Newly diagnosed

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ayline82

Member Since 2012
Hello everyone

I'm Aylin and my cat is Kitty, 7.5 years old. We live in İstanbul/Turkey. She was diagnosed about 3 weeks ago. We tried diet change first, and every week the glucose level decreased. First 385, then 350 and then 320. But last monday, she was so stressed at the vet that her level was unbelievably higher than ever: 405! although I feed her with raw meat and wet food only. The vet had examined her body before he took the blood so she was really stressed. I think the abnormal increase in her glucose is because of that.

Anyways... It was the time I decided to do hometesting, although the vet keeps on saying the numbers wouldn't be reliable. As if the numbers at the vets are very reliable!! He gave me a bottle of insulin (Humilin) some syringes and told me to inject the smallest dose two times a day. He also said he won't be here for 10 days. So I'm alone with first time injections!!! He also told us to take the cat to the vet for glucose tests before the injections so that they can decide on the amount. I don't think this sounds reasonable. How can you decide on the correct amount by looking at the blood sugar levels taken when she is so stressed?

I tried hometesting today for the first time. I managed to take the blood 4-5 times but the machine wouldn't work! It always gives errors. I am probably doing something wrong. First, the blood was too little, then I put the blood late, then I didnt put the blood in the middle! Gosh!! And my little Kitty ended up under the sofa and started scratching me whenever I wanted to hold her. I would do the same. But at least I now know it is doable even thpough I don't have an idea about her glucose level now. Her drinking and urination has decreased quite a lot recently. It was a real surprise to see her levels so high (405). She also didn't lose any weigt and her fur is shiny. The only problem is she is lying on the floor most of the time, but God! it is 36 degrees here and even I can't find a position to keep myself cooler! I hope that's it. She plays with me a little in the evenings. We played with my belt yesterday, for example. She comes to sleep on top of my chest in the morning. She comes to my bed sometimes in the evening and falls down when she rolls over :) The abnormality in her behavior is that she does not follow me everywhere. We have been together for 7.5 years and we always folloed each other in the house. If I can't see her or she can't see me, we look for each other so we never apart at home. Now, she preferes to lie on the floor and only sometimes comes to my bed. I hope it's the heat but I don't think so. Does diabetes make them tired?

Another thing I realized is she is breathing fast. That's why the vet examined her yesterday and caused her to be scared, and said there's nothing to worry about, and it's just because of the heat, she is trying to regulate her body by breating fast and that's also what dogs do.

I refused to start giving her injections under these circumstances. The vet didnt even show me how to inject. Ok, I know how to because Ive watched a lot of videos, but I may not have done so! I will take her to another hospital nearby this week, and after a complete check-up to see if there is anything else, I will start injections with that vet's help. I talked to him on the phone, he told me to do hometest and he sounded very knowledable on the issue.

I'm sure her glucose is in 300s and I do believe with just a little bit of insulin she will be fine. Or maybe that is what I WANT to believe, I don't know.

I think everybody is using Lantus and it's the best. So I will ask the new vet about that one.

I'm so sad for my Kitty :( I can't do anything else but watch her and read things. I can't sleep at night. I can't concentrate at work. Sometimes I fear I won't be able to manage this and will harm my Kitty :( Then I will never forgive myself :(
 
Hi Aylin! You will absolutely be able to manage this, and soon Kitty will be feeling much better. I was very afraid at first and also couldn't sleep at night but within about a month, I am feeling calmer and more in control. My cat Ninja is feeling a lot better too. Like Kitty, Ninja was lying around the floor a lot (I think it is cooler there), but now she is back to almost normal behavior.

I too had trouble with the home-testing, but within a few weeks, my cat is no longer trying to run away from me when I test her. The secret is to give Kitty a treat after you try to test her, and let her go after a couple of ear pokes (whether you get blood or not). That way, she associates the ear poking with something fun (getting a treat). The first few weeks may be difficult, but in time Kitty will come around. I NEVER thought my cat would allow this, but in time, she did -- and Kitty will too. Also, after a few weeks, the ears start to bleed more freely - so now, I often get blood on the first try, where a month ago it was taking several tries. So don't give up thinking it will always be this hard; it won't. Look at my spreadsheet (bottom of this posting, the link called "Ninja's SS" and you will see that I didn't get many readings in the early days of trying. Many people have success within a day or two; but I took weeks to get the hang of it.

To get familiar with how the meter works, it might help to test the meter on yourself by pricking the back of your hand or finger with the lancet device and try to get a reading on yourself. That's what I did.

Good luck!!! Post here if you have questions, and the senior members of the board will be by to answer them soon.

Melanie
 
Thanks for the reply Melanie,

It's a relief to see I'm not the only one. Kitty tolerates me when I'm taking the blood and does not move a lot. But after that, she runs away and hides whenever she sees me. Yours was lying on the floor, too? So it's the effect of diabetes then, that makes them less energetic and depressed. I knew it. She would always be next to me otherwise. There is surely something abnormal. It is again nice to hear he is back to normal now. That gives me hope. I'm so sad :cry:

Looking at the chart you prepared, I see you gave him 1 unit even if you couldn't hometest? Should I do the same thing? Is there a risk of hypo with only 1 unit?

I hope she'l give up hiding soon. I'm giving her treats. I did it three times today, but I think it hasn't been enough for her to make a connection :smile: But I appreciate her tolerance. I didn't even think she would tolerate being ear pricked, but she was soo cooperative once I got hold of her and put on the bed or my lap!

The biggest number has been 385 so far (I don't believe in that final 405), and that gives me hope.

I also see that you (diabetic cat owners) decide how many units they should give on their own after some time, right? Just by looking at the number at the glucometer? So, I won't need to take her to the vet all the time to change the dose of the insulin?

Thanks again for your help
 
Aylin, you aren't alone! What you described above is exactly what many of us have gone through. (((HUGS))) With the help of everyone on these boards, you will be able to manage Kitty's care, and relax and even be able to laugh at the early days.

I love your feisty attitude already, and your willingness to home test instead of getting artificially inflated numbers at the vet's office! For home testing, what I did with my Pumbaa was put low carb treats (I used mushed up sardines packed in water, no salt) in front of him during the testing so he would ignore the fact that he was being tested. Our testing position is sitting at the table, with Pumbaa's butt on my lap and his paws on the table in front of me. I have all of the testing supplies on the table to the right, and put the treats right in front of Pumbaa so he could reach them. Bribery works to distract the cat and turn this into a good experience!

What blood glucose meter are you using? Someone here should be able to help you figure out why you keep getting error messages.

As for insulins, most people here use Lantus or Levemir or ProZinc. Lantus and Levemir are long-acting 12-hour insulins, and there are several threads on these boards discussing the differences between the two. I've been using Lantus for Pumbaa, but have also researched switching to Levemir down the road, as Levemir isn't supposed to sting like Lantus does (I think Pumbaa is very sensitive to that), and some cats are less bouncy on Levemir. Levemir is supposed to have a later onset then Lantus, which is a drawback when you're trying to get BG tests in at night. (My sofa, cellphone alarm and I are now best friends as I try to nap before getting up for a PM +6 test. *LOL*)

Re: Kitty lying on the floor. Did she do this before the FD was diagnosed? I'm in Arizona, and it's hot, hot, hot here. Even with air conditioning, my cats lie on the tile floors or curl up in a sink to stay cool. I also keep a ceiling fan running in the living room for them during the day. Also, the higher Pumbaa's BG numbers are, the more lethargic he is...and before he was on the insulin, just wanted to be left alone. Even now, when his numbers spike on a bounce, he wants to be left alone. When his numbers are lower, he's more like his normal juvenile delinquent self!

Re: Kitty's breathing. I can't answer if that is normal or not. Glad to hear that you are taking her to another vet this week as the first vet didn't sound very good.

I'm so sad for my Kitty :( I can't do anything else but watch her and read things. I can't sleep at night. I can't concentrate at work. Sometimes I fear I won't be able to manage this and will harm my Kitty :( Then I will never forgive myself :(
Click to expand...
After 3 months, I'm still sad for my Pumbaa (none of us like poking our cats incessantly and wish that they either never got FD or would go OTJ), sometimes I still have a hard time concentrating at work (too much FD on my mind), sometimes I still worry that I will do something wrong to harm Pumbaa (as long as you test regularly, this should not be a worry), but, I'm doing the best I can, and with the help of others here, it has become much more manageable, and I'm much more confident and less stressed than I was 3 months ago. (((HUGS)))

Suze
 
I know you must feel alone with all this, with your vet gone and no support system. Well, now you have hundreds of new friends who will support and help you. We have had two members from Turkey; I'll see if I can contact them. They will be able to give you ideas on the best low carb foods to feed and alternatives to Humulin.

Unfortunately, Humulin is a a difficult insulin to use. It tends to hit the kitty fast and drop them into low ranges and then not last very long. I know Lantus is available in Turkey; it is a human insulin that we use in cats, so we'll have more info about that for you.

Did you heat her ear? That was one of the secrets for us. We used a rice sack (thinnish sock filled with raw rice then heated in microwave until very warm) but you also can use a pill bottle filled with very warm water. The other thing that helped us was a big enough lancet. The ones humans use (30-31 gauge) are too small for most new diabetic cats. We suggest 25-28 gauge to make a bigger hole. Also, have you tried the meter on yourself so you know exactly how it works, what angle works best for the strip etc? Sometimes that helps.

Tell us how you test, from beginning to end and maybe we can give you more tips that will help. And as Melanie said, a couple tries, give a treat and lots of praise and then try again later.
 
Thanks Suzie,

I don't remember having such a hot summer for a long time. Two years ago, Kitty had stayed with my parents in another city when we were on holiday, and it was so hot there that when we cam back,I saw her all over the floor having difficulty with breathing. When we came back to our house, the temperature was normal and she was back to normal. This is the second time we are having such a hot weather. I can't be sure if it's the weather or diabetes. She didn't use to do it before, we always slept together. There were times she didn't sleep with me in summer but then she was sleeping in another room on the sofa, not on the floor. But I start to believe that it's because of diabetes. I should immediately start giving her shots. Even a small amount wil work for her to come to normal a little bit, I think.

The glucometer I have just started using today is Accu-check Active. I bought it because it is one the meter that diabetic cat owners recommend here. I think I will learn how to use it in time, but still I would appreciate a little help from people who have been using it.

Keep on sending me and poor Kitty hugs, we need them :)
 
ayline82 said:
I also see that you (diabetic cat owners) decide how many units they should give on their own after some time, right? Just by looking at the number at the glucometer? So, I won't need to take her to the vet all the time to change the dose of the insulin?
Click to expand...

Pumbaa only went to the vet for the initial testing and diagnosis of the FD. He was so agitated he bit me, hard, and had to be muzzled for the blood and urine draws and exam. My vet has access to Pumbaa's spreadsheet, and was all for my home testing due to Pumbaa's agitation. While the vet is there if I have any questions or concerns, the people on these boards are living with diabetic cats and have more in-the-trenches experience than many vets, IMHO.

You'll want to start your own spreadsheet on Kitty, so that people here can see her dosing, her BG numbers throughout the daily cycles, and any other information you provide, like what Kitty was fed, when you checked for ketones in her urine, etc. The directions for setting up a spreadsheet are here: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

The actual dosing is based on the curve of the daily BG readings. The curve is explained here: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=55696&p=603248&hilit=third+eyelid#p617289. The BG test right before the shot (AMPS & PMPS) tells you whether it's safe to shoot/safe to shoot the full dose. The numbers that determine the dose, and whether to increase/decrease are the lowest readings of the day, or the "nadir".

There are different protocols you can follow, which help you figure out whether to increase or decrease or hold the dose. There's Start Low, Go Slow, and also the Tight Regulation Protocol. On top of that, the board members will also help you figure out dosing.

Hope this helps!

Suze
 
Hi Aylin! Yes, there is a chance of hypo even if you give just 1 unit and not home test. But I discussed with my vet, and because Ninja's numbers were so high in the 400-600 range (and her clinical signs were so evident -- urinating a great deal and drinking too much water) the vet felt that one unit would be ok; but she did advise me to be alert for the signs of hypo; AND to keep trying to test. It is not the ideal situation, but one that some newbies are faced with (needing to give insulin but being unable to get consistent blood glucose readings in the first days or weeks). I also want to emphasize that I am using Lantus which is a slower acting insulin and is very different from the Humilin that was recommended for Kitty.

Once I got better at testing Ninja, I would call and discuss her blood glucose readings with the vet and she would advise on increases. Ninja is now up to 3.5 units of Lantus twice a day -- but I would NEVER have increased her to this level without being able to test and without the vet's approval. I think most people on the board keep their vet informed and work cooperatively with their vet on this.

Make sure kitty has plenty of water as that may help her stay cool, and diabetic cats tend to drink more anyway. Don't get discouraged! Within a month, you will be an old pro at this, and giving encouragement to others!!

Melanie
 
Aylin,

I saw in another thread that you got 13 on your meter. I think you use the metric system in Turkey, right? We use the US system so our numbers look very different from the metric. To get US numbers, multiply by 18. So your 13 could have been a good test - it would be 234 for us.

Once you go to set up your spreadsheet (yell if you need help) you can use the World Version and it will automatically convert the numbers for you and for us.
 
The glucometer shows mg/dL. It must be the correct version, because the tests at the vet also shows that: 350 mg/dL for example.

??
 
I've just tried on myself, and it said 110. I think what I did wrong was I didnt wait for the strip to absorb the blood. That seems to be the trick. I must resist the temptation to try on Kitty once again today!!!!!
 
Oh, give her a couple hours, have a treat ready and try again in a couple hours. :-D It will feel so good to get that first test done!

Yes, it sounds like the meter is reading US numbers. Congrats on your nice normal non diabetic number!
 
Noooo, I couldn't resist!!!!!! I tried again on Kitty but again ERROR!!! I know, the drop of blood was very little. Mine was absorbed all over the strip. Bad news: I'm out of strips now!!!! :evil:
 
What brand of meter are you using? With my meter (Relion Micro from Walmart - which I'm guessing is not available in Turkey), I have to hold the meter at a 45 degree angle to the blood drop (holding it upright almost like you would hold a pen) - with the tip of the test strip just barely touching the side of the blood drop. Then the meter "sips" the blood up and gives me a reading. It does not work if I try to hold the meter horizontal to the blood drop or push it into the drop. Also, some meters require a larger blood drop than others. Mine requires .3 which is pretty tiny. Other meters require more.
 
Good luck Ayline!

It is good that you got a good test in. Figuring out that meter is one of the hardest things to do sometimes :-x

My cat lies on the floor ALL THE TIME !!! She used to be like Kitty, follow me around,k sleep with me... those things i miss. Now she goes for cool tiles and cool wood (cool wii board), doesn't sleep on the rug, jump on the couch (haven't had to vacuum it but once since January :shock: ). She doesn't sleep with me anymore, just jumps up in the morning to help wake me for breakfast.

And she does pant frequently- I think her little motor is running on HIGH with the heat and diabetes. I have a friend who has to stay cool because of his diabetes so his apartment is an ice-box to me.
 
Yay yay yay!!!!! At the end of the day and with my last strip, I managed to home-test my Kitty for the first time and it is 319!!! It was 405 at the vet yesterday, I knew there was an abnormality in that!!!!

And I always took Kitty to the vet when she was hungry for 12 hours to get a more accurate result, this time she was not hungry. Does that mean her BG is even lower than 319?

I'm so happy. I was feeding her all wet and raw, and I couldn't believe it got even higher this week than she was first diagnosed. I feel relieved!
 
Congratulations! The testing will now get easier since you are more confident! (((HUGS)))

It's normal for BG tests to fluctuate throughout the day, depending on when they ate and their activity levels. One day, Pumbaa hit every single color on the spreadsheet. Yikes!
 
If you're still struggling with the meter and the strips.... one thing that really helps me is to get the blood droplet then transfer it to the back of my fingernail, then transfer it from there to the test strip. I have more control this way as Zeus hates having the meter near his head and would shake his head causing us to lose the drop of blood.
 
The numbers in general will look something like this if you are using a long-acting insulin like Lantus(Glargine):

AMPS (morning, preshot) 319
Kitty eats breakfast
Numbers will likely climb a bit
+4 snack, numbers begin to drop
+6 to +7 will usually be the lowest
+8 maybe another little snack, numbers rise
PMPS (evening preshot - 12 hours after AMPS) number should be close to AMPS

It is best for Kitty not to have food for about 2 hours before a test and shot. Spreading the food into several small meals will help to level out the blood glucose numbers. It is a bit of a balancing act, but you'll figure it out quickly now that you are home testing - good job!!!
 
I've started hometesting because we haven't started using insulin yet. Most probably we will from this weekend on, so I'm trying to understand what her levels are without insulin, so that we can decide on the amount of insulin.

I think a little bit of insulin will be enough, right?
 
Yes, those are diabetic numbers, but not awful. We say that a cat who is not diabetic should probably range from 40 -120 with the majority of the time spent in double digits. We enourage new members not to shoot if they get a preshot number 200 or under, but to wait 20 minutes without testing and retest. Not only do we want the number a little higher before insulin is given, we want to be sure the number is rising not falling. Once you have accumulated a bit of data and can predict what the cat might do with a certain dose at 200, you can be more daring with the dose.

I would really encourage you to get your vet to prescribe an insulin other than Humulin. It is inexpensive but just doesn't work well in the majority of cats. I think both members from Turkey were able to get their vet to prescribe Lantus, a human insulin. I hope they will contact you with more information.
 
Dear Aylin,
Please contact me ASAP...
I'm in Istanbul...

Hello Guys,
It has been a long time , I was going to write this week, I am too busy with shanga's stomatitis...
Hope you all ok... Miss u guys,

Hugs
 
Hello Aylin,

I know how you feel worrying and not sleeping.
I've been at this for 14 days now and I am still rolling over and looking for my cat and checking on her.
And when I go somewhere away from the house, I'm thinking about what else I can do.

It's so hard to put them thru all this but it's what we have to do..... not doing it is far , far worse.
It does get better, those first few days are hard. There is so much information all at once to digest but you keep at it and go back and review
and ask us and it starts falling into place.
Everything is new, testing, not really understanding insulin or diabetes.

I still have trouble pricking Shadow's ears because I have a lancet that is too fine a gauge. I had to order a new one and eagerly wait for it to get here.
I have been thinking of changing her name to Pincushion. :lol:

Hang in there. Be Patient. It does get smoother and start making sense.
And as long as you reward your baby for putting up with it, they figure it out too.
I hear some cats actually come when they hear cues that it's testing time. ( I can't imagine that yet. )
 
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