Newly diagnosed

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nwfisher

nwfisher

Member Since 2014
Hi everybody, I've been lurking for a couple of days.

Our kittie Spider (13 year old neutered male) was drinking and urinating a LOT, so I was worried what the news would be on the trip to the vet and indeed his blood sugar was 600 on the initial test. Today is the third day they have had him as an inpatient trying to get his level down. I think they have gone from 2 units to 3, not sure if today they are going to give him 4, but I called a bit ago and they said he was still around 500. We are wondering at what point we should try to bring him home. I'm concerned after reading many of the threads here that the diet at the vet may be working counter to getting his level down. My first inclination is to let the vet do her job, but when should I start thinking about taking a little more control of his treatment?
 
Hello to extra sweet kitty Spider and his caregiver and welcome to the message board. Would you share your first name with us please?

There can be complications such as ketones or DKA (diabetic ketoacidosis) that necessitate a newly diagnosed cat staying at the vet initially. Did your kitty Spider have either ketones or DKA at diagnosis?

Was he dehydrated?

What food are they feeding him at the vet clinic?

How frequently are they testing his BG levels?

Do you have these readings that you could share with us?

It's also possible they are giving him some of the short acting insulins that bring the BG (blood glucose) levels down very fast and steeply and those require some careful monitoring.

With the lurking you have been doing, you probably know that we advocate a low carb canned food diet with <10% carb content, a good insulin like Lantus, Levimir or Prozinc and home testing. I'd say, get your home testing kit ready, lay in a good supply of low carb foods, get a prescription from your vet for one of these good insulins and you have the basis for starting to treat your cat at home.

What are the expectations of the vet for BG level readings before they think you can bring your cat home?
 
Find out what insulin they are using - if those changes are to a Lantus dose, they could be going too fast and raising the dose too high.
 
Hi, I'm Nathan, sorry I was a long time getting back to responses, but it has been a crazy couple of days. We just brought him home a few minutes ago and boy was he excited, rubbed on everything in the house I think.

They were giving him the Hills W/D at the clinic and sent me home with some. Apparently they did finally get it down to 145 yesterday after going all the way to 4 units. The insulin is prozinc. He was 300 though on his last test before they sent him home. He is supposed to go back Tuesday for another glucose test. In the meantime we are supposed to give 4 units twice a day of the prozinc. They did not mention ketones, but he was 600 on his glucose when he was admitted and had lost a pound in 3 months.

Our plan at this stage is to get home testing supplies and slowly transition him over several days off of the W/D and on to one of the high protein wet foods. The W/D I brought home is at least wet.

A new adventure begins. Including doing the first injection tonight. Fortunately a very calm and easy to hold kitty.
 
Wanted to add that the 4 units of prozinc seems like a huge dose compared to other dosages I have seen on the board, so intend to be EXTRA careful with diet change.
 
Before you change the food, start home testing for safety!

And you're right; 4 units is a large dose .. mainly because the WD is around 30-40% calories from carbohydrates.
 
I know it is hard to get advice fom strangers on the internet, but we have a very successful protocol for diabetic cats. You have a good insulin but the dose is very high (some ProZinc cats here are on 1 unit or lower). The problem is probably the high carb food and numbers from the vet. Cats are stressed at the vet and very often that stress means higher and not accurate numbers. Then doses based on those numbers can be too high when the cat gets home.

We would encourage you to test at home. The numbers will be more accurate to base the doses on, and you will be able to see how the insulin is working. And you'll save a lot of money!

As soon as you get the testing down, then we'd suggest feeding a wet low carb food (feeding high carb food is like a human diabetic with a diet of donuts). Low carb can make a huge difference in blood glucose numbers. With our Oliver changing from dry to wet meant a lowering of 100 points overnight.

Let us know if we can help. We have taught hundreds of people how to test and would be glad to teach you.
 
Well, I just gave my first injection. He cried with the stick, but didn't really try to break away. I think I did it well. no wet fur indicating it went anywhere but in the little skin tent I created. I gave the full 4 units an hour after he ate some WD. I got a Relion and some strips. If he seems fine tonight I'm going to leave as in for now, start testing tomorrow and then start mixing some fancy feast pate from the approved list into his WD and monitoring.
N
 
Would you please consider adding some information to your user control panel, profile tab, edit signature? The User control panel is at the top of your screen.

We like to see information like your first name, cats name, age and sex, diagnosis date, insulin used, meter used for testing, food being fed, any complicating medical conditions your cat may have like IBD or CRF. These little bits of information give us a quick snapshot of some of the most important data we need to know to help you help your cat better.

Also, if you could update your user control panel, profile tab, edit profile and enter your country, state/province, closest city int he location field, it would be really helpful. This helps us to know not only what time zone you are in, but there may be someone that lives close to you that could help out. Good information to have available to us in an emergency situation.
 
HI guys, I added some info to my Sig. We got our first successful test tonight. I mentioned it in another thread. Now I'm in a quandary. He's on Prozinc. He got an injection (4 units) 12 hours ago, but he just tested 109 on a Relion Micro. We have been giving him this dose the past 4 days NOT knowing his level and all has been fine, but of course I am scared to shoot him at a 109. Thoughts?
Nathan & Spider
 
nwfisher said:
HI guys, I added some info to my Sig. We got our first successful test tonight. I mentioned it in another thread. Now I'm in a quandary. He's on Prozinc. He got an injection (4 units) 12 hours ago, but he just tested 109 on a Relion Micro. We have been giving him this dose the past 4 days NOT knowing his level and all has been fine, but of course I am scared to shoot him at a 109. Thoughts?
Nathan & Spider
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Hi Nathan,

Congratulations on your first successful test! :-D

How long ago was the 109? Did you shoot? I would agree that for a new bean, 109 is too low to shoot with ProZinc. Can you test again? If you're unable to test, I'd skip tonight. It might be that Spider's dose is a little bit too high -- reading back through 4u is fairly high for a newly dosed kitty. How much does Spider weigh? Did they jump him up to 4u bid during his stay at the vets?
 
Jen&Eddie said:
nwfisher said:
HI guys, I added some info to my Sig. We got our first successful test tonight. I mentioned it in another thread. Now I'm in a quandary. He's on Prozinc. He got an injection (4 units) 12 hours ago, but he just tested 109 on a Relion Micro. We have been giving him this dose the past 4 days NOT knowing his level and all has been fine, but of course I am scared to shoot him at a 109. Thoughts?
Nathan & Spider
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Hi Nathan,

Congratulations on your first successful test! :-D

How long ago was the 109? Did you shoot? I would agree that for a new bean, 109 is too low to shoot with ProZinc. Can you test again? If you're unable to test, I'd skip tonight. It might be that Spider's dose is a little bit too high -- reading back through 4u is fairly high for a newly dosed kitty. How much does Spider weigh? Did they jump him up to 4u bid during his stay at the vets?
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He got a shot at 8:45 AM CDT. We tested at about 8:30 PM CDT (roughly an hour ago). This was 1 hour after eating. He weighs 12 pounds. Yes, he spent 3 days as an inpatient. They had a hard time getting him down so they kept upping his dose while he was at the vet, finally sending him home with instructions for us to give him 4 units every 12 hours. I think our plan now is to test him again before we go to bed (it will be 11 CDT by that time) if he is still under 200 then we'll just skip the shot. Make sense?
N & S
 
nwfisher said:
He got a shot at 8:45 AM CDT. We tested at about 8:30 PM CDT (roughly an hour ago). This was 1 hour after eating. He weighs 12 pounds. Yes, he spent 3 days as an inpatient. They had a hard time getting him down so they kept upping his dose while he was at the vet, finally sending him home with instructions for us to give him 4 units every 12 hours. I think our plan now is to test him again before we go to bed (it will be 11 CDT by that time) if he is still under 200 then we'll just skip the shot. Make sense?
N & S
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Great! Thanks for clarifying.

If that 109 was an hour after eating, that number also probably reflects a rise due to his food. As a rule, you'll want to withhold food for the two hour window before your pre-shot test so that the number isn't artificially high due to food, which may wear off relatively quickly. Chances are, without food, Spider may have been quite a bit lower. For data purposes, I think it would be helpful to get a before bed reading, if you're able, but I would not shoot 4u tonight.

Now that you're able to test and see how the insulin is affecting Spider's BG, you might want to think about going back down to maybe 1 or 2u bid, see what his BG tests say, and then gradually bring up his dose as warranted. My concern being that 109 (after food), is pretty low 12 hours after his shot, so Spider may have gone much, much lower than that during his cycle.
 
You're welcome Nathan!

Here's a link to get you started using ProZinc if you haven't already found it: http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=109077
This is the basic starting point protocol. ProZinc is great in that it's flexible to use and lots of different approaches to using it.

Can you also confirm with your vet tomorrow whether or not Spider had ketones or DKA? When we're trying to give guidance on dosing, it's helpful to know if there's a history of ketones or DKA as that may warrant more aggressive dosing.
 
Yes, We'll make sure and ask. He did have symptoms, lots of drinking, lots of peeing. Both reduced since he came from from the hospital stay. I'll post his BG when we test here shortly.
 
3 sticks and couldn't get a blood drop. We're going to skip the shot tonight and test in the AM to see whether to shoot early before a trip to the vet.
 
I think skipping is your safest option tonight. In the AM, if you post either in Health or on the PZI board with your AMPS number in the title of the post with something like "Dose Help Needed", with the "question mark" tag, you can get some eyes on Spider's pre-shot number to get some guidance on dose.

I love his name, by the way. :smile: I hope you can get a profile pic up when you get a chance. I wanna see what a kitty named Spider looks like! :-D
 
Nathan, when you get a chance, if you would please add that meter you are using to test with to your signature it would be appreciated.

Thanks.

Wow! Good call on skipping the shot. Glad Jen was here to help you last night.

ETA: How to get an Avatar up. 3rd reply down has step by step instructions on one way to get picture small enough.
 
I'll start a thread in the Prozinc forum when I get a chance. I just wanted to close this one out. This AM almost 24 hours from his last shot he was 288 on an empty stomach so we gave him 3 units. He's going to the vet to spend the day today, so I assume they do a curve on him. I'll post that in the new thread.
Nathan
 
Hi Nathan,

That is a nice preshot after a full cycle with no insulin. If he were going to be at home today, I would suggest watching him carefully as 3 units is a pretty high dose. As he will be at the vet, it is probably a moot point.

We like curves done at home much better than ones done at the vet. Stress raises blood glucose levels and most cats are very stressed at the vet, so numbers gotten there tend to be pretty unreliable and often more than 100 points over numbers at home. When doses are raised on vet numbers, it is suprising and sometimes dangerous when that same amount of insulin is given once the cat is home and relaxed. I would not be surprised if Spider is higher at the vet than the numbers you have gotten at home.

You might want to take your meter into the vet and compare yours to his. Sometimes human meters read higher or lower than pet specific ones. We don't see that as a problem as we are looking for trends and patterns, but it is nice to know.

I would definitely get some more numbers at home before I would give the higher doses again.
 
Good info, thanks. You guys are an amazing resource.

The 3 units was a dose reduction from the 4 prescribed by the vet. If we had not done the home test and were just following instructions he would have gotten a 4 unit dose last night with the 109 BG, pretty scary.
 
Yes, any insulin on a 109 would have been scary, but 4 units could have literally been deadly. I am so glad you are home testing! The 288 you got this am seems a little on the higher range but when you consider he had been 24 hours since the last shot, it really is a very good number.
 
This is all with him still on Hills W/D wet. We're hoping to start the transition to higher protein food once we get the testing routine down. It's still a bit traumatic. Having to hit the vein to get a sample and he is not a happy camper about it.
 
When you have time, post your testing routine and we should have some suggestions. Two of the things that really helped us in the beginning were to heat the ear thoroughly with a rice sack before poking (you can also use a prescription pill bottle filled with very warm water ) and to use a big enough lancet.(people use 30-31 gauge which may be too small for cats at first. Many new diabetics try 25-27 gauge)
 
I just wanted to say welcome to the board, and really think about the advice everyone on this board gives you. My Hidey wouldn't be doing as good as he is if it wasn't for the people and the advice given on this board.

Ex.
Vet said to test every so often....maybe once a week- WHAT! Would you do that with a child? If I would have listened to my vet Hidey would of went into hypo within the first few days of having him home.

Vet said his diet was ok and to just switch his dry food to the w/d dry- found on this board hw bad dry is and found a ok dry food to give them along with a better choice canned food.

Vet said give him 2 units twice a day- First few nights I couldn't even give him an evening dose because the dosage was wrong, although I wont say WRONG. At the vet his numbers are higher because of stress and harder to come down because of stress so Im sure he needed a higher dose.

Vet said only animal approved meter like alphatrak- I found out the first week I'd go broke if I tested the way I am supposed to, so I quickly switched to a human meter.

The most helpful tips I have learned as to HOW to test was the warming of the ear and also DIABETIC APPROVED treats. All my cats LOVE the Halo freeze dried chicken treats, so much so that Hidey will get on top of the counter and knock them down like he's saying "HEY! Come test me so I can have my treats" lol.

I will never say DONT trust your vet. My vet is great. She is knowledgeable and caring BUT she doesn't have all the information and she doesn't know my Hidey like I do, and she also doesn't deal with this everyday all day and tries to stick to the books and what and how she was taught. Sometimes things don't work well on one that worked well on another.
 
Wife took him in for visit today,. They did not seem pleased that we were taking control and testing as opposed to just doing what they say... Not a good sign at ALL. At work so only have a second. I'll post more later.
N & S
 
They would have preferred you give him 4 units for a non diabetic number and he hypo? Not too logical. You are his best advocate and the one who cares most about him; you have to decide what is in his best interests and do that.
 
Start keeping track of your test numbers and what you are feeding and how often. Also track any other outside influences. Trips to the vet, and any time spent away from home are stressful. Also track how your cat is functioning on those numbers (how he looks, how his fur feels, etc - my cat's eyes water when his numbers drop, and his fur gets fluffy and soft, and the opposite when his numbers rise.) As the numbers come down, you will see your cat adapt to the numbers where he feels more like himself. Those aren't necessarily the numbers you want him to stay at, but gradually he will respond to lower numbers and lower insulin. The more info you record, the more reference points you have when you see numbers going up and down.

Relion has a nice lancet pen and use the 26 guage lancets. Use a thin swipe of vaseline on the ear to help the blood pool up, it makes all the difference. And the warmer the ear the better.

Some vets are very timid about diabetes, and some may not even have much experience with it. The numbers the vet saw probably had a lot to do with a bunch of strangers in a strange place, poking with sharp objects. And the numbers might have been bounce numbers so they thought they wouldn't come down. I completely agree with backing off to 1 unit. Even if you see high numbers, I would try 1 unit for a week, and let him settle in. It's important to home test, because with the food change, his numbers are going to get down to nice low numbers in no time. And after that 109, you really want to test before you shoot because you never know when he is just going to stop needing insulin one day. It happens a lot around here.

I would recommend ketone test strips as well, when the numbers get too high there is a risk of ketones, that's very dangerous.

Now if your mind isn't totally spinning yet, and don't worry that's normal too, you have come to right place, and you are in very good company here.
 
Vaseline IS the key! HUGE help by stopping the blood from just spreading in the fur.

I posted detail in the prozinc forum of his last couple of readings and shots. I got Ketone test strips yesterday and we're working on a good method for getting samples.
 
Not sure you saw this, so I'm repeating it again for you.

Deb & Wink said:
Nathan, when you get a chance, if you would please add that meter you are using to test with to your signature it would be appreciated.

Thanks.

Wow! Good call on skipping the shot. Glad Jen was here to help you last night.

ETA: How to get an Avatar up. 3rd reply down has step by step instructions on one way to get picture small enough.
Click to expand...

Not sure what color Nathan is, but my sugardude Wink is black with black ear edges, plus he's a long haired cat so his ear hair really was getting in the way. I used a safety razor and shaved a tiny spot on the edge of his ear, where I poke. It made it so much easier to see that dark red blood without squinting to find the blood drop in all that dark hair.
 
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