Some help please!

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Jessfletch

Member Since 2014
Hi everyone, my name is Jess and my 17 year old cat was diagnosed with diabetes about a month ago, my vet said that I didn't really need to test his levels much for the first weeks but I was curious today, so I went ahead and his morning pre-shot number was 5.1 mmol and 6 hours later it was 3.1, which seems scary low since when we started a month ago it was 27! My vet is no longer in the office today and I'm not sure if I should give him his shot before bed, any advice from the experienced? I've been keeping an eye on him and he is a little agitated, I just gave him a tiny squirt of corn syrup... Help!
 
Hi Jess and welcome to the message board.

Boy, it's a good thing you tested and found that 3.1 (55) low reading.

Which insulin? How much?

No, I wouldn't shoot this evening. "Better too high for a day, than too low for a moment."

We do not suggest that new members give any insulin if the pre-shot test is <200 mg/dL (11.1 mmoL). I would not have shot that 5.1 mmoL (92 mg/dL) this morning. To convert from mmoL to mg/dL, just multiply by 18. Most of us are in the US, so we think better in mg/dL.

What food are you feeding?

Did you do a recent BG (blood glucose) test this evening?
 
Thanks for replying! I just tested him again and it's 4.2 mmol (75.6), so I will skip the shot tonight and check in the morning. He is on lantus, 2.5 units (the needle says each unit is a half ml) and when I found out he was diabetic I switched him to a grain free, low carb, wet food... My poor guy
 
Jessfletch said:
...and when I found out he was diabetic I switched him to a grain free, low carb, wet food... My poor guy
Click to expand...

Hi and welcome, Jess.

Well done for learning to test!
Switching to a low carb wet diet can reduce the blood glucose levels a lot in some cats. Those are lovely normal blood glucose numbers that you're seeing there.
Did you give insulin at that 5.1 preshot? Or did you skip that shot?
The insulin dose will certainly need reducing. And it may even be that your kitty is going into remission ('Remission' means that the diabetes can be diet-controlled.)

It'll be interesting to see what his numbers are in the morning.
Do post us an update then.

Eliz
 
I did give him insulin after the morning test, everything I could find online said not to give the dose if it was less than 4... I wish I hadn't! I will definitely post the numbers in the morning! Thanks again, remission would be AMAZING
 
Hi Jess and welcome this site is awesome and remission is very possible. My cat was Dx in 2010 and in 2 month working with this angels here FDMB (not my vet) he was in remission and it lasted 3 years 8 months. This time my vet advised me to come back here she was so impressed and she checks his spread sheet all the time. Awesome that you are home testing and once you get more info here....reading their notes ...you are going to find out so much. Lantus is what Trey was on and it worked for him so hoping it works for your boy. Big thing is start slow with the insulin but I will let these angels advise you there Hugs and tons of healing green light to your boy Fletch Hugssssssss Kath ~O) :YMSIGH: ;-) cat(2)_steam
 
Jessfletch said:
...the needle says each unit is a half ml...
Click to expand...

That isn't quite right.

Lantus is a U-100 insulin. This means there are 100 units in 1 mL. If your syringe is also a U-100 syringe (and it should be), then depending on size, it will mark half units (increments of 0.5), single units (increments of 1.0), or 2 units at a time. For the finer dosing needed in cats, you usually want a 3/10 mL syring marked with half units. Quarter unit amounts are eyeballed or folks use calipers for consistency.

Its a good idea to visually check your syringes; sometimes the marks are not stamped on accurately.
 
Ok, so this morning he is at 6.1 mmol, so I won't give him is insulin? Should I call the vet or just play it by ear?
 
BJM said:
Jessfletch said:
...the needle says each unit is a half ml...
Click to expand...

That isn't quite right.

Lantus is a U-100 insulin. This means there are 100 units in 1 mL. If your syringe is also a U-100 syringe (and it should be), then depending on size, it will mark half units (increments of 0.5), single units (increments of 1.0), or 2 units at a time. For the finer dosing needed in cats, you usually want a 3/10 mL syring marked with half units. Quarter unit amounts are eyeballed or folks use calipers for consistency.

Its a good idea to visually check your syringes; sometimes the marks are not stamped on accurately.
Click to expand...

I typed it wrong anyhow, I meant to say 1/2 cc, not ml, but I am very new to the syringes, they are u-100, and his current dose is 2.5 units
 
Hi Jess,

Jessfletch said:
Ok, so this morning he is at 6.1 mmol, so I won't give him is insulin? Should I call the vet or just play it by ear?
Click to expand...
No insulin this morning.
As Deb said above, we recommend that folks new to feline diabetes don't give insulin at below 11(200). You may find that his blood glucose is high enough for insulin this evening though since it's come up a wee bitty since last night.

You could try feeding your kitty small snack meals today if possible. That can encourage the pancreas to work without overloading it with too much to do at any one time.

Eliz
 
Jessfletch said:
Just tested again, 2 hours after the pre-breakfast test and it's lower! It was 4.0 mmol (72mg). I'm confused!
Click to expand...

If his pancreas is working well the breakfast could have dropped his blood glucose (stimulated the pancreas to produce insulin). That's a very good sign! :smile:
 
Ok, so this morning is 6.1 again, I'm feeling really hopeful that he could be in remission... When will I know? How long with no insulin before I can be certain? And how often should I be testing, he hates that part, the poor guys ears are all scabby :(
 
We consider BG readings in the 40-130 mg/dL (2.2-6.6 mmol/L)range using a human glucometer to be in the normal range. If your kitty stays in that range for 2 weeks without insulin, then we would consider them to be diet controlled and in remission.

Or as BJM has it listed:
50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

If you are trying to see if you can manage an OTJ trial, here are the instructions. OTJ = off-the-juice, insulin being the juice.

OTJ Trial instructions

Here are the instructions for an OTJ trial:
  • Test at your normal AMPS and PMPS times. Feed multiple small meals throughout the day as much as possible (small meals are less likely to overwhelm a newly functioning pancreas). The morning test is now called the AMBG. The evening test is now called the PMBG.
  • If your cat is green (0-99 mg/L human meter, 0-130 mg/L pet meter, 0-5.5 mmoL) at your normal test times, no need to test further until the next "PS" time, just feed small meals and go about your day. If the numbers are blue (100-199 human meter, 130-230 pet meter, 5.5-11 mmoL), feed a small meal and test again after about 3 hours. Food raises BG's. So if the number is lower 3-4 hours after a meal, then the pancreas is working!
  • After 2 weeks, if everything is looking good, we have a party! And boy, do we party hearty. :cool:

Sometimes, the trial doesn't work the first time and we have to give a little more support by starting the cat with a tiny dose of insulin again. I had to do that with Wink. We simply start the cat back on a tiny dose of insulin to support the pancreas with healing for a bit longer. Our goal is a strong remission and it's better to be safe now then sorry later that you rushed it. With just a little more time we will probably get that strong remission we are looking for.

So, since your kitty is ranging a bit high in those BG readings, we suggest you feed a small meal and test again after about 3 hours. The blue and green colors mentioned in the trial instructions refer to the color coding on our standardized spreadsheet.
 
You guys are amazing, such a big help to me (and Peanut!). Thanks! I will try the OTJ trial, that's kind of what I've been doing, I just did his bedtime BG (pre-food) and it was 5.8 mmol, I'm feeling really optimistic!
 
As a newbie I only have partially valuable info to provide concerning switching to the low carb food from higher. Simmie, in 9 days, dropped on average from 350 to 270, consistently. If I had used the spreadsheet I am sure this would provide more valuable info to the community so they could help more...I am still thinking about creating my spreadsheet. I've been too groggy lately so I am afraid I won't do it properly and I don't want to waste anyone's time. I would recommend that you take the experts advise and start using the spreadsheet.

As for Simmie, I believe his BG would be even lower but I do give him about an 1/8th of a cup of dry M/D during the day because I believe I switched him too quickly to the low carb food...he had the runs.

Good luck and everyone is with you in heart and spirit. This is a wonderful place.
 
OK, so 7.1 mmol/L (128 mg/dL) this morning and then you did a test 3 hours later as the OTJ instructions suggest. You got a nice lower 5.9 mmol/L (106 mg/dl). Yes a tad high, but not too bad considering that you are not giving any insulin.

You could continue the OTJ trial for a bit longer. Some cats tend to be a bit high the first few days and then settle back down into the lower BG ranges. I'd suggest giving the trial a bit more time.

If you start to see signs of excessive peeing, or excessive drinking or signs that Peanut is not feeling well, then you might consider stopping the OTJ trial.

Hey, I didn't "flunk out" Wink on his first OTJ trial until day 13-14. His numbers were just trending a bit too high for my comfort so I started him back on the teeniest dose of insulin, 0.1U.

What food are you feeding Peanut? Perhaps there is a lower carb food option we could suggest to help keep those BG readings lower.
 
I did switch him to a low carb, grain free diet as soon as I found out he was diabetic, he has wet food twice a day and a small bowl of grain free dry food (blue buffalo wilderness), he did have the runs for the first week, but it has adjusted to normal. I just did his PMBG and it was 6.8 and I will check it out again in 2 hours, I do feel pretty encouraged, but I will keep monitoring him for the 2 weeks for sure, I can't wait to call the vet on Monday and tell him! But then he will make us come in again I'm sure, this diabetes has already cost about $1100, that old cat is lucky I love him
 
Grain free is not low carb. Carbohydrates may be found in legumes (peas, beans), fruits, and starchy vegetables.

Evo Cat and Kitten (8%) and Young Again 0 Carb (5% the way we calculate it) are the only 2 kibbles we know are less than 10% calories from carbohydrates.
 
He doesn't really eat it unless I sprinkle it on the wet, but this is the percentages (I thought it looked pretty good) :
Guaranteed Analysis:
Crude Protein (min) 45.0%
Crude Fat (min) 18.0%
Crude Fiber (max) 4.0%
Moisture (max) 10.0%
Magnesium (min) 0.1%
Taurine (min) 0.15%
Omega 3 Fatty Acids* (min) 0.15%
Omega 6 Fatty Acids* (min) 2.0%
 
Not how we do the math; we use the as fed or the dry matter basis, not the guaranteed analysis.

Add the percents together and subtract from 100.
That is an estimate of the carb content by weight, not by percent of calories.

3.5 calories per gram of Protein
8.5 calories per gram of Fat
3.5 calories per gram of Carbohydrate
 
The food contains does contain a number of carbohydrate sources (potatoes, peas and others).

If you could eliminate this food from Peanut's diet then achieving remission might be that little bit more assured...

If you think Peanut will miss the 'crunch factor' of dried food than you could consider some freeze-dried meat treats, maybe?

It's looking good for Peanut.
We're keeping fingers and paws crossed here...

Eliz
 
He wouldn't miss it all anymore, just at first he wasn't into the wet food, now he pretty much ignores the dry food, so that's an easy fix. :)
 
If it's an easy fix, and Peanut can give up that last little bit of dry food, then you have a better chance of diet controlled remission. He's looking good, but a little bit lower in the BG readings would be great to see. Some kitties are very carb sensitive and even a few pieces of a higher carb food like that Blue Wilderness Grain Free may be spiking the BG levels a bit.

ETA: Jess, Would you please go back to your very first post in this topic and take off that 911 icon? Click on the little edit icon over towards the right on your post, then change the post icon from the 911 to either none or maybe the question mark if you're still looking for feedback. We use the candle and rainbow icons for a death of a cat. We like to reserve that 911 for health emergencies and Peanut is past that point. Sure would appreciate it.
 
It's funny in a way...I thought Simmie would never be ok with losing his small amount of crunchies every day, and you know what, he adores the wet food so much he doesn't even yowl for anything..except his ice :lol:

I think I generate more anxiety by my hovering over him than the lack of his crunchies would ever do! I think there are so many lessons we all can learn from having to care and monitor our sugar kids. If I had thought about feeding in a more logical manner I think I might have prevented Simmie from getting so heavy, and diabetic, in the first place. I remember when I lost my first sugar baby20 years or so ago I swore it would never happen again. I have noticed that it seems that very few of the sugar babies on this board are actually overweight. This causes me a lot of thinking. Regardless, I think Simmie would have been ok if I didn't overfeed him.

Nonetheless, it is what it is and just feel great about the fact that you are taking outstanding care of your baby! Good sleep!
 
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