Oreo 8 yrs diagnosed with diabetes & perhaps kidney desease

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My Oreo

My Oreo

Member Since 2015
Feeling lost!... Went on vacation & came back 3/30 to my sick cat Oreo. Started on Novolin 70/30 (0.07 cc), took Oreo back to the vet's office 4/2 - BG was over 500, vet gave 0.08 cc but BG dropped to 50... The vet told me to keep the dosage at 0.07 but today kitty crashed hard, so I jumped in the car & took him in (BG was 30)! CBC today shows Oreo is anemic now so gave fluids tonight. Is this kidney desease on top of the diabetes? I feel like I should be monitoring BG at home... Vet said to give 0.06 now, but does this make sense? Is this a hopeless situation? Where should I start? $1,300 later...
 
Can't help with the novolin dosage but a big yes on the home testing its going to save you a small fortune at the vets and prevent hypo as well as give you more accurate results. Vet stress can make the readings that vets get pretty inaccurate. No need to get a special cat one most of us here use human meters.

It's definitely not a hopeless situation and you have found the right place to get help. Home testing will be the best place to start.
 
Novolin 70/30 is a combination R (30%) and N (70%) insulin and is not suitable for cats. R is very fast acting and while N last longer it is not really good for cats since it only lasts 8-10 hours.
o.o7 CC is 7 units and units is used to describe insulin dosing.

I would ditch the Novolin 70/30. and get a better insulin like the human Lantus or Levemir (get the pens and use the syringe to draw the insulin out of the pen since pens only does in one-unit increments and frequently vats require doses between one-unit increments). There is also the pen-only insulin ProZinc and BCP PZI.

Yes it is very desirable to test Oreo's BG at home using a human BG meter. Most of use record our cat's BG and other info in a a spreadsheet that others can view. For instructions for setting one up see:
http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

What are you feeding? a low-carb canned is best for diabetes. No reason for a prescription. For kidney deficiency yo also want a low phosphorous food.

Did the vet do blood work and say Oreo had kidney problems? Can you post the results of any bloodwork? Also do you know the specific gravity of Oreo's urine? that is an indicator of kidney insufficiency.
 
7 units is likely way too much insulin in 1 dose.
If you change food to lower carb, the dose will reduce further, so you need to be home testing.

We recommend ProZinc, Levemir, BCP PZI, or Lantus insulin for cats as these all last about 12 hours in the cat.
 
Novolin 70/30
4/9/15 7:00 pm BG 430 gave 0.05 insulin + 150 cc fluids(vitamin B12/no glucose). He ate, but I forgot to give 1 cc of honey… which my vet recommends giving with each injection...
o 9 pm Oreo didn’t seem right BG was 28! Gave him 2 cc honey
- 4/10/15 7am gave 0.04 insulin + 1 cc honey
o 9 am Oreo didn’t seem right BG 53 gave 1cc honey
o 1 pm BG was 197
o 7 pm BG 398 gave 0.03 insulin + 1 cc honey. 150 cc fluids. He seemed fine when I went to bed at 10:30 pm
- 4/11/15 7 am BG 463 0.035 insulin + 1 cc honey. He finally pooped, hadn’t since Wednesday.
o 9 am he didn’t seem right BG 32 + 1 cc honey
o 11 am BG 135 (called vet with info, said to stay with 0.03 insulin - doesn't quite understand why Oreo's low is at +2 hours
o 7 pm BG 405 gave 0.03 insulin + 1 cc honey + 150 cc fluids
o 9 pm didn't take BG, but normal signs of previous lows gave 1 cc honey

Very frustrated. Asked multiple vets about switching to a different insulin, but both said "NO!" This one seems to be working... I am so exhausted! Will try to upload his CBC from Wednesday.
 
Thanks for weighing in & all your support! I'm so sick with worry... Oreo is such a trooper! Putting up with the poking + syringe feeding! My vet says he should only eat fish canned low carb cat food... Haven't found one that Oreo likes (seemed to like California Nature "salmon & sweet potatoes", but doesn't anymore. Nor does he like weruva). Vet says to stay away from meats due to kidney insufficiency... So we are down to 0.03 insulin (Novolin 70/30), but dropping BG in the 30s at +2 hours. Now it's Sunday tomorrow... How much should I give? Oreo's BG is still getting in the 400s after 12 hours... I'm afraid his BG will drop again even if I drop to 0.02... Need some rest!... Thanks in advance for all your advice!
 
Yes, the bloodwork shows kidney degradation. The high phosphorous requires the use of either a low phosphorus food or a phosphorus binder like aluminium hydroxide added to the food. For more inof on treament for kidney problm see:
http://www.felinecrf.org/index.htm

For the diabetes get the vet to prescribe a better insulin. Novolin 70/30 is not satisfactory for cats. Novolin N would be better but still not good. If you can't get your vet to do that find another vet.
Also, in the future report yu yur BG and does as:
- BG before shot as AM PS or PM PS. AMPS is morning and PMPS is evening preshot BG. For BGs between shot show that a +X followied by the BG value. Where X is the time since the shot.
 
We have a primer on using the Novolin/Humulin NPH insulin here which you may find helpful.
Your vets are seriously out of date with what they are having you use and the procedure they are having you follow. The American Animal Hospital Association Diabetes Guidelines are here. The International Society of Feline Medicine Practice Guidelines are here.
By the way, we report insulin doses in units. For the Novolin 70/30 (and most other human insulins, there are 100 units per mL. These are designated U-100.
 
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Please do try to find a different vet. I'm not nearly as experienced as Larry and BJM, but it seems very strange to me that your vet wants you give honey along with the insulin! This forum and the people here are a wealth of information and support so you've come to the right place.
 
Larry has provided you with the best site for cats with kidney disease. It has list of foods which will tell you the phosphorus levels.
I have a diabetic cat who also has early kidney disease. As far as I am aware fish has much higher phosphorus levels than meat. I would not feed fish meals except occasionally. Your vet is probably thinking of the protein levels and there are two schools of thought with feeding lower or normal levels of protein in the diet of a CRD cat. You need to research that and you can do that on the site Larry provided.
I feed a home prepared diet of raw and cooked meats ( normal level of protein) and egg whites which lower the overall phosphorus level of the meal. My cat's kidney levels have been stable so far (anti jinx).
It is not a hopeless situation and can be managed. You need to get the low anaemic issue addressed as well. You need to look for a low carb, low phosphorus canned cat food. The alternative is to use phosphorus binders to lower the phosphorus in the diet. You need to ask for a copy of all the tests done so you can keep a track of how things go in the future with the CRD. Did your vet take Orea's blood pressure and test his urine. Both tests are relevant to CRD.
 
Thank you, Larry and Kitties, BJM, Mitzelplik's Mom, & Bron and Sheba from the bottom of my heart!! I am really appreciative of all you help! Oreo seemed to feel really good yesterday!! Played with his favorite catnip banana for the first time! Here are his latest numbers: 4/12/15 AMPS 393 (gave 2 units of Novolin 70/30) +11 208 (I took BG right before feeding - I am trying to feed 1 hour prior to injection). 4/13/15 Fed @ 5:30 am 2 ounces canned food. AMPS 316 (gave 2 units of Novolin 70/30). Tomorrow we do another CBC. I am praying for good news re: kidney values. When my neighbor initially brought Oreo in he had a high WBC and was treated with antibiotics... Could the kidney values have been elevated temporarily due to concurrent infection around the kidneys? I understand your feedback regarding Novolin, so I will discuss this. The literature is really there, so I'm not sure why my vet started him on Novolin. My vet's office is really well respected for their use of Eastern & Western Medicine... I'll keep you posted!
 
Novelin is the name for a family of insulin made by Novo Nordisk Inc, not just 70/30. In most places you can purchase Novoline N (or Humulin N made by Eli Lilly) or similar N/NPH like Walmart's brand without a prescription. I would do that vice using the 70/30 if you can't get your vet to write a script fort a better insulin.
 
The nadir, or lowest glucose is around +3 to +4 hours post-shot, you want him staying above 50 mg/dL at the nadir, for safety.

Here are the locations of veterinarians in Akron, Ohio, per Google Maps.

And there are Vet Interview Topics in my signature.
 
Dear FDMB, I cannot thank you all enough for being there for Oreo & I!! I felt so overwhelmed, but you made me take matters in my own hands!! Oreo's last insulin shot was last Monday morning!! Home-monitoring was key!! It's a miracle that I didn't kill him that first week I gave him 7 units twice a day because I didn't know any better... Because that's what my vet told me to do... Oreo's kidney panel even looks better!! Again, thank you for caring!!!
 
If you go 14 days with glucose under 130 mg/dL without insulin, we consider him officially Off The Juice (OTJ).
 
Oh! I was wondering :) Fingers crossed!!! I can't thank you enough for your support!! You gave me hope & strength! Not only feedback here, but your advice on other posts I read!! I feel like I was so ignorant about everything! The dry food!... Why did my vet recommend "Purina One" indoor formula?... Giving insulin without first checking the BG... I'm grateful that I found FDMB! You were there to point me in the right direction!! THANK YOU!
 
Each of us started pretty much blind and learned as we went. Now, if you wish, you can pay it forward, and help new folks learn about feline diabetes.
 
Each of us started pretty much blind and learned as we went. Now, if you wish, you can pay it forward, and help new folks learn about feline diabetes.
 
Each of us started pretty much blind and learned as we went. Now, if you wish, you can pay it forward, and help new folks learn about feline diabetes.
 
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