Newly Diagnosed Today- and having LOTS of problems

[Simon's & Oscar's Mom]

Hi Everyone,

My baby, Simon, is 10 years old. We've had him since we adopted him as a kitten. A lot has gone on since July 2013- we sold our home, moved in with my mom while our new house was being renovated, and as of Dec. 2nd we now live in our new home. My cats (I have two, both 10 yrs old) have never sprayed in their lives. Now, Simon the one that was just diagnosed with diabetes today, has been spraying since we moved in. He has lost 6 lbs in the last 4 months. Honestly, I thought that it was stress-related and that it would get better. He is acting like a different cat. He jumps up on counters/table CONSTANTLY and won't get down. He'll just look at you and lay down. If you pick him up and put him on ground, he'll just jump back up. Then there's the spraying. He has now hit every room in the house with the exception of my bedroom. In the last three days, he has actually made a puddle on the floor which has also never happened before.

I need help with a few things:
1. What do you recommend to help with the spraying and do you think that starting the insulin and new diet will help with that? I currently have the Feliway spray and diffusers, but it's not helping. I haven't used Nature's Miracle on it- does that work? Should I get that asap? I really need help with this as he just CAN'T continue to pee all over our basically brand-new house. My husband is ready to kick him out.
2. He has diabetes. His number was at 500. I picked up his insulin today and the vet showed me how to administer it. OMG!! I'm very nervous. He only currently weighs 8.5 lbs. I'm supposed to start with 1 unit every 12 hours. He was prescribed Lantus U-100. I've read all this info about switching his food to wet and the low-carb, is that going to be ok with the insulin injections? I'm very nervous to begin all of this.

Thanks in advance for any help/suggestions that you can offer. I'm glad to have found a place that I can go for support.

 

[BJM]

Litter Box Avoidance

After you rule out any medical issues (diabetes, infection, stones, etc), here is a list I compiled previously. Some of the items may not apply or gender may be incorrect.

***********************************************************************

You might try an integrated approach using multiple options from the list below on a consistent basis:

* start with crating, using a medium large crate (30" long is big enough for cat and a litter box) until progress. S/he probably won't go where s/he'd have to lie in it ... but if s/he does, something is wrong and it may be medical.

* tarps and newspapers may be easier on clean up if you don't crate her/him

* feeding on a schedule and then placing her/him in the litterbox (maybe in a crate) within 15-20 minutes after eating, until she goes, then praising and letting her out.

* Feliway/Comfort Zone - friendly facial pheromones which reduce stress and may reduce marking behavior. Cheapest prices are usually on the net (ex http://www.LambertVetSupply.com ) I've used it and it helps.

* Cat Attract litter - supposed to help attract cat to litter box

* Rule out arthritis or constipation - pain causes box avoidance

* watch if the other cats ever attack her/him in the box and if so, you may need to keep her/him separated from them. I've got one the others attack, completely unprovoked.

* litter box should be 1.5 times length of cat, litter cleaned frequently, but avoid really strong smelling cleaners as cats may avoid them due to the scent.

* you've got to get residual odors out from areas which were 'nailed' - Nature's Miracle is one option and has good reviews. It _can_ require repeated applications.

* regular play sessions of about 15 minutes to reduce stress and promote bond with you

* reward desirable behaviors - if you see her/him use the box, praise and treat her/him

* put unpleasant textures in places s/he has peed to encourage avoidance

* read some of this author's books: http://www.catbehaviorassociates.com/ she's pretty good - ex "Starting from Scratch"

Good luck.

 

[BJM]

Controlling the glucose will help with the spraying.

You are starting with a low dose of Lantus - that's often a good starting dose for many cats. For 8.5 pounds 1 unit is an
OK starting dose.

Note:
- Vet stress can raise the glucose from 100 to 180 mg/dL.
- Diet change may drop the glucose 100 mg/dL

We strongly encourage home glucose testing with an inexpensive human glucometer such as the Arkray Glucocard 01 or 01 Mini which is also sold as the WalMart ReliOn Confirm or Confirm Micro.

 

[Simon's & Oscar's Mom]

Thanks so much for the info! I was really hoping that the insulin would help with the spraying. I'm crossing my fingers.

I guess the next thing that I need to look into is the home-testing. I know nothing about it. Nothing. Do you have to actually prick them for blood? I know it sounds stupid, but I really don't know. I need to get to the store and buy all of these supplies. I guess I'll start with the Fancy Feast wet food.

 

[BJM]

Thanks so much for the info! I was really hoping that the insulin would help with the spraying. I'm crossing my fingers.

You're welcome. Just passing on what I've learned here.

I guess the next thing that I need to look into is the home-testing. I know nothing about it. Nothing. Do you have to actually prick them for blood? I know it sounds stupid, but I really don't know. ...

There are no stupid questions; this is stuff that is new to you. Many of us started from scratch, too. You get the meter, matching test strips, and 26 to 27 gauge lancets which you will use to prick a tiny little hole on the outer edge of the ear. There aren't a lot of nerves there, so it is more of an annoyance, than painful.

Also pick up some urine ketone (or ketone and glucose) test strips, and maybe some plain aquarium gravel to make testing urine for ketones easier. See my signature link Secondary Monitoring Tools for additional assessments you can make to monitor his health.

I guess I'll start with the Fancy Feast wet food.

Fancy Feast Classic pates is what you want to get.

 

[ebuckley]

Hi Stacy!

You've found a message board with a wealth of information and very kind, knowledgeable folks. It might get overwhelming at first, but hang in there.

I'll just second BJM's advice (hugely helpful for us):
1. Home testing. This was really hard at first but very, very important!! and it got easier. The Relion micro from Walmart is great. I'll post some of the helpful tips that other's gave me if someone else doesn't beat me to it Home testing tips.
2. Low carb canned food. We had to do this carefully because we had already started Lantus, and the food could lower the glucose on top of the insulin.
3. The spreadsheet and systematic testing as recommended by the folks here. You can see other people's spreadsheets if they have them linked in their "signatures"; like "Napa's numbers" below altho mine is in no way a shining example of how to do it, lol, but might give you a sense).

Did I mention you might get overwhelmed? ;-) Just keep asking questions.

I've used the Nature's miracle and it does help (neighborhood feral stinking up the garage and the outdoor cat that we've had in due to the weather peed on our newly remodeled bathroom floor). Cats with unregulated diabetes have to pee a lot and may not make it to the box in time. Poor Napa peed in her bed a few times; I don't think she even knew she was going it until it was too late.

 

[Maggies Mom Debby]

Spraying could be partly caused because he has to pee often and urgently. It could also be a way of letting you know he isn't feeling well. My first diabetic cat was diagnosed because he was spraying. Getting his diabetes treated stopped the spraying in our case.

As to Nature's miracle, I use it but mostly on vomit. If he has sprayed on carpet, you need to treat the pad as well as the carpet.

 

[Linda and Scooter & Jack]

Hi Stacy! Welcome FDMB!

2 months ago I was right where you are at and now I feel like a pro.

BJM greeted me to with amazing advise and I followed every bit of it. Getting that spreadsheet started will help people help you some more. There are sticky notes at the top of the forum. I suggest you click on everyone of them and read them a few times. You may get overwhelmed as I did but I came on this website very frustrated many times and people still helped me. They will help you to!

There is a forum down below that says insulin support groups. Two of them are lantus and they will help you there as well. Please read the note from a kitty to Mom. It helped me a lot.

I want to tell you that natures miracle was my personal miracle as Scooter was peeing at the beginning. I learned that the natures miracle that worked best has a yellow ribbon on it and says urine destroyer on the front. I clean the urine up with Mr clean and then put the natures miracle down and he never goes back and the smell is gone.

There may have also been cats outside he can see and he is marking his territory. Having a new house is hard on a kitty but you can do this! Diabetes is manageable and begins by changing his food and picking up the kibble!

I hope I see you around the TR lantus forum. Just introduce yourself and help will arrive.

Linda

 

[Simon's & Oscar's Mom]

Thanks everybody, I feel better already. Really, I do. It's just SO OVERWHELMING and SCARY at first, and now I know that I can manage this. I had no idea that something was this terribly wrong with him, so it was quite a surprise and I was TERRIFIED!! I have started giving him a mix of his old food (Iams dry weight management) and the new Fancy Feast Classsic varieties, and he is loving it. So is my other cat, who I am switching to all of the same food, etc. I did find that neither of them likes the chicken one, but LOVE the turkey and giblets, lol ;-)

I did notice yesterday that Simon was EXTREMELY lethargic, it seemed more so than normal. Could that be due to the new food and/or insulin shots? He is currently on 1 unit, and I've only switched part of the food out (1/4 new with 3/4 old).

Now I need to look into these testing kits and get going on those. I have not done any testing yet.

 

[Jen&Eddie]

Lethargy can be a symptom of a serious problem -- either hypo or DKA, both bad complications of diabetes. If you can, try to pick up a test kit and get to testing. Lethargy is one of those symptoms that can be caused by a million different things. If you can see what his BG number is, that can give you some idea if a high or low blood glucose level is the problem. I don't want to frighten you, but it can be an emergency situation. Are there any other symptoms?

 

[Simon's & Oscar's Mom]

Not that I can tell. He is eating ok. He's just laying around a lot, and in weird places. He was in my closet a lot yesterday. He usually doesn't lay in my closet, my other cat does. Great, I'm at work today...

 

[Jen&Eddie]

It could also be nothing. When you have a chance, please update us as to how he's doing. We'd rather err on the side of caution when someone posts reporting some potentially troubling symptoms, so I don't want to panic you, but you should be aware of the following symptoms:

Hypoglycemia (Blood sugar too low)

SYMPTOMS
Some cats may have NO symptoms whatsoever, but here are the most common ones:

MILD HYPOGLYCEMIA
Sudden ravenous hunger
Shivering
Weak or lethargic

MODERATE HYPOGLYCEMIA
Disorientation
Trouble with vision... bumps into furniture
Poor coordination, such as staggering, walking in circles or acting drunk
Changes in head or neck movements
Restlessness
Urgent meowing
Behavioral changes, such as aggressiveness

SEVERE HYPOGLYCEMIA
Convulsions or seizures
Unconsciousness

Symptoms of DKA (diabetic ketoacidosis)
Drinking excessive amounts of water OR no water
Excessive urination
Diminished activity
Not eating for over 12 hours
Vomiting
Lethargy and depression
Weakness
Breathing very fast
Dehydration
Ketone odor on breath (smells like nail-polish remover or fruit)

 

[Simon's & Oscar's Mom]

Well, he is rather lethargic, but that's the only sign I'm seeing. I'm not sure if he just still doesn't feel all that well.

We started insulin on Sunday, and I'm so happy to report that he hasn't sprayed at all since then (at least that I can find anywhere). You have no idea how thankful I am about that, and really hoping that we can stay that way.

On another note, I'm confused about what meter to get. I just want something that's easy and accurate- what do you suggest? So far, I haven't tested his levels since starting Lantus on Sunday. Not that I'll even know what the heck I'm looking for anyway, but I have to start somewhere. Any suggestions?

 

[Jen&Eddie]

It's entirely possible that he just isn't feeling all that well yet. :smile: In terms of meters, you really don't need the animal-specific Alphatrack one which is spendy, and the strips are astronomical. Most of us use one of the Wal-Mart Relion brands. The meter itself is cheap, and the strips are about as cheap as they come. And, I think most people find them pretty reliable for home testing purposes.

Home testing can seem really daunting at first, but you'll get there! Good for you for home testing! It really will give you not only some peace of mind that you know what his blood glucose levels are doing, rather than trying to guess but, you'll also be able to move him more quickly and more safely into more healthy numbers if you know how a dose is affecting him.

There's a wealth of information here in terms of home testing tips and strategies. Almost all of us struggled with it when we very first started. Here's a couple links to get you started:
https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub
http://www.felinediabetes.com/bg-meter.htm

For me and Eddie, some things that helped were to keep his treats inside his testing kit so all of his supplies smell like his favorite treat, making sure his ear was warm before poking, using a larger gauge lancet to start with, and remembering to take a deep breath! If I was nervous or frustrated, I'm sure Eddie could sense that.

Keep us posted!

 

[KPassa]

Hi Stacy and Welcome!

On another note, I'm confused about what meter to get. I just want something that's easy and accurate- what do you suggest? So far, I haven't tested his levels since starting Lantus on Sunday. Not that I'll even know what the heck I'm looking for anyway, but I have to start somewhere. Any suggestions?

Most of us here in the US use the ReliOn brand human meters from Walmart because they're reliable enough and cheap enough. The cost is not in the meter but in the test strips. The ReliOn Confirm/Micro (or you can order it online as the Arkray Glucocard 01) requires a small amount of blood (great when first starting out testing) and the strips cost $36 for 100. The ReliOn Prime (no Arkray equivalent) requires a bit more blood (better when you've gotten the hang of testing) and the strips cost $18 for 100.

As to reference ranges for BGs, I simply use Wikipedia's Blood Sugar Guidelines to know what I'm looking at. For when to test with Lantus, dosing is based moreso on the nadir/low point than on the pre-shots so I always try to get at least 4 tests minimum each day:

• AM Pre-shot test to know if it's safe to give a shot
• AM mid-cycle test, if possible (this one I sometimes skip because of work). It lets me know how the dose is working and how low Mikey might go
• PM Pre-shot test to know if it's safe to give a shot
• Before-bed test to see how low he might go overnight while I'm sleeping

All other tests, I consider them as more data points on how Michelangelo reacts to the insulin in that particular cycle, how food and/or activity affects his numbers, if he needs an increase or decrease in dose, how he might be handling a new dose, etc.... I basically play fill-in-the blank across the week and try to grab tests at different times across different days with a few repeats thrown in.

We also use this spreadsheet to help us keep track of the test results, spot patterns and dosing changes, and share with others here for advice or suggestions. Questions on understanding how to use the spreadsheet get asked a lot, so I thought I'd share a quick run-down of spreadsheet-specific terminology:

• Fur shot: when the syringe needle pokes through almost like a sewing needle through fabric and it is unknown how much, if any, insulin actually made it inside the cat. Usually detected by wet fur or the smell of insulin (it smells like band-aids or scotch or antiseptic). IT IS ALWAYS ASSUMED THAT THE CAT GOT THE INSULIN AND YOU NEVER GIVE ANOTHER SHOT. It is always better to miss a shot than to give too much insulin.
• AMS/PMS: morning (AM)/evening (PM) shot
• AMPS/PMPS: morning pre-shot test/evening pre-shot test (it's assumed the shot is given within 15 minutes or less of this test).
• +1, +2, +3...: How many hours after a shot, i.e. +1 would be one hour after their last PS (pre-shot) test
• BG/BS: Blood Glucose or Blood Sugar (numbers). Usually used in relation to testing and dosing and what "level" or "point" the cat is at. Used in a sentence: "Michelangelo's BGs have been high so I've been increasing his dose."
• AMBG/PMBG: morning/evening Blood Glucose. Used when no shot has been given at the regular shot time.

 

[BJM]

We suggest using an inexpensive human glucometer with pet-specific reference numbers. One many of us use is the WallMart 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.)