Scared to death! Newly Diagnosed

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Lilys Mom

Member Since 2014
My baby, Lily, was diagnosed yesterday and I need some help. It's all so overwhelming. I am not sure about my vet's advice after reading through these forums and other articles I have been reading so I'd love some advice. I don't want to do anything to hurt her either so right now I'm just taking the instructions from the vet.

Lily is a rescue who turned 4 years old in September. My daughter rescued her from a gas/service station when she was approximately 8 weeks old. She was taken from her mother at 3 weeks old and sent to a gas station. One of the workers' had a girlfriend who's cat had kittens. He tried to bring her home and his parents wouldn't let him keep her so he took her to the gas station where he worked. The owner said that she could stay there a few weeks and once she was old enough they were going to let her loose. She ate hot dogs and hamburgers from their lunch, was knocked around a lot from the other workers, and my daughter found her sleeping in a box that she also used as a litter box although there was no litter to be found in there. She came to me drenched in urine and her own feces and very underweight. I told my daughter that once I nursed her back to health we would find a home for her. I fell in love the moment I saw her and begged my landlord to let me keep her and paid him a hefty deposit as well. On the 2nd day that I had her, I visited a pet store chain who had a popular animal hospital inside so I've been bringing her there. Lily had a mild case of asthma from the fumes at the service station so they were very helpful with that back then. Since then with air purifiers in my apartment and a little lovin, she's grown out of her asthma.

I took her to the vet yesterday for her routine dental cleaning. About 3 hours later I received a phone call saying that she was diagnosed with diabetes. Now, I don't know all of the words that she used (I was in shock) but she said that her levels were at 284 and they not only did a blood test but a urine test as well to make sure. She was there about 4 months ago for her vaccines and nothing showed up then so the vet tells me that this just started. Lily is overweight although I've been using the recommendations of the vet. I do think my 18 year old daughter feeds her more when I'm not around because she cries for food. We have since nicknamed her MooMoo because she stands at her bowl crying for food constantly.

She's been on Royal Canin since she was a baby (vet recommended) of wet and dry. Once I did some research about a year later, I switched her to Dry Innova but had to kept feeding her the Royal Canin wet because she wouldn't eat anything else. I read somewhere then that a wet and dry diet was the best for them. I guess I read wrong. First of all, Lily hates pate. Since the Innova dry food recall, I slowly switched her to Simply Nourish and Turkey & Oatmeal. The pet store recommended that after the Innova wasn't available at the pet store anymore. That was about 6 months ago.

The vet asked me a bunch of questions when I picked her up about signs and symptoms. Lily has none. She isn't sleeping more than normal, she hasn't lost any weight (she's the same weight she's been for 2 years now at 13.4 lbs and should be at 11 lbs according to the vet) She isn't any more thirsty (she won't drink out of a bowl. She will only use the bathroom sink) and hasn't been urinating any more frequently or not that I have noticed. I scoop the box once a day and nothing different. She's still as playful as ever and always has an appetite. She put her on 1 unit of Lantus twice a day. Lily got her first injection about 2 hours ago and is fine although I was a basket case when I was giving it to her. The vet prescribed either Royal Canin Diabetic (said I could do either wet or dry)or Hills Feline W/D. I opted for the royal canin since it wasn't pate and she was used to the morsels. Obviously, I've read here that she shouldn't be eating dry at all so I haven't even opened the bag.

The vet was a nice girl but young and didn't seem well versed in the subject when I was asking questions. She did say that normally they would have diabetic cats come in a few days later to check their levels but because Lily is so stressed at the vet that they didn't want to stress her out more so she would put her on the insulin and the prescription diet and I'd come back in 2 weeks. I asked her if it was possible for me to check her levels myself. My mom is a diabetic and checks her blood sugar every day. She told me "well I guess you could. I've never had an animal parent ask me that before so I need to check with my colleagues and call you tomorrow." They had another cat in distress and she had to attend to him since she was the only vet on duty so she left in a hurry. She did call me back today and emailed me a video with how to do the monitoring myself and told me to call her with questions. I did ask a few questions again but some of her answers went against what everyone is saying here. For example, she told me that cats should be on a high fiber diet, which I see here is not the case.

So here are my questions after reading these posts and other websites for 4 hours last night and 2 hours tonight.

1) Should I be feeding her the Royal Canin wet (won't do dry now that I've read the posts) since it's smothered in gravy. The can doesn't have the carb percentage on it and I've gone to their website and I can't find anything on there either about the carbs. I also went to the sites recommended here and can't find the carbs for the Royal Canin canned Diabetic formula.

2) If I switch her off this food to a high protein and low carb diet, will I be sending her into a hypo episode with the amount of Lantus she's taking? The vet says it's a very small dosage. I've seen the Fancy Feast options that are low in carbs too but will that put her in a dangerous situation and does anyone know if the Fancy Feast low carb option has anything in chunks and not pate. Lily is a picky eater.

3) The vial of Lantus says to discard after 28 days but I'm reading here that you can keep for 6 months. I asked the vet today when she called and she told me to hold on so that she could ask another vet. She came back to the phone and said that the other vet said that I could keep it for more but the potency might not be the same so I'm taking a risk with that.

4) I asked her about remission today and she said that it can happen but they don't see many cases of cats going into remission. Is this because they're prescribing this food? Even though I can't tell what's in this Royal Canin Diabetic formula food, from reading here, it might be high in carbs.

5) She told me that I should do the monitoring 2 weeks from now for a whole day. She said to do it before I feed her and give her the insulin and then check the level 2 hours later and then every hour after that until it starts going back up again and then every 2 hours if it reaches the level that it was at before I fed her and gave her the insulin and then write down results of each time. I should call her with my results and then we'll schedule another appointment a few days or a week after that. Does this seem crazy that I should wait 2 weeks from now?

6) I'm thinking I need to find a new vet. How do I find an expert in my area. I live in Chicago so I have to think that in this big city there has to be an expert but have been surfing the net for an hour and can't seem to find anyone.

7) How much should I be feeding her? The cans are 3 oz. cans. Today, the vet said that I should follow the instructions on the can but there are none. I gave her a can this morning that she ate quickly and then a can right before her insulin shot but she keeps crying by her bowl right now. It's about 2 1/2 hours after I gave her the shot.

8) If I give the insulin at 11 hours or 13 hours, will that hurt her? I'm just thinking that if I get home from work late or have to leave the house at night to go somewhere like to my daughter's volleyball game an hour before she would normally get it, will that hurt her? The vet only said that I had to feed her before I gave her the insulin.

I'm sure I'll have so many other questions but if anyone can answer these questions for now, I would greatly appreciate it. Lily is the love of my life. My girls and I are heart broken. By the way....money is not a problem. I can pay whatever I need to for food and insulin. I'll get a second job if I have to in order to keep her alive. No really...if I need to pay $200 to $300 a month for insulin and food, I will do that.

Thanks to you all and I'm so glad I found this site.
 
Let's start with testing. Since you are already giving insulin, home testing will keep your cat safe.
You'll need an inexpensive human glucometer, matching test strips, and 26 to 28 gauge lancets to prick the outer edge of the ear for a blood sample.

Next, food.
Ideally, you should feed < 10% calories from carbohydrates. Of course, they don't put it on the can. There is a wonderful food list over on Cat Info, compiled by Dr Lisa Pierson, a vet who specializes in feline nutrition. CAUTION: Keep the diet unchanged until you are successfully testing. A switch could drop the glucose level about 100 mg/dL and drastically reduce the insulin need.
 
Yes, I read her list and her whole article. She recommends the high protein/low carb. I have no problem with that but wonder if that will send Lily into a crisis. I did look for the Royal Canin Diabetic formula and can't find on that list although I did find the Royal Canin Adult she was eating was loaded with carbs. Lily only hate 1.5 oz of that per day though. The rest of the day she ate dry food; first Innova and then this Simply Nourish. I'm just thinking that she was fine 4 months ago at the vet and I switched the food 6 months ago. Is this a coincidence? Thanks for the post. I'll keep studying this food list.
 
Testing first, then diet change.

OR

Hold the insulin, change the diet, test the glucose, and monitor for urine ketones. The level you mentioned could be a combination of vet stress (raises office glucose 100-180 mg/dL) and diet (100 mg/dL.

Note: Young Again 0 Carb (actually 5% as we calculate it) Internet orders only, is a low carb dry if you cannot get her eating low carb canned or raw.
 
I don't know if that was a conincidence or not. I can tell you that Izzy was in for full check up and her BG was elevated. They had me bring her back in 2 weeks to determine if the elevated levels were due to stress at her original visit. The 2nd test came back within normal limits so it was determined to be stress.

Literally within a month she was staggering and could barely walk and when I took her in her blood glucose was over 800! No special testing needed there to diagnoses Diabetes....so yes, it can happen...just like that, as weird as it seems :)
 
Great! Thanks. I'll go out tomorrow and get the testing items you suggested.
Wow! 800...I would have gone over the edge.
She's tugging at my leg with both of her arms every time I pass her as she sits at her food bowl.
 
She's hungry because she can't use the food she is eating. It is OK to feed her about 50% more than a non-diabetic cat.

My cats (14 civvies and 1 diabetic) seem to run on 1 oz per pound, dividedi into 2 feedings that are left out until the next feeding. I'm feeding Friskies pates in the 13 oz cans.
 
Okay, great idea. I do think I can change her dry since I've done it just recently. I just mixed the food she liked in with it and then slowly, every day, took a little of the Innova away until she was on the other totally. Could I do that again? Only took about a week. So I'm not hurting her by not giving her the insulin? Vet did say that there was no liver or kidney damage and everything else was fine except for her pancreas obviously. Said we caught it early. I also bought a drink well fountain last night at the pet store so that she doesn't have to climb up and down from the sink. Vet said to make sure that she had water available if I was going with the dry. I do fill up a water bowl every day but it's never gone. Every once in a while I forget to turn on the sink when I go to work. When I get home, she meows for me to follow her into the bathroom and jumps up on the sink so I know she's thirsty. Since I've been doing the wet since about 6 p.m. yesterday, she hasn't been asking for water (when I'm home I turn the water off but she comes to get me when she's thirsty) since going to the wet.
 
Welcome Lily and her mom! :YMHUG:

Being only 4 years old, there's a very good chance that she'll go into remission. Did she get steroid shots for her asthma, by any chance? Steroids can often induce diabetes, but there's usually a good chance of remission if that is the case. You also caught it quick and it sounds like before any of the noticeable symptoms started becoming noticeable. 284 is also a relatively low number for newly diagnosed diabetics. Vet stress alone can raise BG (Blood Glucose) levels by upwards of 100 points and it sounds like she gets stressed! What dose did they have you start with? I'd be suspicious if she even was diabetic....

I'm going to see if I can answer all your questions, so let me know if I missed any or if you need any clarification. ;-)

Lilys Mom said:
So here are my questions after reading these posts and other websites for 4 hours last night and 2 hours tonight.

1) Should I be feeding her the Royal Canin wet (won't do dry now that I've read the posts) since it's smothered in gravy. The can doesn't have the carb percentage on it and I've gone to their website and I can't find anything on there either about the carbs. I also went to the sites recommended here and can't find the carbs for the Royal Canin canned Diabetic formula.

2) If I switch her off this food to a high protein and low carb diet, will I be sending her into a hypo episode with the amount of Lantus she's taking? The vet says it's a very small dosage. I've seen the Fancy Feast options that are low in carbs too but will that put her in a dangerous situation and does anyone know if the Fancy Feast low carb option has anything in chunks and not pate. Lily is a picky eater.

3) The vial of Lantus says to discard after 28 days but I'm reading here that you can keep for 6 months. I asked the vet today when she called and she told me to hold on so that she could ask another vet. She came back to the phone and said that the other vet said that I could keep it for more but the potency might not be the same so I'm taking a risk with that.

4) I asked her about remission today and she said that it can happen but they don't see many cases of cats going into remission. Is this because they're prescribing this food? Even though I can't tell what's in this Royal Canin Diabetic formula food, from reading here, it might be high in carbs.

5) She told me that I should do the monitoring 2 weeks from now for a whole day. She said to do it before I feed her and give her the insulin and then check the level 2 hours later and then every hour after that until it starts going back up again and then every 2 hours if it reaches the level that it was at before I fed her and gave her the insulin and then write down results of each time. I should call her with my results and then we'll schedule another appointment a few days or a week after that. Does this seem crazy that I should wait 2 weeks from now?

6) I'm thinking I need to find a new vet. How do I find an expert in my area. I live in Chicago so I have to think that in this big city there has to be an expert but have been surfing the net for an hour and can't seem to find anyone.

7) How much should I be feeding her? The cans are 3 oz. cans. Today, the vet said that I should follow the instructions on the can but there are none. I gave her a can this morning that she ate quickly and then a can right before her insulin shot but she keeps crying by her bowl right now. It's about 2 1/2 hours after I gave her the shot.

8) If I give the insulin at 11 hours or 13 hours, will that hurt her? I'm just thinking that if I get home from work late or have to leave the house at night to go somewhere like to my daughter's volleyball game an hour before she would normally get it, will that hurt her? The vet only said that I had to feed her before I gave her the insulin.
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1) Royal Canin Prescription wet is anywhere between 14-38% calories from carbs. For diabetics, it's recommended to feed them less than 8-10% calories from carbs (the lower the better). Some inexpensive OTC brands are Friskies Pates, Fancy Feast Classics, or Wellness Grain Free. Cats need protein, not carbs (or fiber). And pretty much even the worst low carb food is still better for them than the most overpriced high carb food. As to texture, Fancy Feast Chunky Classics work pretty well. My favorite is the Tiki Cat Chicken for both quality and texture, however it is quite expensive.

2) You are absolutely correct that you don't want to switch her before you start home-testing. A diet change can lower BGs easily by about 100-200 points. You might even want to try stopping the insulin altogether and going with the diet change first. She might not even need insulin because she was already "low" to begin with (definitely diabetic numbers, but much lower than most cats who are initially in the +300-600).

3) The "discard after 28 days" can be ignored. As long as you keep it refrigerated and don't roll or shake it, a vial can last up to 6 months (some have reported longer). My one vial lasted me 4 1/2 months (I now use pens; much more economical for me because I use them to the last drop). If you're home-testing, you'll be able to tell when it starts losing its potency as the BG numbers will creep upward or seem "off."

4) Yep, it's definitely because they're prescribing crappy food. :lol: I've been on this board for over a year and I have seen more kitties than not go into remission with a good, low carb diet, the right insulin, and home-testing.

5) Yeah, that's insane. Home-testing is not something you want to jump into immediately with a curve. Some people have no problem testing right off the bat, but for the majority of people (and cats), it can take a couple of weeks for it to fall into place. If Lily doesn't need insulin and she just had something causing the high numbers or if Lily heads to remission quickly, waiting two weeks will put her in more danger of a hypo.

6) You don't necessarily need a new vet; you just need a vet who is willing to work with you and to learn. Most vets are trained in many different species for many different things, so they're more experts on the "big stuff" of diabetes, like hypos and DKAs.If you don't trust her with the "big stuff," however, then I would find another vet. Start a new post here with something in the subject along the lines of "Seeking new vet in Chicago area."

7) Newly diagnosed diabetics are usually starving. You can feed her a bit more, if you like. Once you get her switched over to wet food and her numbers become better regulated, she'll be less likely to overeat and will probably lose some weight naturally because she won't be trying to compensate for all the excess carbs she's getting. You can read more about feeding portions and calories on the catinfo.org feline obesity page.

8) If she has a good appetite, she doesn't need to eat at shot time if she's not hungry. Since Lantus is a long-lasting insulin, it doesn't start kicking in for a couple of hours and "peaks" around 5-7 hours after the shot. It's more important they eat mid-cycle if necessary (i.e. to bring up low numbers) than it is to eat at shot time.

Lantus works best when the same dose is given 12 hours apart. You can adjust the time by moving +/-15 minutes each cycle or 30 minutes once per day. Sometimes, though, you'll end up giving a shot late. That's okay, but be aware that the numbers might be higher during that cycle and that you'll have to give the next shot late as well (to keep that 12-hour schedule).
Because of the cumulative nature of Lantus and Levemir, please be aware:
Shooting an hour or two early = that of a slight dose increase.
Shooting an hour or two late = that of a slight dose reduction.
The next shot is due 12 hours after the time of the early or late shot if you're shooting twice a day.
Oftentimes the effects of an early or late shot will not be seen until the next cycle. Please monitor carefully when shooting early.

A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.
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Kpassa,
Haven't read through your entire post yet but wanted to answer before you left. gave her 1 unit of Lantus twice a day. It's such a small amount. It's hard for me to even see the first mark. had to get the magnifying glass out.

Yes, she gets very stressed at the vet. They have to sedate her every time even to give her the vaccines. She's afraid of everyone except for me and my kids. The gas station worker said that the guys there would smack her around and yell at her and hit her if she was climbing on the counters or getting into trouble. She was a kitten for goodness sake...of course she was going to get into trouble and climb around. She was curious. The gas station worker told my daughter to come there because he felt bad for her so it was quite the kidnapping :) But, yes, the vet said that the levels could be raised from being there so they did a urine test??? I was out of it when I heard the news so I'm not sure that I'm correct in that statement. I just asked if they were sure and she said yes, we did the blood work and then another test...thought she said urine.

No, never gave her any steroids for her asthma. She only had 2 asthma attacks and they were mild. They just gave me a lot of info and gave me an inhaler and the face mask for kitties. I only had to use it a total of 3 times and she's was well under a year old. She's outgrown it, I hope. It's been more than 3 years. She doesn't even breath heavy any more when we play hide and seek. She used to get exhausted back then.

Reading the rest of your post now.
 
Some people give a half unit and some even give drops (0.10u or less). I have a feeling that with the one high number you've gotten, that 1u may be a bit much, if she even needs it. Lantus initially takes 5-7 days before the full effect is seen, so you definitely want to be home-testing and quickly lower the dose if she drops below 50 at any point.

It sounds like they might have just tested the sugar levels in the urine, which only shows she had elevated levels since the last time she peed. If she was there for 3 hours and they took the sample toward the end, then it's highly possible it's still stress-related. If they ran a fructosamine, that usually requires a couple of hours (if they have the equipment onsite). I think my vet called me back a day later with the results of that one. The fructosamine is more accurate in diagnosing diabetes because it's an average over the last two weeks. Heck, she might have even had a dental infection that was causing the higher numbers and now that it's taken care of, her numbers could drop even further.

Okay, sounds good about the asthma. :smile: Just checking on possible causes because, as I said, she's fairly young to be getting a diabetes diagnosis, so usually there's an underlying cause.

And I'm on the West Coast so I'll still be up for a few more hours. ;-)
 
Just read the entire post...you're a god send. All of this info is great. Haven't fed her dry food at all today. She's literally grabbing my leg as I walk by her bowl because she's still hungry. She's had (2) 3 oz. cans total today. I guess it's not going to hurt to give her a little more. It is the Royal Canin Diabetic though. I still have some Royal Canin Adult which I saw had quite a few carbs in it too though so I guess it doesn't matter.

Have a friend I called who lives in Seattle who I know does a raw diet. She gave me some info too. She gets hers delivered every two weeks. Said she sprinkles freeze dried beef liver or dried turkey treats on the top so that they'll eat it.

She also said that she mixes 2 tablespoons of low salt chicken broth on their food to make it more moist and they love the taste of it. Wonder if I could mix the chicken broth with the pate and see if she'll eat it.

The expense is not an issue so whatever food you think is best, I'll try.
 
You can return the Royal Canin to the vet for a refund; just say that Lily won't eat it. ;-)

Catinfo.org also has a recipe for cat food if you want to make your own raw (best option of all).

Make sure the chicken broth has no onions or garlic or carbs/sugar. Just plain water will also work. I "rinse" out their cat food cans into their food so they get "gravy" with their food and they don't even notice the difference. :lol:

As to "treats and toppings," pretty much any raw, plain-cooked, or freeze-dried protein will work. I sometimes give my kitties raw chicken bits when I'm cooking it or I boil them up a breast to top their food throughout the week. They LOVE it! :-D

ETA: stay away from deli meats, though, as those usually contain sugar.
 
Okay, so I just want to be clear here. If I don't give her the insulin shot in the morning or for the text week or two for that matter while I get "used" to the home testing, I'm not hurting her in any way by not giving her the insulin?

Keep feeding her what's she normally been eating or the diabetic formula until I'm able to get a read on the home test kit and then switch the diet to a low carb diet and see where the numbers are then? She's afraid of loud noises and she doesn't like to be held for a long time. She's afraid of everything...loud noises, sudden movement, strangers, etc. She will take off running so I'm not sure how this testing is going to go and how soon I'll be able to do it. I don't want to continue to stress her out. She's literally a nervous wreck for a day or two after she comes home from the vet. She wanders around the house rubbing up against everything to put her scent back on and oh my gosh, she saw the cat carrier out this morning and freaked out. I had to wash it out because she urinated in it several times while she was at the vet and on the way home so I had it drying before I put in the closet. As soon as she sees it she goes and hides. She HATES the vet and car rides. The display comes up at the vet when you're waiting in the room and it always says "Danger. Cat bites and scratches" and hisses like there's not tomorrow even when I try and take her out of the carrier when she's there. Otherwise, here at home, she's a sweetie. She doesn't like to be held but she loves attention (on the ground) and loves to play. She rolls over on her back as soon as I take my coat off because she wants me to rub her belly. When I lay on my bed, she comes to the side and lifts her arm up and swats at me so that I pet her.

One last thing...about 4 a.m. every morning she stands at the side of my bed and pokes me. When I don't respond she climbs up on my nightstand and swats at my arm to get my attention. If that doesn't work, she starts nibbling on my arm so that I get up to feed her. Is this okay to feed her that early...I guess what I'm asking is that the vet said 2 to 3 meals per day. She's used to 4 or 5 small meals throughout the day. Is this okay to continue to do? She was angry this morning when I wouldn't get up. She poked and prodded me for about an hour until she huffed and puffed and went in the other room. However, she came back about 30 minutes later with the same exact routine so I never did go back to sleep again. She's so used to me getting up and giving her a teeny bit of food at 4 a.m. It's very, very little. It's almost like she just wants me up because she will eat that little bit and then come back in and make me pet her. It might just be for me to give her attention but its her routine. It was heartbreaking this morning because its really become my routine too. It's our "alone" time when we bond.
 
If you stop giving her insulin, you can make the switch fully over to low carb food without having to test her. She should be fine for a week or so without insulin. Many cats when initially diagnosed have been diabetic for half a year or more without insulin. You'll want to be testing for ketones, though. You can also check out these Secondary Monitoring Tools, written up by BJ.

Michelangelo was a part-feral, six-month-old kitten when I had to learn how to test him so I feel your pain. I wrote this up for help testing difficult cats that might give you some ideas.

As to feeding, if Lily used to graze, then let her graze. The only time you want to take food up is two hours before the next shot time because, if you're home-testing, you want to be able to get a pre-shot number that is not food-influenced. Food can artificially elevate BGs and might make you think it's okay to give a shot when it's not. Eventually, after enough data through home-testing, you'll be able to skip this rule. If you're not giving insulin, then no need to worry, either. ;-)
 
makes total sense. Thanks for the insight and the links. I'll try to start tomorrow. Let's see how she does. Now I'm curious about the new food thing. My mom's cat switched the same food at the same time as she was using Innova as well. I buy the food so they were both eating the same thing. He is scheduled for his exam in March. I wonder if his BG will be higher now with that same food.

Thanks for your time!
 
Definitely switch them both to low carb. Henry, my non-diabetic, eats exactly what Michelangelo eats (5% carbs) and is healthier for it. A cat's natural prey has very low carbs and they don't normally eat vegetables in the wild. Cats are obligate carnivores and only need around 12% calories from carbs (diabetics even less).
 
Hello

Before you stop giving her insulin please if you would come back and post her numbers(blood glucose) if you would after you switch her food over to wet. That way if she is still high and may require some insulin we can get you some help on dosing from the Lantus people.
She may still require a little bit or may not, but lets see what her numbers say.

Terri
 
Terri, the one test they did at the vet during a dental was a 284 and it doesn't sound like they ran a fructosamine. She's just started the insulin and hasn't (yet ;-) ) started home-testing. So, I've been suggesting she stop the insulin and go with the food change first while she learns how to home test. After about a week or so, we'll be able to see if Lily still needs insulin or if the diet change (and lack of vet stress) will drop her numbers into normal range. :thumbup
 
This is what the vet emailed to me after I insisted on home testing Lily myself. We're about to give it our first try. Just went out and bought everything needed...I hope I did.

Here is the link that contains the video for drawing blood via the ear for glucose testing. The page also includes a link that explains what equipment is recommended.
http://www.veterinarypartner.com/Content.plx?P=A&A=605

Here is the schedule I would like you to follow for the glucose curve two weeks after starting the insulin, as we discussed on the phone:
1. Draw baseline blood sample and write down reading
2. Feed Lily and then give insulin
3. Blood sample two hours from baseline reading
4. Subsequent blood sample collection should be done hourly from then until you reach the lowest glucose reading.
5. Once you have obtained the lowest glucose reading, readings can be pushed back every 2 hours.

We should have 6-8 readings by the time you are done. Please make sure to document the glucose levels and times. We will evaluate when Lily has her lowest glucose reading and make adjustments to her insulin based on that.

Please let me know if you have any other questions or concerns. The best way to reach me is by phone at xxxxxxxxx.

Have a good day!

Dr. Smith
 
Sounds good.

Here are more testing tips and videos.. https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

Also I usually recommend 3-4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low she is going. The low point "nadir" is what you base dose changes on since you don't want her dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what her overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.


Wendy
 
I tested her with the Reli On Confirm. The first time it was 43 so I thought I didn't do it correctly. 5 minutes later I tried again and it shows 37 on the meter. She hasn't had any insulin today. Only one dose of 1 unit yesterday about 16 hours ago. I wanted to test her first before I started doing the insulin.

This number is low, isn't it?

She ate about 4 hours ago but only about 2 ounces of high carb food - the prescription Royal Canin for diabetics. She's standing at her bowl crying right now. She's not acting any different. My daughter has been home with her all day. She said that she played, slept, and is acting normal. She's playing with "da bird" right now.
 
The testing went better than I thought though it took two of us. She thought she as getting her nails trimmed which she loves. The first time was pretty easy but the 2nd team 5 minutes later was a little more difficult because she knew and flinched this time.
 
Lilys Mom said:
I tested her with the Reli On Confirm. The first time it was 43 so I thought I didn't do it correctly. 5 minutes later I tried again and it shows 37 on the meter. She hasn't had any insulin today. Only one dose of 1 unit yesterday about 16 hours ago. I wanted to test her first before I started doing the insulin.

This number is low, isn't it? ...
Click to expand...

With a glucose that low, no insulin is needed. We suggest new folks not give insulin below 200 mg/dL.

And its OK to feed her some food, preferably low carb. You may even leave it out for nibbling throught the day.
 
Congratulations on getting the first couple of tests in! Don't give her the shot. Those are low numbers. Either the 1u from the night before was too much or she doesn't need insulin. Have you fed her already? If not, please do so! Her regular food for right now is fine. What glucometer did you get?
 
I started a new post because I was scared to death with the low number. I got Reli On Confirm. Got a 42 reading the first time and then 5 minutes later did again and was at a 37. Got scared so I called the animal hospital. they said no insulin...give her food immediately and whatever she will eat...just have to get food in her. They said that she might not be diabetic at all because with only one insulin injection 26 hours earlier, it really shouldn't have kicked in with only 1 unit. She did eat the dry food and tested her 20 minutes later and she's at 42. I'm going to test her in a few minutes again because I did give her a teeny bit of karo but she was mad so didn't give her a lot at all.
 
Okay, those numbers are great for a cat not on insulin. Since you gave 1u last night(?) you do want to test again to make sure it's gone up slightly. The Karo should have helped. But just feed her regular low carb food from here on out. And no more shots! At least for the time being.
 
After she ate about 20 minutes I tested and it went from 37 to 42. I tested again about 20 minutes after the karo and she's up to 52. She ate a few minutes ago, very little, but she's now sleeping. I think she's good. She's not acting funny or anything. I think I'm going to call and make an appointment for another vet about 5 minutes from my house who everyone in the neighborhood swears by and get a 2nd opinion. I also think she will be less stressed because she hates the car. This vet is 5 minutes away while the other is about 25 - 30 minutes away. That might help with her stress level. I didn't know about this vet and how she comes highly recommended when I took Lily in. It doesn't hurt to hear from someone else. I'll test her again in the morning but I think she's going to be okay. I'm going to leave some food out for her overnight. Thanks so much for you help. I'll let you know how it goes. :-D
 
See my signature link Vet Interview Topics for some questions to ask.

And a vet who is willing to learn if not up to date on feline diabetes? Priceless.

(And those numbers do not look diabetic!)
 
Any advice on switching the wet food? I gave her a low carb version about 2 hours ago. She ate a few bites but then walked away. She used to the slices in gravy and this was pate. Do I mix what she likes with this and slowly take the gravy version out like I did when I switched the dry 4 months ago?
 
Mixing 20-25% different food at a time helps the transition and reduces GI upsets. Maybe add an extra tablespoon of water to make it more gravy-like.
 
She ate a few bites of the low carb Fancy Feast about 5 hours ago. She came back an hour later, sniffed it and walked away. She came back an hour after that and ate another bite or two but left. She hasn't even eaten an ounce yet today. Just tested her and she's at 39. Think I need to give her some of the food that she likes for now and visit the pet store today and buy all kinds of different low carb versions and try them all to see what she'll eat. For now, I'm thinking she needs to at least something. Just tested her and she's at 39.

Somehow, I think she was misdiagnosed. I've done about 8 or 9 readings since last night and they're all in the 37 to 52 ranges. It doesn't seem right and no insulin for almost 48 hours and only one dose of insulin total since she's been diagnosed.
 
Those are normal, non-diabetic numbers. My non-diabetic, Henry, often tests in the high 30s on the Micro/Confirm. And great job on getting all the tests in! I agree that she doesn't appear to be diabetic. Keep testing once or twice a day for a few more days and if the numbers are below 120, then she definitely does not need insulin.

You'll eventually find a low carb food she likes. Mixing it with her old food and some water, as BJ said, helps them transition faster.
 
So I went to the pet store today (yes even with the blizzard conditions in Chicago today) to get more food. Grabbed all kinds and all say Grain Free....all chicken or turkey formulas too. So, I'm safe to assume it's low carb if it says grain free? Here's why I ask...I bought something called Nature's Recipe Grain Free Chicken Recipe, which says #1 ingredient is Real Chicken and it says "Chicken recipe in Broth" which she might like...broth instead of gravy might be okay. I also bought something called Nutro Natural Choice that all say grain free. They have ones called Minced and Sliced and showed a picture and they look closer to what she normally eats (Royal Canin) Neither of these brands were on any of the lists that I've looked at on this site. So it sounds like grain free means low in carb. Is this correct? After this scare I want to make sure she's eating healthy and already talked to my mom about switching her guy over to wet grain free. He's a dry food addict. Once I get Lily under control, I'll get to him. He's 16 lbs and on a 4 out of 5 scale for weight the vet says. He's 6 years old so now that I know what I know, he could develop diabetes at some point if we're not careful.
 
Sorry, grain free is NOT necessarily low carb. Peas, beans, carrots, potatoes fruits are all carb sources.

Go to Cat Info and check your purchases with the. Downloadable food list pdf in the right hand, black, column. Return anything with over 10% calories from carbohydrates.
 
I talked to Lily's vet again today. She told me to stop the insulin injections and continue to home test her at least twice a day and write everything down. She said that her BG was 284 at the vet and that they did do a urine test and there was "urine spilling over into her kidneys" which is a sign of diabetes? I'm not really understanding that. She said that they normally wouldn't see that under just vet stress. Can someone explain in lay terms? She does want me to get a urine sample from home and I'm going back in two weeks. I suggested I bring my home test and compare to the readings that they get there when we go as all of you suggested. She agreed. That's why she wants me to gather the urine and bring to her so that they can do a comparison of the urine as well.

She did seem very interested in the recommendations of all of you and I asked her if it would okay to send her some of Dr Lisa's articles, etc. on low carb options and such and not giving dry food or the prescription diabetic formulas. She said she would love to take a look at these articles. She's young and said that she's sure that there will be many more patients like Lily and the more she educates herself, the better off she will be. So thanks for that advice as well.

Any suggestions on gathering the urine samples? Somehow, I don't think she's going to let me put a little cup or spoon underneath while using the litter box. She's very private when she's in there and very, very clean...doesn't even like you peeking at her.
 
Reading more about urine now and that's what she said...that the glucose spills into the urine. So they did do a urine test but only the two.

Anyway, she doesn't want me to do the stick. She wants a fresh sample of urine to bring with me on 1/20. Any suggestions?
 
There are a couple of urine testing ideas in my signature link Secondary Monitoring Tools, as well as other assessments that may be made. The test she could have run is fructosamine, which is an average over 2 weeks (sort of like humans H1ac test). Infection plus vet stress can raise the glucose high enough to excrete glucose via the urinary system. Maybe also be alert for signs of renal impairment.

Also print her these American Animal Hospital Association diabetes guidelines
 
Thanks BJ! I'll read this over. She did mention infection as well. I guess I'm just not sure why then she diagnosed her with diabetes so quickly if there could have been other causes. We're not out of woods yet though. It still might be although I did 2 tests today and both were low 40's and she's still eating the higher carb food. Trying to make the switch but she's fighting me on it. With her BG so much lower, I don't want her not to eat either. She did take a couple of bites of a no grain but then turned away. we'll get there....just have to keep trying until I find something she likes or try to trick her.

I was impressed that the vet listened and said that she was going to do some more research on the matter herself. I sent her the catinfo.org site and this site for her reference and worded it so I didn't offend her.

Thanks again!
 
Cats generally won't go into hypoglycemia if off insulin, other than a few rare conditions.

And you don't diagnose based on glucose in urine or blood; the standard is fructosamine. An elevation of 300 mg/dl can be a combination of vet stress and diet, never mind infection.

There are a very few low carb dry foods you might use while working on transition to wet low carb food.

Young Again 0 carb - actually 5% calories from carbohydrate as we calculate it. Internet orders only. Seems pricey but they may eat less.
Evo Cat and Kitten - pet supply stores
Stella and Chewey's freeze dried - pet supply stores
 
Just wanted to say that's great your vet is willing to look at the info! That seems pretty rare with those who've been practicing awhile. Hope you guys can get it figured out!
 
Hello Everyone,
Lily and I just returned from the vet. She asked me to take a urine sample from home and also bring my glucose monitor. They did not find any glucose in the urine that I gave them the sample of. Also, they left me in the room with Lily and left me for 30 minutes while I calmed her down and pet her until she relaxed. Once she was purring and calm, I took a test from their hand held test and it was a 68 and took with mine and mine was a 58. So in short, Lily does not have diabetes according to these test results today. She does now have a UTI, which I was given antibiotics for. I did ask the vet if there was any sign of infection two weeks ago when I was there and no, the urine didn't show a UTI and the blood work didn't show any other infection. They're contributing the 284 BG number to vet stress and she was so stressed out that it spilled into her urine. There is no sign of renal problems either. Lily is healthy. She has lost a few ounces since a couple of weeks ago as well now that she's on wet food only. I still plan to move her to low carb slowly. BTW...I took her a test from home before I took her to the vet and she was at 39.

Thank you to everyone who calmed my nerves and shared their expertise with me. I plan to continue to check the site and educate myself in case this ever happens again. I will pray for all of your animals who have this disease. I give you all so much credit for taking the time with your kitties. Your babies are so lucky to have you as their owners.

I will continue to randomly test my girl for BG just in case and I think with all of this, we've educated a young vet.
 
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