Newly diagnosed

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Juleslynne43

Hi,
I've just joined the forum as my cat, Silver was diagnosed a month ago. This is the story so far:

Diagnosed in September. Changed his diet to Purina DM cans and dry per vet recommendation.
Two weeks later - back to vet - no change in his levels - 19 (I don't know what you measure in US, I am in Canada - does anyone know how to convert so it makes sense? I do not understand the 300+ numbers I read here).
Started on Lantus insulin (vial. What are the pens? How do they work?). Only one unit once per day. He is a big cat - 15lb although he has lost a bit now - I think he may be only 13.

A week later I home tested - this was VERY hard. I pricked his ear three times and barely got a small bead of blood. Please someone help me learn how to do this with one prick. I watched youtube vids but no luck.

His level was 21! I was horrified it went up after a week on insulin and (I probably shouldn't have without vet advice) - increased his dose to 2 units. I told vet and they said to leave him two more weeks and bring him in for a glucose curve. I really cant afford this but I will do it because I need them to help me do the testing. Hoping they will allow me to do any future curves.

Week three - due at Vet's this Saturday for the curve - he started pooping on the floor. This isn't like him. Anyone else had this experience and how did you stop him doing it?

I am well out of my depth here. Its very stressful, very expensive and I am out of savings.

Any advice will be very very welcome and I will read the threads to pick up info.

How long does it take to start dropping the bg levels???

A worried mom.
 
Welcome to FDMB,

I have no experience with Lantus except from what I have read on here, Hidey was on Prozinc, but from what I'm seeing...your only giving one shot a day? Insulin needs to be administered twice a day because it only lasts for 12 hrs at most. Lantus is a depot insulin and takes some time to build up in the system (I think a few days). As to diet, you can feed a cheaper canned food as long as its 10% carbs or less, but the dm dry is too high carb. Most here feed fancy feast pates or friskie pates....I think they have them in Canada, I dont remember. As to the dry, it is recommended to be removed but if it is a MUST it is recommended to be either Young Again Zero carb (online only), EVO cat & kitten, or stella & chewys freeze dried.

As to making it easier to test, have you tried warming the ear. You can use a warm rice sock or something similar. Also, you may want to use some neosporin ointment with pain relief. Make sure it is ointment not cream.

As to the conversion......I just searched and found to get US numbers youd take your reading and multiply it by 18

I hope some of this info helps :)


OH, and as to the pens, from what I gather its cheaper to get a prescription for the pens and then you use a syringe to withdraw the amount needed directly from the pen. Hopefully someone with Lantus experience will pop in soon.
 
Thanks for the reply. Only giving once per day per vets instructions. They were a bit upset I increased the dose.

Will try warming the ear. Thanks.

Insulin here isn't expensive (just $88 for vial) but vet visits are very high so hoping I can get the hang of testing myself. Disappointed his levels are still so high. Vet recommended the dry food. Hard to know who to listen to. I'm thinking of switching to fancy feast when I'm finished this case of DM.
 
Every vet is different and you have to do what you feel is right for your fur baby, but what you may want to give a try is 1 unit in the morning and 1 at night. Two units is high to start out at all at once, and could cause bouncing....which causes high numbers. What happens is too much insulin causes bg to drop too low, which causes the pancreas to kick into high gear shooting the numbers up high.

Have you read all the great info on catinfo.org

It explains food, dosing, and a bunch of other helpful stuff.
 
Hello and welcome!

The vet at the practice where Saoirse was initially diagnosed wanted her to eat dry food but thankfully I found this site and catinfo.org and learned that wet, low carb food is much better for all cats but especially for diabetic kitties. One of the vets at our new practice has a diabetic cat himself and he feeds her wet, low carb food. :smile: The amount of experience different vets have in the treatment of diabetic cats varies, and so does the advice.

I've posted a link to the main Lantus Tight Regulation Support Group board below. If you click on it, you'll find lots of 'sticky' posts at the top of the board. There's a treasure trove of information there to help you learn more about the insulin you're using, the dosing protocol that the members of the group use, and there's information on home testing there, too. As you continue to test, very quickly new capillaries will develop in the test area and it will quickly become much, much easier to get blood samples. Make sure that you warm the ear for a decent amount of time as that improves the blood flow to the test area. A thin film of neosporin ointment or petroleum jelly will help the blood sample to bead up, making it much easier to get the sample onto the test strip.

http://www.felinediabetes.com/FDMB/viewforum.php

The Tight Regulation protocol has been published in scientific journals. If you print off a copy, you could maybe use it as a basis for discussion with your vets? It contains clear instructions on how to adjust doses based on the results of your kitty's home tests. Doses are adjusted very gradually - either by 0.25 or 0.5 units depending on how high a dose the kitty needs - and held for several cycles to see how the kitty responds.

Testing at home will give you much more reliable data upon which to base dosing adjustments, since you will be able to eliminate the possibility of BG levels being elevated by vet stress during the curve. It will also save you money. Best of all, home testing will help you to keep your little one safe. :smile:

On bouncing, your kitty's body has become accustomed to blood glucose levels that are too high and its set-point for 'normal' is in the wrong place. Now that insulin is being given, the BG levels start to go down towards healthy numbers but your kitty's liver needs to learn that the lower levels are OK. It takes time for your kitty's body to adjust to a lower, healthy set-point. Until it does, lower numbers may cause the liver to 'panic' because it thinks there's not enough blood glucose in circulation. When that happens it may release too much sugar from its glycogen stores into the bloodstream and BG numbers may temporarily get higher until your kitty's system settles with that particular insulin dose. Too high a dose of insulin can also cause the liver to overcompensate.
 
Hello and welcome from a fellow Canadian. People here record the data from their blood glucose testing on a common spreadsheet. It helps tracking and giving suggestions on what to do for the dose. As a side benefit, the World version of the spreadsheet automatically does the conversion between US and metric numbers. It is as easy as multiplying by 18, but even easier if the spreadsheet does it for you. Instructions on how to set up the spreadsheet are here. Once you've done that and can test regularly, you can do away with vet visits for a curve. You can do the curve yourself at home.

As others have said, Lantus most often works best with two shots a day. And Lantus is a depot insulin. We recommend holding the dose 5-7 days before increasing, unless of course kitty goes too low at that dose. Cats are all different, it can take varying amounts of time to get regulated. Getting rid of dry food is a big help, but don't do that until you can test as it can suddenly reduce the amount of insulin needed.

In Canada we can buy Lantus in cartridges, which is like a mini vial, and is the refill for the pens. This post on the handling and storage of Lantus shows some pictures of how to use a cartridge.
 
Thanks for all the info. Finding it all very overwhelming. I just want vet to tell me what to do rather than me figuring out dosing and bouncing etc myself.
 
Yes, it would be nice if you had a feline diabetes vet who was up to date on contemporary treatment. That, however can be difficult to find and 24/7 access to such a vet is rare.

Take it one step at a time such as the home testing. That will help you keep your cat safe. Make 1 change at a time as you learn what works for your cat.
 
Don't worry.....I think we were all overwhelmed in the beginning. LOL Heck I know I was scared, distraught, overwhelmed.....and overall going crazy trying to figure out how to do all this and how to deal with it emotionally. Heck I started crying when the vet first taught me how to inject Hidey......I swore I was hurting my baby, I know I dont like shots! Not to mention my vet is not very educated on feline diabetes which she wont admit. I hate it I LOVE my vet, but when helping me with Hidey's diabetes I found more helpful information on here which led to Hidey's remission.

Overall, I think you just have to push forward with what you think is right and go with it. My vet didn't advise home testing or diet change, but I felt both were best and he's never acting better. He acts like a kitten now, I have to get onto him about getting into trouble when I havent done that in years I LOVE IT! Not to mention Hidey doesn't mind testing at all since he knows he gets treats! He waits to be tested!

It will get easier!
 
Thankfully - in himself, Silver is fine. Not listless, plays like a kitten, eats and drinks normally now. The only outward sign of his diabetes is that he walks on his feet rather than his toes so he's very unsteady. He can't jump up on my bed anymore as its too high for him and he has trouble with the stairs.

He has now started pooping on the floor which is an added stress I didn't need.

He goes to the vet for his first glucose curve on Saturday and I am going to do the next curve myself if I can only get better at getting blood from his ear with just one prick instead of messing up his ear :-(

I am also going to ask the vet re a dose twice a day rather than just one as everyone here seems to say two a day. I don't want to make the decisions to change his dose or frequency without vet advice. I am not knowledgeable AT ALL and so cant follow my instincts on this one. I don't want a somogyi effect happening if I mess around with his dose.
 
Julesynne43 said:
The only outward sign of his diabetes is that he walks on his feet rather than his toes so he's very unsteady. He can't jump up on my bed anymore as its too high for him and he has trouble with the stairs.
Click to expand...

Ask your vet to check Silver's B12 levels. A course of B12 injections could help a lot with the diabetic neuropathy symptoms.
 
Juleslynne, you'll get better at the home testing. I know it sucks. It really does. But today was a scary day for me (my kitty dropped down to 38...which I think is around 2 for you). I had no other choice than to keep testing him throughout the day to make sure the precautions I took to avert a hypo incident were working.

Things that have helped me:
The warming sock-find an old (clean) sock you'll no longer use anymore, fill it with 2-3 tablespoons of rice, close it off with a rubber band or a hair tie (be sure it doesn't have a metal piece on it). I pop mine in the microwave for 30 seconds. I actually have to hold it to his ear a little longer than I expected it. I also, "milk" his ear as I'm holding it. I don't know that it's a technical term, but I use my thumb to stroke upward on his ear....from the middle of the base of the ear towards the top/edge of it (where I'll be testing). I thought, at first, 10 seconds of holding it there would be enough. It's more like 30-45. He seems to like it too. I've even held the sock there after testing (after the bleeding stopped)...seems to soothe him a bit.

Lancets that were 26 gauges: If I remember correctly, the lower the gauge, the bigger the needle. A bigger needle, essentially, creates a bigger hole. And I think I'm starting to see the beginning of what some have mentioned-more capillaries being created in the areas that we test. The amount of blood I'm getting from one of his ears is quite a bit. It happens to be the ear that's easiest for me to reach with my dominant hand. Previously I had to prick him 2 or 3 (sometimes 4) times to get a little glimmer of blood. So small, I wasn't sure if it was blood or his shiny fur. We had a couple tests we had to redo, because we didn't have enough blood...and our testing kit doesn't call for much.

Testing in a quiet room, with no one else: This happened to be my spare bathroom today. It was WAY easier to test him in there, than it had been on my kitchen counter with all of our other animals running around...and our day to day lives happening. I have the kit ready with a test strip half way in (not enough to turn it on...and I only do this, because one of the first times I tried testing him, it took so long-with the strip in-that the machine timed out), I have a lancet ready, a single square of toilet paper (to hold over his ear, after), the warming sock (already warmed up) and whatever treat/food I intend to give. Then, I go get him and close the door. I put a towel on my lap to prevent getting too much cat hair on me. I sit on the toilet. I hold him on my lap. I sweet talk him. I have the treats/food ready-and he knows they're there-I can see him smelling the air for them. And, as someone suggested to me recently, I pretend I know what the heck I'm doing. That false confidence will turn into real confidence over time.

He may not understand all of what is going on with him (or between you two) right now, but you do. This is important. You have to do it. This is how you care for him and protect him...and that's what he's counting on you to do. I'm not used to it yet. I still feel like I hate it. But I feel way better about it than I did a week ago. It'll take time, but it will get easier. Promise.

~hugs~
 
A couple other tips that help testing. First, you can put a small dab of Vaseline on the fur. That helps the blood bead up so it doesn't get lost in the ear hair. After the poke, make sure you compress it for a while to staunch bleeding. To help healing, put some Polysporin Complete (with Heal Fast Formula) on the poke spot. You can also use that instead of Vaseline to help the blood bead. Just make sure to wipe off the excess. What blood glucose meter are you using? Some need smaller drops of blood than others.

As for the neuropathy, Amazon.com doesn't ship to Canada and you can't buy Zobaline from Amazon.ca, so you have to buy it from Lifelink direct. Prices are fairly comparable. I think some people have found methyl B12 powders, but it's mostly in sublingual format so you have to hunt for it. And you want one that doesn't have carbs in it. The Zobaline just crumbles into food so is pretty easy to give.

As for listening to the vet on dosing, we all did that at first. There's a lot to learn and it's very easy to get overwhelmed. Just treating your cat by giving insulin and starting to do tests puts you miles ahead of many other caregivers. :YMHUG: I got tired of how much it cost to run a curve at the vet and was pretty annoyed how much I paid for them to do 3 blood tests and keep the cat for a day. I could buy a lot of test strips for what they charged and my kitty was way less stressed at home. When cats are nervous/stressed, their blood sugar is higher. My non diabetic kitty once tested 11.6 (209) at the vet and then 2.9 (53) at home the next day. You wouldn't want to base a dosing decision on those elevated values.
 
I believe VitaCost has a methly-B-12 that has no sugar, nor sweetener in it.
 
Thanks for all the info. It's helpful knowing I'm km not alone in this. Vet put him on B12 after I researched feline diabetes and asked if we could try it. He's has two of six doses once per week.
 
Juleslynne43 said:
Thanks for all the info. It's helpful knowing I'm km not alone in this. Vet put him on B12 after I researched feline diabetes and asked if we could try it. He's has two of six doses once per week.
Click to expand...

How are things going with you two? I'm guessing that if the vet is giving him 6 doses a week, he's giving him cyano-b12 shots? This is different from methyl-b12 and is better suited to help reduce inflammation (vs. neuropathy).

The methyl-b12 is mixed into food daily between 3-5 mgs (3000-5000 mcgs). Some cats have an almost immediate difference in their neuropathy, but in general, it can take up to six months in conjunction with better glucose regulation before seeing improvement. Here are the links again for Zobaline (the cat version) and Vitacost (the human version that can be used on cats).

One other thing about the neuropathy: this might very well be the reason he's started pooping on the floor. You may want to look into getting another litter box that he can easily step into or maybe adding a home-made ramp to his current litter box and see if that helps.
 
Things are not good. This morning he started peeing on the floor too and I read online this could be a FLUTD issue. He has no problem getting into the box but spends a long time there she. He does. He must be in pain. I asked thx vet for the methyl b12 and was told cyano b12 breaks down into the methyl and wouldn't give me the methyl. I can't mNage this myself so have to follow vets instructions.
 
Yes, he could have a bladder infection (FLUTD = feline lower urinary tract disease). Antibioitcs typically treat infection. Cystitis and stones get treated differently.

Methyl B-12 is available over the counter. Check VitaCost on our shopping link above, and use the Amazon link there (it'll help fund the message board that way)
 
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