Newly Diagnosed...help!

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Just got off the phone with the vet and Smoke will be going in next week to get all set up for insulin. She wants to start him on 1 unit probably once a day. Is that the smallest dosage? I have no problem home testing him or giving the insulin, but my biggest fear/concern is hypoglycemia. What do you all think? Hopefully he won't need the insulin for very long....
 
Cats generally need two shots a day because they metabolize the insulin much faster than humans and other animals (that is my understanding of why anyway) so don't be surprised if you are told to give two doses 12 hours apart. I am glad that you will be home testing and the very minimum is the preshot tests so you know whether to give the shot.

As for hypo, make sure you have some honey or karo syrup handy and plenty of strips for the meter as well as some canned food with gravy and then make sure to post if you have questions. You are going to do just fine. Hoping for a short run on the juice for you!
 
Just got off the phone with the vet and Smoke will be going in next week to get all set up for insulin. She wants to start him on 1 unit probably once a day. Is that the smallest dosage?
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No, 1U is not the lowest dose of insulin you could give your kitty Smoke. We have some microdosing pictures that show how to measure 0.75u, 0.5u, 0.25U, 0.1U, Some insulin. There is even a method by which you can measure out drops of insulin.

If you scroll down, about 2/3 rds of the way in this post, you will see some pictures of these lower doses. It's a link from a post over in the Lantus TR forum, called STICKY: LANTUS & LEVEMIR - NEW TO THE GROUP? PLEASE READ, up towards the top of the forum.

In order to shoot these lower doses, or any dose really, it is best if you get the 3/10 CC insulin syringes with 1/2 unit markings on the barrel. Many places carry them. I get mine at Wal-Mart.
 
Lantus is best dosed twice a day as it only lasts 12 hours in the cats system. I would start with 0.5 twice a day and see how it goes. But don't shoot if he is under 200 for now until you have data. And drop to 0.25 if he goes under 50 at any point.

I think setting up a spreadsheet would be very useful for both you, and us to help you. Heres how but let us know if you need help : http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Wendy
 
Hi everyone! Happy (very belated) New Year!

I thought i would give you all a brief update and pick your brains a bit. I hope you are all well!

In December, we brought Smoke back in for his monitored blood glucose curve. The vet used both my reader and her's for comparison (we found out my meter is about 30 points higher than hers). So, they started the curve at around 9 AM and concluded about 4 PM. What they found out was the same thing I had been seeing- Smoke only has high BG levels for a few hours during the day! Remember, he is only eating FF classics and Friskie's Pates, along with a small bit of Wellness core (in hopes to gain some weight). Anyway, his numbers never exceeded ~250 and since he is typically low in the morning (around 80-100) and in a decent range at night (about 150-170) the vet has decided against insulin because of this information. I tend to agree because it really is just a small window of time in the early to mid- afternoon that he is in the high 200s. What do you all think?

I am frustrated right now just because of his weight. His blood tests/full lab workout in September were all normal (minus the BG) but the poor thing is not gaining weight! He isn't losing any, either (stuck at 6.5) and he is noticeably skinny/bony. He has a very sensitive spot on his back that he gets pred for twice a week and eats, drinks, and uses the bathroom normally. Everything is fine EXCEPT for his weight and weakness. Sometimes he shakes his head and loses his balance and his walking can be a bit unsteady. I'm just worried he is wasting away. Any insight would be greatly appreciated!
 
If he isn't allergic to foods, try kitten food. They higher protein and fat content for growth and development. Ex Evo Cat and Kitten canned, Fancy Feast Turkey and Giblet canned.
 
Here are some of my thoughts. Just brainstorming here.

1. Well, since Smoke goes up to the high 200's (around 250 you said) in the afternoon, he is over the renal threshold. That means glucose is spilling into his kidneys and urinary tract system. Excess glucose causes ongoing, slow but steady organ and nerve damage, such as diabetic neuropathy. The excess glucose is because he can't process all his food properly without enough insulin being produced by his body. Food not being processed properly would contribute to his inability to gain any weight.

I'm wondering if just a tiny dose of insulin would help Smoke out. Like 0.25U

2. If his BG's only spike in the afternoon, I'm thinking something may be going on in the digestive tract. Like inflammation or infection. Maybe take his temperature at the same time you take the BG readings? See if the body temp is spiking in the afternoon too. I suggest this because something similar was happening with me. My body temp would spike every afternoon. Went on for a long time. It finally got pinned down to inflammation caused by diverticulitis.

3. The vet only did a curve for 7 hours. Smoke may have gone higher later than this. A normal curve is for a 12 hour cycle, testing every 2 hours. Some kitties do a double dip, especially towards the end of a 12 hour cycle. Do you have all the readings from the vet for that curve that was done? Do you have some other data that perhaps you have gotten to share with us? Have you done a curve at home?

4. Any correlation between the pred shots and the BG readings? We know that steroids can bump up the BG readings. Maybe chart the BG's in relation to the pred shots to see if there is a pattern.
 
Those are very good thoughts; I appreciate your time.

I'll continue to see if he goes up in the afternoon, as that makes sense that those few hours could be hindering his weight gain. My vet initially wanted to do 1U when we were contemplating insulin, but that's much too high (as she felt)

Interesting about the infection! Would there be any other symptoms?? Everything else on him checks out normally. Hmm.

I continued the curve once he got home...no spike, although I can't say for the hours of 11 PM- 7 AM (bedtime for all). He's always given the Pred in the early morning with breakfast, so I'm not sure if that would impact the afternoon reading??

He doesn't have food allergies, just a sensitive tummy if things change. Unfortunately, the one flavor of FF he doesn't like is Turkey! Loves chicken feast and the beef, too. If anyone knows of any other "fattening" foods that are sugar kitty friendly, let me know! I'll continue to do my home readings; he's just not getting any stronger at this point
 
Interesting about the infection! Would there be any other symptoms?? Everything else on him checks out normally. Hmm.
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Infection or inflammation can be very well hidden in a cat. Plus, they really can't tell you if they are feeling well and where.

Teeth are always a good place to check.

Can't think of any other ideas right now that would be causing those BG spikes, except for the pred itself.

You can always add up to 20% of protein, like plain cooked chicken, to his food intake to help him gain weight. Does he like chicken?
 
"Sensitive tummy" could be an inflammatory process such as inflammatory bowel disease.

To read more about the GI tract, there is an excellent description of it at Feline Constipation. Plus, it is an excellant reference on feline constipation, should that ever become an issue.
 
The spike could be food related too - Friskies pates are higher carb than fancy feast and maybe they cause it. What flavours of both are you using?

How old is he? Many older cats have problems putting on weight just because their digestive systems aren't as efficient.

Wendy
 
Friskies: turkey & giblets, live & chicken, very seldom tuna & egg
FF: chicken feast and tender beef

He's 13, and is down to 6.5 from about 8-9 lbs

Also, I'm thinking about asking the vet if we can wean him off the pred and switch to glucosamine. He's taking the pred for a suspected slipped disc. What do you think about switching him? I feel it might be having an impact on his muscles/overall weakness.
 
If he is diabetic, you might find providing Methylcobalamin, a form of Vitamin B-12, will help over time.
 
heres the breakdown

Friskies: turkey & giblets 8%, live & chicken 9% , very seldom tuna & egg 8%

FF: chicken feast 4% and tender beef 5%

So.. I would try just the FF and see if it makes a difference. Some cats are more sensitive to carbs.
 
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