Newly diagnosed!

Status
Not open for further replies.
L

lizhazel29

Member Since 2013
Hi everyone! My Tigger (domestic short hair neutered 7 year old male) was just diagnosed at the beginning of June. I have been reading all your information and posts, and honestly, my vet was really impressed with all the knowledge I had accumulated. Having a new sugar kitty is scary, but once I set my mind to it, checking his blood sugar and insulin injections have been going well!

Tiggy doesn't mind his blood being checked AT ALL, I'm really kinda amazed because he's an angry cat at the vet (and at home with the vet) so I have to do 100% monitoring. I have been reading on techniques for giving the insulin...one little hint I'd like to share - BRING THE INSULIN TO ROOM TEMPERATURE BEFORE GIVING IT. Tigger was REALLY REALLY sensitive to the cold and the first time I tried to give it fresh from the fridge without warmed he ran and broke the needle....I've noticed if I drawn the insulin, and then play with him and pet him for about 5 minutes, then give the shot, he still doesn't like it but he doesn't freak out like he used to. Its a lot easier for him I think when its room temperature.

thanks to everyone for all the great advice I've been reading and all the helpful info on the main page. This was the first place I came when Tigger was diagnosed.

All my support!
Liz, Tigger, and Princess.
Lantus 1 unit twice a day
Purina DM dry food (he hates wet food)
 
Welcome. If you are olny giving one unit of insulin or so , the insulin will be warmed by the syringe unless you also store the syringes in the fridge.
 
If you're stuck with dry food, Evo Cat & Kittern, Wellness Core in the tan and Gold bag, and Young Again 0 Carb are over the counter options for variety and possibly cost savings over the D/M prescription food.

Have you had a chance to read Cat Info? Dr Pierson has a lot of tips on transitioning to canned or raw diet which you might consider. It took her 6 months to transition one of her cats, so persistence is critical.

Good for you on the testing, too. That's a hurdle many folks find difficult. We have a Google Docs spreadsheet to track the glucose tests. Because it is online, you can let others review it and give you feedback on any patterns they observe.
 
Hi guys! Thanks for the tips - I don't store my syringes in the fridge so they aren't cold. But I did switch to a kroger brand (our local grocery store) needle - maybe that made the difference? I dunno! Its all trial and error at my house!!

I tried different wet foods, and found that the normal cat scarves it all down after Tigger turns his nose up at it. She's gained weight!! So I stick with the Purina DM for now because I know he likes it. His BS went from 580 at diagnosis to now at 370s. I know it takes time but I'm encouraged!

:)
Liz and kitties
 
Looks like Tigger could use a dose change. We could help with that if you could set up our spreadsheet.

For those people home testing, we have a wonderful way to keep track of the test data and shots. There is a google spreadsheet template you can use so you don’t have to start from scratch and figure out what you want it to look like.

We have instructions on how to set one up. how to setup a SS and link to your signature The color coding is helpful to see trends over time in how the insulin is working. We even help set them up for people that may be technology challenged. Please ask if you need help.

Having a SS set up and linked to your signature is a great way to get some suggestions from the experienced people on FDMB. You can even share the spreadsheet with your vet, by email. It's totally optional but it can get you some great advice on how to manage your cat with his BG numbers.

What do you think? You can look at Wink's SS in my signature to see what one looks like. I found it invaluable.
 
Since I just started the insulin last week, I'm waiting to see how his numbers look after a few more days before sending it in to the doctor. I'm really hesitant to adjust him until my vet oks it. :D
 
I should further clarify - Tigger was diagnosed June 2, started on DM food for a month to see how he did. Then of course, he didn't let the vet look/see/smell/touch him while he was at home, so I had to wait for my glucometer that I ordered through the mail - THEN I started the insulin July 11....Missed that important piece didn't I.. :S
 
I didn't catch what insulin you were using.

Good insulins for cats in the US are Lantus, Levemir, and ProZinc as they last roughly 12 hours. Humulin/Novolin, Caninsulin/Vetsulin don't last long enough in most cats.
 
Sorry I didn't respond, its been a bit insane here. Tigger is up to 3 units twice a day Lantus. He's fighting me pretty much every dose, but there are some days that he's ok with me giving him his shot. His numbers are still high (in the 350s) and yesterday when I got his BS it was 441 in one ear, and 401 in the other (I didn't think it was right, so I tried the other ear). I looked to see if my meter was working correctly with the control solution and it was. SO. I'm trying to make sure he gets the insulin whether he likes it or not, and some days it takes hours to get him to let me do it. I have fresh scars all over my hands... I inject in the scruff with the tenting technique, which works ok when he allows it.

so, I need reassurance that I'm doing everything right. I know it takes time to get the sugars until control. I just need reassurance....

Thanks for the ears everyone.
 
Hmm I have a few suggestions for tweaks here

1. What syringes are you using? Use a short syringe 5/16" then you might not need to tent .. so as much as pull the skin up by the fur and stick the needle in. And if you have the vet shave a few spots that will make it even easier. Do you do it when he is eating? Makes him distracted.

2. Did you try to transition to wet food? If you really cant get him to eat it no matter what then I would suggest you move to a lower carb dry to see if we can get his numbers down a bit ie Innova Evo Cat & Kitten 8%, Wellness Core Grain-Free Original Formula (tan gold bag)11%, Nature's Variety Raw Instinct chicken 7%, and Young Again zero Carb 0%.

3. what time of day are you testing? The key to see if a dose is working is not only to test preshot but also mid cycle (5-7 hours after the shot) to see how low the insulin is bringing him down. and do that a few days in a row just in case he is bouncing from a prior low.

Wendy
 
You might wear fingerless gloves and Kevlar arm covers (seriously - they make them for vets!) to protect yourself.

If he'll play at all, get a good 15-20 minutes of active play to wear him down a bit before testing.

And always treat - be it low carb food bits, brushing, etc.
 
Hi Wendy.

I use 5/16 syringes. I've tried the pulling the fur and sticking it in the skin, which he really didn't care for, so I tried the tenting technique. It really depends on what kind of kitty mood he's in that leads to my success. I can't explain it, he's just AN ANGRY DIABETIC CAT. LOL

I tried to transition to wet, but since I work it wasn't feasible because my non-sugar cat likes to scarve all the wet food right away, so Tigger wouldn't get any. I tried though, and used different kinds of wet food,and he really just didn't seem interested in them. (Princess on the other hand LOVED THEM). The purina DM is what my vet recommended, and he really likes that. I can ask my vet if its wise to change foods again. He seems really sensitive to that.

I try to test 6-8 hours post injection. I was told to do this for a few weeks and report my numbers back to the vet. She's very happy to help me on the phone since Tigg can't go to the vet (i.e. due to the whole ANGRY DIABETIC CAT syndrome). The vet wanted both pre-shot and 6-8 post shot, and honestly he's still in the 350-400 range. One time he got to 254 and I was really excited (it was 6 hours post). It only happened once though. :( do you recommend twice a day testing? Right now I'm only doing once a day. He doesn't mind the testing part - sits really nicely for me...so that's not an issue.

I guess I wanted immediate results....and with cats that just doesn't happen!! Thanks again.
Liz
 
I also treat after a successful shot - he really is so picky i give him like 1/4 of a normal treat and Princess gets the other part. Testing isn't the issue, giving the shot is...I honestly have scoured youtube for techniques...

He's not a food distraction kitty, I've tried that. He'll be eating and i'm trying to give him his shot and off he runs... Even tried chicken, NOPE. and tuna, NOPE. He just isn't distract able with food!!!
 
Really it depends on your goal.. the purina DM at 15% carbs is probably keeping his blood sugar high and it means you will need to increase his insulin more to bring him to a reasonable blood glucose level. Remission will be unlikely.

However a lower carb dry under 10% carbs will reduce his blood sugar and in some cases this board has seen it cause remission (much more likely with wet though).

I always recommend a test before every shot to ensure you dont shoot when he is too low. And a spot check during the day which i would vary a bit because low points dont always fall at 6-8 hours post injection..

Wendy
 
Thanks so much Wendy - I'll try switching his food to one of the ones you suggested. I'll also ramp his testing to two times a day (pre and 6-8 hours post). I really appreciate your help. I was getting discouraged!!
I'll let you know how I do.

(((HUGS)))
Liz
 
Can I also suggest you set up a spreadsheet? Like this? http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207
We use it here to track trends and it allows us to keep an eye on your kitty and advise you. Plus you can share it with your vet! let me know if you need help setting it up!

Transition in the new food gradually to avoid diarrhea -do it over about a week.

Lastly here are some tips for transitioning to wet - because it will make all the difference. Many people have managed it here - just takes patience! I know one person who did by increasing it by one tablespoon of wet a day .. Sometimes its just a case of finding a wet they really like too. I literally went to the pet store and bought 1 can of every low carb wet I could find. They love the fancy feasts.
http://www.catinfo.org/docs/TipsForTransitioning1-14-11.pdf

Wendy
 
Fantastic!!

Are you only dosing once a day in the morning? thats what it looks like on the sheet. Lantus only lasts 12 hours so I am confused.

Once you switch to a low carb dry i would strongly suggest a test before every singe shot as his numbers could drop and you dont want to shoot if his numbers are too low ( as a newbie thats under 200)

let me know on the dosing?

Wendy
 
If he's in the 300-400 range at mid-cycle, how high is he at pre-shot time?

I'd really like to see a couple of pre-shot tests. We recommend those pre-shot tests as a necessity before every shot of insulin. To make sure the numbers are not too low to shoot. Without those pre-shot tests, it's impossible to put the mid-cycle tests in perspective. How much did the 3U take him down after the shot? We don't know since there is no number to compare it to.

Since you said he is easy to test, how about a regular pre-shot test from now on?

We recommend a mid-cycle test each day if your schedule allows it and also a before bed test. That makes it 4 tests a day. Think he'll let you do that?
 
Is the "PMPS" on the spreadsheet the pre-shot number? i'm a bit confused so bear with me...

His pre-shot numbers are roughly high 300's to 440 at the highest. He started out at 580 when he was first diagnosed.

I'll be doing the pre-shot testing now every time. Maybe it'll be easier to give him his insulin because he sits so nicely for the pre-shot. *crossing fingers*

I changed the ss to show the second dose. I'm still learning all this stuff, and since I don't use google much, its a bit more complicated.
Thanks again for the advice.
Liz
 
And one more thing - I ordered the Young Again Zero Carbs to try for him...a little bit more expensive than the vet, but honestly it'll be worth it!!!

and Tigger lets me test him whenever I want, so multiple tests throughout the day would be fine with him...
 
Yes, the Young Again Zero Carb may help. Many people have reported that the poops are quite odiferous on the YAZC, more than 2 months from some reports.

AMPS = morning pre-shot test
PMPS = evening pre-shot test
+1 = one hour after the shot
+2 = 2 hours after the shot
U = Units
Remarks. Anything noteworthy. Behaviour if he seems different, what he is eating and how much, note a poor appetite, any additional medications he is on, etc.

We'll keep our fingers and 3 sets of paws crossed here that his pre-shot testing makes it easier to give him the shots.
 
OK so I pre-tested him this morning. And of course he sits nice and pretty for me. Then right after I gave him his Lantus. Sat nice and pretty for that too. Gave him a tiny treat and he was off to start his day.

PLEASE let this continue.... ;-) It was a good morning!
Liz
 
Let the trend continue! Those treats for the pre-shot test also work great for the shots.

Be interesting to see if he continues to "sit nice and pretty" for you.
 
If you're still having difficulty with shots, try using a different length needle as Wendy suggested. There are "short" needles, which are 8mm (5/16") or "long" needles, which are 12.7mm (1/2"). My personal preference is the long needles, however my brother (who occasionally gives Mikey his shots) prefers the short needles.

Where are you giving him the shots? If in the scruff, try changing it to the flanks or the sides. You can also try giving "flat" shots (no tenting). Practice on a cut apple or potato first to get the technique and angle down and to prevent poke-throughs. You gently pull the skin flat and go in at about a 15-25 degree angle, slightly steeper than parallel to the skin.
 
Some of the following clarify why we encourage blood glucose testing.

ETA: updated to include AlphaTrak and mmol/L
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}
- 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 mf/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.
 
Can you get a few mid cycle tests in the next couple of days? and a before bed test every day?

I havent seen anything but pinks and want to be sure he is coming down a bit before a dose change.
 
Hi there - last two insulin shots were fur shots (yesterday's numbers). Changed him to Young Again zero carbs late on Wednesday. Today's shot was good!! I'm hoping the numbers start coming down with the change of food.

YA called me and talked to me for about 20 minutes about Tigger, asking questions about how his insulin regime is going and what food is he currently eating. Jennifer (YA mgr) told me I'll see a drop in his number quickly and to check before his insulin shot is due. she also said that the majority of their DM cats get off of insulin all together with the change to the zero carb food. Sometimes it takes 6 days, some times it take 6 weeks. I'm really hopeful! he likes the food, and that's a huge hurdle plus they have treats!!!

Liz
 
Hi Liz, would you please add the meter you are using to your signature? We'd really appreciate it.

A general location in the edit profile, Location field would be nice to see also.

Thanks for your consideration.
 
All good now. Thanks for the additional info in the signature.

Let's hope the new YAZC food does the trick and brings down those numbers. Keeping our fingers and paws crossed and hoping for no more fur shots. ;-)
 
Tell me what OTJ means?

Yeah fur shots are no fun, he likes to take off when he hears the cap come off the needle..LOL

Liz
 
OTJ stands for off-the-juice, insulin being the juice. It means the cat is diet controlled and does not need insulin shots. The cat is in remission, still diabetic but the bean (short for human being) doesn't have to give shots and only tests once a week or less.
 
Can you put (fur shot) in your U columns for those days you think you gave a fur shot? Just so we know.

It can take a couple of days for the high carb dry to clear the system and the blood glucose to drop so keep testing and paws crossed! We may still need to increase the dose after to break any insulin resistance but lets give the new food a few days first.

Wendy
 
Did you get a before bed test? I hope so with these numbers cos it looks like he was dropping

If you see a low preshot like this a before bed test gives you more info - like if he is dropping and by how much. If the before bed (2-3hours after evening shot) is a bit lower than the preshot you might want to set the alarm for a mid cycle test as it can mean an active cycle.


Wendy
 
Because I usually space 12 hours (he got his am shot at 9 am and pm shot at 9 pm) 9 pm is the evening shot - his pre-shot was 252 this was before bed. We usually go to bed about 10 or so. He was a bit lethargic this morning but his bs was 367 before his 730 am shot. I was gone until 3 pm - found a little bit of throw-up. Tested him at 3 pm and he was 152 which is the LOWEST he has ever been. Didn't eat his treat either this morning or this afternoon after testing. I'm going to do another test in about 2 hours to see how he's doing. Not sure what to make of the drastic drop? Could it be the food?? Should I be concerned about the little throw up? It was the color of his food...

Thing is, yesterday we bought him a new feather toy that had ribbons in it, and he ate two small pieces of ribbon (and then threw them up) so I cut all the ribbons out of the toy - who the heck would do that on a cat toy...I was stupid for not doing it right away (only had it for like 30 minutes before he ate the 1/2 inch piece of ribbon)...could the puke from today be residuals??


Liz
 
He could be coming down from a bounce... See below.. That's why more testing is important today.. We want to know how low he went that he triggered that bounce.. If its under 50 he gets a dose decrease.

Also you might be heading to a low PMPS and shooting low so please get a +11 and come here and let us know so we can prepare to help you through it. No food after +10.

Read this too. http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

Wendy


Bounces - what are they and is my cat doing them?
When a cat is first diagnosed, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.
 
I'm going to do hourly testing until his next shot is due - which is 730 pm. I'll post as soon as I draw, so you know. Are bounces common? He's been 350s since I started and this is the first real difference I'm seeing. I'm sure its the combo of food and insulin. I won't shoot if he's under 200 at 730 but I"ll continue to do hourly tests until I go to bed just to make sure he isn't in the danger zone.

Should I be concerned about the throw up?
I really REALLY appreciate this help.
Liz
 
Bounces are VERY common.. Cats tend to bounce for a while and then possibly stop bouncing and go into remission.

I wouldn't worry about two throw ups.. If he keeps doing it then I would worry. How long did he throw up after eating? It could be scarf and barf..

Wendy
 
Not sure if it was a scarf and barf - he does that sometimes but this was more liquid brown (color of his food) so it may have been a delayed scarf and barf. I had tested him, shot him, and left an hour later. (and consistently worried about how he was a tired kitty this morning).

I'll post his numbers as soon as I draw them. Thanks again.
Liz
 
I believe the Young Again allows for free feeding, correct? The cat may be overeating a bit at first. The throwing up may be due to overeating or the system is adjusting to the new food.

It's not uncommon for a cat to puke, have loose, even runny stools for a few weeks after a diet change..
 
If you gradually change food 20-25% per day, you may minimize GI upsets of nausea, vomiting, and diarrhea.
 
Hi gang - Tigger was at 152 this morning for pre-shot - so I didn't shoot ! He's doing nicely - his numbers are coming down! Whoot!!
Liz
 
Next time you see a number under 200 there are a few things you can do..

Come here for advice

Stall 30 minutes (don't shoot or feed) to see if he goes up naturally and/ or shoot a reduced dose and test a few hours later

No matter what, get a test a few hours later..today it would have been good to see how low he actually went.. We can't assume that blue preshot was the lowest he went. Also more data will help prepare you for shooting low which you will need to learn to do as over time he should come down into more normal numbers.. So read this too http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147


Wendy
 
Status
Not open for further replies.
Back
Top