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KatWolfdancer

KatWolfdancer

Member Since 2013
I try to be obedient. :~/ But I'm rarely good at it.

My Harley, 13 years old, and I've had him since he was 4 days old, has just been diagnosed with diabetes. In an effort to educate myself, a member of this fine Community guided me here. I am hoping to learn all I can to manage my baby boy's diabetes, so that we can continue -for as long as God allows- to thrive.

Thank you for .. well, being here

>^,,^<
 
Welcome to the best place you never expected to be. We have lots of members who have been exactly where you are now. A new diabetes diagnosis for their beloved cat.

Harley is your cats name. What is your name? Where do you live? US, Canada, International. This helps us to tailor the advice to your specific country.

We advocate a good long lasting insulin, home blood glucose testing to keep your cat safe, an appropriate starting dose of insulin, and low carb canned food.

What would you like help with first?

Home testing?

Best insulins to use for a cat?

Diabetes management guidelines?

Food Advice?

{{{{Hugs}}}} for you. We are here to help. Let us know what we can do too help.

p.s. Remember to take deep breaths, lots of deep breaths. This disease can be managed and cats can have a long life.
 
Hello and welcome!

How was your kitty diagnosed? Did the vet send the blood to a lab? Did he mention the fructosamine level?

Wendy
 
ohmygod_smile
OH yeah. MY name. :shock: Y'all mean you're not omnipotent? I meaN, i did INCLUDE THE important PERSON! ohmygod_smile
My name is Kat. (I also have wolfdogs, so imagine the razzing I get :razz: ) I live in Oregon, in the US.

This has all been rather whirlwind for us both. I brought Harley (his whole name is Harlequin Davidson Katt) in originally because I thought he might have arthritis, and I know that most pain-alleviating drugs are anathema to cats. He was in deep pain, and rather lethargic, and had lost weight. He had dropped down to 12 pounds from his normal strapping 19 pounds. (Yes, he WAS a tad overweight, but he is also one of the tallest longest non-Maine Coon cats I've ever met. Harley is a strappin' laddie!) I put all these symptoms to the pain.

Turns out he landed wrong as he jumped off our bed. How VERY fortuitous for us both. We had a full blood panel done, which is when my Vet (may all the *Angels* Keep and Bless her) discovered his diabetes. His BG (blood glucose abbreviation, right??) was hovering around the 550+ zone. :sad:

I bought an AlphaTrak monitoring system and TRIED to get it to work, but kept getting error messages. NOW I know that because he was in such distress, it was VERY hard to get even the teensy bit of blood required. I followed doctor's orders for 1 unit twice daily.

After about 4 days, at 2 am on Saturday o'dark hundred morning, I don't know what woke me up out if a DEEP sleep, but when I turned the lights on, Harley's eyes contracted, they didn't blink, nor did they dialate. He was limp, unresponsive to my voice, and panting out of his mouth. I remembered that the Vet had mentioned having Karo syrup on hand, so I began applying Karo to his gums every oh, every breath I took in panic mode. He began to have Gran Mal type seizures, along with Petite Mals. The Gran Mals were accompanied by his screams, and my breaking heart. At 4:45 am I finally got a hold of the Vet, and began to administer syringes full of Karo every 15-20 min. At 4:45 am I finally was able to test. He was at 37. I have NO IDEA how low he was when I awoke, I couldn't hold him still enough to draw anything. At 8 am, I met the Vet before her surgery schedule.By then, he was fairly stabilized. He has had one more low BG level event, but this one -at 30- had no symptoms, and after several hours of eating and Karo, we got his levels up.

So we took him off the insulin for the past four days. Today is the first day back on, we are starting at 1/2 unit daily for one week, then we're going to look at the monitoring charts I've been taking, and probably increase to 1 unit daily. OH and I am using Lantus. and No, Wendy *frown* no one has mentioned -to my knowledge- the fructosamine levels. Can you explain? Maybe they were in the blood work, and I didn't yet know the right questions to ask.

We have gotten back 3+ pounds of his lost weight, he's no longer boney. But I AM going to be careful about watching his weight ! We tried the diabetes-specific canned food, and he HATES IT. I literally have to with hold ALL foods from him before he'll eat it. So that is a NoGo. Since we are also a multi-cat household, that has added to the Diet Challenge. I got some Instinct canned, and add either tuna or fresh roasted chicken to it.. Add to this, RenaFoods (a kidney strengthening supplement) Oasis Feline (vitamins -the BEST- specially designed for domestic cats so that I could be assured that the semi-BARF diet had the taurine+other misc minerals & vitamins I know he needs) plus a teensy bit of fish oil for the Omegas. Sometimes I add a TBSP of Friskies. I bought some Taste of the Wild kibble (Bison/Salmon formula 53% Protein/17% carbs) which I keep in a Tupperware next to my pillow for those times in the middle of the night when he demands a snack. I also make him home-made no additive nothings chicken jerky, which he loves.

Harley LOVES his crunchies. Does anyone have a good natural low carb kibble recipe? I don't mind cooking for him. He HATES raw food. I have tried liver and hearts, NOGo. I even tried braising them in organic chicken stock. NoGo. The majority of his diet now is "wet" (I hesitate to say "canned" , because I add whole meats to the canned foods, and sometimes he gets just the whole meats -with vitamins of course-

Also another question. Should I be testing before AND right after his insulin shot? Or should I wait? We have ascertained that he has a four-to-six hour "response"?? curve to his insulin.

I am very fortunate that I am disabled. I cannot IMAGINE how I would have been able to do all this and work full time! I would have lost my job for sure by now... Because I WILL NOT, SHALL NOT CAN NOT give up on my Baby boy. Long post, *sorry* Tried to get all the facts down..

>^,,^<
 
Hi Kat and Harley!

OH yeah. MY name. :shock: Y'all mean you're not omnipotent? I meaN, i did INCLUDE THE important PERSON!
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I did not want to make an assumption based on your user name. You know what they say about assumptions. ;-)

Lantus is a good, long duration insulin with a slower more gentle onset and is used by many cats here on FDMB.

This has all been rather whirlwind for us both.
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That is a very good way to describe this disease. I refer to your continuing lessons in managing this condition as a crash course, graduate college level in feline diabetes. :shock: :o :shock:

Should I be testing before AND right after his insulin shot? Or should I wait? We have ascertained that he has a four-to-six hour "response"?? curve to his insulin.
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You want to be testing before every pre-shot. The test in the morning is the AMPS, the test in the evening is the PMPS. Additional tests are useful to see how Harley reacts to insulin. A +2 (so named because it is taken 2 hours after your pre-shot test) can be useful to tell if this is going to be an active cycle or a more normal cycle. A mid-day test is very helpful because Lantus dosing changes are based on this mid-cycle number, not the pre-shots.

Are you home testing now?
Does your vet want to get a curve, 6 tests 2 hours apart starting with a pre-shot test? You can do that curve at home for a much lower cost than at the vets.

p.s. I like to have some quick at hand information in your signature. To do this, go up to the upper left of the screen and click on user control panel, then click on the tab labeled Profile, over on the left hand side is a list of items you can update. First, to add your location, click on Edit Profile, put Oregon in the location field and click on the submit button down below.

Next select Edit Signature and a free form text box will appear. Here is where you can enter some basic information like Your name, your cats name, insulin used, meter used for testing, any complicating health factors your cat may have, what food you are feeding. Since you are using the Alphatrak meter, select that text and change the font to large. In the middle of the editing codes bar there is a drop down list with the work "Normal" displayed. Click on the arrow and select the "Large" font.

That will alert us to the fact that your meter reads 30 points higher in the low range, 30-40% higher in the upper range, then the human glucometers most people use. Normal non-diabetic BG numbers for cats with the Alphatrak are 80-150

Data like that gives us a quick snapshot and allows us to help you and your cat better. Would you be willing to add that information please?
 
I believe I did the signature thingie correctly??

"Crash Course, Graduate College level... " YES. That's how it feels exactly. All squashed into an accelerated 4 week course ! :shock:

uh oh...
You want to be testing before every pre-shot.
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a PRE-shot? OK, I may not have the correct questions.
I feed Harley his breakfast immediately upon awakening -even before my coffee :roll: (how ever does she function, you may ask?)- As soon as my eyes have unfogged, I give him a Monitor test poke. (and write the numbers, date, time, and what he had for food and how much in his Journal, along with any observations I may have) Then I give him his insulin. Then I test him again, after about oh, say 1 hour. I will also test him at the 4-6 hour time element (would this be considered, then, a +4-6?) that my Vet said was his .. "insulin curve"??? (again, I may be using incorrect terminology??) and I will test him again about 2 hours before bedtime, and again at bedtime.

This is our USUAL (as if anything about diabetes is "usual"???) schedule. Is the PRE-shot test the test I do after breakfast? and before insulin? (i realize this may REALLY seem like a stupid question, but I DO know about assumption thing!)

>^,,^<
 
Signature info is great.

Is the PRE-shot test the test I do after breakfast? and before insulin?
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Yes, the order should be test, feed, insulin shot. Or Test, insulin shot, feed if you cat always has a good appetite, you may be able to shoot as he is feeding.

You want to test in the morning before the shot and before any food. That way, the BG number you get is not influenced by food. Food does take 20-30 minutes to have any effect on the BG numbers.

Are you that quick in the morning, that you are getting your AMPS test within 20-30 minutes of Harley starting to eat?

Does Harley get an evening insulin shot? Then he should have an evening blood test. This evening BG number is called the PMPS, PM for evening, PS for pre-shot.

The test one hour after insulin +1 isn't giving you much data. It should be about the same as your AMPS/PMPS shot. A more useful number is the +2 BG test, having food before this number is fine.

The +6 is the normal time cats go their lowest. This is known as the nadir.

A curve has two meanings. First meaning is the shape of the numbers plotted out onto a graph. A typical lantus curve is in the shape of a smile.
The second meaning of curve is to test every 2 hours for a 12 hour period, starting at AMPS and ending with PMPS. This BG curve is used to see how the cat is doing over time and to see if a dose adjustment is necessary.
 
no one has mentioned -to my knowledge- the fructosamine levels. Can you explain?
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Fructosamine test is a blood test that measures the average blood glucose levels over a 2-3 week period. I've seen references that say 2 weeks, others that say 3 weeks.

It is a good indicator that your cat actually has diabetes, in conjunction with other clinical symptoms and other tests. A single blood glucose test taken at the vets office or a urine test for glucose are not definitive tests for diabetes. They are clues in this puzzle. Other clues are peeing excessively (think lakes and puddles) polyuriaor P/U, and drinking water excessively, polydipsia or P/D.

Other conditions in your cat can have many of these same symptoms. See this recent post for some other conditions. http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=94948&p=1020533#p1020533
 
Are you that quick in the morning, that you are getting your AMPS test within 20-30 minutes of Harley starting to eat?
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NO. I am barely functional pre-coffee.SO I take this to mean I should TEST FIRST, feed second, then insulin third? Then, after say 2+ hours (because we are still getting the whole *balance* graph/curve thing down?)

We are -at this time- only doing 1/2 Unit per day in the morning. Next week, we go to the Vet, have more panel work done, and increase his dose to 1 unit in the morning, test, curve, monitor, and then I presume the week AFTER depending on his blood work and tests, we may go to 1 unit twice daily. Again, only after the Vet does her voodoo blood work magic. :) nailbite_smile

I don't believe we have enough long term information to have had a fructosamine draw yet.

>^,,^<
 
SO I take this to mean I should TEST FIRST, feed second, then insulin third? Then, after say 2+ hour
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You got it!
1. Test
2. feed
3. insulin
4. next test if you want to gather more data +2
5.+6 BG test

Next week, we go to the Vet, have more panel work done, and increase his dose to 1 unit in the morning, test, curve, monitor, and then I presume the week AFTER depending on his blood work and tests, we may go to 1 unit twice daily.
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Lantus is best dosed on a 12/12 hour schedule. Twice a day, as close to a 12 hour schedule as your busy life allows you.

Lantus is a depot insulin and right now, by only shooting once a day, that depot does not have any extra insulin to store up. Also, the insulin is probably only lasting 14-16 hours so your cat is in higher numbers for 8-10 hours a day.

It would be best if you could find a dose that could be given twice a day. Right now, that 0.5u dose you are giving would have a better effect if given 0.25U in the AM and 0.25U in the PM.

If the vet is going to increase the dose to 1u next week, it would be best to split that one unit into 2 doses for the day, 0.5U in the AM and 0.5U in the PM.
 
It would be best if you could find a dose that could be given twice a day. Right now, that 0.5u dose you are giving would have a better effect if given 0.25U in the AM and 0.25U in the PM.

If the vet is going to increase the dose to 1u next week, it would be best to split that one unit into 2 doses for the day, 0.5U in the AM and 0.5U in the PM.
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I do not believe I can effectively draw 1/4 unit. I had troubles drawing 1/2 unit this morning. And THAT was using my +5 Magic Reading Glasses of Improved Vision. I can *mostly* effectively split the 1 unit draw into 2 doses, but even at the 30 unit insulin needles I am now (correctly!) using (that is a whole 'nother story of my steep learning curve !) I won't be able to beat all accurate splitting the 1/2 unit dose into 2. Are we in trouble?? confused_cat

>^,,^<
 
No, I would not call it trouble. Only a challenge to your eyesight. :shock: :o :shock:

Here are some pictures of what some smaller doses look like. The syringes in the pictures have 1/2 unit markings.

Pictorial guide using a U-100 syringe marked with half units:

someinsulin-1.jpg

01unit-1.jpg

025unit-1.jpg


I don't suppose those 3/10 cc syringes you have come with the 1/2 unit markings?

ETA: If you can't do it, you can't do it. Simple as that.
 
You think your learning curve was steep, finally finding out that you needed to use those 3/10cc syringes? I'm fostering Wink for a local shelter. The folks at the shelter had been using 1cc syringes for months to give him anywhere from 0.5U to 4.5U. That is what they sent me home with. To give 1.5U. It was hard to measure accurately. I need really bright light these days.

It wasn't until I got on here, that I found the recommendation to use 3/10cc syringes. At that point, I contacted the shelter and asked if they had any in their box of donated diabetic supplies. They did and I took a whole bunch, including all the Walmart Relion syringes with 1/2 unit markings. That made a HUGH difference in being able to do accurate, consistent dosing.

It's the consistency in dosing that is more important than a precise 0.5Unit.

You could make yourself a reference syringe. Take a used syringe. Draw up some colored water to the 1U mark. Twist the end of the plunger (clockwise or counterwise, your choice) to slowly push out same sized drops. Count how many drops you push out. Do this until you get a consistent number of drops.

Divide the number of drops in half. Refill the syringe back to the 1U mark. Push out half the drops. Make a mark on the syringe at the line where the plunger hits the barrel. This is your 0.5u reference syringe.

Now do the fill but only up to your 0.5U reference line, and push out, counting drops sequence again. Until you can push out a consistent number of same size drops. How many drops this time? Divide the number of drops in half. Refill the syringe back to the 0.5U mark. Push out half the drops. Make a mark on the syringe at the line where the plunger hits the barrel. This is your 0.25u reference mark on your reference syringe.

We don't usually have to teach people this until they have been here for a while and are ready to microdose. Not many people start with such a small amount of insulin at the beginning. We are much more used to having too much insulin prescribed by vets than a tiny 0.5u a day. Your breaking the mold here Kat! :lol:

Make sense? Want to try it?
 
Makes HUGE sense !
I was using the same syringes as you did .. at first. Obviously not now !! :shock: I like the diabetes needles MUCH better (so does Harley)

I think more and more that I am pretty derned Blessed to have the Vet I do.. Since the second Hypo-event (the one with no symptoms) she decided we need to dose low and work up to find the right balance. (good thing, my heart can't handle any more EVER! of these terrible hypo events !)

>^,,^<
 
she decided we need to dose low and work up to find the right balance.
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We call that method SLGS or "start low and go slow".

As you have found out with 2 hypo events, you can't take the excess insulin out of the cat once it is in. We like to start with smaller doses and slowly work the dose up by 0.25 units at a time. So if we were advising you, the next step up from 0.5u would be 0.75u dose.

I know you have just started on your journey with diabetes with Harley, but you have learned a lot already.

I think it is time for you to set up a spreadsheet. Here is the link to our standard format, color coded spreadsheet with how to instructions. http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207 Ask for help with the spreadsheet setup if you need it.

With the color coding, you can see the waves of action. It's pretty cool. :cool:
 
Hello there,
Sounds like you have been getting some good advice from deb. before you make any dose changes though let's get you set up on a spreadsheet. Lantus dose changes are based on the lowest number (nadir) of the day and once you know what that is you will get a better idea of whether you need to increase.

You really want to find a dose that you can give twice a day. Lantus lasts 12 hours and given he already had a hypo at 1unit, he could do it again even if its only given once a day.

Let us know if you need help with the spreadsheet. Also have you tried freeze dried chicken as an alternate crunchie instead of kibbles? Or maybe we can find a lower carb crunchi..
 
The spreadsheet is a google doc. There is a template that you use and copy.

If you do not already have a google account, you should sign up for one.

Here is the link to the directions again: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207 The link is better because it has picture examples.

And right here in this post:
Hello everyone! The following contains the link to a spreadsheet template to help track your cat's BGs using a 12/12 insulin.

**there are two options for getting a spreadsheet template***

1) Check google doc template gallery to see if it is playing nicely. One click and you've got a template!

OR

2) you can download a excel spreadsheet (directions by Sam and S'Mores), which you have to then upload back to google docs

I would advise those who are less computer savvy to try #1 first. If the template is not copying to your account or not loading, then try Sam & S'Mores directions (option #2). Note: Sometimes it takes 1-2 minutes for the google template to "copy" and "load."


Please follow these directions, step-by-step, to the very end. If you have questions, please post a new topic in the TECH forum and someone will help you.

You can click on the link in my signature for an example of a spreadsheet (SS)

SET UP (everyone should follow these directions)
1) You will need a google account.

In order to get a google account, click the link here: New Google Account

You do not need to have a gmail (email hosted by google) account. You can use your current email address and link it to the google account so you can have access to google docs.

Now we're ready to begin!!


A. Getting and Using the Template

Option #1: Direct from Google Docs:
1) Sign into your google account
2) Go to THIS TEMPLATE if you live in the USA. Go to THIS TEMPLATE for a WORLD spreadsheet if you live anywhere else.
Click on "use this template" button.

Image

3) go to step 6 of the directions below and continue from there.


OPTION #2 (directions by Sam & S'Mores)

1) Go to this post for the links to the templates to download.

2) sign into your google account.
3) go to googledocs
3) Click on "Files..." from the "upload" menu
4) Select the XLS file you downloaded and click "open"

5) If the "upload settings" box shows up, make sure "convert documents..." is selected and click "start upload"

6) A copy of the SS will appear. Click on "File" then choose "rename..."

Image

7) Call your SS whatever you like.
8) enter dates, BGs, and doses as indicated on the SS.

B. Publishing your SS, aka Attaching to signature (directions by Squeem3)

1) In a new browser tab, open up your google doc
2) Click on "FILE" in the toolbar and then choose "publish to the web"

Image
3) MAKE SURE that "automatically republish when changes are made" has a check mark next to it.

Image

4) click on "start publishing" button.
5) if a box saying "Are you sure you want to publish this document?" appears, click OK.
6) Copy the link in the DOCUMENT LINK box. (CTRL + C or CMD + C)

7) For a simple text link, like http://spreadsheets.google.com/pub?key= ... utput=html, replace the words "link here" in the following code with the link to YOUR spreadsheet: link here

It will look like this:
Code: Select allhttp://spreadsheets.google.com/pub?key=p4nuph4W6EFUSqZA10igCfg&output=html

(go to #8 below)

7) If you would like a "word" link, such as Cosmo's SS, use the following code: text. replace "link" with your spreadsheet URL, and replace 'text' with the name of your spreadsheet.

it will look like this
Code: Select allCosmo's SS

8) Go to the "User Control Panel" at the top of this page, and go to profile tab. In the edit signature tab, paste the code you created (control v or command v) and save it.


If you have questions, post a new topic in the TECH forum and ask away! Someone will help!
Click to expand...

Using the link is better because all the pictures are lost when I copied the directions here.
 
Hows things going? we could probably help you to move the excel into the spreadsheet format to use from now on.. its pretty easy

Let me know if you would like ?
 
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