Our 15 year old Himalayan just diagnosed

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Joe & Kushi

Joe & Kushi

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I am definitely a newbie.....Our 16 year old Himalayan (Kushi) was just diagnosed and the vet has her on 2 units of Glargine 2x a day. Cat seems to be doing fine. Our vet also wants to put her on Hill's Prescription canned food (she has always been on dry food) which we now know is bad for her. I bought a couple cans of EVO Turkey and Chicken to try and she seems to readily be accepting the change. My question is: should we tell the vet to forget the Hills Rx. Doesn't appear to have any benefit that the EVO doesn't have.

Joe
 
Welcome Joe and Kushi,

It is overwhelming at first, as is this site with all its info. The very best thing you can do for Kushi is to read and reread and ask lots of questions.

It is great that you have changed to wet lo carb. The FD vet explains why it is best: www.catinfo.org BUT food can make a big change downward in blood glucose levels and you have started on a higher dose than we might recommend. (Oliver went down 100 points overnight when we switched from dry to wet.) Our motto is to start low and go slow, so you don't run the risk of a hypo. We usually suggest starting at one unit twice daily.

So we would suggest that you start home testing now. You need to be able to see exactly how the diet and insulin are working together (BTW, Glargine is a great insulin; we call it Lantus). Here is a good beginning site: Newbie hometesting site and a video: Video for hometesting If you are willing to learn, we would be glad to help.

We have a Lantus support group. viewforum.php?f=9 There are several starred threads at the top, under the grey line, which will give you valuable information on how Lantus works in cats and how best to use it.

We would love to help you help Kushi. Just ask!
 
Welcome :smile: Any commercial canned food is better for your cat (and easier on the wallet) than the prescription stuff :smile: You can just tell the vet that you are feeding low carb canned food and do not want to feed the prescription stuff. You don't really need to explain the reason why unless your vet keeps insisting on prescription food. EVO is good and there are many others, including Fancy Feast and Friskies and other not so expensive brands.

Glargine aka Lantus is a great insulin to use :smile: But your dose of 2 units twice a day is a bit too much for a newly diagnosed cat. It's recommended to start as low as possible, like 0.5 units or 1 units twice a day, and only slowly increase the dose by no more than half a unit based on blood glucose curves. Insulin dose is not based on weight.

There are a few things you need to know about using Lantus, such as how to handle it and the "storage shed". All the info is over on the Lantus support group at near the top: http://felinediabetes.com/FDMB/viewforum.php?f=9

Are you testing your cat's blood glucose levels at home? Blindly giving insulin can be dangerous because you don't know what your cat's blood glucose level is and if it's at a safe enough number for insulin to be given or not. Some vets don't tell their clients about hometesting. Others may say it's unnecessary and/or harmful which is not true. You just need a Human blood glucose meter and related supplies (test strips, lancets).
 
Thanks so much for the prompt feedback! Should I just go ahead and reduce the Lantus to 1 unit 2x/per day or check with the vet first? This Monday will be a week and I'm scheduled to take the cat in for a glucose curve. What meters do you suggest for home testing?

Joe
 
The curves is better done at home. Stress raises bg levels and most cats are very stressed at the vet. If you can get testing down this weekend, you can have curve numbers available for your vet on Monday! You can have numbers by your next shot time if you start today so you will know how the dose is doing by tonight.

Here is a shopping list:

A human glucometer. Any one that sips and takes a tiny sample is fine. The meters are often free at drug stores; it’s the strips that are expensive. You can, however, buy them on ebay at less than half the price of stores. Lots of people here also like the ReliOn from Walmart. It is an inexpensive meter and its strips are the cheapest around. Try the meter out on yourself or someone else before you try it on your cat. You want to be familiar with it before you poke the cat.

Lancets and a lancet device. Usually, until the ears “learn” to bleed, a 25-26 gauge is good. Any brand will work.

Ketone strips. (Ketostix) Just like human diabetics use. You will sometimes need to test urine if the numbers are high.

Rice sack. Make this out of thinnish sock, filled with raw rice or oatmeal and then knotted. You heat this in the microwave until very warm but not hot. Then heat the ears before poking.

Also nice to have. Flashlight: so you can look at the ears and find the little capillaries that come off the vein running down the ear. Vaseline: Put a tiny smear where you want to poke. It will help the blood bead up.

And some lo carb treats to give your kitty, successful test or not Lo carb treats

It is not always as easy as it looks on the video. We all have tips that helped us. The rice sack was the magic trick for us - nice warm ears bleed better. If you have trouble, just ask for advice.
 
This is just my opinion because I'm not a dosing expert, but I don't think you should be shooting 2u without hometesting. I would drop it down to 1u until you get some data to adjust the dose. Many cats never need more than 1u. Bandit started out on 1u of Lantus (glargine) and never needed more insulin than that, and he is not a small cat.

Hometesting is great because you can collect daily blood glucose numbers and know how the dose is affecting your cat. When you think about it, a human would never shoot insulin without testing their blood sugar, and it's the same for cats. For glucometers, I use the Aviva Accuchek now, but I started out with the Relion Micro and liked that one, too. If there's a PetSmart near you, pick up some Beefeaters freeze dried Salmon or Chicken to give as treats. Bandit LOVES them and you will want to give a treat after every test, because it makes testing so much easier. Another thing I would add to your list is a small tube of antibiotic ointment + pain relief. You put a tiny bit on before or after you prick for blood and your cat's ears won't get sore. There are other things you can use to warm the ears, too, if you can't find a rice sack (I could not for the life of me find one anywhere). I used to heat a damp washcloth in the microwave until it was warm (not hot) and stick it in a plastic baggy, which worked very well.

Good luck Joe! If you would like dosing advice I recommend checking out the Lantus user group forum: viewforum.php?f=9. The people there are very experienced in dosing and can give you some excellent guidance.
 
Be sure to read about the "shed" and hypo on this forum. Once the body's shed gets full, the risk of hypo is greater if a high dose continues. I think that is why they suggest to start with a low dose so that you have a better control of the need for insulin and can monitor. If I had only known...I would have started with a lower dose. With my cat, we started out with 2 units twice a day and eventually went up to 4 units twice a day. The high doses filling his shed very fast and the change to all canned food, I believe, contributed to his seizure since his need for insulin drastically lowered because his pancreas had started kicking in. Because of the information about hypos and what to have on hand in the event of one (on this website), we saved my cat's life. He had absolutely no symptoms prior to the seizure. When he had his seizure, i had Karo syrup and a liquid medicine dispenser ready and gave him some syrup. Then I followed by giving him some high carb food with gravy to eat while I got his carrier to take him to the emergency vet. He is off insulin now and I believe is a diet controlled kitty. For a while I gave him 4 small meals a in a 24 hour period. Now since he is off the insulin, he eats twice a day like my other cats. Hang in there. This is a great group of people. So very helpful!!! Good luck.
 
Thank you all again for your replies. I have just returned from Walmart with my ReliOn Tester and supplies in hand. Boy the test strips for the Relion are much less expensive than the others I looked at. I also talked to my vet this morning and she said she would stay with the 2 unit dosage, but I think I will drop it back to 1. By the way.....what is the "normal range" for glucose levels in cats??? Now I must get up the nerve to "poke" Kushi in the ear; yikes!

Joe
 
So glad you decided to hometest! It can seem hard at first, especially if you don't have a cooperative cat, but there are many tricks we all have used to get our cats on board until they get used to it (and believe me, they all do). With Bandit, when he struggled I wrapped him up in a blanket and placed him in a basket. And of course, treats after every test! Soon he came running when he heard me turn on the glucose meter.

Please consider setting up a spreadsheet to record your numbers so that people in the Lantus group can give you advice if you need it! Here's the template that we all use, and instructions on how to set it up and put it in your signature: viewtopic.php?f=6&t=18207

Here's a link that I used for target BG numbers: http://petdiabetes.wikia.com/wiki/Blood ... guidelines. It tells you the normal range, but for now you're going to try and aim for numbers a little higher than normal BG so that your cat is regulated safely. Once regulated, you can fine tune the dose.
 
We generally say a regulated cat is somewhere in the 200s at pre shot and in the 100s at nadir (lowest point in the cycle). That is a cat on insulin. A cat is getting into hypo territory and may need some intervention in the 40 range.

A cat in remission (off insulin) runs between 40-120, staying in the double digits most of the time.

One of the most important elements of testing is the treat! The cat earns a treat with every poke, blood or not.
 
It's great you've decided to test at home. Knowing Kushi's numbers is so important! Knowledge is everything.

Normal BG for the average, non-diabetic cat is 70 - 120 mg/dL -- though they can be higher or lower.
Regulation -- your aim will be to keep the blood glucose above 100 all the time, and below 200 as much as possible.

Did your vet talk to you at all about hypoglycemia? Hypos happen when there is too much insulin in the system which causes the blood glucose to drop too low. 40 and below needs to be treated promptly. 40-60 needs to be watched, though some cats who are not diabetic can be in that range. Here is the link to our page that talks about hypos and how to treat them. viewtopic.php?f=28&t=15887.
 
jphilllips said:
Should I just go ahead and reduce the Lantus to 1 unit 2x/per day or check with the vet first?
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I would tell the vet that you feel that 2 units is too high and that you want to start at 1 unit twice a day. A too low dose is better than a too high dose, IMO.


T
jphilllips said:
his Monday will be a week and I'm scheduled to take the cat in for a glucose curve.
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Hometesting may take a bit of time to learn so if you want you can still go ahead and take your cat to the vet for the curve. But I wouldn't do any more vet office curves after that. You can do that at home.

jphilllips said:
What meters do you suggest for home testing?
Click to expand...

I like the AccuChek Aviva. Very cat-friendly and easy to use :thumbup Tests trips are kind of expensive, though. I usually bought the mail order ones from HealthWarehouse.com Some people buy test strips from Ebay.
 
Well, my first attempts at testing were complete failures; tried several times and didn't get the first drop of blood. I reduced the Lantus dosage to 1 unit just in case. Will go at it again tomorrow and warm up the ear. Don't know who was most upset, me or Kushi!
 
Warming the ear is usually really important at first. It also really helps to have something behind the ear to poke against - some people use the rice sack, others use a pill bottle (which when filled with hot water can also work for warming the ear) We used a makeup sponge.

Are you sure aiming for the right spot? Where to poke You are aiming for the little capillaries that run off the vein that runs along the side of the ear. '

You can double poke - just a quick second poke in the same place.

A tiny smear of vaseline can help the blood bead up.

It is hard at first. We spent an entire weekend poking poor Oliver before we ever got a drop. Once you get it, though, it feels so good because you are finally in control.

And remember, a treat every time, successful or not.
 
Sue and Oliver said:
Are you sure aiming for the right spot? Where to poke You are aiming for the little capillaries that run off the vein that runs along the side of the ear. '

You can double poke - just a quick second poke in the same place.

Thanks! The large photo was very helpful. I got a nice drop this morning after abandoning the lancing device and sticking Kushi manually....she never even flinched! Now it seems to me that running a curve is a LOT of sticking for those tiny ears :o
Click to expand...
 
Hurrah! Welcome to the Vampire Club! :RAHCAT

You can put a little neosporin with pain reliever on her ears. Also, hold the ear for a few seconds after poking to eliminate bruising.



How about sharing your number? We are dying to hear!
 
Sue and Oliver said:
Hurrah! Welcome to the Vampire Club! :RAHCAT

You can put a little neosporin with pain reliever on her ears. Also, hold the ear for a few seconds after poking to eliminate bruising.

How about sharing your number? We are dying to hear!
Click to expand...
Number was 222 (before injection),sorry I meant to post it.
 
You dropped back down to one unit, right? I think that was a good move. That is nice beginning number.

Time to get your numbers into a spreadsheet: viewtopic.php?f=6&t=18207 Then you can see trends and patterns and we can help because we will have a snapshot of your dosing history. The template is loading slowly. If you have problems, just ask.

If you have get some more tests in today, that would be good. Around 4-6 hours after the shot should be near the nadir (lowest point in the cycle)
 
That is a nice long surf. When you get to the normal +12 shot time, if he is not over 200, I would not shoot. Wait 30 minutes and test again. Come on and get some advice. We generally tell new diabetics not to shoot under 200, as you have no data and can't be sure how low he could go. Once you have gotten lots of numbers and can figure out his pattern, you can be more daring.
 
Thanks Sue, having NO experience, I thought maybe my first result was erroneous. I really appreciate you keeping up with Kushi and me. We both need all the help we can get; actually I need more help than she does. BTW Kushi is looking over my shoulder as I write and asks that SHE be referred to in the proper gender...... :lol:
 
8 pm test results: 239.....shot Kushi w/1 unit; will see what the number is in the morning and start my spread sheet.
 
Kushi was high (355) this am, so went to 1.5 units ) maybe I should have stayed with 2?). Should I check her in one hour or wait two?
 
When we test, we use the flashlight that you put on your head like a miner.. It is called a headlight. That way we have both arms free. My husband wears the flashlight on his head and holds my cat while I give treats and do the testing. i still have to poke a few times before I get any blood. It gets a little easier though!

I think as a newbie, the more you can test, the more you will know how your kitty reacts to the doses. Keep the spreadsheet up to date so that people can give you the right advice. It really helped for the readers to advise me with my kitty. They were wonderful!
 
Yep, I use the "miners light too. And I resumed using the "lancet pen" and it is working just fine; one poke, no flinch, and we're done!
 
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