Newly Diagnosed - Leonard

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steviep

steviep

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Hi everyone,

In an effort to read every available resource out there after my cat Leonard was diagnosed with diabetes, I stumbled upon this forum. I thought I would say hello! Len's a 12 year old neutered male who was previously a little overweight. After I noticed him losing weight, eating more and drinking a ton of water I took him to the vet last week and received the diabetes diagnosis. He hasn't started insulin yet (we're going back to the vet tomorrow so they can teach me how to do it) but I'm a little nervous about it! I look forward to reading advice and tips in here so I don't get too overwhelmed with everything.
 
Welcome.

It can be overwhelming at first, but I promise you that in time it gets easy.

Do you know what type of insulin your vet may start you with?

Now would be a good time to talk about diet, like humans, diet can affect blood sugar, in some cases a diet change alone can help your kitty go off insulin. Like humans, testing blood sugar at home is also invaluable, it will tell you how your cat is doing, tell you if it's safe to give insulin and if your cat does go OTJ (off the juice - off insulin) it's through hometesting that you would know what the BGs (Blood Glucose numbers) are.

May I ask what type of diet Leonard is on now?
 
This forum is full of great info. The more you know, the better you can help Leonard. Have you read the FAQs? http://binkyspage.tripod.com/faq.html

We have a great protocol that has worked well with hundreds of cats. We feed wet lo carb food (http://www.catinfo.org) and test at home to be sure it is safe to give insulin and to monitor how much is needed: Video for hometesting We advocate starting at a low, safe dose and increasing the insulin in small increments as needed.

Keep reading and ask questions. We would love to help you help your cat.
 
Thanks for all of the information!

He was diagnosed last Thursday. Since then, I've changed his diet (and his sister's) to a high protein diet using Merrick's low glycemic wet food (Thanksgiving Feast I think). I've gone from leaving them dry food out to only feeding them wet food twice a day. Already he's been peeing less and more normally, which is a good sign I think. The switch was easier than I thought, only his sis seems to miss the dry food and that's going away as well.

The insulin I have is Glargene. He hasn't yet had a shot as we go back to the vet tonight so they can teach me the proper technique for giving him the shot as well as how to use my Glucometer. I'm hoping I can send his diabetes into remission although he did have signs of back leg weakness (minor but it still worried me!) I have to give him 0.5 insulin twice a day.

I'm really going to be as aggressive as I can in treating this as I want my man to feel well again. It's definitely new to have to come home at very specific times of the day - I live alone and work a rather demanding job. I'm already looking into cat sitters who are used to diabetics in the Toronto area as I have to travel for work on occasion, which is stressing me out the most.
 
Sounds like you are off to a great start. You're on a excellent insulin and a very good starting dose.

About the only thing I can add at this point until you start getting numbers and see how the insulin is working for your furry son. Is that you can free feed canned food, lots of us do here. And smaller meals several times a day is usually better for a diabetic kitty. Since I'm at home all day with my bunch I feed them about 4 times a day. 7am, noon, 6pm and then again right before we go to bed so somewhere between 10-11pm. Most days I just mix about 1/3 of a can (5.5 oz can) of water into their food so it is about the consistancy as applesauce. If we need to be gone for an extended period of time (my husband is a musician so occasionally we are gone to the wee hours in the am) I just mix the water into their food and then freeze it into little cat food hockey pucks, frost these with some fresh food, that way they have some to eat right away and can nibble on the rest as it defrosts.

Mel, Max & The Fur Gang
 
Unfortunately once the wet foods down they eat it up right away and I'm gone for the day so feeding them that often is a bit tough. I'll try to work on having him not eat the wet food as quickly but he does love it so it's hard to leave it out! I'll try the frozen method if he ends up needing more food as I know the spikes in blood sugar with twice a day feeding may not be ideal - that sounds like a good idea.
 
The other thing you can do is use an automatic feeder and set it to go off several times a day. We love our PetSafe 5.

Have you seen our Lantus Support group? The stickies at the top will give you great information on the way Lantus (Glargine) works in cats and how to best dose it. viewforum.php?f=9 The group all use your insulin and are very numbers driven. They will want you to set up a spreadsheet so they can give you good advice when you need it: Setting up a spreadsheet It is a great color coded tool that will help you and your vet see patterns and trends.
 
I'll definitely be getting a Petsafe5, that looks great!

I've downloaded the spreadsheet and after our vet visit tonight I'll familiarize myself with it more. Thanks so much!
 
Hi there!
I am in Toronto as well and there are quite a few others in the GTA.
Can't help you on the cat sitting myself as Tom was not on insulin for very long - we got him diet controlled (OTJ or off the juice). Tom is now 17.5 years old and doing awesome. All with the help of the people here.
Maybe some others in the area will chime in, otherwise you could post another specific message about it.

Welcome.
 
I just returned from the vet and gave Leonard his first shot. The vet had said something about 0.5 dose on the phone but when I got there it was actually a dose of 2. A little nerve wracking as it's higher than I thought. I'm not sure how to translate this but his glucose levels after our first appointment last week were 40 - the calculator indicates that's 720? Really, really high. But when I learned how to use the glucometer, his levels were down to 22.5 (405) today, pre-insulin! I think the diet switch to wet food and removing free feeding may have helped! I'm worried about hypo but I think that's being a new mom to a diabetic cat. I'm going to test his levels again before I go to bed and if he lets me prick his ear.

Thanks again for all of your great recommendations. I'm currently using the spreadsheet and will add it to the footer.

I was shocked by how simple the insulin shot was. I thought it would be such an ordeal. He really didn't care in the slightest.
 
steviep said:
I just returned from the vet and gave Leonard his first shot. The vet had said something about 0.5 dose on the phone but when I got there it was actually a dose of 2. A little nerve wracking as it's higher than I thought. I'm not sure how to translate this but his glucose levels after our first appointment last week were 40 - the calculator indicates that's 720? Really, really high. But when I learned how to use the glucometer, his levels were down to 22.5 (405) today, pre-insulin! I think the diet switch to wet food and removing free feeding may have helped! I'm worried about hypo but I think that's being a new mom to a diabetic cat. I'm going to test his levels again before I go to bed and if he lets me prick his ear.

Thanks again for all of your great recommendations. I'm currently using the spreadsheet and will add it to the footer.

I was shocked by how simple the insulin shot was. I thought it would be such an ordeal. He really didn't care in the slightest.
Click to expand...

Does your vet know you switched to low-carb canned food. Usually, cats should
be started at about .5u to 1.0u 2x/day.


Hee heee....the shot's easy, isn't it. Often the reason owners give up
on diabetic cats...think it's gonna be hard, but it's not, as you now know.

Yes, keep testing.

Test before each shot, and if BG is below 11 (US=200) NO SHOT....come here for
advice.
 
Now I'm a bit nervous.

I did argue with them slightly about the dosage I had received from the vet versus what they were telling me but they did show me his notes. Perhaps I'll switch tomorrow's am dose to .5 until I can speak to my vet about it - he wasn't there, but another vet did come in to reassure me that based on his levels and weight the 2 dosage makes sense. I did tell them I had changed his diet to low carb. Should I leave some dry food I still have out for him tonight in case of any issues?

If they gave me the wrong information and something happens, so help me god.

I'm using Glargene, the needles are U-100 insulin.
 
I agree starting at 2 BID is a little high, we usually start lower and work our way up, it's safer that way and you have less chance of skipping over the right dose.
 
The best way to relieve your nervousness is to test. Test a few times tonight - lots of people set their alarms. Then tomorrow you can do the lower dose if you get a safe number to shoot.

Lantus is dosed by weight but your dose sounds high. Here is the formula: viewtopic.php?f=9&t=1581 It's toward the bottom of the page. This is from the stickies on the Lantus forum. They are full of great information about your insulin: viewforum.php?f=9
 
Should I be concerned about hypo right now? I'm pretty worried right now. I should have listened to my gut on this.
 
Why don't you try posting on the Lantus board? Read the stickies at the top of the bord to get all the information you can and they can walk you through monitoring tonight if you're concerned.
No offence to vets, I got better information here for the day-to-day monitoring, feeding and dosage.
 
Most likely not. Lantus builds up a "shed" (read about it in the stickies I gave you) and it is after the shed is built up ( a couple cycles) that you usually see it start to work. Having said that, every cat is different and it is best to be prepared. And you are, because you can test and be sure Leonard stays in safe numbers.

It is always scary at the beginning; it feels like such a big responsibility. But realize that you are in the minority of diabetc cat owners. Most get a dose and go home, shoot twice daily and never do any research or test. And usually, their cat lives another few months or so and has multiple hypos. You are going to do much better than that for Leonard. :-D
 
You will need a spreadsheet since Lantus is a very numbers driven insulin. It is a great tool for you and for us, when you want dosing advice. We can see your history of doses and numbers at a glance. Here are the directions: Setting up a spreadsheet If you need help, just ask.
 
I've been trying to do a spreadsheet but my mac is fighting against it.

Just took a reading of him now. Dosed 2 at 7pm and his reading was 25.3. Now it's 8.3 (167) so I'm concerned but he seems ok other than really mad at me for poking his ears. Needless to say this is a lot of stress that the vet tech/alternate vet has caused. Hopefully all will be well.
 
If you need help, send me a pm. I have a Mac and it works with the template. The World template which you will want to use does take several minutes to load up.

How many hours since the shot is the 167?

Be sure you give him a treat each time you test so he will associate the test with something good.
 
It's okay just breathe...It really does get better.

Your not going to have to worry about hypo until you start seeing numbers in the 40s and 50s US or 2.2 -2.7 ish if I did the math right. Being freaked out and a little worried right now is an okay thing, just means your a good extra sweet kitty mommie. We all were right where you are now.

Mel, Max & The Fur Gang
 
He's eating Merrick's low glycemic wet food but I also have some high protein dry food around which he hasn't had lately but I may give him a bite of just to be sure.
 
steviep said:
He's eating Merrick's low glycemic wet food but I also have some high protein dry food around which he hasn't had lately but I may give him a bite of just to be sure.
Click to expand...

I would't go with the dry. I posted on the Lantus board to have someone come take a look at this thread.
 
Hi Stevie-

Merrick canned is a great choice to feed your cat. Beef (Cowboy Cookout), Chicken (Grammy's Pot Pie) and the Surf and Turf are the lower-carb choices if you want to experiment. Also, your vet prescribed a terrific insulin but I would agree that it's too high a dose to start. I definitely agree with the others that you could try to cut it to 1 unit twice a day. If your numbers tell you that it needs to go up, that's fine, but the numbers could also tell you to cut the dose further. If I had listened to my vet (who recommended 4 units twice a day) and not to the good people here... well, let's not go there. You're off to an amazing start and the people on this board are happy to help you get the hang of this. Let us know how it's going.
 
Thanks all for your replies! It's helping me to calm down a bit (I'm normally very laid back, but not when it comes to Len!)

I'm going to try to test him again at 11 and tomorrow (if his readings are good) cut the dose to the 0.5 the vet had initially told me last week. I don't understand how the mix up today happened with the vet tech and another vet, but 2 seemed too high to me! When they brought in the vet to reassure me that it wasn't I felt good but as soon as I dosed him with it, I had second thoughts about the entire ordeal.
 
I'll test again at 4.4. The vet said to call if levels are below 4.4. I'm wondering if I should give them a call now though. Is there a number where it usually hits the lowest point? I'm sure it's different with every cat. I'm pretty frustrated that I didn't go with my gut on this.

He's walking funny right now. Calling the vet.

He just ate some food so hopefully that helps make sure it doesn't go too low.
 
4.6 (83) is not too low but you need to feed and keep testing so he does not fall too much as you are still early in the cycle.
What do you mean by walking funny?
 
Welcome. I'm one of the folks from the Lantus Board that Sonia rounded up.

As for initial dose, there is actually a weight based formula for calculating dose. It's based on your cat's ideal weight and usually comes to somewhere around 1.0u.
initial dose = 0.25 x ideal weight in kilograms​

It may help if you familiarize yourself with the starred sticky notes at the top of the Lantus Board.
  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in German and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
  • New to the Group: Everything you wanted to know about the Lantus forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot/shed: This is an important concept for understanding how Lantus works.
  • Becoming Data Ready: What data you need in order to be able to work toward remission or tight regulation.
 
Welcome!

I'm sorry you're having a scare right off the bat. It looks like others here are capably helping you with that, very very good that you're able to do the testing already. Bravo!

I just have to add that insulin is a hormone and should not be dosed by weight, although I see you've been given a formula by another poster, but please note it says "ideal" weight." That is sometimes difficult to determine. Insulin needs vary from cat to cat and even a large cat with an ideal weight over 14 pounds may need only 1U or less of insulin to do well.

Another reason we suggest beginning with only .5U to 1U of Lantus, or the other long lasting insulin Levemir, is that the best way to find the best dose for the cat is to begin at a dose lower than what they may need. That way you can test the blood glucose periodically to determine how well the insulin is working.

Until we can be sure Leonard is safe tonight, it's probably best to continue posting in this section as more members will see your thread here.

It gets easier, I promise! You've already found the best online resource for feline diabetes and you're already home-testing. That alone can be overwhelming for some people. You're doing fine.
 
I just measured again - big struggle this time around. He's definitely not liking this whole testing thing.

He's at 4.9 now, not much of a change.
 
Thanks all for all of the Lantus information. I have read through it all. I'm definitely not dosing him with this much again until I figure out what he needs by starting small. I'm quite upset about the whole thing and plan to speak to the vet's office tomorrow.

He may not let me test his blood the rest of the night - he's very angry at me right now, which never happens!
 
It's a good sign that he seems to be leveling off. It would be nice if he would stay in this range for a few hours.

Be sure to give treats and just tell yourself it is something you have to do to keep him safe.

if he starts fighting you, you can try the kitty burrito. Wrap him up in a towel with only his head showing. You should get some more tests in tonight but I would think you could wait until 6 hours after you gave the shot.
 
I've set an alarm to try to test him again in a few hours. Hopefully everything will be fine. :)

Thanks for all your help. I'm still trying to get the spreadsheet to work for me but I'll try updating it tomorrow from work.
 
So Leonard's doing fine this morning. I couldn't test him at 2am but he seemed okay other than tired because I've been messing with him so much, I assume.

I tested him at 7am before his dose, which I was planning to switch to 0.5 for now. However, his test results were 7.0 (141) so I held off on the dose this morning and will test again once I get home from work. He seems okay other than very angry with me for this needle business. He's onto me so I have to pin him down while his sister freaks out over what I'm doing. I'm setting up his chart right now.
 
Yes. Please post that chart and I would suggest you start posting on the Lantus board. You open 1 condo (thread) per day and people there will walk you through what you should do.

Nice number this morning :-D
 
Your chart says 126 at +1. Is that after eating and without insulin a drop from the 146? If so, you may have a functioning pancreas. We consider a cat in remission if their numbers run between 40 - 110 or so without insulin. Your Leonard is close to that.

Agree that you need guidance from the Lantus forum if you are going to be giving mini doses to get him down that final bit. The other things that can help him go down on his own are the frequent small meals of the lowest carb food. (So if you are feeding 6-8% carbs now, try some foods in the 2-4% range. Limit fish to a few times a week however.)

Looking great!
 
ARGH. Posted a reply but it did not show for some reason...

A few comments on your chart:

1. It does not convert to US numbers. Would be easier if it did or if you input in US equivalent (x18). Edited to add: It does convert on the US page...

2. The 25.2 number, I believe that was pre shot last night? I should be input as PMPS (PM pre shot), with the follow tests shown in the number of hours since shot. (+)

This morning's number should show in AMPS. PS numbers are pre shot, pre food. The chart will allow you to get information on Leonard's BG though the day and allow for easier decision making.
 
I think I fixed it. I swapped the worksheet order but it should display the US based one first now.

I actually miscalculated the initial numbers from this morning (made a bit of a mistake with the calculator, forgot to switch both to whole blood) - his number was 126 this am without an insulin shot. Since it was 126 I didn't dose him at all this morning. I'm currently posting on the Lantus board (just trying to find the FAQ on jargon so my post makes sense! I've read through all the stickies, just so much information to absorb right now.
 
It is a LOT of information and overwhelming at first. But you found the best place to help. You will see a change in Leonard when he starts having lower numbers and feeling better. It's all worth it.
 
My chart should be all fixed up! Thanks so much for the acronym explanation. I've been searching around for one but having a hard time finding a little 'dictionary'.
 
No one's answered this in the Lantus board so I'm hoping someone can help here:

So since I didn't give Leonard his insulin dose this morning due to a low number (126), I expected to come home and test him to find his numbers very high. Nope. Just did a PMPS and it came up as 10.5 (189). I'm not sure whether I should proceed with a .5 dose or just leave it for the night? Any help would be great.
 
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