Newly Diagnosed...Feeling a little shocked

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Pixel

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Hi all.

Kind of glad I found this place. My name is Andrea, I have two cats- Hiro and Ginger. Both are rescues, though Hiro is a pure-bred Siamese. Um...Ginger was diagnosed with diabetes just yesterday. I'm a little stunned by the diagnosis honestly, she's only 2 years old and has never been overweight. She is an orange tabby and I've heard that those red/orange colorations tend to have some genetic predispositions towards disease, but it's still a shock. She'd been doing poorly for a while- rough hair coat, pu/pd, losing weight slowly, but early this week she started going very much downhill (not eating, having trouble urinating...) and so I took her in. Her blood glucose was 540, and her BUN was slightly elevated.

I feel...not really scared, but almost like I did something wrong. Mostly because I'm a veterinary technician student. I feel like I should have seen this sooner. I'm not having any trouble with giving her fluids or her injections (she's pretty dehydrated right now, so she's getting 30cc's of fluid SQ twice a day). She's on 3iu of insulin twice a day, we're using ProZinc. She's been very lethargic all week, but I have noticed even after two doses (last night and this morning) that she's eating a little better and she's urinating more like my other, non-diabetic cat. She's still lethargic though and I'm just...I don't know how to tell in a cat that was sick when I adopted her whether she's feeling better or not. I have only had her a couple of months and have only gotten to know her in her "ill" phase. I don't know what behaviors to look for in a very 'mellow' cat.

Anyway, advice is appreciated. Even just validation that I'm not a horrible person that overlooked my kitten being sick. :sad:
 
Welcome! Of course you are not a horrible person! :smile: It is hard sometimes to see things with our own kitties when we are around them all the time. Ginger is lucky to have you and you can learn together!

More people will be along to share their experiences and answer questions; just wanted to say Hi and glad you are here.
 
I hope it will help to know that we all missed the signs and felt guilty. I am convinced that Oliver got diabetes because I fed him high carb food for years, but I didn't know.... And we were all overwhelmed. To break down the information into a couple of bites:

We advocate feed wet,lo carb food. This website by a vet explains why: http://www.catinfo.org It makes a huge difference. When we switched Oliver from dry to wet, his bg levels went down 100 points overnight.

Which brings me to the second part of the protocol: Hometesting. After the food change, if we hadn't been testing Oliver at home, we would have overdosed him on insulin using his regular dose. Here's a video: http://www.youtube.com/watch?v=_zE12-4fVn8

And we advocate insulin, starting low and going slow - usually one unit twice daily. Did you start at 3 units? If that dose was based on bg levels taken at the vet, sometimes vet stress can raise the numbers by 100 points or more. If you start at a higher dose, you can be over your kitty's ideal dose and they can be in rebound: http://petdiabetes.wikia.com/wiki/Somogyi_rebound

It is a very steep learning curve at first, but using hometesting and low carb, you can get a handle on this fast and really be aware of how the insulin is working and how you need to adjust for it. Everyone who posts here is paying it forward for the help they received as newbies. Ask questions, re and reread. It will be fine. You can do it; we'll help!
 
Hometesting is a lifesaver and will enable you to know what her BG is at any moment. Fairly high starting dose so I strongly recommend buying a meter today and testing her BG. Also, you did not mention if the vet checked her for ketones. Ketostix or KetoDiastix will test for ketones in the urine so while you are buying a meter buy a bottle of those. I would definitely want to rule out ketones. Have you checked her temp also to see if she is running one?

You've done nothing wrong even if you are a vet tech. It really would depend on how many diabetics the vet you work for has seen for you to be exposed to FD and gain knowledge. She is young but we've had young ones on FDMB before. Hope was dx'd at 3, Mishka at 5...so not totally out of the norm.
 
Andrea, you are not a terrible person! Our four-legged people have a remarkable ability to conceal the fact they're not feeling well.

Ginger needs to be on a low carb wet food diet. With apologies to your current/future employers, the food recommended and/or sold at the vet's office is not what is best for Ginger. Please take a look at Janet & Binky's food chart here http://www.felinediabetes.com/diabetic-cat-diets.htm, and you will see a number of brands (Friskies, Fancy Feast, etc.), that have many varieties that are low carb. Not only is this food better for Ginger, it is far more economical than D/M, M/D, and the like. You will need to monitor Ginger's BG levels when you convert her diet to low carb wet, as some have reported a 100+ drop with change of diet alone.

Speaking of monitoring BG levels, we encourage home testing. Information on home testing is here: http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=287. Once you learn to home test, you will be able to make informed decisions regarding Ginger's insulin dose as well as do BG curves on your own and provide the information to Ginger's vet. Frankly, we've found BG curves done at the vet's office to be less than helpful because of the effect "vet stress" has on a cat's BG level. In my case, B.K.'s BG level can jump 300+ at the vet's office, and even my mellow Chester will increase 100+ - all as a result of vet stress. For obvious reasons, it's not good to base a cat's insulin dose on inflated BG numbers.

There are supplies you will need to have on hand in the event Ginger has a hypo incident. Information regarding those supplies and how to deal with a hypo incident is here http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=2354 and here http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=1122.

I'm not familiar with ProZinc (my fur kids use Lantus), but I'm sure someone will be along soon that does use that insulin.

You are going to have many questions...please post back and we'll do our best to help and support you.
 
Pixel said:
... she's only 2 years old and has never been overweight. She is an orange tabby and I've heard that those red/orange colorations tend to have some genetic predispositions towards disease, but it's still a shock. ...

I feel...not really scared, but almost like I did something wrong. Mostly because I'm a veterinary technician student. I feel like I should have seen this sooner. Anyway, advice is appreciated. Even just validation that I'm not a horrible person that overlooked my kitten being sick.
Click to expand...

Lord, I know what you mean - my buff tabby, Spitzer is 1 of 11 cats in the household and I didn't notice just how much weight he'd lost! He's only 3 and was never overweight to start. And with over 30 years of living with cats, this is my first one to be diabetic. Plus, I work at a department of health where I'm bombarded with messages about warning signs for this and that, including diabetes, and cats have the same symptoms!

Hang in there. Switching to the low carb, canned diet seems to be helping Spitzer - take a look at his spreadsheet in my signature block.
 
I want to thank everyone for posting. Ginger's playing around my husband's feet right now (one of her favorite places) and I've been reading quite a bit more. Finding a good diet looks to be something very important, but I definitely am going to wait until I can buy a meter as well as some urine dipsticks to do so. The positive thing is that I can bring some of her urine to school and test it there for free on Monday. My personal vet has done a lot of work with diabetic cats, he'd mentioned the diet change but was concerned about switching foods suddenly because of my inability to keep constant watch on her bg levels. He gave me a few options, both prescription and non, but I admit I was nervous cause she tends to be a bit persnickity with switching foods and I didn't want to add hepatic lipidosis to her list of troubles. >.<

I'll be going to Walgreens and trying to pick up a glucometer and some sticks... does anyone have a brand they recommend as being a bit more reliable/less traumatic in terms of the lancet-ing?

Oh, and no we didn't test for ketones. She has no fruity scent to her breath or urine, however. I will be trying to get ahold of the dipsticks that test for the ketones too, I'm hoping I can find ones similar to the ones we use at school...
 
I imagine the ones you use at school are like the ChemStrip ones I also will use......they test for everything.....but I doubt you will find that in a pharmacy. All you really need are the Ketostix (tests urine for ketones only) or the KetoDiastix (tests for ketones and glucose in the urine). Either one will do for testing for ketones. A lot of people here use Walmart's Reli-On meter......cheap as are the test strips. I only use the One Touch Ultra (not the mini) which most pharmacies carry. A lot of us also use BD Ultra Fine II lancets......easy to hold if you choose to go free hand on the poking. I use a lancing device that fits the BD lancets........quicker and easier for me than free handing. I use a ladle to catch urine mid stream and pour it into a plastic, disposable cup. That way I have urine if I want to do another test just in case I mess up the first one. Don't forget to buy extra test strips for the meter.......sometimes a meter comes with 10 strips.....sometimes nothing.

At the top of the page is an ad for Hocks. That is where a lot of us also buy our diabetic supplies once you need refills of anything.

With testing to know her BG, diet change to all canned once home testing, and possibly a few shots of insulin, she may very well go off the juice (OTJ) but there is always the chance she will need insulin long term. I still think that 3 units b.i.d. is a high starting dose and you may very well have already shot past what she needs.
 
Okay, I knew I'd have a ton of questions. >.< Sorry if I'm being a bit of a pain, but this...is confusing me.

Ginger is 4.8lbs (just over 2kg). I believe her ideal weight should be somewhere closer to about...8lbs for her size (she has a very small frame). In looking at 90% of these canned foods, I am seeing several that would be good high protein/low carb choices. However, she is very low-activity and I do not want to exacerbate her issues by causing weight gain and the vast majority of the good foods with muscle meat as the main ingredient are also very high in fat. So I guess my question is- have you guys found that there is a delicate balance with the high protein/low carb vs high fat content in canned foods? Are some better than others in that regard?
 
By definition, a low carb high protein diet is going to have quite as lot of fat since removed carbs have to be balanced with something and protein is not always used for the substitution. Unlike for dogs, a relatively high-fat die is OK for felines. The key to weight control is to control the quantity of food and weight the cat frequently and adjust the amount appropriately.
 
It is a shock at first, but it gets easier.

You're getting great advice, so I'm not going to add to that. What I wanted to tell you about is when I adopted Tucker. It was July, 2005. I was told by the shelter he was around 6 yrs of age. They brought him to my house on a Sunday, the very next day our vet visits started. Tucker was a very sick kitty and I had no idea.

First his teeth, we had to pull a few, then one of the areas where there was an extraction kept getting infected. Three separate times he was on ABs. One time we spent a Saturday night at the ER.

After that things went down hill. He got sicker and sicker. It was November when the FD dx came, then there were months with biopsies, vet said any internal organ that could be biopsied we needed to do. After months of specialists, surgeries, insulin, meds, Tucker has lots of things wrong.

So, how do you know your kitty isn't feeling well when you never really saw your kitty healthy?
"don't know how to tell in a cat that was sick when I adopted her whether she's feeling better or not. I have only had her a couple of months and have only gotten to know her in her "ill" phase. I don't know what behaviors to look for in a very 'mellow' cat."

One thing I learned is to trust myself. Second thing I learned was to trust Tucker. When his coloring was off, he was not well. Tucker is a dark orange kitty, when he doesn't feel well his fur goes pale. I watch his face, if he scrunches his head, he's not feeling well. If he sits in the meatloaf position with the scrunch face, he's feeling cruddy. When he started lying belly exposed, he was feeling great.

You probably already know exactly when your kitty is feeling off, just trust yourself. Watch for changes, the tiniest change, even a good change, is a change. Kitties our creatures of habit, if they are suddenly sitting under the coffee table and they never did that before, something could be off.

But, once you start hometesting and seeing the changes along with the BGs, you'll have an even better idea of what's really going on.
 
Cats can tolerate, in fact require, a diet higher in fat than humans.

So don't be too put off of low-carb cat foods that are higher in fat than you, yourself,
would eat.
 
Just noticed your starting dose of 3u bid.

That's a very large dose of insulin. Especially for such a small cat, though
cats are not dosed by weight.

We advocate 'start low, go slow' here.

That is start at 1u bid. Wait about a week for the insulin to 'settle', then
do a BG curve. Raise dose only if curve indicates it is warranted. Raise
only by .5u to 1u at a time. Never raise dose based upon a spot-check.

Wait 5-7 days between before raising the dose again.

That dose (3u) is asking for trouble, in my opinion.
 
Re: Newly Diagnosed...Feeling a little shocked (update)

Just a quick update here-

went out and bought all Ginger's hometesting supplies yesterday and got myself pricked a few times (yeouch!!) but managed to get the hang of doing the ear-test. Also switched her to Whiskas Purrfectly Chicken wet food (honestly, they smell better than my diet! =P) and she happily made the switch, didn't turn up her nose at all.

Regarding the starting dose- I know it's high, but that one was strictly vet recommended. He and I have a phone call set up today to talk about the results of the home testing I did this weekend so that we can see whether I can take it down. I've watched carefully for any signs of 'hypo' but honestly she seems happier than I've seen her...well...ever really.

Thank you to everyone for the good (and amazingly swift!) replies. Much, much appreciated all, gave me the bit of help I needed to not feel so lost.
 
Can you ask why 3 units? It is one thing if you are testing and know a thing or two about diabetes (no offence) and are trying to knock down high numbers, but you aren't testing. Sometimes 1 unit can be enough esp on a diet low in carbs

Jen
 
Fantastic that you are hometesting! Welcome to the Vampire club.

We are curious what kind of numbers you are seeing with 3 units, because we do feel that is a high starting dose. It may be okay with dry food, but with some kitties, the bg levels really drop fast with the new diet. With Oliver, his numbers dropped one hundred points overnight with the switch from dry to wet.

Just be very vigilant with testing, getting numbers before every shot and at the nadir (lowest point in the cycle.) now that you are feeding wet. With ProZinc, the nadir is usually somewhere between 4-6 hours after the shot. It is wise to keep all the data you get from testing. We have this great spreadsheet that is color coded: viewtopic.php?f=6&t=18207

Keep us up to date. We want to help in any way we can.
 
Unless you are up 24/7 you cannot always watch for a hypo. I'm still concerned over the 3 units b.i.d. and now you've switched to wet food. FWIW, before I learned to test many years ago, Baby(GA) had one hypo at 4:30 a.m. and luckily I was up. She was going around sniffing the carpet, would not recognize me, just kept going. The second one again was in the early a.m. hours and she was sleeping right into it. I went over to check and pet her and she wasn't waking up and reacting to me. There is no guarantee you will "see" the hypo starting.....fine one minute and then vomiting, loss of urine, hallucinations,.....can present in many different ways. Patches(GA), long before FDMB was even a thought in Rebecca's mind, had a major hypo in the morning 12 hrs. after his last shot and right before he was due to be fed and given his a.m. shot.
 
Hi and welcome! I don't have any real advice for you, we've only been on this journey for a month ourselves. Charlie's on prozinc, too, but we are still working to find his ideal dose. Our vet told us to start at 2u once/day, which I did for 1 day. I didn't feel comfy with that high dose, so with the support of the veterans here, I dropped to 1u bid. We've been increasing in tiny increments from there to make sure we don't overshoot his good dose. Yay for you for hometesting! It's empowering to know you can have all the info you need at a moment's notice!
 
You guys just answered my other questions- when/how often to test! =) I am a full-time student, so I have to run home to try and get her numbers. I did three so far today, we had 403 (+/- a few, I don't have the test in front of me...) right before her am shot, 507 a half hour after her am shot, then about 4.5 hours later she had 130 and was being very active, very love-y and was playing with my other cat. I'll be testing her again before her next shot. I'm a little nervous about tomorrow, I'll be gone all day...I might cut back her insulin dose cause I won't be able to come see her during the day. :?

Re: the dose- The reason I was given is because the vet has had most of his diabetic cat patients not respond to lower doses on the ProZinc, so he felt it prudent to start at a higher dose but to be prepared to adjust down should I see anything out of the ordinary. I actually worked with this vet during my internship and they do have several diabetic cats and dogs as patients (they're pretty well known in our area as a safe place to board your diabetic animals) so I have faith in him (and I guess he has faith in me and my monitoring skills). I should be hearing from him in the next couple hours today to hear what he thinks.
 
Well, I understand his reasoning, but I have also seen cats overdosed on less than 3 units, and as a student you will not be holding your cat's hand (so to speak) every minute of the day, nor should you have to.

I also understand that you respect this vet and that he is willing to work with you and that is very important; just know that this course of action is risky. It may work out just fine, but please proceed with caution. And even if you don't lower the dose, please keep posting any question/update

Jen
 
IIWY, I would cut the dose. From the 500s to the 100s is a long way down. if you were able to get a number closer to 6hours after the shot, it could be lower still. It seems basic, but it is better to give a lower dose and run the risk of running a little high than a higher dose and risk a hypo. Especially if you will not be home.

We urge people to start low. You can always increase. It seems unwise to generalize about cats on PZI. We certainly have seen cats start at one unit on PZI and never increase. Every cat is different and they all react differently to insulin types, doses and food.
 
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