Newly diagnosed inviting input from experienced

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expatri

Member Since 2014
Hello all...

I have 2 cats. One (Nixie) is younger (about 3-4 years) and somewhat new to the house (been here since Feb of 2013). My other (Clint) is older (11 or so years) and has been with me since 2005. Nixie is a pretty much average sized cat, while Clint is a little bigger, though not overweight, just a larger frame.

Last week (3/13/14) I took Clint in for some long overdue dental work. From his pre-screening blood work they diagnosed his diabetes.

So since that time I have been administering 2 units of Prozinc insulin twice a day. I have removed the dry food (Iams original) that I used to leave out for them (mainly due to Clint's dental work...multiple tooth extractions...but also due to the numerous posts on the internet recommending no dry food for diabetic cats), and they each now get a 3 ounce can of Fancy Feast Grilled twice a day (though of course they move back and forth between bowls so who knows how much each is actually consuming).

I try to keep Clint's shots 12 hours apart, but unfortunately I work 12 hour shifts 3 days a week, so on workdays, there can be just under 14 hours between his morning and evening shots, leaving only about 10 hours between his evening and morning shots (the vet advised keep as close to a 12 separation between shots as possible). Regardless of that, Clint has really perked up these past few days and seems to be doing well with the new routine (though I'm wondering how long until he makes the connection between being fed and getting his shot and starts hiding after eating his fill).

Earlier today Clint had his first glucose check since being diagnosed. His blood sugar was a bit lower than the vet wanted (but not drastically low), so the vet has dropped his dose down to 1 unit twice a day. We'll be going back on Friday to check his glucose again.

So that is my long, detail-laden introduction to the community here at FDMB. Please, feel free to offer any advise or insights you might have from your own experiences. I think I've covered most of the questions I've had with my vet, but if anyone thinks of anything that I should be asking about or investigating, please share.

My most immediate, specific information request is about glucose meters. Any guidance on a good one I could get to check Clint's levels at home? The trips to the vet, while I understand will taper off as we determine his dosage, are no treat for either of us. Clint's not a fan of travel, and Nixie will spend days hissing at him for changing his scent on her (even after a year, EVERYONE still gets a sniff test from Nixie before she'll have anything to do with you).

Thanks for your time and attention. Hoping all your fur-persons are doing well and staying healthy...:)
 
Hello and welcome to sugardude Clint and his caretaker. Would you share your first name with us?

My most immediate, specific information request is about glucose meters. Any guidance on a good one I could get to check Clint's levels at home?
Click to expand...
You asked about what meters we use here. Most of us live in the US and use the Wal-Mart Relion brand, either the Confirm or Micro models since they take a tiny drop of blood, only 3 microliters. It's the cost of the test strips that are a big factor, and these meters have some of the lowest cost strips available. Arkray Glucocard 01 is the unbranded version of this Relion Confirm meter and available at our shopping partner American Diabetes Wholesale.

Do you live in the US? or elsewhere?

I have removed the dry food (Iams original) that I used to leave out for them (mainly due to Clint's dental work...multiple tooth extractions...but also due to the numerous posts on the internet recommending no dry food for diabetic cats), and they each now get a 3 ounce can of Fancy Feast Grilled twice a day (though of course they move back and forth between bowls so who knows how much each is actually consuming).
Click to expand...

Good job on making that diet change. You could tweak it a bit more, and go lower carb to help out your kitty Clint. A change to a lower carb food can result in a dramatic drop in BG (blood glucose) levels, so we strongly recommend home testing first before you make the diet change. The change you did from the very high carb dry food (~41% carbs) to the medium carb wet food probably was at least half the reason Clint is getting better BG readings at the vet now.

Those Fancy Feast Grilled flavors you mentioned you are feeding are higher in carbs, 13 to 18%, than we like to see for our diabetic cats. You might want to try the Classic Pate, Tender Pate, Chunky, or Flaked styles in the Fancy Feast line.

This food chart, by vet Dr. Lisa Pierson, gives you some good information on food choices. We look for foods that are <10% carbs, 3rd column of numbers, for our diabetic kitties. Some of these include the Friskies pates and Wellness grain free foods, widely available and lower cost.

Prozinc is a good insulin for cats and a good choice with your schedule. There is more flexibility in dosing that in and out type insulin than the depot type insulins like Levimir and Lantus.

Please, let us know how else we may help you and welcome aboard.
 
We suggest using an inexpensive human glucometer with pet-specific reference numbers. One many of us use is the WalMart Relion Confirm, or Confirm Micro, which is also sold at American Diabetes Wholesale as as the Arkray USA Glucocard 01 or 01 Mini (same manufacturer - Arkray USA). It uses a tiny blood droplet and the cost is significantly lower for test strips (like $0.36 each).

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.)
 
Deb & Wink said:
Hello and welcome to sugardude Clint and his caretaker. Would you share your first name with us?
Hi Deb and Wink...thanks for the welcome and helpful information. My name is Chas, btw.
My most immediate, specific information request is about glucose meters. Any guidance on a good one I could get to check Clint's levels at home?
Click to expand...
You asked about what meters we use here. Most of us live in the US and use the Wal-Mart Relion brand, either the Confirm or Micro models since they take a tiny drop of blood, only 3 microliters. It's the cost of the test strips that are a big factor, and these meters have some of the lowest cost strips available. Arkray Glucocard 01 is the unbranded version of this Relion Confirm meter and available at our shopping partner American Diabetes Wholesale.
Click to expand...
American Diabetes Wholesales seems to have a good selection. Gotta remember to get syringes also...
Deb & Wink said:
Do you live in the US? or elsewhere?
Click to expand...
Yes, I'm in the US. Western Missouri...:)
Deb & Wink said:
I have removed the dry food (Iams original) that I used to leave out for them (mainly due to Clint's dental work...multiple tooth extractions...but also due to the numerous posts on the internet recommending no dry food for diabetic cats), and they each now get a 3 ounce can of Fancy Feast Grilled twice a day (though of course they move back and forth between bowls so who knows how much each is actually consuming).
Click to expand...
Good job on making that diet change. You could tweak it a bit more, and go lower carb to help out your kitty Clint. A change to a lower carb food can result in a dramatic drop in BG (blood glucose) levels, so we strongly recommend home testing first before you make the diet change. The change you did from the very high carb dry food (~41% carbs) to the medium carb wet food probably was at least half the reason Clint is getting better BG readings at the vet now.
Those Fancy Feast Grilled flavors you mentioned you are feeding are higher in carbs, 13 to 18%, than we like to see for our diabetic cats. You might want to try the Classic Pate, Tender Pate, Chunky, or Flaked styles in the Fancy Feast line.
This food chart, by vet Dr. Lisa Pierson, gives you some good information on food choices. We look for foods that are <10% carbs, 3rd column of numbers, for our diabetic kitties. Some of these include the Friskies pates and Wellness grain free foods, widely available and lower cost.
Click to expand...
Yes, I did check out that chart and was disappointed about the carbs for the grilled, especially since Costco carries the 36 can selection of chicken, beef and turkey for less than $18...:) Ah well, I'm sure Petco or Pet Smart will be glad for the extra business...hehehe.
Deb & Wink said:
Prozinc is a good insulin for cats and a good choice with your schedule. There is more flexibility in dosing that in and out type insulin than the depot type insulins like Levimir and Lantus.
Click to expand...
That's good to know. My schedule will be changing in a month or so to something more accommodating to Clint's medical needs, but in the meantime, good to be on an insulin that's more flexible...
Deb & Wink said:
Please, let us know how else we may help you and welcome aboard.
Click to expand...
Will do, and thanks again for all the information. Hopefully we'll be able to settle into a good, healthy routine quickly...:)
 
BJM said:
We suggest using an inexpensive human glucometer with pet-specific reference numbers. One many of us use is the WalMart Relion Confirm, or Confirm Micro, which is also sold at American Diabetes Wholesale as as the Arkray USA Glucocard 01 or 01 Mini (same manufacturer - Arkray USA). It uses a tiny blood droplet and the cost is significantly lower for test strips (like $0.36 each).

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.)
Click to expand...
Thanks very much for this chart, BJM. This will be very useful in helping to keep Clint safe...:)
 
When you order syringes, you want to get the 3/10 cc, 29 to 31 gauge, with 1/2 unit markings on the barrel. Those 1/2 unit markings will come in very handy when you are measuring doses in 0.25 and 0.5 unit increments. There are no syringes with 0.25U increments, so you have to eyeball those doses.

Don't forget the lancets. At the beginning, lancets labeled "for alternate site testing" work easier for most new caregivers. The 26-28 gauge lancet has a bigger point for poking and makes it easier to get blood. The 30-31 gauge lancets make such a tiny hole, it's often difficult for you to get enough blood until angiogenesis occurs. Angiogenesis is the ears forming new capillaries and that makes it easier to get blood. We often refer to this process as "the ears learn to bleed".

Here's a link to the new member shopping list, to make sure you get everything you need for home testing. https://docs.google.com/document/d/11Ufa3ylqsQFrzcGUFIpzlQ4KKovZ8C9iqdbYJ1L1XcE/edit?pli=1
 
Here's a link to another post about glucometers. http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=70140 You want to find one that takes a very small blood drop, so that is one reason I told you about the Arkray Glucocard 01 because I know that one takes a tiny drop.

I also have this link for you that has some meters, shows blood drop sizes and cost of strips. It's the strip cost that is the most expensive part of the testing, so that is something to watch out for.

ETA: There was a recall on some of the FreeStyle meters very recently. So watch out for those. We've been telling people for some time, that many people here have found they give false low readings when used on our cats.
 
Deb & Wink said:
When you order syringes, you want to get the 3/10 cc, 29 to 31 gauge, with 1/2 unit markings on the barrel. Those 1/2 unit markings will come in very handy when you are measuring doses in 0.25 and 0.5 unit increments. There are no syringes with 0.25U increments, so you have to eyeball those doses.

Don't forget the lancets. At the beginning, lancets labeled "for alternate site testing" work easier for most new caregivers. The 26-28 gauge lancet has a bigger point for poking and makes it easier to get blood. The 30-31 gauge lancets make such a tiny hole, it's often difficult for you to get enough blood until angiogenesis occurs. Angiogenesis is the ears forming new capillaries and that makes it easier to get blood. We often refer to this process as "the ears learn to bleed".

Here's a link to the new member shopping list, to make sure you get everything you need for home testing. https://docs.google.com/document/d/11Ufa3ylqsQFrzcGUFIpzlQ4KKovZ8C9iqdbYJ1L1XcE/edit?pli=1
Click to expand...

.5 and .25 units? Wow...it gets that exact? I'll be sure to ask the vet about that. Hopefully this recent adjustment in his dosage will do the trick, but judging by vet's report, 1.5 units might be in Clint's future. Good to know...
 
Deb & Wink said:
Here's a link to another post about glucometers. http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=70140 You want to find one that takes a very small blood drop, so that is one reason I told you about the Arkray Glucocard 01 because I know that one takes a tiny drop.

I also have this link for you that has some meters, shows blood drop sizes and cost of strips. It's the strip cost that is the most expensive part of the testing, so that is something to watch out for.

ETA: There was a recall on some of the FreeStyle meters very recently. So watch out for those. We've been telling people for some time, that many people here have found they give false low readings when used on our cats.
Click to expand...

Thanks for the links, Deb. You and Wink are rock stars!! :-D
 
Hey Chas! Welcome to both you and your extra sweet Clint!

You're in the best place you never wanted to be here on the FDMB! The people here do nothing but deal with feline diabetes and the diseases that tend to come with it, and have lots and lots of experience to share with you!

The first thing I'm going to say is that your vet most likely hasn't got anywhere near the experience the people here do. I'm not slamming your vet at all! It's just vets really can't keep up with the latest treatments for every disease in every type of animal they see. As I said earlier, all the people here do is deal with diabetes, 24hrs/day, 7 days a week, 52 weeks a year. You just can't buy that kind of experience for any price!

Testing at home is the best thing you can do for Clint. It takes some practice, and everything thinks their cat will hate them for the rest of their lives, but almost 100% of the time, within a week or two, the cat's jumping on their "testing spot" and reminding us it's time to test! It's also the ONLY way you can keep Clint safe! You should always test before giving insulin to make sure they're high enough to get it. You wouldn't think of giving a young child insulin without knowing where their blood glucose was first, and our furkids are the same. Also, when you can be at home, you can get those expensive "curves" done instead of paying the vet to do them, and they'll be more accurate since just the stress of the vets office can raise their numbers up to 200 points! If you get our spreadsheet working, you can test at home and share the link with your vet if he/she wants to keep track of how Clint is doing! (info below)

Are Clints dental problems 100% cleared up? Dental issues are one of the number 1 things we see keeping numbers higher than they should be...the other being UTI's (urinary tract infections)

The other great thing you can do is start a spreadsheet for Clint and enter the numbers you get when you test. That way the people here with the most experience with ProZinc can help evaluate how Clint is doing, and give suggestions on dose increases as well as decreases! It's very simple once you have it set up...You just enter the numbers as you get them. Here's How to get your Spreadsheet set up and in your signature

It's great to hear Clint is responding well, but dropping down to 1 unit from 2 may be too much. There's really no way to know without testing. We do increases and decreases in .25 unit increments (which is why those half unit syringes are so great!) ProZinc insulins are U40, but you can buy U100 syringes at WalMart and use the Conversion Chart to get the right doses.

Good luck with your journey, and ask all the questions you can think of. The people here are very generous with their time and are happy to help!

Again, welcome from a fellow Missourian! I think you're the first one I've met!
 
Oh darn! I forgot you were using Prozinc when I talked about those syringes with 1/2 unit markings.

I don't believe there are any U40 syringes with the 1/2 unit markings, but as Chris pointed out, you can use U100 syringes with a U40 insulin as long as you use that conversion chart. In fact, the tinier doses our kitties need would be easy to measure down to .2U with a U40 insulin like Prozinc and U100 syringes.

What were the BG readings you got at the vet?

Would you be willing to add some tidbits of data to your User Control Panel, Profile tab, Edit signature section? It would help us to help you better having these little bits of data right at our fingertips.

Chas and Clint (male, age 11)
DX date xx/xx/2014
Prozinc w/ xx meter
type of food fed
any complicating medical conditions such as CKD, Hyper T, IBD, etc

While you are there in the User Control Panel, Profile tab, select Edit Profile and add your country and state to the Location field and save it. That way, if there is ever an emergency situation, we'll know what time zone you are in and know if we can stay up with you to guide you along or find someone that lives farther west to help out.
 
Promising news!

After his 30 day follow up, the vet and I are going to try a week or so off of the insulin!
I suspected that things might go this way after his one week follow up when the vet cut his dose in half to one unit twice a day.

So with any luck we'll be able to control things with his diet alone. Hoping for good news at next week's follow up...
 
How low are his numbers? I hope you wean him off gradually - going cold turkey on insulin can stress the pancreas and make the remission not permanent.
 
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