Sage was diagnosed with FD in September

Status
Not open for further replies.
S

Sage's Mom

Member Since 2011
Hello everybody!

My cat Sage, an 8 year old male, was diagnosed with diabetes back in September. When the vet first diagnosed him, they kept him for a whole week so they could monitor his glucose level, since he seemed to be one of those cats whos glucose levels were all over the chart for some reason. When they finally let us take him home, we were told to give him 5 units in the morning and 5 in the evening. As of today, he's just on 3 units in the morning and none in the evening. The insulin the vet described is called Lantus and the food he's on is Purina Diabetic Management, 1/4 cup per meal.
We had A LOT of issues getting his glucose level where we want it, on his last check-up his level was 150, this was tested around 1PM (he usually gets fed around 4:30 in the morning and evening - if that matters any). A few times they thought he was reversing already, which only turned out to do nothing but give us false hope.

The reason I am posting here now, is because for a week or 2 now, he urinates in our bed just about every 2 days (and everytime it's on my side of the bed, is he mad at just me?)!!! He STILL drinks a lot of water and, unlike our other cat, when he urinates it is A LOT!!! This is getting extremely frustrating, because all the vet told us on his last checkup was to pretty much just "deal with it" and the reason for urinating on the bed is because he's "ticked off" about something. We suspect he's mad at us because it seems that only a few hours after feeding him, he's starving again!! He'll take any opportunity he can to sneak into Cobie's (our other cat) foodbowl and he'll eat a lot when he does get into it.

From what I have read so far, it seems most cats, once they are sent back home from the vet, stop the excessive drinking and urinating, so we're really not so sure about what our vet is doing/telling us, is the right thing for Sage. I'd love to get a 2nd opinion elsewhere but we've already spent a lot of money on him these past few months and we really cannot afford to get another bill on top of our current expenses for him, so taking him to a different vet - with the chance of them running into the same issues / telling us the same things being high as well - would really be our very last option. As a side note, I've been taking my cats to the same vet since they were kittens and I have always been happy with his services, so I'd like to believe our vet DOES know what he's talking about lol, as I've delt with him for 8 years now.

Thank you for reading! And happy holidays to everybody!
- Karo & Sage
 
There are people here who know a lot more about insulin and dosing than I do, so I'll leave that to them.

Do you test Sage's glucose levels at home? If not, you should consider starting-it has made a HUGE difference for me as I've tried to get my cat regulated over the last month. It's not hard, and again, there are people on here who are more expert than I and can help you get started. There are several options for meters and test strips. Generally, if your cat is still drinking and peeing a ton, it's a sign that he is not regulated yet.

Peeing outside the litter box is often a sign of a urinary tract infection, or UTI for short, or some other issue. The "he does it out of spite" reasoning is a myth...the vast majority of cats simply don't do that. You should definitely get him checked for a UTI; having one can have a huge impact on his glucose numbers, and clearing it up can help in the regulation process.

I'm still pretty new to the whole FD dance, so I'm sure you'll get better advice from some more experienced folks. Welcome to the board-it's a great place to be and I literally don't know what I'd do without everyone's help!
 
I am quite new to this too but it seems to me that your vet is doing the wrong thing. Lantus should be dosed twice a day and Sage is clearly not regulated. Home testing is pretty essential, a bit scary at first but you and Sage should get the hang of it pretty quickly and then you, with the help of the experienced people here, will be able to see what's going on, correct the dosing and get the diabetes under control, or better still in remission.
 
Thank you for the answers so far!

Our vet strongly advised us AGAINST home testing his glucose levels, so we never looked into it, especially since the way they test him at the vet's office, is they either draw blood from one of his legs or cut his nail so short it bleeds (that last method always makes me feel sooo bad for the poor little guy :( ), so how would we go about testing him at home? I definately don't see myself poking him with a needle until I hit a vein (I already dread giving him his insulin shots) or cutting his nail until it bleeds!!!

Would they not have noticed the UTI when they first diagnosed him though? My other cat Cobie used to have them, to the point where it got so severe he had to undergo surgery to remove ALL his boy parts :(. I remember his symptoms (he'd hide in a dark spot by himself and if you'd get near him or even touch him he'd hiss - this cat NEVER hisses), and Sage doesn't have ANY of these. Back then the vet told me the reasoning behind this was because Cobie was neutered when he was only a few weeks old, and I know Sage was neutered only a few weeks after he was born as well, so I did always consider that to be an issue but it never occured.
 
Homes Testing is very easy once you get the hang of it. Here is an excellent video of one of our member's testing his cat Buddy. http://www.youtube.com/watch?v=_zE12-4fVn8. Basically we test our cats at home much like human diabetics test their's except we use the edge of their ears rather than their finger.

Any human meter will work as long as it takes a small sample of blood, and the strips (the most expensive part) fit well into the budget. We even have a newbie kit program through the board that we all donate supplies for to give those just starting out the best start possible. Lori and Tom (GA) run the newbie kits and I believe she only asks for $8 to cover the shipping, it will have everything you need to get started, meter, strips, lancets and lancing device, rice sock for warming the ear, and even a nice catnip toy for Sage.

The others are correct Lantus needs to be dosed twice a day as cats metabolize insulin twice as fast as humans and dogs, also Lantus builds up a shed before it starts helping the cat control their bloodsugars, so only dosing once a day you are always filling and draining that shed, so very little of insulin is going to Sage to help with the lowering of blood sugar.

Mel, Maxwell, Musette & The Fur Gang
 
Sage's Mom said:
Thank you for the answers so far!

Our vet strongly advised us AGAINST home testing his glucose levels, so we never looked into it, especially since the way they test him at the vet's office, is they either draw blood from one of his legs or cut his nail so short it bleeds (that last method always makes me feel sooo bad for the poor little guy :( ), so how would we go about testing him at home? I definately don't see myself poking him with a needle until I hit a vein (I already dread giving him his insulin shots) or cutting his nail until it bleeds!!!

Would they not have noticed the UTI when they first diagnosed him though? My other cat Cobie used to have them, to the point where it got so severe he had to undergo surgery to remove ALL his boy parts :(. I remember his symptoms (he'd hide in a dark spot by himself and if you'd get near him or even touch him he'd hiss - this cat NEVER hisses), and Sage doesn't have ANY of these. Back then the vet told me the reasoning behind this was because Cobie was neutered when he was only a few weeks old, and I know Sage was neutered only a few weeks after he was born as well, so I did always consider that to be an issue but it never occured.
Click to expand...

First thing: Go to a pharmacy and pick up a blood glucose meter, some lancets and some test strips. Ask your vet if HUMANS are strongly advised not to hometest! Of course not because it's not safe!

Testing at the vet is ridiculous; my two cats test differently at the vet due to STRESS. Shadoe tests much higher at the vet, and Oliver has been known to test very LOW at the vet. Within 30min of getting back home, their numbers return to their TRUE BG numbers.

Get a new vet!

I have a problem with Shadoe where she will pee outside the box when her numbers are very HIGH or very LOW.
At a dose of 5units am and pm, your poor Sage is likely feeling like crap and he is probably dropping into too low numbers all the time.

So, get a meter, something like Relion is very economical, and the strips are cheaper than other meter brands. Anyone here can help you test and there are great videos to watch as well. All you do is poke the tip of his ear to get a drop of blood then sip it with the strip in the meter.

Food. What are you feeding? Best food for diabetics will be low carb wet food, NO dry food or treats, and don't buy the expensive vet food.

Your dilemma is that you are giving likely too much insulin and need to drop that down to 1unit twice a day, BUT you need to drop before making any food changes, OK? If you are feeding dry or high carb food, that food may have saved Sage from having a full blown hypo and ending in the ER.

Very very few cats need 5units of insulin twice a day, except those with insulin resistant conditions.
Best for you to start testing immediately and find out where Sage's numbers are going, so once you get the meter and supplies, post here and lots of people can help you get on the road to a healthier Sage and a happier you.
 
We will definately look into buying our own meter and strips, I watched the video somebody posted earlier and it looks SO easy, and definately not as cruel like they do it at the vet's office!!!

After reading everybody's responses so far, I'm quite frankly kind of mad at my vet now, because it seems all he's doing is getting money out me, and Sage isn't being helped at all.

One thing I did want to correct, I believe it was Gayle who posted this, Sage is currently on 3 units of Lantus in the morning.. the 5 units am/pm was a few months ago now, at one point they had us give him 6 units in the am, none pm, then dropped to 5units am, now down to just 3 units am and none pm.

I feed him Purina Diabetic Management, dry food, runs at $30+/6lb bag. Which wet cat food would you recommend? And if he is getting 3 units now, should I get a meter first and start testing before I change any of his food / insulin units and keep track of it for a few days before I change anything?

I also read somewhere that people "free feed" their cats, up to 5 times a day, I was told to feed him 1/4 cup per meal twice a day. When I brought up the issue to the vet that Sage seems to be starving again only a few hours after he eats, I was told that, by upping the amount of food, the amount of insulin units would need to go up as well.

Thank you to everybody for the advice so far, I feel so helpless in this situation, I have never dealt with diabetes treatment before, especially not in cats, so I feel incredibly lost and my instincts at first were to believe my vet since hey, he's the one who went to school for this right? :(
 
It is discouraging, but we are happy with a vet as long as they are willing to listen and perhaps learn. A vet is like a gp - they know a little about a whole lot of things. Most get a workshop on diabetes in vet school and their nutrition classses are often sponsored by Purina. All we know is feline diabetes and we do a protocol that works well - a mild long lasting insulin (you have that - one point for the vet!) given twice daily, wet lo carb food and home testing.

We feel new diabetics are not processing their food well so we think it is okay to feed more than we might regularly. And lots of us think feeding small more frequent meals will help support the pancreas. Your vet is right - if you are feeding high carb dry, then feeding more does raise the blood glucose levels and could mean more insulin. That's why we feed wet lo carb: www.catinfo.org (a great website on feline diabetes and diet by a vet)

We would suggest making one change at a time. When we switched Oliver from dry to wet, his blood glucose levels went down 100 points overnight. If we hadn't been testing and had just given the usual amount, we would have overdosed him. Making the food change should probably happen after you are regularly testing at home.
 
Good am to you & Sage!

I wanted to say my vet suggested not home testing and told me to quit looking and reading the internet. He increased her insulin from 1 unit to 2 units - 2 times a day.

Because of this forum and the ppl here, I did not. I started home testing: took a bit to get the routine down. I did not increase to 2 units, but did increase to 1.5 and to 1.25 (again, because of this site). Please take a look at the spreadsheet for Bean. She was only 27, 2 hours after her shot!!!!! OMG, the ppl here helped me help her not hypo for 4+ hours. She is still with me today.... WE have not been back to that vet, or any other vet since that curve day. She is now in remission!!! hurray for Bean.

If I had not home tested, and just listened to the vet (have no idea why he really did not want me to home test), and had not found this place, I know I would not have my sugar girl today! Way way too much insulin.
I would strongly suggest not taking away the food if you are shooting that much until home testing....Really, it is not that hard to do! And the best thing you could do for Sage.

My Bean also was sent home with expensive pet script food, we changed to Binkys chart as suggested here. I printed the list and away I went to find low carb foods, took the script back for credit/refund and she did just fine. Matter of fact, once I took up the carb dry and she was just eating the binky foods from the list, she dropped almost 100! If I was not testing, I would have never ever known that.

If you want to share the area you are in, and would like some hands on to learn, just let us know and I am sure someone is close to you. I did, someone offered and I took them up on it with my Civvie Slappy girl and I am sooo glad I did. Folks here are just absolutely great.

Keep us posted on Sage and happy paw hugs going your way :cool:
 
Welcome to the board! I will also encourage you to home test. I left my vet's office with syringes and insulin in hand after a 90 second instruction on how to shoot. I have never given anything by needle in my life and hubby has a definite fear of needles. Now when I reach into the box for a lancet I hardly blink and this is only 7 days in.
Yes, I still struggle with poking my cat's ear but I think it is more of a nuisance for him than anything and I've gotten great advice to get Neosporin OINTMENT with pain relief to apply lightly to the ears.

I'm glad you made it here. I'm sure sweet Sage will thank you all the more for it.
I'm going back to my vet this Monday armed with my own spreadsheet in hand. Knowledge is power. Home test Sage so you can see where the Blood Glucose (BG) numbers truly are.
 
One more thing... I understand you completely when you say that you trust your vet and that he/she went to school for this after all. Well, my blind trust could have led to a horrible ending as I initially blindly dosed my cat 3U 2x per day without knowing where his BG #'s were. I found this board and decided to home test and after giving the test I saw that he was at 74. This was right before he would have received that next 3U shot. THANK G-D for this board. Without knowing his # I would have blindly shot 3 units on a 74 blood glucose. I don't even want to think about it...

You can do this. Home testing is the way to go.
 
Hello again,

I finally got the glucose meter today (Thank you SO MUCH Lori and Tom), and oh my...

This morning at 5:30am he got his 1/4 cup of food along w/ the 3 units of Lantus.
He ate his dinner around 4:30pm (1/4 cup of food again) and I tested his level an hour later and it's at 511!!!!!

How do I know now IF he needs a shot( not sure if him eating only an hour ago could have spiked it THAT high), how many units etc etc?
 
Did you do a test before food?
The idea is to test 2 hrs before food and shoot from that number. Or on nadir number....
BTW...congrats on the home testing.... it does get easier - promise promise
 
So test him 2 hrs before his feeding time. Then when can I give him the shot? Still after he eats? IF he even needs a shot depending on what his level is?
 
I was wondering if anybody would be able of assitance whenever you have a moment :)

So this morning I tested his level and 5:30am and it was 355.
Fed him and give him 3 units of Lantus
Just restested it at 4PM and it was at 295.

He was fed 1/4 cup of food this morning, and has not eaten his dinner yet.

When I feed him, it kind of looks like he'll need a shot, how can I determine how many units he needs? Is there some kind of conversion chart that I could use to know how many units he needs depending on how high his glucose level is?

Thank you in advance for the replies!! :)
 
With Lantus you don't dose from one shot to the other on the preshot numbers. Lantus has to build up a shed or depot under the skin. Which needs consistent dosing to achieve. So if he is currently on 3u of Lantus then you give that dose both morning and evening and hold that dose for 5 days, then run a curve (testing every 2 hours from one shot to the next). Dose changes with Lantus are based off the nadir (the lowest point in the BGs) not the preshot numbers.

Read through this page http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581 It will help you understand how to raise and lower doses with Lantus.

Mel, Maxwell, Musette & The Fur Gang
 
Hi Sage's Mom!

I think ohbell misspoke yesterday--you want to test immediately before you give the shot an feed, not test 2 hours before. I think maybe she meant to say that you should make sure that you don't feed Sage 2 hours before the test. Food can artificially inflate the number.

The normal order is test, feed, shoot--or you can shoot while your cat is eating if you want him distracted. :-D

I see that you're feeding Purina DM dry--dry food is not good for diabetic cats at all. The only prescription food that is appropriate for a diabetic cat is Purina DM Canned, but honestly it's waste of money. It's pretty much the same thing as the lower carb versions of Friskies, Special Kitty, or Sophistacat foods, so you're paying a huge markup for the label alone.

Here's a great link with some extensive food lists: http://felinediabetes.com/diabetic-cat-diets.htm. You can pick anything canned that's under 10% carbs. The grain-free versions of Fancy Feast are very popular here because they are a decent quality food that are very easy to find in most stores.

Dosing with Lantus is determined by the nadir, or the lowest number of the cycle. This means getting a test in about 6 hours after you shoot each day (so that's a total of three each day--once before each shot, and one half way through either cycle). Here's the link to the sticky that explains how dosing on Lantus works: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

I would urge you to set up a spreadsheet so you can get advice from many of the experienced Lantus users on FDMB. Here are instructions on how to do that--please ask if you have any questions! There are a ton of people here to help. http://felinediabetes.com/FDMB/viewtopic.php?p=179835#p179835
 
How big is he, and how big is he supposed to be (weight)? The average male cat (12-14 lbs) needs about 6-8 oz of food a day. It depends on the food you're feeding though--you would feed less of a higher calorie food like Wellness or EVO than something like Fancy Feast or Merricks. It's also good to split meals into smaller, more frequent amounts with diabetics--I like to feed Bandit four times a day. Plus, it helps out a lot with begging to feed often! :-D

If he's an uncontrolled diabetic, you want to feed more than usual because diabetic cats are literally starving.
 
One thing I want to stress, and this is VERY IMPORTANT, is to make sure you lower the dose of insulin and are testing regularly before you change the diet to canned food. Most cats see a dramatic drop in their blood glucose numbers once dry food is completely removed from their diet--anywhere from 100-200 points. This can cause a dangerous hypoglycemic incident if you haven't lowered the dose to adjust. Most cats on a low carb canned diet do not need much more than 1u of insulin.
 
He's 11.5lbs (he used to be 18lbs! lol). The vet said he shouldn't be gaining anymore weight. He's not a tiny kitty though lol!

Anyway, I've made my first attempt at making a spreadsheet, I hope I'm doing it right :)

After reading a bit more we've decided that we want to eventually take him off the dry prescription food and change him over to Fancy Feast wet food.

So for now, would it be a good idea to keep feeding him the dry food until we until I had him on the 5 day cycle and try to get him at least somewhat regulated with normal BG numbers, before we start changing him to the wet food?

I'm SO very excited because it seems like there's finally light at the end of the tunnel!! He was diagnosed over 3 months ago now and he's still not regulated, and it's obvious he's not feeling well (seeme like he's always starving, excessive drinking/urinating etc) so it was starting to get really frustrating to deal with! so THANK YOU SO MUCH to everybody!!! :RAHCAT party_cat
 
If you are testing him at home there is no reason not to go a head and switch him over to alow carb wet diet. Sometimes cats will drop 100 to 200 pts alone on diet change.

My Maxwell went from 485 when diagnoised to in remission with 2 weeks of insulin and a diet change and has remained insulin free for over a year now and is completely diet controlled.

Mel, Maxwell, Musette & The Fur Gang
 
Ok so today was his first day on Fancy Feast and we split his meals up in 4 instead of just twice a day, as suggested here numerous times :)

I have his spreadsheet in my signature now. I did not fill out his PMPS reading for today because we took it 3 times and 3 times it was different!! All in a 5min time period or something (poor kitty), the 1st number was 300+ the 2nd number was 350+ the last number was almost 500! Not sure what was going on there, has that happened to anybody before? i rechecked him +2 and 3h45m after his last shot and it's going down a bit again, but still at 400 now.

I can tell SOMETHING is working though, he's not drinking as much water comparted to even yesterday!! Maybe soon he'll be able to come sleep on the bed with me again!! :D party_cat

From what it looks like so far, am I doing things right or are there any adjustments I should be making right away that could be dangerous to him? His 77 reading at 11am this morning almost had me worried but now his numbers are through the roof again lol.. Starting this home testing is definately a challenge but I'm very happy to finally be doing it! :)
 
Awww, Sage is adorable! It looks like he's on the same page as Bandit: http://i277.photobucket.com/albums/kk67/swusagi/BanditSleepy.jpg

I am SO glad you dropped down to 1.5u! 3u was definitely too high. That 77 is a great number to get for a nadir! Before most cats get regulated on Lantus, they go through a period where they bounce up and down. This is because their bodies are so used to the constant high blood sugar, when you get a normal number like that 77 their livers dump glucose into the bloodstream to counteract what is perceived as a low number. Eventually, their bodies relearn what "normal" is and this stops happening, but it can take a little while sometimes.

Definitely keep getting those mid-cycle checks, because it's possible he'll drop even lower with the diet change. You never know how much the diet change will reduce the need for insulin. Most cats on a low carb canned diet don't need much more than 1u of insulin. I think the highest dose Bandit ever needed was 1.25u.

Now that you have your spreadsheet up and running, you can always post over in the Lantus TR forum if you need advice. There are many people there who have a lot of collective experience with Lantus who can help you make dose adjustments.
 
Status
Not open for further replies.
Back
Top