? Newly Diagnosed Concerned owner. Are we doing the right thing

Hi everyone. Our 6 1/2 yr old just got diagnosed last Friday with diabetes. We caused it feeding her what we thought was a reputable food (hills science diet). Only now after much research did we realize what garbage it is. She was never very active so that didn't help. Anyway we are where we are and now we have to knuckle down and make her life long and happy. Our vet prescribed glargine 2 units twice a day and sent us home with Purina DM dry food and Purina DM selects wet food. Well that first night i gave her two units and again the nest morning another 2 units. By the afternoon you could see in her eyes she wasn't right but thankfully she came downstairs to eat and perked up. So we decided to drop the dosing to one unit only in the morning for a couple of days to monitor, then upped it to one unit in the morning and one in the evening. We put out the dry food just for grazing if she wanted it. She has been drinking 375ml of water each day. She is 4.6kg after losing 1.2kg. Last night and the whole day before we deliberately didn't give her dry food. Her water consumption dropped to 250 ml. I hope this is an indication we are getting this under control. She is supposed to go the vet this Friday for a curve but she is an anxious cat and no point in taking her to a place that gives her anxiety for a blood curve. The results will be screwed and she may end up getting overdosed on insulin. We intend to buy a blood glucose meter and monitor her water intake and food consumption as a sign of her health. Are we doing the right thing?

 

Hello and welcome to the best place you never wanted to be. First of all, yes, buying a blood glucose monitor and testing at home may save her life. Kitty name? What country do you live in? That may direct some of the suggestions we give you. Also lowering the insulin dose was a good call. We prefer starting at a lower dose and working our way up. The starting formula is typically 0.5 to 1.0 units.

Curves at home are a much better idea - you can suggest that to the vet as an option. Many cats test higher at the vet due to stress, so you don't want to use those numbers to determine the insulin dose. Plus it's just cheaper to test at home. Also, you can use a human blood glucose monitor, no need to get a special pet version. That'll also save you money.

Besides testing blood sugars at home, the other two important pieces are a good insulin for cats (Lantus/glargine is excellent choice) and low carb food. Unfortunately, there is nothing special about the DM vet foods, other than their price. The DM dry is too high in carbs for a diabetic cat - note, they were forced to change it to dietetic management, not diabetes management. The DM selects wet food is 10% carbs, so also higher carbs that most people feed. We recommend under 10% carbs. Again, depending on country, we can suggest better options for you.

Regarding food, don't change a thing until you are home testing first, as that can drastically lower the insulin needs of the cat.

 

Thank you Wendy i put her details in my signature line

 

Hello David - waving at you from the pacific side of the Rockies.

Since you figured out the signature, here is a post that talks about the things we like to see to help you.
New? How You Can Help Us Help You!

OK, meters first. In Canada, many users use the Freestyle Lite. It takes the smallest blood drop. There are others available too, so look around. You want something with a small blood drop and as cheap a test strips as possible, as that's what you'll go through most. Having something you can pick up easily up more test strips should you be running out is also a good idea. Some people in Canada find good test strip prices on eBay. Yet another link with some information and videos on home testing: Hometesting Links and Tips

Are you using U-100 syringes with half unit markings to give the insulin? The BD syringes, purple and yellow box, are the ones I used to use. Available at regular pharmacies. Prices for it and many other insulin supplies do vary a lot, so check around.

Most of the foods available in the US listed in this food list, are also available in Canada. Look for anything under 10% carbs. A few other Canadian options are listed in this list, which is not complete but another set of options: CANADIAN Food Chart

 

Wendy i think you have the better weather on the other side of the rockies lol. Once again thank you. How many test strips do people usually go through in a month? Are you testing before every meal or doing a curve once a week?
On the food list i already saved the big pdf list as an excel file and went through it deleting all those that were higher than 10% carbs then did the same for those whos protein was less than 40% or where the fat was significantly higher than the protein. I also then checked what is available locally. Still work in progress but Tiki is available here in Edmonton. I plan on changing her over when the cans i bought are running low. Her problem is she hates pate and loves gravy.

 

Both Tiki and Weruva have chunks with gravy, but fortunately not gravy made with flour or potatoes for most of them.

As for testing, we recommend a minimum of 4 tests per day. One before each shot (that's two) and ideally one somewhere in the middle between the shots. We determine how to change doses based on how low the dose takes the cat and glargine has a downward curve, with the low point typically around mid point, with variation by cat and other factors. I always made sure I had a extra bottle of unopened test strips around. And truth be told, I cross border shopped or had them sent to a post box across the line. Test strips are so much cheaper down south. I did have a backup Contour in case I needed it.

The Bravo meter and strips are the cheapest in Canada, but only available on line so you have to plan for possible disruption in supply. More information and link here. https://diabetesexpress.ca/products/bravo-test-strips

 

Hello and, welcome! I am only a rookie, but you will find help here!!! I test my kitty at home and perform my curve. Then I report the results to his Vet and listen to advice. Otherwise, I'd be taking time off work to get him a curve quite often. It would be costly and stressful for me and him. Do you test her at home?

 

Hi Shell. We will be testing at home once i buy the kit. Is your cat really on science diet? We are sure the high carbs in that contributed to our cats diabetes.

 

Different things can cause diabetes in cats. There may be more than one cause for some cats. Some develop diabetes from a carb heavy diet. Others are just genetically prone to diabetes and a carb heavy diet doesn't help. My current diabetic has always eaten raw food and now has steroid induced diabetes. The steroid was to manage his IBD and asthma. Don't beat yourself up for not knowing that dry food is bad for cats. We do the best we can with information from the vet, the marketing pet food companies do, what other pet owners say, etc. If you want to read more about dry food issues, you can read through http://www.catinfo.org

Just keep plenty of test strips on hand How many you go through will depend on how often you are testing. Someone can say that they use up 50 strips a month but another person can say they use up closer to 100 test strips. Just have at least two extra packages of test strips on hand and be sure to use them up before they expire. You'll be glad to have extra test strips on hand if your cat ever has a hypo episode. During a hypo you'll be testing every 15 minutes or so while giving corn syrup / honey / high carb food until the blood glucose level is in safer numbers and stays there.

At a bare minimum, test before giving each insulin injection. That way you know what your cat's level is and if it's safe to give insulin or not. A few mid cycle checks is ideal if you an get those. Curves are done when you have a full day free which is typically weekends for most people. You don't need to do a curve every single weekend unless you want to and the cat is cooperating.

 

Hi! Yes, it's Science Diet. I read that and thought it's probably the same contributor here. He's been eating it his whole life. I had my suspicions, but many years ago, it used to be recommended way back. But, there are sure so many newer brands of cat food since.

 

So i didn't get chance to do a curve today. I fed Ivanka 1/2 tin or Purina DM selects this morning at 8:00 am. I just measured her BG at 7:30 pm and it is 24.7 mmol. I believe this needs to be between 5 and 10. I am going to give her the usual 1 unit after eating and measure her again in 3 hours. I thought she was sleepy because of low blood sugar. seems high does this too? Although she hasn't been drinking a lot today.

 

You may have noticed that most of us have spreadsheets linked to our signature. That's where we record the blood sugar readings and are extremely helpful (might even say required), for us to properly help you with dosing. Links to how to do the spreadsheet are linked in the post #4 above. Let us know if you need any technical help with this.

There are a couple possibilities for higher numbers. One possibility is not enough insulin. Another possibility is that she saw a number lower than she's used to and is responding with what we call a bounce. Here is the description:
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

 

Hi Wendy. Yes i have created a spreadsheet for completing a curve. We just got a meter today so i intend to make good use of it. I will modify it so i can also track intermittent readings. Once up and running i will add to my signature

 

I see you have a version of the spreadsheet ready, but you need to make it a hot link so it's easy for us to click on.

PS: Any old data you have will be helpful too. For example, if you gave 1 unit today, you can put that in the AM units cell.

 

How do i make it a hot link?

 

Welcome. I can see your spreadsheet when I click on the link.

 

Looks like you got it - thanks.

 

@David Thompson
David can you add to your signature the insulin you are using and the meter you are using please
and on your spreadsheet can you add where is says DX
Date Ivanka was diagnosed

You might want to read all about Lantus/Basalgar here
https://www.felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
Read all the yellow stickys especially the 2 dosing methods to choose from .When you decide add it to your signature and your spreadsheet where it say Dosing Method ( SLGS or TR) not the work pen
The doing methods will let you know when to increase or decrease
@David Thompson
You also need to be testing at AMPS and some additional tests after that ,Same goes for the PMPS cycle so you can see how the insulin is working and how low Ivanka is dropping

 

Hi Diane the info is on the world mmol tab. She is being treated using basalgar 100U pen. Vet recommended 2 units 2 times a day. She looked strange on that so we dropped it to one. We got a tester on Saturday and have now bumped her back up to 2 units after looking at the numbers. We will track for a few days and see which direction 2 takes her. She really hates having her ear pricked though and struggles. Stress may be inflating the figures a little so i want to minimize the pricking to rule out stress.

 

Hi David
I do see your info on the World Tab in your spreadsheet we need you to add it on your US Tab on your spreadsheet.
Most of our members are used to reading the US tabs and US numbers
So can you add everything there also
And add the meter to your signature that's the first thing our members will look at.
David you need to stick to the same dose of insulin for at least 7 days
then do a curve.
Unless your kittys BG drops under 90 at any time you need to reduce by 0.25 units.
We don't adjust the dose by the pre shots , we adjust the dose by how the dose us taking them.
By the way you need to add to your Signature what you are feeding your kitty so members can see that right away
Is it low carb wet only, or is it Low carb wet & Dry Kibble
What Brand

I see you said she hates the ear pricks , you can try giving her a freeze dried treat it's low carb before you test her and after you test her so she starts to associate getting a reward every time you test her.
Or even a small piece of boiled chicken nothing in it
You at least need to test AMPzs and PMPS to be sure the number is safe to give the insulin and at least another test @+6 for both cycles

When telling us what her BG when you post can you please post the US numbers
Whatever your World BG is multiply it by 18 that gives us the US BG
@David Thompson

 

Hi i can only adjust dose by 1 unit with our pen. we are sticking to wet food and not going to feed the dry the vey gave us.

 

If you get syringes with half unit markings you can draw up the insulin from the pen so you can give smaller increases and decreases.

 

Thank you i will ask at the pharmacy. I need special for 100U strength insulin right?

 

Using syringes with a pen, cartridge, or vial:

• U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus, Levemir, or the Biosimilars from vials, cartridges, and pens.
• BD Ultra-Fine, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings.
• Syringes come in ½ inch or 5/16 inch needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest)
• Full and half-unit syringe scales:

 

Here’s a sticky in syringes and fine dosing.
https://felinediabetes.com/FDMB/thr...info-proper-handling-drawing-fine-dosing.151/

 

@David Thompson

I found this posted by a member about U-100 syringes with half unit markings from Canada
Check out your local pharmacy for the BD Ultrafine II syringes (purple and yellow box). Those are U100 syringes. If you have a Costco near you, check them out. Or Safeway pharmacy