Pixie holding steady around the 270's, but limping

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pixiesmom

pixiesmom

Member Since 2013
This is week 1 with testing and Lantus. I thought he'd have a bit more energy, but he still just kinda lays around.
Although he wasn't overly active to begin with, he just seems tired.
He used to run at the sound of food, his or the other animals and now seems to be fine waiting to eat.
(He is not turning food away if offered, though)
Also noticed that he seems to limp a bit on his back right leg...coincidence?
Is this normal behavior for a newly diabetic?
This is only day 3 with insulin.
 
You do have to give it some time - it is a process, not an event.

That said - have you checked for urine ketones?

See my signature link Secondary Monitoring Tools for tips on urine testing and for other assessments you may wish to make for your cat. Some of these subtle indicators are things the vet may ask when you go in for a visit - eating, drinking, etc.
 
I haven't checked ketones. I know the vet checked and it was normal.
It being said that it is a process and not an event, I am to assume that the lethargy
is normal. He's eating fine, alert....not stumbling, just a bit of a limp.
He'll follow me downstairs and instead of trying to attack every piece of laundry like he used to, he just lays down.
He's not sleeping all day, but rather tired and I just need to know that this is "normal" behavior.
Also, can i assume once his levels drop again, maybe after an insulin increase, he will perk up a bit?
Just not used to seeing this behavior...
 
Lethargy may reflect excess glucose or something else unrelated to diabetes. After seeing the spreadsheet, I'm going with excess glucose.

You've been on insulin barely 2 days - it can take 3-5full days to determine if a dose is working effectively or needs increasing. Getting a test around the nadir - from +5 to +7 hours after the shot, will help determine if it needs adjusting.

Ketones can develop in a day; please pick up some testing strips while you are still regulating.

For the limping - does it seem like the leg won't support the weight and kind of buckles? That may be diabetic neuropathy, which is treated by 1) getting regulated and 2) methylcobalamin a specific form of Vit B12. Its available over the counter. Get some with no sugar or starch. It is water soluble and excess is excreted through the kidneys. See Jasper's Story for more info.
 
Just tested +5 and it was 217.
Talked to the vet about his high white count during initial visit.
They will recheck the smear and I will bring him in again next week for another CBC.
He said the same thing...give it some time....may increase this weekend to either 1.5 or 2 units.
I think I would be more comfortable doing a .5 increase to see what happens.
And maybe waiting until the week to increase when I know the vet will be open in case of emergency.
He doesn't seem to be limping like he was this am. Maybe he just twisted something.
 
With most insulin, we generally increase 0.25 units at a time so as not to jump over the optimum dose, unless the nadirs are over 300.

You do have to eyeball it as no retail syringes measure that finely. It may help to use calipers, so you are always at the same position on the syringe.

Keep an eye out for the ketones and observe the Secondary Monitoring Tools in my signature link - there's more to your kitty than just glucose :smile:
 
Yes, don't forget to tell us about the 5 P's and Pixies appetite. Peeing, purring, pooping, preening, and playing are the 5 P's. Put those together with the appetite, and you have the WCR or Whole Cat Report.

Please, only 0.25U increases on the insulin. We don't want you to bypass a good dose for Pixie.

You only just started Pixie on the Lantus. We have some general guidelines for you to follow.

"General" Guidelines:
•Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).
•Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).
•Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.
Click to expand...
You are only at day 3 with filling the depot. You need to be patient and not raise the dose yet.

You certainly don't want to jump from 1U directly to 2U. That could easily be too much and hypo your cat.

This is a marathon, not a sprint. It took time for Pixie to become diabetic. It will take time to get the BG numbers regulated and your cat feeling and looking better.
 
His numbers are looking ok so far - keep up the good work!

As for limping - is it one leg or both? Is he walking on the flat part of his legs?

Also I agree with BJ - diabetic cat owners should check for ketones twice a week or whenever the cat is over 370 because diabetic keto cidosis can develop fast and is very serious and expensive to treat.. Strips are like $8 from Walmart and its fairly easy to test the pee.. easier than blood and you already got that down!!

Wendy
 
He is doing great today. Morning BG 300...higher than I thought it would be. No limping and when I was up during the night I actually saw him scratching on
his favorite magazine rack like he normally would. He followed me around this morning because he was so hungry.
Now he's back to laying around....
So I plan on doing the curve on Sunday/Monday.
I imagine he will need an increase and looking at the syringe it seems almost impossible to do a .25 increase.
How do you accurately measure .25 ??
 
Magnifiers help a great deal. There are syringe magnifiers which clip onto syringes, visor magnifiers for those who don't wear glasses, clip on magnifiers for those who do wear glasses, and free-standing magnifiers. (All available from our shopping partner, Amazon)

Some folks have used calipers to measure a specific distance on the syringe. This can be quite helpful if you get a batch or syringes which have been poorly marked (It happens, so always look at each batch you get and check the consistency!)
 
Glad to hear that Pixie is not limping the morning. It's a relief it was a temporary thing.

Pictures of those small doses for you, with a syringe with those 1/2 unit markings on the barrel. So important to have these syringes.


Click on attachment for a larger image.
 

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Thank you...will try my best when it comes time.

One question...advice from the vet, feed in am and pm. Nothing in between.
Pix has always been a free feeder, multiple times throughout the day and now he acts as if he
is starving.
I am doing 1.5 FF in am and 1.5 FF in pm.

Tried freeze dried treats and he hates them....however, he loves tuna and I'd like to give
him 1/2 a can in between if it won't mess with his levels too much.
Thoughts??
 
If your cat is used to grazing, there is no reason to not continue with this. TO free feed canned food, simply add water to the food and leave it out. The water will ensure it stays moist longer and that he gets plenty in his system.

As to amount of water - most people use 1/3 or even 1/2 can of water - me I use 1 can of water to 1 can of food.

And most cats as well as people do better when eating "mini" meals throughout the day or grazing, rather than eating two large meals. The food spreads out throughout the day and helps to avoid food spikes of BG levels.

Many of us use the mini meal or free grazing method, no reason why you can't too.
 
Free grazing is not an option as Pixie has always been a little too stout to jump and his food
is on the floor with 2 labs around it won't last long. He is used to me just feeding him whenever he wanted, little bits throughout
the day.
Off for the summer, but when i go back to work in Sept, I will feed in am, treat when I get home and feed in pm.
Thanks!!
 
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