Recent diagnosis, new to FDMB

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Jackson

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Hello all. Our family pet is Jackson, a black/gray/white tabby. He is neutered and appx 8 yrs 2 mos old.

At Thanksgiving we left Jackson home alone for a little over 72 hrs. **edit: sorry- our family Thanksgiving was this last weekend, 12/3-5** A few days before we left for Thanksgiving we noticed he was drinking a lot more water, and eating more, too, but hadn't really gotten concerned, as he was otherwise acting normal. When we came home from traveling on 12/5, we found he had been urinating in the corner of our son's room. My wife noticed he looked thinner, and he was a little less active. His urine was very strong smelling. My wife suspected a UTI, and she took him to the vet on Tuesday, 12/7/10. He was diagnosed with feline diabetes.

Jackson goes berzerk at the vet. He is fiesty but loveable at home, but he hisses and attacks at the vet's office. As such, the vet sedates him so that he can work with him. The vet diagnosed Jackson after a UA, but we requested a blood test as well, which the vet said confirmed the diagnosis of FD. A UTI was also diagnosed.

The vet said he was in pretty bad condition and would have gone downhill very quickly had we not gotten him to the vet.

Jackson was perscribed 2 units of ProZinc (we use U-40 syringes) every 12 hours, which we started the morning of Wednesday, 12/8. He gets his shots at 6:30 AM and 6:30 PM. He was also given amoxicillan antibiotics for his UTI.

A dietary change was not perscribed. Right now Jackson eats Meow Mix Indoor Formula.

His energy level seemed to pick up a little by Wed night, and he has been better since, although I would not say he is back to 100% (more like 85% of what he was a month ago).

Last night (Sat, 12/11) Jackson vomited nearly all of his food 1-3 hours after his shot/antibiotics (not sure exactly when as we were watching a movie in another room). This morning he vomitted again and urinated in the same corner. (again, not sure exactly when- we went back to bed after his meds this AM)

He eats a little during the day, and doesn't always vomit--it seems to happen a little bit after his shot/antibiotics.

Jackson's blood sugar has not been tested since last Tuesday. The vet said not to bring him in for testing because Jackson goes crazy. He said excitement causes a rise in blood sugar, so, in addition to safety concerns for both Jackson and the people at the vet's office, he wouldn't be able to get an accurate test anyway. The vet instructed us to call in on Tuesday (the 1-week mark), and he would adjust the dosage, if necessary, based on Jackson's behavior.

I just found FDMB earlier, and I have only read a little bit. There is so much helpful information here tat it is almost overwhelming (plus there are a lot acronyms that I am I do not know). However, it seems clear, from what I have read so far, that we need to be testing his blood sugar levels here at home.

This is all new to us. We have never had a pet with a chronic health problem. Also, we are still reeling from the shock of the financial implications of this diagnosis.

If you have read all of this, thank you. Any advice/input is appreciated.
 
Welcome to the site. I know at the beginning it's pretty shocking to get this news - I did not even realize that cats could have diabetes - but it's not as bad as you think. Once you start giving insulin, and ensure his diet is correct, you are going to be seeing a much happier and healthier Jackson.


First thing is the diet. By switching to a low carb WET food diet, you will see dramatic improvements in Jackson - see Binky's list for foods you can feed - just try to keep the carb % below 10%, and around 5% is great.
Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition

Next thing is to home test. Again, this will be the best way to track how Jackson is reacting to the insulin so you can keep him safe. Taking him to the vet for regular curves are totally unnecessary, so don't worry about any return visits to the vet for that part of things. You can use a regular human glucose meter that you can pick up at the pharmacy. Just a poke along the tip edge of the ear is all it takes; my two literally sleep through the ear pokes.

I can't comment on the insulin you are using but others in this group will help you with dosing.
I hope the UTI gets cleared up and that Jackson continues to improve with the insulin.
 
Hi and welcome,

I'm glad you found this site so quickly. Yes, the learning curve on FD is very steep in the beginning but once you get started it will become much easier very quickly. There is alot of information in the stickies at the top of each forum to get you started.

Home testing is the only way to keep Jackson safe. We test before every injection to make sure their blood sugar isn't too low thus making it unsafe to get insulin. We use human glucose meters. I use the Walmart brand Relion Micro meter, the test strips are the least expensive of the meters. You will also need Lancets to poke his ear, gauge 26 or 28 work the best in the beginning. I really doubt that a vet or anybody else can tell what a cats bg is by looking at them, so don't waste your money on that vet visit, I'd spend that money on the meter, strips, lancets, ketostix and karo syrup.

The motto around here is "Start low, go slow" we usually start out with 1 unit two times a day. The Vet was basing his dose on Jackson's bg while he was stressed at the clinic. Jackson's bg will be lower when he is at home and calm.

Check out Janet & Binky's Food charts for low carb wet canned food.

Come back and ask whatever questions you have.
 
Welcome! I just want to let you know that it gets much easier quicker than you may expect. It looks bleak at first, I know that. But educate yourself, switch to low-carb wet food, start hometesting, and it will truly all become second nature. I never had a special-needs pet, either, before Charlie was diagnosed, but it gets easier. Ask lots of questions, we're all here to help!
 
Thank you for the responses. We purchased a glucometer tonight. The ReliOn Micro.

Jackson's blood glucose was 327 at 7:17 pm. We then gave him 1/4 can of food and 2 units of ProZinc insulin. I tested him again at 9:55 pm, and his blood glucose level was 369. I don't understand how it went up after giving him 2 units of insulin.
 
We read that it can take a couple of hours for the insulin to work, so we stayed up and tested him again at 11:42. His BG was 257. We are now giving him 1/3 can of Friskies Ocean Whitefish & Tuna, which according to the table is 6% carb. We will see what his AMPS BG is.

Thanks again for the comments and please feel free to add more comments. Hopefully we can get a handle on the FD soon.
 
Ugh. 12:45 AM- Jackson just barfed up his Friskies. He had only eaten a little over half of the amount we gave him. There was a good sized hairball in the regurgitation- I wonder if that was the cause? I hope so.
 
Welcome to our site! May I ask your name? I am amazed at how quickly you are learning everything. Most people find it quite difficult in the beginning---especially the home testing. It is wonderful for your cat that you are taking all the necessary steps to keep him safe. Keep posting and asking questions.

AMPS and PMPS----morning and afternoon PRE shot (the BG just before shooting)
peak or nadir---the lowest bg value on the 12 hour insulin cycle
GA---(after a cat's name)
---gone ahead, passed away, etc
DH, DH, etc---dear husband, dear wife
IMHO----in my humble opinion
FWIW --for what it's worth
ECID---each cat is different
SLGS--start low go slow
 
Hi there and welcome.

Just wanted to also point you to our *draft* newbie checklist [if you have not found it already]. It has a lot of links to various sources of info on hopefully what you need to get going.
viewtopic.php?f=24&t=31358

Congratulations on getting the hope testing going. That's a huge hurdle you have navigated.

Good luck.
 
Well, until we get a spreadsheet set up, we will update his numbers here.

Today, his AMPS at 5:45 AM was 380.
2 units at 6:30 AM.

At 4:53 PM today his BG was 258

His PMPS at 6:07 PM was 313.
2 units at 6:23 PM.

At 9:58 PM today his BG was 291

Thanks again for your continuing advice and supportive comments. My name is Josh and my wife is Michele.
 
Hi Josh (and Michele),
Glad to see you posting! (and testing!)
TO make things easier (and more uniform) we don't use time of day (this is a national and international board with people in different time zones), instead we talk of the number of hours since the last insulin shot. For example, if you gave insulin at 6:30 AM, and tested BG at 4:58, we would say + 10.5 258 BG (at 10 1/2 hours since shot at 6:30 the bg was 258).
Also, we recommend the preshot be not more than about 20 minutes before giving insulin. The numbers can change quickly, and the point of the preshot test is to be sure the number is not too low for insulin.

It's a good idea to post the numbers here till you have your spreadsheet up. Any questions---feel free to ask!
 
Good to know- thanks. That leads me to a question: If the BG is 380, as it was this AMPS, is it ok to give him a shot, even if he isn't eating? The main reason for the 45 minute delay was that he wasn't eating, and we were told not to give him insulin if he hadn't eaten. He finally decided to eat at 6:30.
 
I am not sure--others will know better. You want him eating so his BG doesn't get too low. You could retest closer to when you are ready to shoot, or you could wait to test till you see he is eating. But with a number like that, unless he is on a hunger strike, seems to me there is no real danger. (but let others confirm that---I am not positive)
 
That's a pretty nice day he had yesterday. His PMPS was alot lower than his AMPS so keep an eye on that, if his PS's continue to get lower and lower you may want to reduce the amount of insulin you give him. But we can look at that after a few more days of data.

Judy is right, we want them to eat before getting insulin, is he a picky eater or just didn't feel like it at that moment.


12/13 AMPS 380
+10.5 258
PMPS 313
+3.5 291
 
How to do a Curve
Example of a typical curve:
+0 - PreShot number.
+1 – Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 – Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

Hopefully the above will help you understand the numbers you are getting, provided you have a kitty whose nadir is around mid cycle, but as you gather info in your testing and start to fill out your spreadsheet, you will see how your cat reacts.
 
He's a semi-picky eater. We are trying to switch to canned moist food after feeding him dry since we adopted him (6.5 yrs ago).

Today's (12/14) numbers were higher:

AMPS: 459

+10.5: 323

PMPS: 491

+2.5: 379

+4: 299 (edited post at 11:25 pm)
 
2 units twice a day is a higher starting dose than we usually see. 1 unit twice a day is what is typically recommended here and on the prozinc website.

Starting on too high a dose can result in passing the perfect dose before you even get started.
 
Rob & Harley said:
2 units twice a day is a higher starting dose than we usually see. 1 unit twice a day is what is typically recommended here and on the prozinc website.

Starting on too high a dose can result in passing the perfect dose before you even get started.
Click to expand...

Hmm- that was what the vet perscribed based on the diagnostic blood test. Considering that his BG is still so high, do you think 2 units is too much?
 
I think that what Robin is getting at is that with the food change you might see a reduction in the need for insulin [sometimes dramatic]. So you really need to stay on top of the BGs and be ready to reduce as needed. Or many times it is recommended [if the cat has no ketones] to lower the dose back down to 1u twice per day then wait a while [about a week] and see how the diet change effects things. Then up the dose if needed in smaller increments but a methodical way. For between 1-2u that would be .2u increments about every 3 days [unless you notice improvement]. Between 2-3u that would be .3u increments.

Also the "skipping" Robin is talking about can happen if the dose increase increments are too large the cat can go into a chronic rebound type situation. Rebound can be read about here:
http://petdiabetes.wikia.com/wiki/Rebound

Ultimately you are the one holding the syringe and it's your choice and duty to make the decisions. :smile: We are second fiddle to your first fiddle :smile:
 
Gator & H (GA) said:
I think that what Robin is getting at is that with the food change you might see a reduction in the need for insulin [sometimes dramatic]. So you really need to stay on top of the BGs and be ready to reduce as needed. Or many times it is recommended [if the cat has no ketones] to lower the dose back down to 1u twice per day then wait a while [about a week] and see how the diet change effects things. Then up the dose if needed in smaller increments but a methodical way. For between 1-2u that would be .2u increments about every 3 days [unless you notice improvement]. Between 2-3u that would be .3u increments.

Also the "skipping" Robin is talking about can happen if the dose increase increments are too large the cat can go into a chronic rebound type situation. Rebound can be read about here:
http://petdiabetes.wikia.com/wiki/Rebound

Ultimately you are the one holding the syringe and it's your choice and duty to make the decisions. :smile: We are second fiddle to your first fiddle :smile:
Click to expand...

Wow- good to know. Thank you for the link- that is a very interesting event that I have never heard of until I read that.
 
Just wanted to say hi and that I'm fairly new to this too. Today is Sam's 3rd day home after a week in the hospital recovering from severe DKA. We're on 2 units of prozinc also, which is what the vets at the hospital established based on trying to get him regulated there. I've since switched Sam (and our other 3 cats) to a low carb diet so I'm carefully watching his bgs too. Sam also has to get sub-q fluids due to some unknowns about his kidney functions, although they're starting to improve.

Getting the hang of all this - the testing, the numbers, giving shots, understanding the lingo - was extremely frustrating at first, but I'm finally starting to feel some sense of "getting it" and you seem like you are too. Keeping the spreadsheet seemed like something I'd never be able to manage, but now that I am, I'm so glad! My vet was very impressed that I had two days of bgs to bring into her during our check up yesterday.

Stick with it. I think you're doing great.
 
To answer your question about whether or not to give a shot if the cat hasn't eaten, your best bet is to get SOMETHING into the cat, whether a treat or syringed watered down food or whatever, and then give a shot, perhaps a reduced dose. At 380, with no food on board, your cat needs insulin. Its just tricky to do it without food onboard as you don't know whether the insulin will work TOO well then or not. High blood glucose levels can make a cat feel inappetant...

Jen
 
Well, Jackson's BG was 107, 96 and 106 this AM. We checked it 3 times to be sure. We didn't give him his shot (glad we were home testing!)

At 2 hours before PMPS he was at 461, and his PMPS was 526.
+3: 261

We have started a spreadsheet, but we haven't yet figured out to get it online for others to view.
 
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