Rags, Newly diagnosed.......Vineland, N.J. USA

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yo hon

Member Since 2013
I really have a hard time finding a place to ask my questions. I hope this is right place. my boy was diagnosed on the 15th with diabetes. The doctor that he is going to says I have to buy diabetic food for him. I thought there were other foods, like Fancy Feast patae that he could eat. Does anyone know of any other canned food that he can eat? he does like the Fancy Feast. He will not eat the diabetic food. I'm having a very hard time giving him his insulin shots. He has very very long gray hair, and I keep putting the needle on the other side of his hair. Just having a very hard time with this. Also he runs away from me every morning because he thinks he's going to go to the doctors. So I'm having a hard time trying to change his insulin times. The doctor says I only have to check his blood once in the morning before insulin. I think I should check it more often because he is newly diagnosed. He would not eat any food today and his blood sugar was 595 at 130 pm I gave him his shot at 7:30 a.m.also I don't have money to buy lancets and I only have 3 left. I had to borrow a glucometer, and my friend is buying the insulin the kayo syrup. my vet did give me a case of food. My vet also gave me a box of syringes.I won't get my check until the third of the month so I can't buy anything now or then.I really need to find a food that he will eat, because he is a very very different cat. I've had a total of 23 cats that I have taken care of and none of them were like him. His ways are very very different, he doesn't like it if you talk loud he will leave the room, he urinates wherever he wants to, usually my living room. I have six litter boxes, upstairs and downstairs. I showed him how to use the litter box. Sometimes he will and sometimes he WON'T. ! I made the HUGE mistake and put catnip, sprinkled on top of the litter in his box, NOT !!!!! NOW when I put catnip down for my other kids, yes, he urinates on it right away. He fights with all my kids. I tried feliway for three months. It did ABSOLUTELY nothing for any of them !!!! Anyhow, I am soooooo frustrated with this whole diabetes thing. The Vet that I specifically asked for when I called to make Rags appt., diagnosed him but didn't tell me that she wouldn't be there Monday or Tuesday when I brought him in to regulate his insulin. So Rags is now seeing the Doctor that owns the place who is VERY old school. The reason I asked for her is because she is up to date with everything. She goes to all the seminars and she helped me to reverse my girl, Freeway when she had kidney disease. I am very angry about that whole situation, because now HE is taking care of my Rags. Does anyone have any help for me ??? Also, the Doc said he can only eat one quarter of a can of food in the a.m. and p.m. and a half a can in between. That' it !!! He was 16 Lbs., now. /13 lbs. Yes I know he was over weight, but he also is a BIG boy. I really love him and want to do good by him, ya know ???
 
Re: Rags, newly diagnosed.

Hello and welcome to the board!

I will try and answer some of your questions:

1. The doctor that he is going to says I have to buy diabetic food for him.
Not true - those are expensive and many cats dislike them. Many of us feed fancy feast classic pates, friskies pates or Wellness grain free since they are low carb which is good for keeping the blood sugar under control but also reasonably priced. But if you switch to wet you absolutely need to home test!

2. I'm having a very hard time giving him his insulin shots
My cat Tiggy is long hair and I grab his fur and kinda roll it back so I can see skin. Or you can ask the vet to shave a few spots till you get used to it. How long has Rags been diabetic?

3. Also he runs away from me every morning because he thinks he's going to go to the doctors.
You can distract him by shooting while he eats or giving him a treat after

4. The doctor says I only have to check his blood once in the morning before insulin. I think I should check it more often because he is newly diagnosed. He would not eat any food today and his blood sugar was 595 at 130 pm I gave him his shot at 7:30 am
What insulin are you giving and how much? Most of the good ones are supposed to be twice a day.

5. I don't have money to buy lancets and I only have 3 left. I had to borrow a glucometer, and my friend is buying the insulin the kayo syrup. my vet did give me a case of food. My vet also gave me a box of syringes.I won't get my check until the third of the month so I can't buy anything now or then
Try DCIN for a free meter and supplies.http://felinediabetes.com/FDMB/viewforum.php?f=15 Also return the prescription food and get your money back and tell him your cat wont eat it and get the foods I mentioned above instead.


6. Doc said he can only eat one quarter of a can of food in the a.m. and p.m. and a half a can in between.
What would you say his ideal weight is? We can work out his calorie requirements from that.

Wendy
 
Re: Rags, newly diagnosed.

You are absolutely correct that you need to test his blood sugar more than once a day, at the very least you want to be testing before both the am and pm shot times as well as getting in at least a couple of spot checks.

You DO NOT need the prescription diabetic food there is nothing special in it, plus there is better stuff ingredient wise on your grocery store shelves. I have a gang of 14 cats two of which are diabetics, everyone here eats what my diabetics do and that is just plain old fashioned Friskies Pate style canned food. My one guy is also a very large fellow at a lean 17lbs (most likely he has a lot of Maine Coon in his bloodlines) and he eats 1 1/2 cans (5.5oz) of Friskies a day and maintains his weight just fine, but then again he has also been in remission now for over 2 years and insulin free. In the beginning diabetics are ravenous because without enough insulin production their bodies can't properly use the food they are eating.

One question I know everyone will want to know to give you the best ways to help Rags is what kind of insulin did your vet prescribe? And at what dose?

BTW Welcome to the FDMB family the best place on the web that you never wanted to be, but will feel so blessed to have found. DO a lot of reading and ask any questions that come to mind, there is always someone around to help answer them and there are absolutely no silly or stupid questions except those that go unasked.

Mel, Maxwell, Autumn & The Fur Gang
 
Re: Rags, newly diagnosed.

Yep- that vet is old school alright.

FF pates are great for your diabetic kitty- as is friskies, 9-lives, and other, less expensive foods- since you have a house hold full of them.

You can re-use lancets a time or two but not syringes. I use 1 lancet a day.

Treats help a cat with testing- and use this teat ONLY with testing and not at any other time. Sometimes the cat likes to be ornery b/c this is something new. You test at least twice a day, most of us do more when possible. While the PS (pre shot) test gives you the number to make sure it is safe to shoot the other tests tell you how much the insulin has effected Rags during the day.

What insulin are you using and what is the dose?

Eating- human diabetics are told to eat several small meals throughout the day- why should a diabetic cat be different? Bear in mind that he will be eating a lot more until he gets regulated and his body is getting the necessary nutrients out of the food. I free fed mine (tough to do in a multi-cat household) but a meal after AM/PM shot, and at least one meal during the day (if not 2) and one before you go to bed at night (and a snack if you happen to be woken up in the night like Sneakers did with me) DON"T feed 2 hours before the shot to get a fasting number.
 
Re: Rags, insulin and amount

This is the second time I'm writing this. The first one just went away. Anyhow, Rags is taking humulin N, I am now giving him 5 units. The Doc that I wanted to take care if him, but didn't said he should only be on five units period. The old school Vet gave me a chart if how high he sugar is and how many units to increase it by. God I am soooo confused. I just don't know what to do anymore and he will NOT cooperate with me. He hides somewhere in the basement. I searched for a solid hour, in the ceiling, boxes, pallets everywhere. Could not find him. I think he is hiding in a "crack" somewhere. Yesterday he got 7 units because his sugar was over 600. It went down to 35 in the afternoon. That's when I was told five units only by the other Doc and to hold last nights shot. When I did get to take his blood today it was 9:08 a.m. it was 560. I gave him his five units. He ate a little and hid. I got home at 3:00 and he ate two bowls of ft beef patae. When can I take his blood again ? Do I keep him on the five units ? That's what that Doc said and I don't know what to do !!!!! I really do not want to call the Doc. I called him this a.m and told him Rags was hiding and I couldn't give him his shot. He told me to re-home Rags to someone who could take care of him. That made me VERY angry. I could take care if him if he wasn't soo stressed and the Doc would explain things to me and help me. The diabetic food was given to me, yesterday they even gave me a free bag of dry food which has carbs in it. (Diabetic food, ha !). Rags has always ate ft tuna and whitefish. He will no longer eat that. He likes the beef and chicken. So, I will keep the basement door closed in the morning, except that's where their litter boxes are. I have one upstairs for my cats with arthritis in their shoulders. Now I just need to know how much insulin to give Rags and how you know if you have to add more. Also when he can be tested after he eats . Someone PLEASE help me I am so frightened !!!!! Yo Hon
 
Re: Rags, newly diagnosed.

You need to start with only 1u insulin. For cats it is not based on how high the BG is or how heavy the cat is (dogs, yes, cats, no). Humulin is not the best insulin out there but they like it because it is cheaper than the better ones. It is a fast acting insulin that drops a cat fast- which is why you have them eat before you shoot- and is out of the body in 6-8 hours leaving the cats BG to rise for the next 4-6 hours so don't expect any low PS tests until you dose every 8 hours- and some have been successful at it. I would change insulins when you can.

If you've only just started insulin drop it to 1u twice a day. Rags is plain miserable as his sugars are going so low then shooting up so high. Plus all this is new to him so he doesn't like it anyway.

To stop Rags from hiding... get him to associate testing with treats. This might take some time to do. But always test him before a shot and try to get mid-cycle shots in as well. It might take a few weeks- it took Sneakers a week for her to figure out that we were testing, no matter what she thought about it, frequently. Associate with treats or a meal. And you test him as often as you can. I test about 5 times a day right now- a 24 hour day, not sun up to sun down :lol: . With Humulin you want to test early- like +2, +3, and +4 after his shot, while later testing- +6, +8, +10 would let you know how long the insulin lasts in his body. It just depends on when you can do it.

There are many people who have vet problems as vets tend to believe they are the end-all and be-all of vetinary care and there word is golden. Golden poop maybe- but poop is poop no matter what the color. As the old vet hasn't yet felt the need to learn about FD from his old school days that can make him very deadly so I would disregard anything he says pertaining to FD for the time being.

Just calm down and breath slowly- you have the links to the food list, start weening the group off the dry and you won't have so much litter box changing to do and other problems hopefully should clear up too.
 
Re: Rags, wrong insulin name

OMG , I don't even know what kind if insulin my poor boy takes ! It is NOT. Humulin, it is Novolin-N. So sorry for giving the wrong information. I fed Rags at 3:00, two bowls of ft beef. Took his BS at 5:00 and it was 480. His shot is due at 9:00 p.m. Do I keep him on the five units ?? If I listen to old school I should raise it by one unit tomorrow morning. New school wants me to keep it at five. I do NOT know what to do ! I just do not understand the food and the insulin. He is starving, he wanted food when I fed my other four and I feel sooo bad that I can't feed him until his shot. Can someone explain this to me ? Does the food raise his sugar, and the insulin lowers it ? So sorry I am so incompetent. Yo Hon, Becki
 
Re: Rags, newly diagnosed.

Becki,

You are not incompetent, just new at learning all the information involved in this new sugardance with Rags.

Yes, food raises the BG numbers. Insulin is needed to process the food so the body can use it. When there is not enough insulin, the excess blood glucose will be processed through the kidneys and end up in the urine.

Yes, Rags BG numbers are high right now but you have just started and it takes time to get a cat regulated.

Sorry, I can not advise you on the dosage for Novolin N, no experience with that one so do not want to tell you the wrong thing.

You want to take any and all food up 2 hours before you give your shot of insulin.

I believe that the Novolin N insulin you are using is quick acting in cats, 1-2 hours before it starts working. I do not know if you need to feed first, What did the vet say?

If the shot is due at 9 pm, then get everything ready before hand. Get your testing supplies out, a treat ready, dish of food. Use the dish of food and the treat to lure Rags to his testing spot.

Close the door so you can not be interrupted by your other furkids. Ignore anything happening outside the room and focus on Rags. Take some deep calming breaths.

I firmly clamp my sugar kitty between my knees because he is a squirmy guy and wants to move around a lot. Have all your testing supplies within easy reach and talk softly and encouragingly to Rags. Kittys love to be told 'your a good boy'.

Warm the ear, hold the ear firmly so he can not flick off the blood, prick close to the edge in the sweet spot, sip the blood up onto the test strip, set the meter aside and give a treat and words of encouragement.

If that does not work for you, have you heard about the kitty burrito? If Rags does not like to be held, you can wrap him up tightly in a towel with only his head sticking out.

Post the number again.

It is hard to listen to all your cats begging for food. No cat will starve to death in a couple of hours without food but they sure will make you think that they will. I have three cats and had to change the other two to the same feeding schedule as my diabetic cat. They didn't like it but it was for the good of all of them. They got used to it.
 
Re: Rags, newly diagnosed.

Novolin-N is really the same as Eli Lilly's Humulin N. Food does raise the blood sugar. I would start over at one unit.
 
Re: Rags, newly diagnosed.

Becki,

Larry has used the Humulin N which is the same as the Novolin N you have for use with Rags. Made by different manufacturers is all.

Larry suggested no more than 1 unit of the Novolin N for now.

How do you feel about that?

I have never heard of the "chart" you talked about in your post that you said you got from your old school vet. You said it told of raising the dosage based on BG numbers? Is there anyway you could type in the information in a post and let us know what it says?

There is a protocol for using some insulins but only for Lantus (glargine) and Levimir. This protocol was not designed for the insulin you are using so I do not have any information to give you on dosing. I would tend to be more conservative and want to use a lower dose. One of our mottos here is "Better too high for a day, than too low for a minute".

You already had one hypo event with Rags and they can be scary to deal with. "Start low, go slow" is another motto we have. It's talking about starting low with a dose of insulin and making changes slowly, increasing or decreasing the dose depending on how your cat is doing.

The switch to low carb cat food can drop the BG 100 points. Keep Rags on that diet for now and keep testing.

Hang in there. Give Rags lots of hugs.

You are the caregiver so it is your decision.
 
Re: Rags, newly diagnosed.

N is not a good insulin for cats and the dose those vets have you using is putting your cat's life in danger. It is a fast acting, short duration insulin. Increasing the dose WILL NOT extend the duration. Also,with N you need to feed at least a 1/2 hr. before shooting because it is so fast acting. What is happening with that huge dose is he is going down too low and then shooting back up even higher. If there is any dry food still out or if you are feeding him during the cycle, that may be the main reason he hasn't totally crashed yet. That is a massive dose for any cat on any insulin unless they have acromegaly.

You need to calm down to help him...your crying, etc. is not going to fix anything. Work with him, use a few treats after testing, and please, drop that dose down to 1 unit a.m. and p.m and get more tests going. Any food you give after his peak/nadir is going to raise numbers up, especially on N. You need to get that younger vet to get you started with either Prozinc, Levemir, or Lantus(Glargine).

I also would not let him outside right now when you are shooting those huge doses of N. He could hypo and you might never find him. If there is any body of water nearby, he could hypo and fall in. I was lucky back in 1990 that my first diabetic that was outside only for a short time did not fall into my garden pond. I caught the actions and knew he was having a hypo.
 
Re: Rags, dosing schedule

As I said at 5:00 p.m his BS was 480, he had two bowls of food at 3:00p.m. took his BS @ 9:00 p.m it is 467. He ate another two bowls. He did real good with the treat testing. The old school vets schedule is as follows : below 60, or 80 do NOT GIVE INSULIN. 81 - 99 lower insulin by one unit. 100 -200 keep insulin the same. 201 -300 raise by one unit. 301 -401_600. Raise by two units. Those numbers all scare me. But you keep telling me to give him only one unit, won't that be too little ?? He has been on insulin since 3-18-13. The normal dose most if the time has been five. What will one unit do ? I don't even want him on insulin. He was approx. A month before getting diagnosed with a 504 reading. He has been drinking and urinating more than usual today. Please help me with this insulin giving. I didn't want to give him a higher dose so I stayed with five. How about if I decrease it by one each day and see how that goes ? I really don't know what the heck to do, I just DON'T want him dropping that low again !!!!! I need to understand this feeding and insulin. Thank you all, I don't know what I would do without you. I just wish you were closer, ya know ??? Yo Hon, Becki
 
Re: Rags, newly diagnosed.

Becki,

We're as close as your keyboard.

Did you give any insulin at 9 PM?

You said he ate two bowls of food. How much in a bowl and what type of food? A can of Fancy Feast is 3 ounces. A can of Friskies is 5.5 ounces. If you are feeding dry food, you need to measure.
 
Re: Rags, newly diagnosed.

Hi Becki,

It's hard to see information in your posts. I see now that you gave 5 units at 9 pm. Is that correct?

If you would please break up your messages into paragraphs, they would be easier to read. With the one big message it is easy to miss things.
 
Re: Rags, newly diagnosed.

Becki, 1 unit may not seem like much but on a lot of cats it is too much. Instead of dropping the dose down 1 unit at a time, try starting at 1 unit, feed a 1/2 hr. before shooting and test even before feeding so food doesn't affect the numbers. Then start doing some tests at maybe +2 and +4, etc. to get a handle on it. He needs to start over on the insulin and sometimes we find out even 1 unit is too much and a kitty only needs 1/2 unit. N is just so short in duration that he will be higher by the time his next shot is due. Ask the vet about a better insulin. Way back before Levemir and Lantus we did use the Humulins...L and U mostly before they were discontinued. Even then very few cats were on N. Rare now for cats to be started on it especially if a vet is no where near knowledgeable on feline diabetes. There is a rebound situation called Somogyi where you keep increasing insulin, especially too quickly, and the more you give the higher the cat goes.
 
Re: Rags, newly diagnosed.

This is what Glendale Animal Hospital has to say:

http://www.glendaleanimal.com/diabetes.htm Please note what they say in the section about dosage and regulation and the "start low go slow" approach.

Too much insulin can put your cat into hypoglycemia and if not caught and quickly treated can kill your cat. "Better too high for a day, than too low for a minute".

It will likely take many weeks or even months to get Rags regulated. This is a "marathon, not a sprint".

No pet owner wants to have their pet on a medication but we want to make them feel better and keep them healthy so sometimes we need to give them medication.
 
Re: Rags, newly diagnosed.

Larry and Kitties said:
Novolin-N is really the same as Eli Lilly's Humulin N. Food does raise the blood sugar. I would start over at one unit.
Click to expand...

I agree. Or even 1/2. Please don't start Rags at 5 units, especially if you've changed his diet or he's not eating or you won't be there to monitor him. That's a huge dose.

My cat Louie was diagnosed the same day as Rags (March 15) and my vet prescribed an initial does of 2 units of Novolin N. She was 380 at the vet. Had I continued with that dose, blindly following the vets prescription and not found this board that evening and learned to test, she'd probably be dead.

I'm now using a scant 1/2 unit, I try to get the syringe a shade under 1/2, so maybe 1/3. She is running 166-196 preshot over the last 5 days. There is a huge drop on Novolin N with her in just 3 hours, often down to the 80s then she peaks at about 4-1/2 to 5 around low to mid 60s). I've been testing her pretest, hour 3 and hour 5, or sometimes hour 4 and hour 6 so I'm getting a better feel about how the insulin is working. I've had a couple of bad drops BS 55 and 40, and was there to give her some carbs. Those scary drops were on doses half to a fourth of what the vet prescribed.

Lantus seems to be the better insulin for cats according to the experienced on this board and I'm going to ask about a switch at her next appt, will probably change vets because I've lost considerable confidence in my vet as well.

You might want to discontinue the insulin completely for 3-5 days, get Rags destressed and comfortable on the new diet and with testing. A few days off insulin won't kill him, giving him too much, especially on an empty stomach and when you're not around to monitor him, can kill him quickly. Start low and don't worry about his numbers too much for the first week. Keep your dose at 1/2 or 1 and keep testing through the week. They should come down on lower carb and they night also be stress-related. You can always raise it gradually later.

You definitely don't want to give him insulin before he has eaten: Test, feed, wait 30-40 minutes to make sure he eats and keeps the food down, then give the insulin if his numbers justify it.
 
Re: Rags, newly diagnosed.

SierraNevadan - Thank you so much for posting your 'newbie' experience with your diabetic cat on Novolin N. Here's hoping Becki, Rags mom, signs back on and reads through all this.

Becki- Please note the advice from SierraNevadan on the tests she is getting on her cat. Because this is not a good insulin for a cat, you need to test more to see that Rags BG numbers are not plummeting and putting him in danger of hypoglycemia and death.

This wiki article explains the different insulin types: http://en.wikipedia.org/wiki/Anti-diabetic_medication The Novolin N you are using is one of the intermediate insulins. This group includes NPH, Humulin N, Novolin N, and Lente. They all have the same sort of effect.

I found a protocol for using these intermediate or lente type insulins. This link from the University of Queensland talks about dosing with NPH or lente insulins. http://www.uq.edu.au/ccah/docs/diabetesinfo/link2.pdf Please read it.

Dosing is based on weight in kilograms. Rags is 13 pounds so 13 divided by 2.2 kilos = 5.9 kilos.
5.9 kilos times 0.5 units (if initial blood glucose is > 360) = 2.9 units two times a day
This protocol says DO NOT INCREASE IN FIRST WEEK.
This protocol says DO REDUCE IF NECESSARY.
This protocol says YOU MUST FIND THE LOW POINT OR NADIR IN ORDER TO KNOW HOW MUCH TO REDUCE THE DOSE.

You also made a major change to Rags diet from high carb to low carb food. This can easily drop a cats blood glucose levels 100 points.

Based on this, your vet started Rags on much too high a dose. If I were you, I would:

1. stop all insulin for now and get Rags used to BG testing at home
2. get Rags transitioned over to the low carb wet food only. Do not let him eat any of the other cats food. This may mean making changes to how you feed your other cats.
3. get a spreadsheet set up so you can track the BG numbers you are getting and people on this message board can see them also
4. after one week, start Rags on 1 unit, BID (twice a day)
5. continue to blood test, feed low carb food
6. talk to your vet about a better insulin for a cat. Either Lantus, Levimir or PZI

We need to get a spreadsheet started for you. Please follow the instructions in this link http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207 to set up a spreadsheet (SS) for your Rags. Give a shout out if you need some help.
 
Re: Rags, newly diagnosed.

Rags has always been eating fancy feast patae. He ate very little dry food. All he eats now is ff. He does not eat a lot. 1/4 can in a.m after his insulin, or while I'm giving it to him. Six hours later he may eat 1/2 can. At his p.m. shot, it depends, sometimes 1/4 to 1/2.
Yes, last night I gave him the five units at 9:00. His BS was 467. This morning at 7:30 his BS was 228. He ate 1/4 can of ff. His very first blood sugar was 504. That's when Vet started him at five units, on the 18 th.

I really want to lower his dose, but should I do it gradually or stop like you said for a week ???? It scares the hell out of me. I have been testing him three times a day. A.m., six hours later, then again p.m. before he eats.

The Vet hasn't told me to bring him back, it's like they just want me to handle everything with the little info. that they gave me. I do not have the money to take him to another Vet, my Care Credit Cards are maxed.

What will happen to him when I totally stop his dose ??? What if his BS goes up real high, what do I do ??? How will his BS be when I give him only one unit of the Novolin-N ? Will his BS go up ??? I REALLY do want to do what you are all telling me, I'm just scared for him !!!! I want him off all insulin. I actually think I have another cat with diabetes. I'm gonna check her BS too.

I'm gonna go to the link for the spread sheet and do one. I don't even know what it is, but I'll do it. I have a book that I keep track of times, dates, BS, and insulin given and what he ate.

Thank you all so much for getting right back to me !!! I REALLY need your guidance. I also NEED the encouragement to do what you tell me because you all have much more experience with this situation, and I REALLY. want my boy off this insulin !!!!

Now, today, do I still give him five units tonight or stop all together ??? Even if his sugar is over 400 ?

I'll be back, I'm gonna try and get the spread sheet so I can do it and send it to you. Thank you again !!!! Yo Hon, Becki
 
Re: Rags, newly diagnosed.

Hi Becki,

Get that spreadsheet set up as soon as you can and get it linked to your signature. That way, when you post, we can see the BG numbers to see what Rags is doing.

Sorry, I'm working today and won't be back until after 4pm, same time zone as you are in.

I'll log back on and hope to see you have got the spreadsheet created and I'll take a look after 4 pm.
 
Re: Rags, newly diagnosed.

Well I guess no spreadsheet today. My tablet says they can't find it. I have been trying for an hour now. I have to go somewhere so I'll have to try again finite. I don't know what I'm doing on this computer, but I WILL try again.
 
Re: Rags, newly diagnosed.

1/4 can in a.m after his insulin
Click to expand...
With N insulin you need to feed at least 1/2 hr. before shoooting. If you give him a shot before eating with that fast acting insulin, what are you going to do if he refuses to eat? You can't get the insulin back out.
 
Re: Rags, newly diagnosed.

Exactly what happens. I give him his shot and he won't eat. The Doc says INSULIN first, then he can eat- do you see why I get soooooo confused about all this ??? I think I cannot listen to what he says at all. Have you seen his dosing schedule that I put on here ? He will not Change his insulin, he won't do anything. They don't even call to see if I'm having any problems and they KNOW I don't know what I'm doing and how afraid I am about all this.

Thank you for your input, I do appreciate it !!! I only work three half days a week, every other day, so I am home most of the time. I'm just really scared to lower his dose to one unit cause I just don't understand any of this. I'm gonna give him his five units tonight just to see how his numbers are after two days of the same amount. I'll let you know.
 
Re: Rags, newly diagnosed.

Honestly, if you give 5 units, you could be endangering your cat. Until you understand how to test and how the insulin works, I would advise NOT giving 5 units.

If your vet will not work with you, is there another vet in the office that will? and if not, then honestly you need to find a different vet, one that will work with you, prescribe better insulin and not make you feel scared and inept.

Have you contacted DCIN, they may be able to help you get different insulin? also if you look in the supply closet - you will find people with insulin to share - here is one example: viewtopic.php?f=15&t=91625

PZI is a decent, easy to use insulin and gentle, long lasting and much better than what you have now.

If you are up to the challenge of doing this without your vet, (Although we recommend having a vet to support you) you can and we can help you....this is one way to do it.

free or inexpensive insulin.....and there are also people giving away syringes, meters, strips etc

viewforum.php?f=15

what do you think,
 
Re: Rags, newly diagnosed.

Hillary, honest to God I am scared to death !!! The truth ! I have been giving him five units for two days, twice a day.

3/22/13 at 9:08 a.m. BS -548. And 5 units given. AT 4:59P.M BS- 480. At 8:53 BS - 467 And 5 units were given.

3/23/13 at 7:30 a.m BS - 228 AND 5 units given. At 6:53 p.m. BS - 470 NO UNITS GIVEN YET. Doc said keep him at five units two days ago. Said I have to give the same dose at night that I give in the a.m. is that right ???? I don't know what to give him at 7:30 tonight. Supposed to give 5, what do I do ?? I don't want to kill my boy !!!!!!!!!!!!!!! Please, please understand that. I love him sooooo much, I just don't know!!!
 
Re: Rags, newly diagnosed.

I think follow what they say here - lets start him back on 1unit tonite and we will go from there.

Now, do you have urine ketone test strips?

Can I ask what country/state you live in? That will help with our advise..

Wendy
 
Re: Rags, newly diagnosed.

Reposting what deb said :

Based on this, your vet started Rags on much too high a dose. If I were you, I would:

1. stop all insulin for now and get Rags used to BG testing at home
2. get Rags transitioned over to the low carb wet food only. Do not let him eat any of the other cats food. This may mean making changes to how you feed your other cats.
3. get a spreadsheet set up so you can track the BG numbers you are getting and people on this message board can see them also
4. after one week, start Rags on 1 unit, BID (twice a day)
5. continue to blood test, feed low carb food
6. talk to your vet about a better insulin for a cat. Either Lantus, Levimir or PZI
 
Re: Rags, newly diagnosed.

We are trying very hard to keep you from killing your boy also. No cat is ever started on 5 units of any insulin!!!!! Have you even read the info I posted on Somogyi (rebound)? So far you have been lucky and his liver has probably kicked in to help send him back up, sometimes even higher, to keep him from a major hypo.

What exactly is somogyi rebound?

Easy answer: term to describe the process in which the body reacts to low blood sugar or a rapid drop in blood sugar. When the body perceives a fast or low drop in glucose, it protects itself by releasing natural glucagons from the liver, which raise the blood sugar; (from the FDMB glossary).

Harder answer: hypoglycemia induced hyperglycemia. If too much insulin is received, the body will try to protect itself and responds by releasing glucose (glucagon) from the liver and secreting diabetogenic hormones which induce hyperglycemia.

It is important to note that a hypoglycemic episode does not have to happen for somogyi to set in. A drop in blood glucose that the body thinks is too fast will result in glucagon being released and the sugars being raised.

So basically, somogyi is a result of the body's defense mechanisms against hypoglycemia.

If nothing else we write can convince you we know what we are talking about, at least drop his dose down to only 2 units of N. Test him, feed/ him, wait a bit and then shoot 2 units.

N is not a good insulin, dose is way overboard, and personally.....I'd like to smack your vet a good one for his advice :evil:
 
Re: Rags, newly diagnosed....Vineland, N.J.

Becki,

Please log back on and tell us that you did NOT give Rags the 5 units of insulin this evening.

You need to go back through everything we have been telling you in this post and make sure you understand what we have been saying.

Bottom Line: YOUR INSISTENCE ON KEEPING YOUR CAT ON A HIGH DOSE OF A INSULIN THAT WORKS POORLY FOR A CAT COULD END UP KILLING HIM!

Please drop the dose down IMMEDIATELY!!!!!
 
Re: Rags, newly diagnosed....Vineland, N.J.

yo hon said:
Exactly what happens. I give him his shot and he won't eat. The Doc says INSULIN first, then he can eat
Click to expand...

No. Make sure he eats first:

Test
Eat
Wait at least 30 minutes.
Shot if his BS is over 200.

Get him on a set feeding schedule so he is hungry when he is due to be dosed. Make sure he isn't sneaking the other cats' food.

yo hon said:
I'm just really scared to lower his dose to one unit cause I just don't understand any of this.
Click to expand...

This is exactly why you SHOULD lower his dose. Especially if he is barely eating when he should. You seem to be more scared of a high blood sugar number than by bottoming him out and putting him into a coma and doing permanent damage (if he survives). Rag's numbers have been high for a while, a few more days high will not hurt him! It might take awhile to find his ideal safe dose by working up from low to high, that's OK!

Please take the time to start him slow and safe at 1 unit and get him into a routine where his testing numbers mean something and you can see a meaningful pattern to how he reacts to the insulin. There are a whole lot of reasons for dropping his dose and none for keeping it at 5 units. If he is in a rebound cycle like the more experienced posters have mentioned as a possibility, you need to know how to handle that -- with LESS insulin, not more. If he is eating different amounts at different times, that will effect his BS and his starting dose. If he goes low and you have to revive his numbers with corn syrup or honey, you are see-sawing his blood sugar all over the place. For example, if you give him corn syrup or feed him a carby meal to bring him up and his next shot numbers are higher than before the last shot, you are going to think he's going to need more insulin...he'll actually need less.

You need to be more conservative to start and 5 units is not a conservative amount. Dropping the dose way down will be better for your cat and you'll be able to sleep at night and stop worrying so much.

We don't want to see a candle in front of this thread. OK?
 
Re: Rags, newly diagnosed....Vineland, N.J.

better his bg be too high for a couple days then too low - which is why I am suggesting giving only 1 unit.

we know you are scared and if you can trust us, we can and will help you.

as I wrote, if your vet will not work with you and change insulins, then you need to find a new vet who will. In the meantime, you can get free supplies (including insulin) from the supply closet area - scroll up to my previous post for the links - this will be a much safer way to go then the insulin you are using.

and as I and others have said - WE NEVER RECOMMEND A STARTING DOSE OF 5 UNITS. Look I get the fear of going against the vet and the supposed professional advice. But this is what you need to do in order keep your cat safe. Sadly many vets just do not understand diabetes in cats and give very bad advice.

My former vet actually forbade me from home testing and said if I tested then she would refuse to treat the cat. In the next breath she said that if I home test I must use an animal meter only and cannot use a human meter - she also said that I had to leave Maui with her for one week to get regulated and she would give insulin according to her work schedule which could be anywhere from 6-8 hours apart not 12 hours as the protocol.

All this advice from my former vet was in 100% contradiction to the advice given here on this board and I had to make a decision who to listen to and believe. I chose to listen to the people here and found a new vet who would work with me and I can tell you that Maui has now been in remission for four years.
 
Re: Rags, newly diagnosed....Vineland, N.J.

OK, tomorrow morning, no matter how high his BS number is I will start him on two units, unless I get really, really brave. I'll give him I unit. And feed him 30_40 min. After I give him his inj., right ? I will test his blood two hours later, then four etc. Is that right ? Will anyone be around if I get into trouble ? I did apply for the insulin in the supply closet. I think it was PzI? GOD, I PRAY THIS WORKS FOR HIM !! Thank you soooo much and I WILL be in touch. Yo Hon, Becki
 
Re: Rags, newly diagnosed....Vineland, N.J.

Thank you for believing us when we have all been saying for days to lower is dose.

I've been so afraid for Rags that his BG's were going to plummet and he was going to die. BG numbers too low are immediately dangerous and can kill quickly. High BG numbers are longer term dangerous.

You need to deal with the more immediate danger, which is the BG too low. Lower insulin doses are safer starting out than higher insulin doses.

I think you understood the exact opposite, that the high BG numbers were more dangerous.

Please read this and print it out: http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=15887

Hypos can kill and you need to know how to deal with them.
 
Re: Rags, newly diagnosed....Vineland, N.J.

What schedule are you on for dosing? 7:30 am and 7:30 pm?

Let me know. I'll be sure to be on.
 
Re: Rags, newly diagnosed....Vineland, N.J.

On N you want to test him and then feed him 30 minutes BEFORE you give him his insulin. Then you are going to want to test at +2 and +4 to see how the insulin is working for him.

There is almost always someone around keeping an eye out. If you get in trouble, start a new thread and click on the red 911 at the top of the post. We will spot those threads first log on, and know it is an emergency.

Mel, Maxwell, Autumn & The Fur Gang
 
Re: Rags, newly diagnosed....Vineland, N.J.

And feed him 30_40 min. After I give him his inj., right ?
Click to expand...
NO!

1. Test him

2. Feed him and then wait 30 minutes.

3. Shoot the insulin

The testing will show you his number which will probably be high. Do Not Panic!

I also strongly suggest you give him only 1 unit and stay there. High numbers can be dealt with but one low number....without intervention can kill.

What dose did you give tonight?

Some of us over the years when we thought a rebound might have been happening just didn't give a shot. Let it clear out of the system and start over.
 
Re: Rags, newly diagnosed....Vineland, N.J.

OK, at 7:15 a.m. his BS is 178 which is the best it has ever been. I fed him two bowls of ff at 7:23 a.m. I drew up two units of insulin which I will give him at ten of eight, right ???

Yes, I'm trying to keep him on an early schedule. 7:30 -7:30. I'd like to make it 6 and 6.

I'll test hit BS in two hours and let you know. He is sitting here crying which he NEVER does !!!

I'm reading the info. From the No violin-N (nph). It states it starts working an hour and a half after inj. Glucose, greatest, BS lowering effect is between 4_12 hours after inj. BS may last up to 24 hours.
 
Re: Rags, newly diagnosed....Vineland, N.J.

Becki,

Good job. You are doing the right thing.

Glad to hear Rags ate his food. You say you gave him two bowls. How many ounces? A can of Fancy Feast is 3 ounces. Did you give him one can or two?

Please stay logged on to keep us updated.

Sorry, I'm a little late getting on this morning. One of my cats was sick last night and got up every two hours to check on him.
 
Re: Rags, newly diagnosed....Vineland, N.J.

Am I still going to give him two units right now or five ?

No two bowls , probably 1/2 can, maybe. I'm still waiting to give him his insulin, two is OK ????? I gave him five last night. Actually for the last two days that's what he has been getting.

But only giveTWO now ?????????
 
Re: Rags, newly diagnosed....Vineland, N.J.

No, Please only give him 1 unit.

I'm sorry to hear that Rags is crying. Be calm, talk softly to him, try to reassure him that everything is going to be all right.

Please test again in two hours and post the number.

could you make a little chart in your post like this:

AMPS
+0.25 fed 1.5 ounces ff lc
+.75 1 u Novolin N
+2 xxx (replace the xxx with whatever his BG number is at that time) which would be 9:15 your time
+4 xxx
+6 xxx

People on this board are in all different time zones so the +2, +4, +6 numbers are the times from when you did your AMPS (morning preshot test) or PMPS (evening preshot test). It makes it easier for people in different time zones to see what is gong on without having to adjust for the time difference where they live. Make sense?
 
Re: Rags, newly diagnosed....Vineland, N.J.

Becki - how is Rags doing? Can I ask again what country you are in? Really think Lantus or another insulin like Levemir would be easier on both of you.

Personally when they meow I like to think of it more as complaining, not crying. Crying seems to me more like they are very sad when its more like they are complaining.... "hey wheres my food, feed me feed me feed me" and demanding food now.

Wendy
 
Re: Rags, newly diagnosed....Vineland, N.J.

Actually, I would suggest that you DO NOT GIVE ANY INSULIN if the BG is under 200. When first starting out, we use 200 as a safety zone and especially with the insulin you are using, it is better to have your cat safe and NOT give insulin, then too give too much insulin!

Once you better understand how this works, insulin, BG's, etc, then I would suggest dosing under 200, but for now DO NOT GIVE INSULIN!

Continue feeding the low carb fancy feast and testing.

I do not want to say too much as I do not want to overwhelm you with too much information, but if you can trust us, we will do everything we can to help you help Rags and keep him safe.
 
Re: Rags, newly diagnosed....Vineland, N.J.

Becki, unless it is a specific insulin made for just cats, do not go by what info you find on insulins. Humans can use N, so can dogs, but cats metabolize twice as fast and info won't apply to cats.
 
Re: Rags, newly diagnosed....Vineland, N.J.

OMG NO one got back to me about Rags insulin and I didn't know what to do. I even put a 911.

I just took his BS and it is 106 now what do I do ? He got 2 units at 8:12 a.m. PLEASE DON'T LEAVE HIM HANGING, PLEASE!!!


I WAS AFRAID TO DO THIS TO BEGIN WITH. now I have no one to help me. Please, please help me !
 
Re: Rags, newly diagnosed....Vineland, N.J.

How many hours after the injection is this 106

You need to list your test times and bg's - so we can follow you

like this

AMPS 178 - 2 units
+ 3? - 106

If that is the case that it is 3 hours past - then test again in 4 hours and tell us the number.

Do you have any high carb wet food available - such as anything with gravy? If not do you have any sugar products available?

You may need to give him VERY Small amounts of sugar or higher carb food - because you don't want his drop to go too fast and too low.

This is what we are worried about.
 
Re: Rags, newly diagnosed....Vineland, N.J.

OK - now please BREATHE!

Please read this information about hypoglycemia - this is what we are going to try to prevent - this information will help guide you through the next few hours: viewtopic.php?f=28&t=15887


Any kind of sugar product will work - pancake syrup, sugar mixed into water, honey, karo syrup - of course if you have any higher carb food (not dry) that will work too --


Your best defense against hypoglycemia is home blood glucose testing. If you’re not already doing so and your cat allows it, I HIGHLY recommend you test before each shot.

Hypoglycemia or low blood sugar is a dangerous condition that must be treated immediately. Also known as insulin shock or insulin reaction, hypoglycemia occurs when there is too much insulin in the body potentially leading to neurological damage and/or death.

Knowing how to respond to a hypoglycemic event whether or not symptoms are present can save the life of your diabetic cat. The following general guidelines are intended for those who home test the blood glucose levels in their cats. These guidelines are not intended to replace the advice given by your Veterinarian. It is very important that you discuss any and all treatment options with your cat’s physician BEFORE an event has occurred.

SYMPTOMS
Some cats may have NO symptoms whatsoever, but here are the most common ones:

MILD HYPOGLYCEMIA
Sudden ravenous hunger
Shivering
Weak or lethargic

MODERATE HYPOGLYCEMIA
Disorientation
Trouble with vision... bumps into furniture
Poor coordination, such as staggering, walking in circles or acting drunk
Changes in head or neck movements
Restlessness
Urgent meowing
Behavioral changes, such as aggressiveness

SEVERE HYPOGLYCEMIA
Convulsions or seizures
Unconsciousness


TREATMENT

During treatment for hypoglycemia, try to test every 15 minutes until you see the bgs begin to rise. Then continue to test until you are satisfied that the cat is out of danger.

VERY LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a very low number (under 40 mg/dL or 1.9 – 2.2 mmol/L) administer a tablespoon of corn syrup, liquid glucose, pancake syrup or honey, or INSTA-GLUCOSE and follow with food until the blood glucose numbers rise to acceptable levels. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If using liquid glucose, dilute with water for a thinner consistency.

LOW NUMBERS – WITHOUT SYMPTOMS
Retest glucose using a large blood sample to make certain you have enough blood, and if you still get a low number (40 – 60mg/dL or 2.2 – 3.3mmol/L) give food or treats until the blood glucose numbers rise to an acceptable level. If the cat refuses to eat even his/her favorite foods, you can syringe feed or administer a small amount of syrup.

LOW NUMBERS – MILD SYMPTOMS
Try feeding first or give a little syrup or honey followed by food until the blood glucose numbers rise to an acceptable level and the symptoms disappear. The syrup can be mixed with wet food or poured over dry if the cat will eat the mixture. If the cat will not eat, syringe feed. If your cat will eat dry, feed this first as the high carbs will help to increase his/her bgs quickly. You can then follow with his/her favorite canned food. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.

LOW NUMBERS – MODERATE SYMPTOMS
Give a tablespoon of syrup, a teaspoon of liquid glucose, a tablespoon of honey or a tablespoon of sugar syrup followed by food and continue doing so until you see the blood glucose numbers rise to an acceptable level and all symptoms disappear. The syrup, honey, or glucose can be rubbed against the inside of the cat’s cheeks or on the gums for quick absorption. You can also mix the syrup with wet food or pour over dry if the cat will eat it. Continue to give syrup and food as needed and observe your cat for signs of recurring hypoglycemia. Keep in mind that giving syrup (Karo, etc.) or honey is not enough because the effects wear off quickly. You need to follow with food.
IF IN ANY DOUBT, TELEPHONE YOUR VETERINARIAN.

LOW NUMBERS – SEVERE SYMPTOMS
Rub syrup, honey, or glucose on the gums and cheeks if your cat will allow it. Another option for administering syrup, diluted liquid glucose, honey or sugar syrup to a cat who is seizuring is to fill a needleless syringe with the mixture and insert via the rectum.
NEVER TRY TO SQUIRT SYRUP, HONEY, OR GLUCOSE TO A CAT WHO IS SEIZURING AS THE CAT COULD CHOKE ON IT! RUSH TO EMERGENCY.

AGAIN! ANYTIME YOU CAT IS SEIZURING OR LIMP, RUB KARO, GLUCOSE OR HONEY ONLY ON GUMS OR ADMINISTER RECTALLY AND GET TO EMERGENCY OR YOUR NEAREST CLINIC IMMEDIATELY!!!

Remember that syrup or any other sugared syrup/preparation will spike the blood glucose ONLY for a short period of time, so food is really important with mild and moderate symptoms. Dry food (high carbohydrates) will keep the blood glucose numbers elevated longer, so it’s a better food to give during a hypoglycemic episode.

After a hypoglycemic episode cats may be more sensitive to insulin, so a reduction in dosage is generally required, especially considering too much insulin – whether due to dosage, inadequate food intake, or the cat’s changing insulin requirements – caused the hypoglycemic event in the first place. With moderate to severe episodes, your Vet may have you skip the next injection altogether.
IT IS VERY IMPORTANT THAT YOU DISCUSS YOUR CAT’S HYPOGLYCEMIC EVENT WITH YOUR VET, SO TOGETHER YOU CAN DECIDE UPON THE NEXT COURSE OF ACTION.

Always keep in mind that with low blood glucose and no symptoms, the BG you get is not as important as where it is headed. In other words, if you get a BG of 100 mg/dL or 5.6 mmol/L or less and there are still several hours or more before the insulin peaks, your need to watch your cat (and the numbers) carefully and take appropriate steps. With very low numbers and NO SYMPTOMS, a cat can be fine one moment and seizuring the next.

BE PREPARED! KNOW THE SYMPTOMS AND KNOW THE TREATMENT!
 
Re: Rags, newly diagnosed....Vineland, N.J.

Becki, you were told by 3 of us to give only 1 unit......you gave 2.......imagine if you had given 5 units this a.m.? He isn't going low because you lowered the dose but by lowering it this morning on a 178 you saved him from a major hypo or death.

Now, calm down, 106 is okay because N doesn't last that long, and test again in 1/2 hr. and give us the reading. In the meantime, see if he will eat some more canned food.
 
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