Newly Diagnosed Need Advice

[MABSQ710]

Hello

I found this website while doing my own research on feline diabetes but I am finding this all a bit overwhelming. I was hoping for some guidance.

My 7yr old cat Kitty was recently diagnosed with diabetes on 2/15/16. He was admitted to the hospital with a blood glucose level of 465 and he was also ketotic.

Upon being discharged from the hospital Kitty's blood glucose was 363 and we were sent home with Lantus to be given 1 unit 2x's/day along with a script for the Purina DM wet and dry food. I never purchased the dry food based on what I learned on this blog and at the time I purchased the Royal Canin Gylcobalance wet food which I only used for a few days. After reading more of the blog I switched Kitty's food to Wellness Complete Health Turkey and their Chicken.

Kitty had his first blood curve appointment on 2/29/16 and his BG was at 464, 448, 383, 521 and 500. We were sent home this time with instructions to give 2 units 2x's/day.

The following blood curve appointment was on 3/07/16 and Kitty's BG readings were 162, 181, 198, 325 and 324. We were sent home with instructions to increase to 2.5 units 2x's/day. It was explained to me that the increase in the insulin was because I had informed them that Kitty was still quite ravenous esp at his morning feeding.

I want to quickly mention before posting yesterday's blood curve testing that I only started administering the 2.5 units 2x's/day on 3/15 because I wasn't comfortable guestimating the "1/2" and needed to order the 1/2 unit syringes. So from 3/07 through 3/14 Kitty was still receiving 2 units 2x's/day. It was only from 3/15 through 3/23 that he was getting the 2.5 units 2x's per day.

My cats blood curve testing yesterday was 72, 69, 76, 112 and 149.

Which brings me to my questions for all of you.

Has anyone had any experience/success with not doing home glucose testing and rather having it done at the vet's office bi-weekly? If so how long did the process take as far as getting your feline's BG to the normal range?

I also have a question about the Wellness Complete Health Turkey Recipe and Chicken Recipe. I thought I was doing something good by purchasing this food over the Purina DM. But I was surprised to just read both Wellness recipes contain sweet potatoes, zucchini, squash, cranberries and blueberries. My vet continues to push the Purina DM based on what I am being told are studies where sugar cats were treated and fed with a diet of Purina DM and that there are no studies to support the Wellness brand.

As you can see I am confused about what I am currently doing as far as what is correct and not correct. Any advice would be appreciated. Honestly, it's not the cost of what all of this has already amounted to it's been well over $4K but what I am finding frustrating is that I am really making an effort sticking to the proper diet, feeding schedules, insulin injection schedule and it doesn't appear to be working or is it and I am just still not aware that it is?

In closing I am now back to 2 units 2x's per day and his next glucose curve I was told to schedule in a month?? But I can go back in a week or two weeks if I prefer. I just want to do the right thing and I am not sure what that is at this time. Should I consider having Kitty seen by another specialist for a second opinion as far as protocol?

Sorry for the super long post.

Melissa

PS - Is anyone aware of any support groups here in the Philadelphia, PA area?

 

[Larry and Kitties]

Most of use here test our cat's BG using a human BG meter like Walmart's Relion Confirm or Micro. The strips for those are affordable.
Home test is also a lot less expensive and more convenient that got to the vet a a curve.
We test before each shot and periodically between shots. We record our reading and other info in a spreadsheet. See:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
Here is a link to home testing blood sugarshttp://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

As you know, a low-carb canned is best. No reason for a prescription food. Here is a list of commercial low-carb canned

http://www.felinediabetes.com/FDMB/threads/shortcut-shopping-list-all-8-or-less-updated.117688/

Here is a link to home testing blood sugarshttp://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Yesterdays curve of "72, 69, 76, 112 and 149" culd indicate the the does is to high since frequently vet stress raises BG, sometimes by 100 our more points (USA).

 

[Tuxedo Mom]

Has anyone had any experience/success with not doing home glucose testing and rather having it done at the vet's office bi-weekly? If so how long did the process take as far as getting your feline's BG to the normal range?

Sorry that Kitty has been diagnosed with diabetes. It can be very scary and overwhelming in the beginning.

One of the most important things you can do is to learn to test at home. Besides being much more economical it is much less stress for Kitty and gives a clearer picture of how the insulin is working. Glucose readings can be higher at the vets with some kitties because of stress. Insulin is a hormone which does not keep the insulin levels at a flat number. If a kitty's numbers go lower during a cycle (12 hour time between shots) the body can "bounce" and produce counter-regulatory "glucose" (glucogen) which will bring the numbers up higher, sometimes for several days. If the curve was done during a "bounce" it will show as higher numbers but more insulin may not be the correct approach. Home testing before each shot and if possible several times in between shots will show what is happening during the cycle. Lantus should be dosed on how low it brings the numbers, not how high the numbers are.

Many vets are not well experienced with feline diabetes. We have had members whose vets kept increasing the dose, when the kitty really did not need more insulin. With having had diabetic ketoacidosis (DKA) it is also important to check regularly for ketones. You can purchase ketodiastix which are used to measure ketones in the urine. Any sign over trace is cause for worry with a kitty who has already had DKA.

Low carb wet foods like Friskies pate and Fancy Feast pates are fine for diabetic kitties and much more affordable that the prescription foods, which really are no better. If you have just recently changed to an all wet food diet then it is VERY important to be home testing. Some kitties can drop 100s of points in their glucose levels just from changing to an all low carb wet food diet and the insulin doses would need to be decreased accordingly.

I am sure more members will be by with more information. Just keep reading and continue asking questions. There are lots of experienced members here to help you along as you learn the best treatment direction for Kitty.

This link:

http://www.felinediabetes.com/FDMB/threads/where-can-i-find-________.127890/

has lots of information about many topics.

 

[Critter Mom]

My cats blood curve testing yesterday was 72, 69, 76, 112 and 149.

Really important question: Was your vet using a pet-calibrated meter to do the curve?

If yes, then your cat is possibly on a dose that may be a little too high (68 on Alphatrack pet-calibrated meters is at the very bottom end of the normal range for a cat - below this is definite hypo territory).


Mogs
.

 

[Julia & Bandit (GA)]

The reason why home testing is recommended by current veterinary literature over office testing is twofold--first, as others have mentioned, cats have stress induced hyperglycemia at vet offices that often leads to chronic overdosing. Second, getting good control over blood glucose requires daily testing. With Lantus, you want to test at least three times a day--once before each shot to make sure it's safe to give insulin, and at least one test about halfway through a cycle to see how low the insulin is dropping his blood sugar. I've attached an article below that talks about home testing and appropriate dosing with Lantus--I would highly recommend sharing it with your vet and re-evaluating your treatment plan with Lantus. Doses with Lantus should be adjusted in .25-.5u increments depending on the lowest number (nadir) of your daily cycle (Table 3 in the attached article). Monthly or weekly testing just does not provide a good enough picture of your cat's blood glucose levels to get good control. It's like trying to hit a bullseye from across the room, blindfolded.

Home testing seems scary at first, and you think your cat won't accept it, but even the most fractious cats will accept it if you make the tests part of their routine and reinforce them positively with treats. Bandit fought be tooth and claw the first week of home testing to the point that I was in tears, but now he comes running, sits patiently and purrs through his BG tests.

The food you're currently feeding is great, you're using a great insulin, so if you can just get your vet on the right page with you regarding home testing and dose adjustments you'll be completely on the right path! 80+% of newly diagnosed cats go into diet-controlled remission when the correct diet, insulin, and the recommended dosing guidelines via home testing are used. Trust me, it is definitely worth the effort to work for remission with your cat. Of the 7+ years Bandit has been diabetic, he's only needed insulin for less than 2 of those years overall.