So many questions

[K8&Luna]

Hi,

My 11 year old Luna just got diagnosed a few days ago. Her blood sugar was 22 (396) the day she was tested, and again a few days later when we had our first insulin appointment. She weighs 19.2 lbs. We live in Canada. We have been started on Lantus, and have been told to increase 1 unit a day, so that after 4 days we are doing 4 units twice daily. This seems like a lot based on comments I've read, but maybe it's because of her bg reading and weight?

I know I can buy insulin here at a pharmacy, but I'm wondering about everything else?

The vet put us on purina DM half dry food, half wet food, and told us the amount to hopefully also start to reduceher weight. She said she didn't recommend any other kind of food. But I see from your posts that many of you use other foods? Is the fancy feast pate in Canada the same as it is in US? If so, how do I know how much to feed her? We were also instructed to feed her at the same time we give lantus, 12 hrs apart.

Also, the vet said i should get a bg monitor from her, which i found really expensive, does anyone know cheaper options available in Canada that would work for us? When I get one, how often should i test?

Thanks for your help!!

 

[CandyH & Catcat]

so many answers here -- I'm still a relative newbie, others will be chiming in

your story sounds like so many we hear here -- since most vets don't have the experience of day to day diabetes management in cats, they tell you what the manufacturer representatives tell them -- which can be driven more by financial concerns than health concerns (salespersons !!! )

yes, vets will recommend the prescription foods, and it turns out that is frequently NOT the best for our sugarcats -- go with the Fancy Feast classic pates, that's been proven effective with ours -- and most of us feed small meals through the day since that tends to keep the blood glucose steadier (the feed-only-at-shot-time is "old school" thinking -- current veterinary research doesn't bear it out)

that insulin increase is not at all what most of us have found effective -- if you can, consider dropping the dose down, since most likely you are now giving a dose higher than the optimum for a newly diagnosed cat -- but I'm not a vet, listen to the more experienced members who can give you pointers on procedures to determine what the best dosage might be

however, you need to get some Ketostix or equivalent, to test for ketones, since your situation will be in flux and Luna could be susceptible to those

yes, she probably weighs more than her optimum .. but I seriously wonder if high doses of insulin will help that at all, better to get her eating food closer to what a cat WANTS to eat, and as you work towards regulating her blood glucose, she will feel better, she will get the nutrition she needs, and the weight will come off slowly

vets want to see the results of testing with an AlphaTrak glucometer -- but that is an expensive way to go -- you will notice that most of us are using standard glucometers made for humans -- the "pet specific" meters are a fairly new invention, for day to day use, the human meters work fine -- and the protocols you will see here are designed for use with them

to let us help you, it would be great if you could set up the spreadsheet we use (see this Forum: http://www.felinediabetes.com/FDMB/forums/suggestions-tech-support-testing-area.6/ ) and a signature line (look for your name at the top right of the screen, click and scroll down) - telling us again your cat's name, your name, when you were diagnosed, what insulin, what dosage, what meter when you get it, what you feed, and where you are -- then we don't have to ask (again)

welcome !

 

[Panic]

Hello, welcome to the Feline Diabetes forum! It's great how much you're already reading, I'll tell you the basics that's you've already touched on:

Yes, we mostly feed Fancy Feast Classics or Friskies Pate. No dry food, diabetics need less than 10% carbs, Purina DM dry is 18%. You can return the food if you like, it's very expensive and not ideal anyway. The wet food alone will help Luna to lose weight. I do not know if the Fancy Feast in Canada is the same as the US, I'll let someone else confirm but I would assume it's the same. I will also let someone else comment how much she needs fed - there's a calculator/chart around here somewhere that someone can point you to to determine how much food, (I don't have the time at the moment to hunt it down).

Most of us feed our kitties small meals throughout the day, so you'll have two meals 12 hours apart that you will give her Lantus to her with, but also snacks in between as it helps heal the pancreas better. Some cats free feed!

You do not need a pet glucometer, the human ones work just fine! They read lower than a pet meter but there are certain numbers we look for to help. Ideally you want to test before every shot, then try to squeeze in some midday cycles and one or two before bed as well, it will help you see how well she's responding to the insulin.

 

[Margie and Jackson]

One unit a day is a very high rate of increase! The advice here is to increase .25 unit every 3 or every 7 days depending on the method. I’m very worried about your cat going into hypoglycemic shock. Have you read about that? Please read some of the information on cat diabetes here to learn how to treat it. 4 units is also quite a lot of insulin. Most cats need less.
To determine how much your cat needs, you should test her blood with a BG monitor, most people here use a human BG monitor because it is so much cheaper. Vets prefer the animal monitor, but it’s fine to use a human one. Home testing is really important for keeping your cat from getting too much insulin.

Most people use fancy feast or other foods. The dry purina isn’t even low carbohydrate, and the wet purina isn’t very low carb either, but vets like these foods since the companies promote them. There is a list of low carb foods on the site you can choose from that are much better.

Good luck and thanks for asking questions and caring for your cat. It’s difficult since most vets don’t have very much information about cat diabetes, but the people here are very knowledgeable.

 

[Red & Rover (GA)]

Hello from Ontario.
Raising the dose from 1 unit to 4 units so quickly is incredibly dangerous and raises many alarm bells. Personally, I'd be looking for a new vet.

You need to start over and go back down to 1 unit. Do not give any insulin at all until you get a meter.
I'd also advise you to immediately read the following links.

http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/
and
http://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

Meters. Yes, you can use a human meter. And you need one now because you may well be overdosing the cat. Lantus is a depot insulin and builds up in the system.

A lot of Canadians use the FreeStyle Lite, available at any pharmacy. If you go to Shoppers Drug Mart, you can use your Optimum points. (If you don't have an Optimum card, this is the perfect time to get one.) I cannot remember if the meter comes with strips or not, it's been awhile. You will need at least 100. While Lantus is very cheap in Canada, strips are expensive - roughly $0.80/strip. The FreeStyle Lite uses the least expensive strips and is the best deal in the long run.

If you live near the border, you can buy the strips much cheaper in the US. If you know someone over 55, you can take advantage of Seniors Day at Shoppers to buy strips. Also, check out Costco.

The pet meter AlphaTrak is very expensive and the strips are expensive. Unfortunately, there is no correlation between a human meter and a pet meter. People here are familiar with both types of meters and can guide you no matter which meter you choose. You can always tell your vet that you just cannot afford an AlphaTrak and the strips, but do want to track Luna's numbers.

Lantus. Yes, you can buy Lantus at any pharmacy. You do not need a prescription if it is for a cat. You are looking for a box of 5 vials (roughly $120). The box will last a long time. Stored properly, each vial can be used to the last drop and will last a long time.

Food and feeding. Fancy Feast pates and Friskies pates are just fine. Purina DM wet is as well, but the Purina DM Dry is too high in carbs.

It is best to get Luna off dry food altogether. There is no dry food available in Canada that is low carb. However, taking a cat off dry food can lower the blood glucose by up to 100. That's a lot. So do nothing until you get a meter and are monitoring.

Test/feed/shoot safety protocol
1. Test to make sure the cat's numbers are high enough to give insulin
2. Feed the cat to make sure the cat will eat
3. Shoot

Do feed Luna throughout the cycle, but pick up the food 2 hours before the next shoot. This ensures that the next test at shoot time is not influenced by food. Lantus works best when a cat is fed at shot time and given small snacks a couple of times throughout the cycle.

Sorry for the information overload. The most important thing is to stop giving 4 units immediately and to get a meter and start testing. One of our members has made an excellent video on how to test.

We can help you set up a spreadsheet to keep track of numbers.
The most important thing is to keep Luna safe.

 

[K8&Luna]

Hello from Ontario.
Raising the dose from 1 unit to 4 units so quickly is incredibly dangerous and raises many alarm bells. Personally, I'd be looking for a new vet.

You need to start over and go back down to 1 unit. Do not give any insulin at all until you get a meter.
I'd also advise you to immediately read the following links.

http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/
and
http://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

Meters. Yes, you can use a human meter. And you need one now because you may well be overdosing the cat. Lantus is a depot insulin and builds up in the system.

A lot of Canadians use the FreeStyle Lite, available at any pharmacy. If you go to Shoppers Drug Mart, you can use your Optimum points. (If you don't have an Optimum card, this is the perfect time to get one.) I cannot remember if the meter comes with strips or not, it's been awhile. You will need at least 100. While Lantus is very cheap in Canada, strips are expensive - roughly $0.80/strip. The FreeStyle Lite uses the least expensive strips and is the best deal in the long run.

If you live near the border, you can buy the strips much cheaper in the US. If you know someone over 55, you can take advantage of Seniors Day at Shoppers to buy strips. Also, check out Costco.

The pet meter AlphaTrak is very expensive and the strips are expensive. Unfortunately, there is no correlation between a human meter and a pet meter. People here are familiar with both types of meters and can guide you no matter which meter you choose. You can always tell your vet that you just cannot afford an AlphaTrak and the strips, but do want to track Luna's numbers.

Lantus. Yes, you can buy Lantus at any pharmacy. You do not need a prescription if it is for a cat. You are looking for a box of 5 vials (roughly $120). The box will last a long time. Stored properly, each vial can be used to the last drop and will last a long time.

Food and feeding. Fancy Feast pates and Friskies pates are just fine. Purina DM wet is as well, but the Purina DM Dry is too high in carbs.

It is best to get Luna off dry food altogether. There is no dry food available in Canada that is low carb. However, taking a cat off dry food can lower the blood glucose by up to 100. That's a lot. So do nothing until you get a meter and are monitoring.

Test/feed/shoot safety protocol
1. Test to make sure the cat's numbers are high enough to give insulin
2. Feed the cat to make sure the cat will eat
3. Shoot

Do feed Luna throughout the cycle, but pick up the food 2 hours before the next shoot. This ensures that the next test at shoot time is not influenced by food. Lantus works best when a cat is fed at shot time and given small snacks a couple of times throughout the cycle.

Sorry for the information overload. The most important thing is to stop giving 4 units immediately and to get a meter and start testing. One of our members has made an excellent video on how to test.

We can help you set up a spreadsheet to keep track of numbers.
The most important thing is to keep Luna safe.

Thanks so much for the information. I'm a bit overwhelmed to be honest. I have a small child and work full time, so i am out of the house 10 hours a day.... I'm not sure how I'm going to follow the recommendations for feeding and testing throughout the day.

 

[K8&Luna]

so many answers here -- I'm still a relative newbie, others will be chiming in

your story sounds like so many we hear here -- since most vets don't have the experience of day to day diabetes management in cats, they tell you what the manufacturer representatives tell them -- which can be driven more by financial concerns than health concerns (salespersons !!! )

yes, vets will recommend the prescription foods, and it turns out that is frequently NOT the best for our sugarcats -- go with the Fancy Feast classic pates, that's been proven effective with ours -- and most of us feed small meals through the day since that tends to keep the blood glucose steadier (the feed-only-at-shot-time is "old school" thinking -- current veterinary research doesn't bear it out)

that insulin increase is not at all what most of us have found effective -- if you can, consider dropping the dose down, since most likely you are now giving a dose higher than the optimum for a newly diagnosed cat -- but I'm not a vet, listen to the more experienced members who can give you pointers on procedures to determine what the best dosage might be

however, you need to get some Ketostix or equivalent, to test for ketones, since your situation will be in flux and Luna could be susceptible to those

yes, she probably weighs more than her optimum .. but I seriously wonder if high doses of insulin will help that at all, better to get her eating food closer to what a cat WANTS to eat, and as you work towards regulating her blood glucose, she will feel better, she will get the nutrition she needs, and the weight will come off slowly

vets want to see the results of testing with an AlphaTrak glucometer -- but that is an expensive way to go -- you will notice that most of us are using standard glucometers made for humans -- the "pet specific" meters are a fairly new invention, for day to day use, the human meters work fine -- and the protocols you will see here are designed for use with them

to let us help you, it would be great if you could set up the spreadsheet we use (see this Forum: http://www.felinediabetes.com/FDMB/forums/suggestions-tech-support-testing-area.6/ ) and a signature line (look for your name at the top right of the screen, click and scroll down) - telling us again your cat's name, your name, when you were diagnosed, what insulin, what dosage, what meter when you get it, what you feed, and where you are -- then we don't have to ask (again)

welcome !

Thanks so much for the information, I'll read about getting a spreadsheet set up.

 

[Panic]

Thanks so much for the information. I'm a bit overwhelmed to be honest. I have a small child and work full time, so i am out of the house 10 hours a day.... I'm not sure how I'm going to follow the recommendations for feeding and testing throughout the day.

Test when you can, like weekends etc. An automatic feeder will be a huge help for you.

 

[Peacock]

It can be overwhelming, but we can help you sort it out a little at a time. It is better to make small changes gradually and not all together anyway, so you can see how Luna does with each adjustment.

I think the most important step is to dial back on the rapid dose acceleration the vet office recommended. It is much safer to increase more slowly, in smaller increments, as you see how your kitty does with her dose.

Then keep in mind that changes in diet will likely affect insulin requirements. My cat's BG levels were cut in half when I stopped giving her the dry DM her vet prescribed.

You can get BG testing going gradually too. First you will want to start to get readings before giving a dose, to see if it is safe. When you have more time, maybe on the weekend, get some of the tests in between shots, and that will give you clues about safely adjusting the dose.

 

[Idjit's mom]

Welcome to FDMB, you have received some good informative responses. I agree with others that the rapid increase in Lantus dosage is not healthy for Luna. It puts her in real danger of a hypoglycemic event, which can be life threatening.
I echo Red & Rover's advice to either reduce or discontinue insulin, and start testing.

Testing is going to provide you information on how the insulin is affecting Luna, we do recommend testing before every injection to be sure it's safe to "shoot", as well as at other times during the 12 hour cycle, as you can. Many full time workers try to get at least a "before bed" test on those workdays, then fill in readings at other times on the weekends.

Please visit the Lantus insulin support group forum HERE so you can learn how this insulin actually works, it's not like the insulin that was developed for dogs and have been used for cats, a fast acting, in & out type of insulin. Lantus is a depot insulin, it's absorbed slowly by the body and the depot needs time to fill up. It's very effective with treating feline diabetes.

It sounds like you have your plate full, full time job outside the home, and a more than full time job parenting a young child. And, yes, this new event in your life is overwhelming at first. But, you are in the right place to learn what to do and how to do it. You have the insulin, so you don't need to visit vet again right away. You will get more accurate information, advice and support here than you have received from that vet.

Going forward, please post in the Main Health forum HERE so that more members can read and respond. This Introduction forum is not as heavily monitored, it's just to say Hello and let us know how we can help you further. We really will help all we can to assist you with Luna's treatment and to help you stay less stressed as you progress.

 

[Red & Rover (GA)]

Thanks so much for the information. I'm a bit overwhelmed to be honest. I have a small child and work full time, so i am out of the house 10 hours a day.... I'm not sure how I'm going to follow the recommendations for feeding and testing throughout the day.

It does seem overwhelming, I agree. But it will become part of your daily routine once you learn the steps to keep Luna safe.

It is incredibly important to drop the dose immediately. We have seen too many emergency hypos from the dose being raised too fast, and your vet raised the dose far too fast. Treating a diabetic cat is a marathon, not a sprint – your vet knows very little about feline diabetes and is putting your cat at risk for a hypoglycaemic event and you might not be home to deal with it.

Testing while holding down a job and a family can be done. Many people here do it and manage the best they can.
Work day example:
6am: wake up, pick up food, test
8am: test/feed/shoot
6pm: pick up food, test
8pm: test/feed/shoot
bedtime: test
middle of night (if you are up): test
Once you get the hang of testing, it takes just a few seconds. And you can get a few tests in on your days off to fill in the mid-cycle spaces that you are missing during the work week. Mid cycle tests are important because Lantus is dosed not on how high the numbers are during a cycle, but how low the numbers go during a cycle.

Leaving food out is fine. Just remember to pick the food up 2 hours before the shot is due.

 

[Margie and Jackson]

Thanks so much for the information. I'm a bit overwhelmed to be honest. I have a small child and work full time, so i am out of the house 10 hours a day.... I'm not sure how I'm going to follow the recommendations for feeding and testing throughout the day.

I usually only test 2x a day. Jackson doesn’t get tested if my husband gives the shot, or if there’s a petsitter. I’m more conservative with his dose than some people, so his blood sugar is less likely to reach hypoglycemic levels. The method called Start Low Go Slow is the one for people with less time to test.

You don’t have to spend hours dealing with this!

 

[Red & Rover (GA)]

I usually only test 2x a day. Jackson doesn’t get tested if my husband gives the shot, or if there’s a petsitter. I’m more conservative with his dose than some people, so his blood sugar is less likely to reach hypoglycemic levels. The method called Start Low Go Slow is the one for people with less time to test.

You don’t have to spend hours dealing with this!

It still advised with the Start Low Go Slow method to get as many random checks as possible in.