Newly diagnosed - totally overwhelmed

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Michele&Errol

Michele&Errol

Member Since 2013
Hi my 9yr old DSH Errol was diagnosed with Diabetes yesterday. I am panic stricken as I realise I have to do something quickly and I don’t feel the vet is giving me 100% correct up to date info. I’m in S. Africa, so what is relevant in the USA, may be impossible here.
I know I have to change his diet 100%. He was brought up on Royal Canin and I changed to Hills about 2yrs ago and onto Hills Light about 1 year ago. He was never overweight really, perhaps slightly well covered, but he is a very big built cat. The vet certainly didn’t think he was overweight when I had him checked about 4 yrs ago.
When I look back, I realise his extreme hunger was probably the beginning of diabetes, but I thought it was typical ‘always hungry cat’ syndrome. Needless to say, I feel sick at the thought of that. About 12 days ago, he started urinating and drinking excessively but I put it down to the extreme heat. Then two days ago his appetite almost disappeared. Took him to the vet yesterday am, and he was diagnosed with Diabetes. Was told with insulin, he could have another 3 – 4 yrs.
I was given Lantus and told to administer 3 units bi-daily. Kitty wasn’t weighed, vet felt he had enough experience after 30 yrs to know how much. I had done some reading, and wanted to get a glucometer but was told I would stress kitty and myself out terribly if I tested so many times.
I also read that PZI was a better suited insulin but we can’t get it in S. Africa.
Also, we don’t have access to rabbit or turkey so am at a loss as to what to make a homemade diet from as all the best diets seem to be rabbit or turkey. I’m also really worried about making a balanced diet, and not causing another health issue whilst trying to fight the diabetes and possible future CKD.
As you can probably tell, I’m in a bit of a state, when I read everything on this board I feel my chest tightening and I don’t know if I’ll be able to do everything right and in time for my cat (who is my child, along with my other 2 slightly younger cats). I’m prepared to go the extra mile but I just do not know where to start.
I don’t want to do anything stupid and waste time so if anyone has any advice it will be greatly appreciated. I am going to get stuck into reading as much as I can on the board but it is overwhelming.
I hope you don’t mind random questions, I will really try and search for answers before asking them, but I feel time is of the essence.
Anyway thank you for reading this :)
 
Welcome. Testing your cat's blood glucose level does not really stress a cat. I current have four diabetic cats and test their blood at least twice daily with no problems. For one of them. Patches, I have been doing that for almost nine years. Yu should get a hman meter and start testing. Preferably before each insulin shot and in between shots to determine the right dose.
You say yo are using Lansac insulin. Is that really Lantus?
Three using twice daily is really a high starting dose. Usually the starting dose is 1 unit twice daily.
For dies do y have any canned commercial food available? I do not know what is available is South Africa. It is hard to prepare your own food since it is hard to get the right combination of ingredients. Here is one receipe
http://catinfo.org/?link=makingcatfood
 
Thank you. Sorry about the double post, the first one disappeared only to reappear later. I'll try and delete it to avoid confusion.
That's what I'm starting to realise - after reading the http://www.felinediabetes.com/AAHADiabe ... elines.pdf on this board, I'm starting to see it's imperative to test regularly at home. I can get a glucometer very easily, there are a few makes, is there anything specific it has to have? Is it easy to interpret the results?
Yes, apologies, it is Lantus.
Yes, we have some commercial tinned food which I could use until I can work out a better diet. I'm not sure the canned diet is the best, but we have Whiskas, Pamper, and a couple of others.

OK, just read http://www.felinediabetes.com/start-low-go-slow.htm : " If your cat's blood glucose was less than 400 mg/dl (22.1 mmol/L) at diagnosis, or if your cat is on a low-carbohydrate diet, the starting dose should be only 0.5-1.0 units twice per day."
My cat's BG was 22.4 at the vet after a 30 minute car trip with him quite stressed and crying which would make the BG level higher than normal perhaps? So should I reduce his insulin to 2U bi-daily instead of 3U bi-daily??
 
I would start with the canned. Typically ones without gravy are lower in carbohydrates. You want low carbs. This may help finde low-carb canned food:
viewtopic.php?f=28&t=64843
Most human meter are fine. What meters are available to you?
It is not that hard to interpret BG results. To make it easier, it is recommended that your create a Google docs spreadsheet. For how see:
viewtopic.php?f=6&t=50130
 
Hello and welcome. You will find a lot of helpful information here. Don't be afraid to ask questions and ask the same question more than once if you need to. We all want to the best for you and Errol.

In regards to your question about what to feed, there was a lady that used to post here that was in South Africa. Her profile states she used this recipe from Dr. Lisa Pierson http://catinfo.org/?link=makingcatfood#The_Recipe. She also fed Fancy Feast (Varieties with 10% carbs or less). You should be able to find the carb percentages from the links Larry posted.

I hope this helps.
 
3 units is a high starting dose for Lantus (which is a good insulin by the way). I would reduce it to 1 unit especially if you are making a food change. And I strongly recommend home testing as many cats go into remission with a food change. If you can find a human meter that would be great. We can advise on how to test and when etc.
 
Thank you very much everyone. I reduced the dose to 2.5U before I read this (no internet connection today) so will it definitely be safe to reduce to 1U from tonight?
Can you please tell me exactly how to home test? I think I have to do this pretty urgently.
I have another problem. Yesterday evening kitty wasn't very hungry, nor this morning. This evening he has refused 5 different types of food ranging from fresh beef, fresh chicken, two types of tinned food and even dry (Orijens) which I tried as a last resort.
What now? The vet said if he doesn't eat I cannot give him the insulin. Please help!
He went from a raging appetite for years to not hungry - I am reading as much as I can here, but cannot work out it if is because the diet change has regulated his BG or if he has a secondary problem?
 
I would quickly go to a drug store and urine dipsticks that measure ketones. You can get them alone or in combination of ones that measure glucose in the urine too. If there are ketones in the urine that is serious and and er vet visit is necessary.
Sometime diabetic cats (and people too) get what is called diabetic ketoacidosis
http://en.wikivet.net/Diabetic_Ketoacidosis
 
Here are some ear testing tips to help you get started.

As to not eating = not giving insulin, that is old and out-dated for use with other insulins (like caninsulin, vetsulin, humulin). With Lantus, you can give insulin if they're not eating but their numbers are still high. You definitely want to be home testing if you do this because they may need a reduced dose (lack of food does result in a decrease of carbs affecting glucose numbers). Either way, you really want to make sure your cat starts eating again as soon as possible, even if you have to syringe feed them. Cats can quickly develop hepatic lipidosis from not eating within just a couple of days. Diabetic cats can also go into diabetic ketoacidosis if their lack of appetite is being caused by an infection and if they're not getting enough insulin. You really want to stay on top of that and bring him back to the vet if he's still not got his appetite back because you want to prevent something more severe from happening.
 
Larry and Kitties said:
I would quickly go to a drug store and urine dipsticks that measure ketones. You can get them alone or in combination of ones that measure glucose in the urine too. If there are ketones in the urine that is serious and and er vet visit is necessary.
Sometime diabetic cats (and people too) get what is called diabetic ketoacidosis
http://en.wikivet.net/Diabetic_Ketoacidosis
Click to expand...

Thanks Larry, I don't think he's near that stage, but it is something I worry constantly about obviously and keep an eye on. I phoned the only pharmacy chain we have here and they do not stock the dipsticks. They recommended I get from a veterinary wholesaler but they'll only be open tomorrow. Even so, in this country there are certain things they only sell to vets. Ridiculous, I know.
There is a machine which tests for both BG and ketones - I don't know how accurate it is? The strips are very expensive so wouldn't want to get it if it weren't viable.

KPassa said:
Here are some ear testing tips to help you get started.

As to not eating = not giving insulin, that is old and out-dated for use with other insulins (like caninsulin, vetsulin, humulin). With Lantus, you can give insulin if they're not eating but their numbers are still high. You definitely want to be home testing if you do this because they may need a reduced dose (lack of food does result in a decrease of carbs affecting glucose numbers). Either way, you really want to make sure your cat starts eating again as soon as possible, even if you have to syringe feed them. Cats can quickly develop hepatic lipidosis from not eating within just a couple of days. Diabetic cats can also go into diabetic ketoacidosis if their lack of appetite is being caused by an infection and if they're not getting enough insulin. You really want to stay on top of that and bring him back to the vet if he's still not got his appetite back because you want to prevent something more severe from happening.
Click to expand...

Thank you, I got him to eat a little boiled chicken pieces last night, and again this morning. Just enough to feel safe about giving him the Lantus but it's not balanced and I have to find something that will give him the nutrition he needs. When I read the amount he needs to eat in any 24hr period I despair of getting that into him :(
He has not lost any weight, despite the lack of much appetite.

Wendy&Tiggy said:
I don't like that he is not eating, here are some tips for getting your cat to eat... Scroll down the page... https://docs.google.com/document/d/1NSWUx2ak7wcs2_G5TXr7BhPMrU7CVmW_3ouKPTUQhhA/pub

If he isn't eating within a day you will need to take him to the vet as more serious conditions can then occur. I also wonder about pancreatitis,

Wendy
Click to expand...

Thanks Wendy, I read through that and have tried what I have, as I mentioned I managed to get him to eat a little chicken. I will syringe him if he doesn't eat, but would like to know the cause of not eating. I checked out Pancreatitis and unless it is in the very early stages with him, he shows no symptoms of that nor diabetic ketoacidosis. I realise this can change quickly.


I am disillusioned with the vet, and am pretty sure I'm going to meet the same resistance and opposition to home testing, amount of Lansac to give, diet (they all recommend the dry food developed for FD). He was also dismissive of me as soon as I said I didn't want to feed a dry kibble with a large carbohydrate % as this is (probably) what caused the FD in the first place.
I know as soon as I asked certain questions the shutters went down and there was total lack of interest in anything other than the protocol which they are taught at vet school. Incredibly frustrating. I will see if there is a 'FD specialist' here tomorrow, but I don't hold out much hope as I've had to deal with the closed mind attitude on various occasions. Thank goodness for this board, where more UTD information is available and where lay people are taking control of their cat's wellbeing.

It sounds like there is no ‘standard dose’ of Insulin for a cat. They need to be monitored to give the correct amount every single day. Why would the vet be adamant that 3U is the correct amount and only want to see him in a week to check BG? I find this hard to accept.

I have a few questions if you don't mind:
1. Ruling out diabetic ketoacidosis and Pancreatitis, what would cause his appetite to shrink, from having been starving?
2. Considering his appetite has diminished, why has he not lost weight?
3. His thirst drive has also diminished. It was huge for 10 days, then 2 days after Lansac treatment it is ''normal''. Is that normal?
4. This morning his urine was dark orange and back to the normal quantity. I know that is concentrated, and could this be due to the Lansac or does it purely mean he is not getting enough water? I've made sure his food is wet. Could he be getting enough water from his food now?
5. Is the vet correct in saying I don't have to give the insulin exactly 12 hrs apart, if it' s more or less it is OK?

Thank you so much for taking the time to respond.
 
You can give insulin, especially Lantus, when not eating full amount. In that case you have to monitor BG before shots and maybe between shots to help ensure that he will not go too low.

1. Ruling out diabetic ketoacidosis and Pancreatitis, what would cause his appetite to shrink, from having been starving?
Just not feeling good. Half my cats do not each much and I have to syringe feed them. The vet has not idea why
2. Considering his appetite has diminished, why has he not lost weight?
Do you have an accurate scale and are they being weighted at same time?
3. His thirst drive has also diminished. It was huge for 10 days, then 2 days after Lansac treatment it is ''normal''. Is that normal?
Yes, that is normal for an regulated kitty. If they eat only canned food (no dry), a cat would drink very little if any water.
4. This morning his urine was dark orange and back to the normal quantity. I know that is concentrated, and could this be due to the Lansac or does it purely mean he is not getting enough water? I've made sure his food is wet. Could he be getting enough water from his food now?
Yes.
5. Is the vet correct in saying I don't have to give the insulin exactly 12 hrs apart, if it' s more or less it is OK?
I usually give mine at 12 hours +/- 1/2 hour. A few years ago I was on a 18/8 hour schedule on the weekends. Not optimum at all but my cats did OK.
 
Thank you Larry. You guys on this forum are a godsend. I'm sorry for all the silly questions, and I've done a fair amount of reading here but it's nice to bounce things off those who are doing it for themselves.

I went out this morning and bought a Bayer Contour TS glucometer and have tested it on myself. It's now 16h00. Kitties eat at 07h00 and 19h00. When should I start testing his BG and how many hours apart? I read on one of the stickies that it has to be every 2hrs for the first 24hrs, and then I read somewhere else that it should be done a few times during the day after a feed. Which is correct?
Thank you again!

Oh, nearly forgot: I enquired about Ketostix and Ketodiastix but they've been discontinued in SA. There are some other ones, but they have an extremely short shelf life, are very expensive because they can only be purchase in quantities of 500 or 1000. So I will have to forgo those unless I can find them elsewhere.
There is a machine which does BG and Ketones, but it requires a lot of blood so is also out of the question.
 
I am sort of surprised the ketostix are not available but then again I am not familiar with SA.
There is really to reason to test every 2 hours with Errol not eating normally. I woud test before each shot and then maybe 3 and 6 hours after shot. It all depends upon how much Errol is eating and preshot BG.
 
To practice, I have just tested him, he last ate at around 08h00, it's now 16h30 (8.5hrs later) and his BG says 4.3 and 4.7mmol/L. Not sure what this is in USA measurements? Is it normal, too high, too low?

He was 22.4mmol/L at the vet clinic now down to 4.3mmol/L 4 days later at home.

He is grooming, affectionate, and seems a bit quieter than usual. He hasn't drunk much today, but then he's really only eaten wet food.
 
He's doing well. For us US folks, we multiply those numbers by 18. The chart below has the range they fall in highlighted in blue. They are good numbers.

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- no shot limit for ProZinc, PZI, or other non-depot insulins

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mg/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
 
BJM said:
He's doing well. For us US folks, we multiply those numbers by 18. The chart below has the range they fall in highlighted in blue. They are good numbers.

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

= 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- no shot limit for ProZinc, PZI, or other non-depot insulins

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mg/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.
Click to expand...

Oh I can't tell you HAPPY that makes me!!!!!!!!! I was worried because I changed his diet dramatically, not sure if that's a good thing? I caved in an hour ago and gave him a tablespoon of Hills Light just because he seemed a little flat again. I've got his insulin at 2U, what should I do - drop it to 1U or keep it at 2U?

Thank you guys so much
 
Generally, changing the diet drastically and fast can result in GI upset. Its done now, so just keep going from here.

How many days has he been on this dose and how many days has he been on this revised diet?

As an FYI - we change insulin doses in quarter units - 0.25 - because cats are so small that bigger changes can miss the best dose. You have to eyeball these as no syringes measure in quarter units.

If you're lucky, you have syringes with half unit markings. If not, you may want to get a ruler with millimeter markings and line it up to the syringe and note which mark equals 1 unit and go from there to keep your measurement consistent. No, it won't be exact unit measures, but it will be consistent.
 
Thank you. He was diagnosed on Wednesday morning, vet prescribe 3U Lantus bi daily. Kitty was off food am and pm, so decided to start a wet diet immediately i.e. Thursday evening, so that's 3 full days now.
I have 0.03U syringes which do show 1/2 U so I should be able to more or less gauge what 1/4 of a U is hopefully. Over how long a period does one do the increase or decrease?
 
Gave 2U Lansac about 30 minutes after he ate at 8pm, and tested at 21h45 and it's shot up to 13.1 Is this something I must worry about, advice please!
 
You mean Lantus, not Lansac.

And most cats demonstrate a food spike roughly 2 hours after eating.

It helps to test, feed, and shoot within about 15 minutes time, so the Lantus can start kicking in when the food does.

It also may help to feed 2-3 mini-meals, separated by an hour or so, to space out the incoming carbohydrate in the food.

While you work on the spreadsheet, please report numbers as
AMPS = morning pre-shot
PMPS = evening pre-shot
+1 = any test done 1 hour after insulin
+2 = any test done 2 hours after insulin
+# = any test done # hours after insulin.
Why? Because we're in different time zones and interpreting the glucose level depends on its relation to the shot. Rather than having to figure out your time zone vs our time zones, this quickly lets us know how long it has been since insulin was given.
 
You may find it helpful to read over the Stickie Notes at the top of the Lantus Tight Regulation forum.

Lantus is a depot insulin, so its effects are cumulative. In other words, the first dose takes about 5 days and any later dose takes about 3 days to stabilize due to overlap in effect.

The estimated starting dose is the lower of current or ideal weight, in kilos, times 0.25 rounded down to the nearest quarter unit.

How much does your kitty weigh?
How much should your kitty weight?
Take the lower number.
Convert to kilos (pounds / 2.2) if needed.
Multiply by 0.25.

Compare this to the dose you are giving. You may want to reduce your dose if your current dose is higher. As the insulin builds up, a higher dose could be too much and lead to a hypoglycemic episode. If you don't reduce, it is critical to get tests in the +5 to +7 hours after a shot to see how low the cat is going.
 
Deb & Wink said:
Here is a link to some food possibilities that you might be able to order via the internet.

Canned cat food for EUROPEANS and INTERNATIONAL buyers It's one of the topics in the Feline Health forum, a sticky that is up near the top of the posts.
Click to expand...

Hi Deb, thanks so much. I've read through that and the only foods that we can get are the big brands, RC, Iams, Hills, Whiskas, SOME Friskies (dry kibble and poor quality wet food in sachets), SOME Fancy Feast (no pate), and then some other very low quality brands which are loaded with carbs which my cats wouldn't touch anyway. Right now I am trying to get him to eat anything that looks more or less safe and isn't purely corn and carbs like the first 3 on my list are. I will eventually have to work out a meat diet for myself but right now it's impossible to get the correct ingredients. It's not like the USA or Europe where you can order online. I also need something which is easily accessible so that I can stick to it. Fact is, my cats do not like wet food at all, are addicted to the horrid H kibble and I am battling to get any 3 of them off it. I feel like a parent with a child on a prohibited substance cat(2)_steam
 
BJM said:
You may find it helpful to read over the Stickie Notes at the top of the Lantus Tight Regulation forum.

Lantus is a depot insulin, so its effects are cumulative. In other words, the first dose takes about 5 days and any later dose takes about 3 days to stabilize due to overlap in effect.

The estimated starting dose is the lower of current or ideal weight, in kilos, times 0.25 rounded down to the nearest quarter unit.

How much does your kitty weigh?
How much should your kitty weight?
Take the lower number.
Convert to kilos (pounds / 2.2) if needed.
Multiply by 0.25.

Compare this to the dose you are giving. You may want to reduce your dose if your current dose is higher. As the insulin builds up, a higher dose could be too much and lead to a hypoglycemic episode. If you don't reduce, it is critical to get tests in the +5 to +7 hours after a shot to see how low the cat is going.
Click to expand...

Thanks BJM, you know, the vet didn't even weigh him - said he didn't need to - and my bathroom scale is not accurate enough. Thank you for the info and explanation and when I take him back there on Thurs I will insist on him being weighed. Sigh. FD is definitely not a disease with a one size fits all generic treatment plan. Hold thumbs I can find a GOOD FD specialist this morning.
 
BJM said:
You mean Lantus, not Lansac.

And most cats demonstrate a food spike roughly 2 hours after eating.

It helps to test, feed, and shoot within about 15 minutes time, so the Lantus can start kicking in when the food does.

It also may help to feed 2-3 mini-meals, separated by an hour or so, to space out the incoming carbohydrate in the food.

While you work on the spreadsheet, please report numbers as
AMPS = morning pre-shot
PMPS = evening pre-shot
+1 = any test done 1 hour after insulin
+2 = any test done 2 hours after insulin
+# = any test done # hours after insulin.
Why? Because we're in different time zones and interpreting the glucose level depends on its relation to the shot. Rather than having to figure out your time zone vs our time zones, this quickly lets us know how long it has been since insulin was given.
Click to expand...

I am trying the small meals spread out so that his BG doesn't spike. I'll be happy to get him to just eat more, and will speak to the vet today about something to increase his appetite which won't interfere with his FD or the Lantus.
I will try and do a spreadsheet - not very PC literate hope I can manage.
 
I usually recommend 3-4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

Let us know if you need help with the spreadsheet!
 
Ok, so I have not managed to do a curve yet with work. I will have to do it this weekend and the spreadsheet oo. The vet returned my morning call tonight, and he said to put him on an appetite stimulant. There is apparently no diabetes specialist here. I have gotten him to eat tiny amounts four times today, not nearly what I'm happy with, so hopefully the appetite stimulant will help. The bad thing is, it looks like I am going to have to resort to Hills WD or Royal Canin as he will not eat wet food at least for the interim until I can find a suitable home made diet though he is probably going to refuse to eat that too.

Can you please explain the too low number you quoted of 200? I thought the too low number was 40? I think I've misunderstood something. Thank you.
 
The low number at any point in the day is 40 - if he drops under that then he earns a dose decrease and you may need to bring him up with high carb food and /or syrup.

However the 200 number is for pre shot only. As a newbie you don't want to shoot if his pre shot test number is under 200

Does that make sense?
 
Yes thank you Wendy, it does. Until the weekend when I am able to do a curve I'm just going to check as many times as I can, which will be the 4 you recommended.
Unfortunately I wasn't told this by the vet and I have given insulin when he was below 200 (11.11mmol/L) as I wasn't aware of this. Preshot was 154.8, an hour later it dropped to 90 and now just over 2hrs later it is 28.8 (1.6mmol/L).
I have given some high carb food and some syrup even though he is showing no symptoms of hypo but I am now in a state of controlled panic. I won't sleep tonight and will check his GB every hour. Is there anything else I can do?
 
Your readings today show why you need to be careful about shooting low. When did you give him the syrup? Please test again asap as the syrup can wear off and then he could drop again. Let me know I will wait here.

Wendy
 
I gave him the syrup and food 45 minutes ago and have in the last 2 minutes taken his BG again it has risen to 5.1
I will stay with him and check every 45 minutes if that is OK unless I need to do it more often? Thanks.
 
ok. Hold off on syrup and high carb for now. Measure him again in 30 minutes and see where he is and let me know. We need two readings in a row to be rising (without high carb or syrup) to be in the clear.

Was it high carb wet you gave him or dry?

Let me know. I will be here in 30 minutes.

Wendy

PS this means his dose is too high. Tomorrow lets start from scratch at 1 unit and work up slowly.
 
I gave him dry Hills Light kibble as this is literally all he will eat.
thank you Wendy.

Yes, I've been worried about his insulin being too high. 3U was prescribed by the vet but after reading this board I lowered it to 2.5U and then was told to lower it slower in .25 increments instead which I did until I got it to 2U which is what he's on now.

Because the Lantus is long acting, is he going to be at risk until it wears off in 9 hours, or will he be ok if his BG shows an increase at the next test?
 
Ok well the good news is that the dry will hang around in his system for a while so he may not drop low again soon. The bad news is we don't know how long for as dry hangs around a while and can still wear off and he could come shooting back down. Usually we just give wet and a drop syrup as it gives more control of whats going on.

Anyway lets see where he is in 30 minutes. We might need to get some tests later as well to be sure he clears the lowest point in the cycle which is usually around +5 or +6. (5 or hours after shot)

And definitely restart at 1 unit tomorrow.

I will be here in 30.
Wendy
 
Very difficult to give exact quantities as I have been offering him various things, most of which he has refused. About 2 teaspoons of Whiskas in the pouch, 1 1/2 chicken hearts, +-20g Hill Light, a few tiny pieces of lamb, a tablespoon of low fat milk.
 
Thats probably about 100 calories. thats not too bad. Not enough, but not too bad.

Whats his BG now? Its been 30 minutes right?

Wendy
 
Ok, really battled to get enough blood eventually after 3 attempts. It's 8.2mmol/L as of 23h25 my time which was 4 minutes ago. Not sure what time zone you're in but probably about 6 - 8 hrs behind SA.
(If my calculation is correct that's 147.6 )
 
Yep its 4.30pm here right now.

Ok his BG is pretty good. I would go snooze and set the alarm for another test in 2 hours to make sure it hasn't worn off. I will be here keeping an eye out for you.

What makes you think it isn't pancreatitis?

Wendy
 
That's the thing, he wasn't tested for anything other than the basics so I don't know for sure. I see that IDEXX does a blood test for it which they say is the most definitive diagnosis. I think we have an IDEXX in this country so will find out tomorrow.
It says cats don't show many symptoms, but in your experience what would I be looking out for? Errol has only ever vomited if he has a hairball, has always been a very healthy cat and this diabetes seemed to come out of nowhere, which I know it didn't but there certainly weren't any signs I saw. Apart from having a very big appetite which is common to many cats apparently.

Yes, I think I'll doze for a while and take BG again in 2 hrs as you say. I can barely keep my eyes open,not been sleeping since I got the diagnosis from the vet, waking up in a panic throughout the night. And now I feel so guilty about this hypo episode.
 
About the only thing he will eat is what he ate before. He started leaving a little of his supper on last Tuesday evening. I took him to the vet on Wednesday morning. The week before he was his usual ravenous self. Since last Wednesday he seems not very hungry at all, and seems to only want to eat the Hills Light which he has been on for nearly a year.
 
ok well its important he eats so keep him on the hills dry for now and keep trying other canned foods when you think he might want them. Then hopefully the insulin will start to do its job and he will feel better and starting eating more. and at that point we can work on transitioning the food to a good wet.

Wendy
 
That's great advice Wendy, thanks. I shouldn't have tried to cold turkey him, I was just so worried I think I treated it all wrong. I thought the sooner I got him off the bad food the sooner he could recover and since he didn't really want to eat it anyway.. If he will eat the Hills WD instead of the Hills Light do you think I should rather let him have that and transition him over when he's feeling better?
I spent most of Sunday trying to shop for good tinned food, to no avail. Limited choice. So I'm definitely in need of some ideas :)
 
For now the goal is to get him to eat - so whatever he will eat.

Then i would try

Iams - maximum calorie plus is only 9% carbs.
Hills - are all too high carb
Royal Canin - recovery RS is 7% - otherwise they are all too high

What kind of whiskas can you get access to? and what kind of fancy feasts? We might be able to find some low carb flavours.

Also I sent a PM to another experienced member in South Africa to see what she feeds - I think its fancy feast but we will see.
Wendy
 
Just tested and it's shot up to 18 (324).

Thanks for the food ideas. I will find out exactly what Whiskas we can get. I couldn't find any FF pate of any sort, nor any Whiskas.

Iams - maximum calorie plus is only 9% carbs : Iams SA does not import this particular one from the USA.
Hills - are all too high carb : the only thing I could find at the 5 veterinary clinics I went to was Hills W/D which I bought a small bag of and he has just eaten a tablespoon of it. He refused point blank to even smell the Royal Canin RS
Royal Canin - recovery RS is 7% - otherwise they are all too high : bought some tins this morning but he won't eat it.

When I went to various supermarkets on Sunday I couldn't find any Whiskas or Fancy Feast pate. Just a very small selection of either pouches with gravy or jelly Whiskas and Fancy Feast just a few types with or without gravy. He will not even sniff any tinned food. The only food he will eat is Hills. Believe me, I have tried, and it is driving me crazy that he is so addicted to the stuff.

At the one vet clinic I went to, the nurse said I must try the RC Diabetic Feline but she didn't have in stock so has ordered it and it should arrive at 6pm tonight. She said it has the best palatability.
This is not what I want to be forced to do, having to feed him kibble, but the other option is starvation. Please don't think I'm not trying my best, at my total wits end. I haven't even eaten myself properly in days or slept much and am about to collapse.
 
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