and oh so slowly creeps back into place..... That's dehydrated.

Good luck. I'm praying for you.