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oscarthecat

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Hello, my name's Jennifer and my cat Oscar was diagnosed with DM 3 weeks ago.

Oscar is 15, he was a late adoption when he was 10 so I have no medical history on him from before then. He was a very healthy cat up until 2.5 months ago when he began urinating outside the litter box. We were doing house renos and him and out other cat were very stressed out. Unfortunately, we blamed it on our other cat who has a history of peeing around the house when she is mad so poor Oscar suffered with rising sugars for a while before we took him in.

When his bloodwork was done 3 weeks ago, his BG was 630 and his fructosamine was 500 (I think). He had lost half his body weight, his fur was thinning in certain areas and he was severely dehydrated. I feel awful that I didn't see it happening until he was so sick.

He was started on Purina DM food (wet and dry mixed) and 2 units of Lantus twice a day. Oscar's sugars remained very high and I have been gradually increasing his insulin and he is now up to 5 units twice a day. His sugar seems to have stabilized at 324 with the occasional spike in the morning. I was feeding him 4 small meals a day but have cut him back to 2. I do keep a small bowl of food of the DM food out so the other cat can graze and I know he's nibbling a bit when he's between feeds.

He's gained back some weight, his dry skin is decreasing, his water intake is less and his pees are smaller. He's cleaning himself again and socializing like he used to. He is still peeing outside the box sometimes though despite having a clean litter box. I am not testing for urine ketones and simply don't see this as a feasible option for me (I have quite a bit on my plate at the moment).

Since his sugar is not dropping any lower I am trying to switch over to wet food. I am worried about the amount of insulin I'm giving him. I'm going to do a curve either tomorrow or Tuesday and try to get an idea of what's going on. I was so worried about the poor state he was in, I just wanted to bring his sugar down but now I'm just not sure. My vet is on vacation for one more week but despite that, we are all out of cat money right now so I am trying to manage this on my own.

I am trying to decide if I should try a wet food only diet for a few days, keep his insulin at 5 units and just keep an eye on whether his sugars come down with the diet change and lower his insulin as required or just drop his insulin down now and see what happens. I don't think he's rebounding but I'm just not sure and I guess I won't know until I do the curve.

Any advice would be greatly appreciated and thanks in advance.
 
oscarthecat said:
Hello, my name's Jennifer and my cat Oscar was diagnosed with DM 3 weeks ago.
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Welcome :-D


When his bloodwork was done 3 weeks ago, his BG was 630 and his fructosamine was 500 (I think). He had lost half his body weight, his fur was thinning in certain areas and he was severely dehydrated. I feel awful that I didn't see it happening until he was so sick.
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Don't feel bad. Cats are very good at hiding how they feel. When you see physical symtpoms, it's probably been building up for awhile. Many of us didn't notice anything until the cat was just not being he/sher usual self and/or showing unsuual behaviors.


He was started on Purina DM food (wet and dry mixed) and 2 units of Lantus twice a day. Oscar's sugars remained very high and I have been gradually increasing his insulin and he is now up to 5 units twice a day. His sugar seems to have stabilized at 324 with the occasional spike in the morning. I was feeding him 4 small meals a day but have cut him back to 2. I do keep a small bowl of food of the DM food out so the other cat can graze and I know he's nibbling a bit when he's between feeds.
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DM isn't the best food for diabetic cats. Many vets push it because they know very little about proper nutrition. Many members feed commerical brands of canned foods that are low in carbs. Others feed raw food.

Dry food, even the prescription stuff, can keep blood glucose levels way too high. Even a few pieces can send a diabetic cat's blood glucose levels really high. Dry food in general is one reason why some cats end up diabetic in the first place. Some brands of dry food have as much as 30% or more carbs :shock: http://www.catinfo.org has more about proper diet and reasons why dry foods should not be fed to any cat.

Unregulated diabetic cats are always hungry. It's best to give them as much food as they want but without causing them to gain too much weight. Many people feed several small meals throughout the day with a timed feeder. Canned food can be used in a timed feeder. There are ways to keep it from spoiling too quickly.


I am not testing for urine ketones and simply don't see this as a feasible option for me (I have quite a bit on my plate at the moment).
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It's a good idea to test for ketones. An unregulated diabetic cat can suddenly start throwing ketones and end up with a serious condition called diabetic ketoacidosis. If you can't test the urine, there is a blood glucose meter that will also test for ketones (Precision Xtra, I think??).

Since his sugar is not dropping any lower I am trying to switch over to wet food. I am worried about the amount of insulin I'm giving him.
I am trying to decide if I should try a wet food only diet for a few days, keep his insulin at 5 units and just keep an eye on whether his sugars come down with the diet change and lower his insulin as required or just drop his insulin down now and see what happens.
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Good that you are planning to switch to canned food :thumbup

Yes, you are right to be concered about the huge amount of insulin. 5 units twice a day is A LOT for most diabetics. The DM dry food is probably what's keeping your cat's blood glucose levels from crashing too too low.

Changing the diet while on 5 units of insulin can be recipie for disaster. Low carb food can drop blood glucose levels well over 100 points.

To avoid a hypo, I suggest that you learn how to test your cat's blood glucose levels first if you're not already doing so. Knowing what your cat's blood glucose levels are helps you and your vet see how well the insulin and dose is working and what adjustments need to be made. Kind of like how a Human diabetic manages his/her diabetes.

I don't know how much of a dose reduction, if any, you should do. Some people start back over at 1 unit twice a day, do a diet change, and slowly increase the dose as needed based on blood glucose levels done at home. More experienced Lantus users will be able to recommend what dose you should drop down to.
 
Welcome Jennifer.

You're right -- 5.0u twice is a good amount of insulin. If you're not already home testing, I'm jumping on the bandwagon and encouraging to start doing so. It's the only way to know if Oscar is getting the right amount of insulin. It's also the only way to keep him safe -- especially if you're contemplating a switch to a totally canned food diet. I honestly would not suggest that you switch foods until you are able to home test. Many cats' numbers will drop as a result of a diet change alone.

I'd also second the notion to switch to a better quality food. The site that Squeem linked will point out that most prescription foods are composed mostly of animal by-products rather than muscle meat. in addition, for what you're spending on prescription food, you could be feeding Oscar a high quality, low carb, human grade cat food like Wellness or EVO.

If you've not already had a chance, there's a great deal of information on the Lantus board. This is an overview along with links to the information:
  • Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in Germany and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
  • New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
  • Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
  • Lantus depot/shed: This is an important concept for understanding how Lantus works.
  • Becoming Data Ready: What data you need in order to be able to work toward remission or tight regulation.
 
I have Purina DM wet food here so I think I will start feeding him that with some of the dry mixed in so it doesn't shock his system too much, then gradually decrease the dry. I am blood testing at home so I can keep an eye on his sugar. I think I will drop his insulin to 2 units starting tonight because I really don't want him crashing in the middle of the night. I guess his sugar will be all over the map again for a while then, right?

Sound like a good place to start?
 
Hi Jennifer and Oscar!

Welcome! Nothing to add to the great advice that has already been shared. I will say that if you get started here, not only will get a week head start before your vet gets back from vacation, but you'll also be getting excellent advice for free!

My cat was up to 5u and eating dry when I scrapped his program and started him over at 2U and wet. It's ok to start over. Some cats start at .5u, some at 1u. I'd get some additional guidance from someone with more experience than me before you make any drastic changes.

One thing I do know for sure is that decisions are data driven and home testing is a good and affordable way to manage Oscar's diabetes.

Good luck and welcome!
Bonnie
 
Before you do 2U, how much does your cat weigh? A good starting point is based on his weight. Hang on while I look for that formula (sorry I don't have it off the top of my head!).
 
oscarthecat said:
I have Purina DM wet food here so I think I will start feeding him that with some of the dry mixed in so it doesn't shock his system too much, then gradually decrease the dry.
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That's a good idea :smile: Once your cat is eating only the DM canned, you may want to start siwtching to a commercial brand of low carb canned food. DM is ok but the ingredients aren't great and the food is very expensive. Some cats get bored eating it, too.


I am blood testing at home so I can keep an eye on his sugar.
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Oh, that's great :thumbup Keep track of the numbers you get. Most people here use a blood glucose spreadsheet template from Google and put a link to it in their signature (and also share the link with their vet) but lately it has been very difficult to save a copy of the template to your Google account so that you can use it. You can give it a try, though. The basic instructions are here: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207 There's also this if you can't get a copy of the template from the link in the basic instruction: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=46476

If you're tech-y enough, you can create your own similar blood glucose spreadsheet from scratch on Google and use that instead.

I think I will drop his insulin to 2 units starting tonight because I really don't him crashing in the middle of the night. I guess his sugar will be all over the map again for a while then, right?
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Probably a good idea. Any new dose of Lantus takes about a week to "settle". Stick with a new dose for at least a week before you adjust it based on a curve.
 
Hi jennifer! *waving*

I can't give you any dosing advice. My Callie Mae used PZI, but I can relate to high insulin doses and prescription diet #'s.

My Callie Mae was started out on 5u BID and was eating the dry diet.
Over the course of approximately 1 month, my vet had increased her dose by 1 unit increments until we were up to 9 units BID. I only gave her that 9 units once. Scariest night of my life. Especially now when I think back on it knowing what I do now.
Around the 7unit mark, I found this board and starting reading as much info as I could find.
I also wanted to believe that my vet knew best. I was on the fence with some of the things I read, since after all, my vet is a trained professional and this place is just "some website on the internet".

I had read that switching to an all wet diet would drastically reduce my Callie Mae's bg, so I decided to just start over at 1u and transition her to wet food over the course of, well, however long it took for her to decide she wanted it. She had dry food her entire life. It only took her a couple days to realize she like the wet food, and I home tested as often as I could. It wasn't even a month before I was "micro" dosing her (less than 1 unit shots), and she went completely OTJ (off the juice). For Callie Mae, I believe she is totally a dry food induced diabetic.
Just recently she was testing in high numbers ( I still keep an eye on her) and I thought it was due to some stress that was occurring in the home. Back on the insulin she went. Then I found out, she had found a secret stash of dry kibble and had been eating it. i took it away and her numbers went right back down. :smile:

Not saying this will be the case for your kitty. I just wanted to share my story with you so you could understand the importance of getting that expensive, high carb (as much as 39%) crap out of kitty's bowl.

I didn't buy the fancy expensive stuff. I just went with good 'ole fashioned Friskie's Classic Pate variety. That's the key. Foods that are low in carbs. No gravy or sauce varieties.

if your not already to overwhelmed by all the wonderful info out there, here is a list of canned food that has been broken down.
Look for stuff that is less than 10% carb. I personally use around the 4% range.
The old list is bigger, but please look at both.

http://binkyspage.tripod.com/canfood.html

If you have any questions, ask away.
We love to help!!
 
Ok, found it! You can calculate a good starting point based on Oscar's weight. Before you shoot, can you post his pre-shot number? I'm sure it's high but it's good to know just to make sure he's safe to shoot.

Using a weight based formula for determining a starting dose of Lantus or Levemir:
the formula is 0.25 unit per kg of the cat's ideal weight
if kitty is underweight, the formula frequently used is 0.25 unit per kg of kitty's actual weight
if the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
Online Calculator for Converting Pounds to Kilograms

There are circumstances such as ketones present, an unusually low preshot number, a caregiver leaving the cat with a sitter, relatively high flat curves, loss of appetite, infection, a schedule change, ability to monitor, etc. which may call for adjustments to these guidelines.
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I have a tendency to make short stories long.
When I logged in to post, there was only 1 other comment.
See what happens when I decide to start off writing a chapter. :lol: :lol: :lol:
 
I need to get Oscar's weight. He was 7 lbs when diagnosed but he's already putting weight back on so I have no idea what he is now.

He peed in the middle of the dining room floor last night again and my poor daughter slipped in it this morning! Gah, everything's such a mess.
 
Since he was always good before about using the litter box, I'd be sure he was checked for a Urinary Tract Infection! Which not only causes peeing outside the box - they associated the box with pain - but can GREATLY elevate Blood Glucose. Since his first number was so high - I'd get on that right away.
As everyone else has said - ditch the DM food and go with over the counter brands, many to choose from ALL lower than the vets DM brands wet or dry - some of which are as high as 30% carbs.
Since you said vet was away, maybe some people here can give you leads on treatments for UTI
 
So far so good except for the pee. We had a massive thunder storm last night so maybe he just didn't want to go outside.

dinner @ 700 half and half
BS @ 745 306
2U

breakfast @ 0400 half and half (cats woke me up looking for food and would not stop meowing)
snack @ 0800 just wet
BS @ 900 324
2U

I just need to get that number down lower, but it's still better than the 500 it was. Lets hope cutting out the dry food does it.

Thanks for all the advice and stories you guys, this board has already made me feel more hopeful.
 
Oscar's urine was cleared for infection when he had his appointment. I wonder if he just has to go so bad sometimes he just can't make it. I know this cane be the case in human diabetics pre-diagnosis.
 
oscarthecat said:
Oscar's urine was cleared for infection when he had his appointment. I wonder if he just has to go so bad sometimes he just can't make it. I know this cane be the case in human diabetics pre-diagnosis.
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You might try adding a couple more litter boxes for him in convenient places. Near where he
sleeps or hangs out, for example.
 
Oh my goodness, sounds like you have your hands full! Hope your daughter is ok from the slip and fall. Poor thing.

So I calculated his dosage and at 7lb and at 3.2 kg and it looks like he should be at .8u which you could round down to .75u or 1u. If you don't have syringes with half unit markings, you can get them at Hocks. These are the ones I use though I think some people use Monojet.

But who knows? 2u may actually be the right dosage at that BG level and maybe we should stick with it and see what happens for a few days. Just afraid that 2U may still be too high for Oscar's weight. I'm sorry I'm not experienced enough on this! I would post that question over in the Lantus group where there are more experienced eyes to guide you.

To help them help you, you may want to start a spreadsheeton Google Docs, similar to what you see in my signature. It's hard to tell what time zone everyone is (esp those in Turkey or Australia) and this helps them process the data faster.

I know it's alot to take in so I don't want to overwhelm you anymore than you already are. Please do ask questions!
Bonnie
 
I am four months pregnant and have had severe morning sickness for three of those months. I can barely deal with the two boxes we have let alone adding more. We've blocked off the rooms so he's just in the dining/living room and patio.
 
I was just reading your recent numbers and I wanted to know if you could clarify something for me?
Are you testing Oscar AFTER you have fed him?
You want to test before he eats, as food will cause his numbers to go up.
What we do is Test, feed than shoot.
It's important to test before he eats so you know what his REAL bg number is to calculate a good dose.
If I mis read something, and you are testing before feeding, I apologize.
 
I'm trying to do it in the right order at night but when I'm getting out of bed at 4 am to feed him while feeling as sick as I've been, I'm just feeding him and going back to sleep. I don't want to feed them at that time but the other cat will not stop crying until I do it and I can't just feed her and not him unless I lock her in a room alone and stay up until she's done.
I don't mean to sound difficult I simply am so low on energy right now and my daughter and my health are taking priority over Oscar's.
 
Yeeesh! You REALLY have your hands full! Just do the best you can. You're not getting graded here.

But congratulations on your pregnancy!
 
Got'cha.
A sick momma is no good for anyone! I think I read you were pregnant and dealing with lots of morning sickness? Sure hope that subsides for you soon. Yuk.
I can't offer any dosing advice. I believe you said you were using Lantis, and my only experience was with PZI.
Hopefully you can get everyone in tip top shape in no time. Yourself included. :-D

And believe me, I know all about a cat that wants fed NOW. Callie Mae like to sit beside my face while I am sleeping and tap, tap, tap my cheek with her paw. If I roll over, she will start walking up and down on my body. And she is HEAVY!
If I move around some more, she will go back to the tapping. She does it to my face and any part of my body that isn't under the covers. :lol:
I have to get up to feed her to get her to leave me alone.
She likes to tap my arms and legs when I'm sitting around to if she thinks I should be paying attention to her.
The little poop. I love her! :lol: :lol:
 
Checker sits at the foot of the bed and cries until she actually has the food in the bowl. She's not a Siamese but she sounds just like one. I'm so afraid she's going to work up my toddler I try to just get her to stop! Oscar wouldn't even dream of waking me up, he's such a laid back kitty.

Yep Cherie, I am in Coquitlam too. Crazy storm! My daughter slept right through it until our building's roof leaked into an apartment and shorted out the fire alarm and even then didn't wake up until we went to get her to leave the building!
 
Welcome!!! Looks like you have got a ton of good info. I just wanted to welcome you. It seems very overwhelming at first but gets better. We had the same issue - going outside of the box. What helped was to switch to wet food and add water to the wet food to get fluids through the kitty. Good luck!!
 
Ooo, good idea about the water in the cat food. I am very relieved to see Oscar's fur has already grown back in the little bald spot he had and his skin is minimally dry.

How many times a day and how much does everybody feed their cat? He just seems so hungry all the time but yesterday I totally overfed him I think and his sugar hung around 300 all day. Haven't done a curve yet but I did two extras yesterday at +2 and +7.
 
Many people feed their cats several small meals during the day. It seems to help smooth out the bg numbers. Petsmart has a couple of timed feeders. This might really help you at night. You could set the feeder to open at 3 or 4 AM - whenever your young lass usually decides that she is starved.

I got the less expensive feeder with 2 compartments so I feed breakfast and then set the feeder to open at +4 and then at +8 so that he has eaten all the food by the time I test him 12 hours after his last shot and brekkie. I mix equal water with the food and it seems to last fresh all day. Some people freeze the food - it hasn't been hot enough here in the lower mainland for this to be a real need this summer.
 
I can vouch for high BG caused by just a few pieces of dry food; my Shadoe will shoot to the 400s with just one mouthful. I must raise the dry food for my 2 civvies up on a shelf where they can jump but Shadoe cannot.

Shadoe also has a problem with urinating outside the box and has had this problem since being dx with diabetes.
It's not the LB because she never has issues with stool outside the box, just the urine. I lay out paper and washable mats over the paper in front of the LB, and she's just fine with it.

She's been to the vet several times since dx and there is no health problem to explain her aversion to urinating in the LB.
I have recently started putting her into the LB at certain times and quite often she does urinate, so I have no idea why. Maybe with a bladder full, she is not comfortable climbing into the LB? I put her into the LB first thin in the morn, and just before bed, plus a few other times thru the day and eve.

I feed my cats frequently, and small meals through the day. Just like with human diabetics, small meals and snacks help to level off their blood sugars. When I am away, I have a 5-compartment PetSafe auto feeder which comes in handy.
Petsafe 5-meal Auto Feeder
Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition

I have always added water to my cats' foods as it helps to flush out toxins and also helps to fill them up while they are so hungry before they were regulated. They liked the water so much that I have continued it.
 
Well, Punkin has just been Diagnosed this afternoon. I'm in a real shock and don't have a lot to say at the moment so I'll just read, study and absorb. Thanks for this board and all you wounderfull people. I went through somethng simular several years ago when Shirely was diagnosed with cancer. We went through that, didn't end up well but we tried, so I know I can get through this. Dang it though!

Jerry
 
Jerry, I know what you mean. Our sweet Snowflake died from cancer three years ago despite surgery to remove four large tumors in her mammary glands and now this! I love Oscar as much as I did Snowflake.

Also, today I learned that when Oscar's sugar is 150 after not eating for seven hours, he throws up and starts heading toward hypoglycemia. Got it stopped with some dry/wet mix just as he was getting uncoordinated.

So I guess on days I can't feed him as often, he just needs one unit?
 
Well we've got all all our supplies and enough honey for every biscuit in the county and off we go. Kinda spooked out still, but Punkin and I have started our journey. The little fart just dosen't look sick! After a night at the vet's, I told her it was a B&B she was ready to come home. Eating like a champ, of course drinking and peeing like a drunk, but oh well, we do what we do. Man this stuff is expensive.

Wish us luck.

Punkin
Jerry
 
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