Newly diagnosed

[Niki & Ephalba]

Hello all,

First, thank you! I've been reading through the messages posted and the FD website and you've unknowingly already calmed some of my fears and answered many of my questions. Ephalba, one of my five kitties, was diagnosed with diabetes this past weekend. She is an 8ish year old long haired torti/tab. I love all my kitties equally, though her and I have always had a particular affinity for each other. I noticed last Thursday that she wasn't quite herself and that she had lost some weight. By Saturday she hadn't pepped up, so I made a same day appointment. Right before I took her into the vet, she came up and gave me kisses and her breath smelled like nail polish remover. In my heart I knew it was a very bad sign, but I told myself we'd have some quick blood work done and walk out with clavamox or something. Instead, we were sent straight to the emergency vet and I was informed she was experiencing ketoacidosis and might not make it through the night. Luckily, she's a stubborn girl (and hadn't stopped eating!) and she pulled through. It was an outrageously expensive ER trip (I think we're at $1500 so far) but I'm feeling some relief finding out we can manage the FD mostly at home.

She went back to the vet today to check in and her after food/preshot reading was 265 (that was about 45 minutes after she ate). The vet was hopeful that we'd be able to get her in remission and was supportive of us doing home testing. I do, of course, have a few questions though that I forgot to ask my vet or that I've thought of since! For background info, Ephalba's currently on 1 unit of PZI twice daily and I switched her exclusively to grain-free Wellness when she came home on Monday (she had previously been getting Wellness dry along with a bit of wet a few days a week).

1. My poor girl's ears are pretty beat up from tests at the ER. Would it be okay to wait a couple days before staring home testing? I don't want to start out with this being a horribly uncomfortable experience since we'll be testing daily.

2. When I do test, below what number should I NOT give her the shot?

3. If her glucose is really high, do I need to give extra insulin?

4. We're scheduled to take her back to the vet for a glucose reading next Friday. Would it be better to do it at home and call the vet? I feel like I'm being bled dry here . . .

5. Out of what I offer, she's currently eating 1/4 can of food at a meal (about 1.5 oz, so 3 oz total daily). Is that enough? I had free fed the cats prior to the diagnosis so I don't know if she's still expecting to graze. Also, she's a smaller cat next to my others--her ideal weight is around 8 lbs and she's about 7.5 now.

6. Lastly, a question that's not about FD (well, possibly preventing it in my other cats!). I have one cat that refuses to eat anything else but dry Wellness, specifically the stuff in the blue bag. Well, she is obsessed with the margarine brand Earth Balance! She almost died from fatty liver disease a few years back because she refused to eat when I couldn't afford the Wellness for awhile. I actually am fearful that they'll change the formula or go out of business and Paloma will not have anything to eat! I tried putting down Wellness Core for her so I could at least get her grain-free but she won't eat it (won't even eat her regular kibble that I put in the bowl I removed the Core from). Any suggestions for getting her to switch to wet or at least to a grain free dry?

Thank you, thank you, thank you!

Niki & Ephalba

 

[Sue and Oliver (GA)]

Welcome Niki,

You are really on top of the game already. Your vet prescribed a good starting dose, is okay with hometesting and you are feeding good food. (Did you sure check on Janet and Binky's chart to get a Wellness wet lo carb? We try to feed under 10% carbs.

You really do need to start hometesting now. Otherwise, you are shooting blind. To help her ears, put a bit of Neosporin (with or without pain reliever) on her ears after poking and hold it a few seconds to help with bruising.

Generally we say with newbies, not to shoot under 200. With PZI, you can wait 30 minutes or so and take another test. If she has gone up enough, you can shoot then.

We suggest you stay with the 1 unit for several days to give it time to work. Be sure to test before each shot and try for a nadir. That's the lowest point of the insulin - with PZI, it's often 5-7 hours after the shot. We need to know how low the insulin takes her to see how well your dose is working.

You do not need to go back to the vet for a curve. Often the kitty is stressed at the vet, so the numbers are higher than at home. Then the dose based on those numbers can be too high. Do your hometesting, set up a spreadsheet and have all your numbers ready to fax to the vet. (Saves you $$ too!)

You are doing great! Keep reading and asking questions.

 

[Sarah and Buzz]

Welcome Niki,

You are really on top of the game already. Your vet prescribed a good starting dose, is okay with hometesting and you are feeding good food. (Did you sure check on Janet and Binky's chart to get a Wellness wet lo carb? We try to feed under 10% carbs.

You really do need to start hometesting now. Otherwise, you are shooting blind. To help her ears, put a bit of Neosporin (with or without pain reliever) on her ears after poking and hold it a few seconds to help with bruising.

Generally we say with newbies, not to shoot under 200. With PZI, you can wait 30 minutes or so and take another test. If she has gone up enough, you can shoot then.

We suggest you stay with the 1 unit for several days to give it time to work. Be sure to test before each shot and try for a nadir. That's the lowest point of the insulin - with PZI, it's often 5-7 hours after the shot. We need to know how low the insulin takes her to see how well your dose is working.

You do not need to go back to the vet for a curve. Often the kitty is stressed at the vet, so the numbers are higher than at home. Then the dose based on those numbers can be too high. Do your hometesting, set up a spreadsheet and have all your numbers ready to fax to the vet. (Saves you $$ too!)

You are doing great! Keep reading and asking questions.

I couldn't have said it better myself. Welcome to the board! You have found the best place to help Ephalba and yourself. It sounds like you've done quite a bit of reading already, which is awesome. Your vet sounds very supportive too, which is priceless.

As far as getting your other kitties to eat canned, have you read Dr. Lisa's tips for transitioning cats to wet food? It is an excellent resource. It can be found here: http://www.catinfo.org/#Transitioning_D ... nned_Food_

Dr. Lisa also offers you a guide for how much Ephalba should be eating based on her ideal weight. That is also found within the above article I linked. I would say off-hand that 3 oz. sounds like an awfully small amount of food. Buzz, my diabetic kitty, is at her ideal weight of 10 lbs. currently, and she eats about 6-7 oz. of Wellness a day. Her brother, non-diabetic, weighs 15 lbs but should weigh about 13 lbs. He eats 8-9 oz of FF a day. He has lost weight already (down from 18 lbs) but I believe he was starting to lose too quickly so I upped his food intake. The article will give you a more specific idea of how much weight kitty can safely lose and how to go about it.

 

[Karen & Pearl]

I would like to add since your kitty had ketoacidosis, you want to buy a box of ketostix from the pharmacy and check pretty frequently. Did they find any infection? Like a urinary tract infection at all? Unlike some other folks kitties, with that happening, you will want to be fairly vigilent testing for ketones on a regular basis. It doesn't sound like she was all that lethargic or throwing up or not eating as most cats when they get to that stage. That concerns me. Seems like maybe you should get a cultured urine sample at the vets (sterile and cultured! Don't take just a bladder expression - ask for the real mccoy) and see if that is going on, or if she has maybe some dental issues? (If they already covered all that and found and treated an infection, you should be in the clear for now to just test her regularly) Not to scare you at all! But it may just be your lovely lady is a bit more prone to that than others so it would be good to err on the side of caution.

 

[Niki & Ephalba]

Welcome Niki,

You are really on top of the game already. Your vet prescribed a good starting dose, is okay with hometesting and you are feeding good food. (Did you sure check on Janet and Binky's chart to get a Wellness wet lo carb? We try to feed under 10% carbs.

You really do need to start hometesting now. Otherwise, you are shooting blind. To help her ears, put a bit of Neosporin (with or without pain reliever) on her ears after poking and hold it a few seconds to help with bruising.

Generally we say with newbies, not to shoot under 200. With PZI, you can wait 30 minutes or so and take another test. If she has gone up enough, you can shoot then.

We suggest you stay with the 1 unit for several days to give it time to work. Be sure to test before each shot and try for a nadir. That's the lowest point of the insulin - with PZI, it's often 5-7 hours after the shot. We need to know how low the insulin takes her to see how well your dose is working.

You do not need to go back to the vet for a curve. Often the kitty is stressed at the vet, so the numbers are higher than at home. Then the dose based on those numbers can be too high. Do your hometesting, set up a spreadsheet and have all your numbers ready to fax to the vet. (Saves you $$ too!)

You are doing great! Keep reading and asking questions.

I looked at Binky's site and I have all the safe flavors, so I think I'm good on food. I decided to test the monitor on myself and my husband tonight (ow!) and I'll use it on Ms. Ephalba in the morning before giving insulin. I should be able to test for the nadir Fri-Sun, when I'm off work, but it's a near impossibility on the other days. Hopefully it gives me enough info! I was worried today about stress affecting her readings at the office today--her BG went from 265 to 311 and then 325 while we were there so it got me thinking going to the vet for testing is a waste of time and money and pointlessly stresses Ephalba out. Thanks so much for your reply!

 

[Niki & Ephalba]

Welcome Niki,

You are really on top of the game already. Your vet prescribed a good starting dose, is okay with hometesting and you are feeding good food. (Did you sure check on Janet and Binky's chart to get a Wellness wet lo carb? We try to feed under 10% carbs.

You really do need to start hometesting now. Otherwise, you are shooting blind. To help her ears, put a bit of Neosporin (with or without pain reliever) on her ears after poking and hold it a few seconds to help with bruising.

Generally we say with newbies, not to shoot under 200. With PZI, you can wait 30 minutes or so and take another test. If she has gone up enough, you can shoot then.

We suggest you stay with the 1 unit for several days to give it time to work. Be sure to test before each shot and try for a nadir. That's the lowest point of the insulin - with PZI, it's often 5-7 hours after the shot. We need to know how low the insulin takes her to see how well your dose is working.

You do not need to go back to the vet for a curve. Often the kitty is stressed at the vet, so the numbers are higher than at home. Then the dose based on those numbers can be too high. Do your hometesting, set up a spreadsheet and have all your numbers ready to fax to the vet. (Saves you $$ too!)

You are doing great! Keep reading and asking questions.

I couldn't have said it better myself. Welcome to the board! You have found the best place to help Ephalba and yourself. It sounds like you've done quite a bit of reading already, which is awesome. Your vet sounds very supportive too, which is priceless.

As far as getting your other kitties to eat canned, have you read Dr. Lisa's tips for transitioning cats to wet food? It is an excellent resource. It can be found here: http://www.catinfo.org/#Transitioning_D ... nned_Food_

Dr. Lisa also offers you a guide for how much Ephalba should be eating based on her ideal weight. That is also found within the above article I linked. I would say off-hand that 3 oz. sounds like an awfully small amount of food. Buzz, my diabetic kitty, is at her ideal weight of 10 lbs. currently, and she eats about 6-7 oz. of Wellness a day. Her brother, non-diabetic, weighs 15 lbs but should weigh about 13 lbs. He eats 8-9 oz of FF a day. He has lost weight already (down from 18 lbs) but I believe he was starting to lose too quickly so I upped his food intake. The article will give you a more specific idea of how much weight kitty can safely lose and how to go about it.

I *did* see Dr. Lisa's article and it has some great tips. I'm going to try them with an open mind, though I am nervous of any change in Paloma's diet since she had the fatty liver issues before. Sometimes I feel the cats are teaming up to raid the fridge or something because they aren't big eaters and yet I have some fairly chubby cats, excluding Ephalba!

 

[Niki & Ephalba]

I would like to add since your kitty had ketoacidosis, you want to buy a box of ketostix from the pharmacy and check pretty frequently. Did they find any infection? Like a urinary tract infection at all? Unlike some other folks kitties, with that happening, you will want to be fairly vigilent testing for ketones on a regular basis. It doesn't sound like she was all that lethargic or throwing up or not eating as most cats when they get to that stage. That concerns me. Seems like maybe you should get a cultured urine sample at the vets (sterile and cultured! Don't take just a bladder expression - ask for the real mccoy) and see if that is going on, or if she has maybe some dental issues? (If they already covered all that and found and treated an infection, you should be in the clear for now to just test her regularly) Not to scare you at all! But it may just be your lovely lady is a bit more prone to that than others so it would be good to err on the side of caution.

Hi Karen,

They did do a cultured urine sample and she was clean for infections luckily. She was a bit lethargic when I took her in but still eating. She *was* throwing up almost daily, but she is the household groomer and has long hair, so she tends to get a lot of hairballs. They didn't do a dental exam that I know of, but I'll call the vet to be sure. The ER vet did give me antibiotics just in case there was an infection, but I don't really like treating for a maybe, especially since antibiotics can side effects. Home testing should give me a better picture though I'm thinking!

 

[Karen & Pearl]

Normally I wouldn't want to do antibiotics just in case either buy in this case I don't know, I myself might want to err on the side of caution. Usually there is some kind of infection present. It would be ideal to know what but that may not be possible to find out at this point and you don't want to have to deal with another episode while you get going on this. Others may disagree but that's my opinion.