Starting insulin tomorrow evening.. in the mean time?

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Lys7

Lys7

Member Since 2016
Hotch has always been a bigger boy and loved water so we never really thought anything of him drinking a lot and producing large amounts of urine. I really wish we had caught this sooner. He recently started urinating outside of his litter. At first, I thought maybe he was just acting out but when he did it the second time and tried to a third I was a bit concerned and booked a vet appointment. I also tried researching the symptoms and then it hit me what we were most likely dealing with. I took a urine sample to his appointment yesterday and his sugar level was off the charts. They did some blood work and we got the confirmation this morning that he is diabetic. We went in a few hours ago to discuss with our vet. Hotch has been sleeping constantly when he is not eating, drinking, or going to the bathroom. Somewhere, communication was lost at the vet's office and they had used/given away our insulin so he is not able to start it until tomorrow evening... I am very concerned about this but the vet said, it has already been going on, what is one more day? About an hour ago I did give Hotch the diabetic cat food both canned and the dry and he ate them right up (so that is a good thing). Is there anything else I can do tonight besides keep an eye on him? I have just read about ketoacidosis.... If this was starting to happen would the vet have picked up on it in the blood test? Does it only happen if a cat stops eating and drinking????
I should also mention that he was around 18-20 pounds in November and is now only 13.2 pounds.
 
Hi and welcome! There are a couple of things you can do now. First, and most importantly, pick up a human glucose meter and learn to test Hotch's blood glucose. It's very easy and it is the best way to help him. It will keep him safe from hypos and let you and your vet know how well the insulin is working. If you can start that now, you'll be prepared for when you actually begin giving insulin. While you're at the pharmacy, pick up some ketone test strips so you can keep an eye on those levels as well. Another thing is food. Dry food-even the vet prescribed stuff-is too high in carbs for diabetic cats. Switching to a low carb canned food will help to get Hotch in better numbers. Do not take away the dry unless you start testing though because just that simple change could lower his glucose 100 points or more and the insulin your vet prescribes would be too much. Do you know what his glucose number was at the vet? What insulin will you be using?
 
Thank you for your reply. I will head down to the pharmacy shortly. I read on here that the Purina dry food is not recommended and that is what I got from the vets. Unfortunately, he had already eaten it. His dry food was Merrick's Purrfect Bistro - Grain Free Healthy Weight. Do you think this would be better? I am not sure what the glucose was at the vet. The vet just told my partner that it was double what they would consider high. To me, that means something should be started right away.. but.. he is the doctor :(. He will be taking ProZinc. The vet wants to start at 2.0 units, twice per day. I am going to question this though because I read that if the cat was on a low-carbohydrate diet the starting dose should be only 0.5-1.0 units twice per day. I don't seem to see any carbohydrates on the Merrick bag?? I am assuming they are low. I will have to search online more.
 
Lys7 said:
Thank you for your reply. I will head down to the pharmacy shortly. I read on here that the Purina dry food is not recommended and that is what I got from the vets. Unfortunately, he had already eaten it. His dry food was Merrick's Purrfect Bistro - Grain Free Healthy Weight. Do you think this would be better? I am not sure what the glucose was at the vet. The vet just told my partner that it was double what they would consider high. To me, that means something should be started right away.. but.. he is the doctor :(. He will be taking ProZinc. The vet wants to start at 2.0 units, twice per day. I am going to question this though because I read that if the cat was on a low-carbohydrate diet the starting dose should be only 0.5-1.0 units twice per day. I don't seem to see any carbohydrates on the Merrick bag?? I am assuming they are low. I will have to search online more.
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The only low carb dry food options that are suitable for a diabetic are Evo or Young Again Zero (only available online) therefore a canned diet under 10% is optimal and could definitely bring the numbers down. Merrick makes many canned options that are under 10% carbohydrates. Check out this list here and scroll down to find Merrick. However, once you start insulin and switch to a low carb canned diet, it is extremely important that you are are able to home test as a food switch alone can drop blood glucose significantly. And therefore, as you mentioned, the insulin requirement would change.
 
I will look into those two options, thanks. Is it important to have dry food readily available though (in the correct daily amount)? The vet tech had mentioned this. I wonder why my vet didn't mention us doing home testing. He did mention bringing Hotch in and doing tests, but said sometimes these can just cause more stress and not give true results. Hotch is a tad anxious and upset at the vet. I have now purchased a glucose meter and will look into how to use it on him.
 
So glad you are going to home test. Let us know how we can help. My hints are to warm the ear and use a larger gauge lancet at first (25-27 gauge). Yes, levels at the vet are usually higher than those at home because of stress.

Very few people here feed dry food. A vet explains why wet is best here: www.catinfo.org. BUT as others have said, you want to be comfortable with testing at home before making a good change. When we switched our cat from dry to wet, he dropped 100 points overnight

We suggest starting with 0.5 or one unit of insulin twice daily. You can always increase as your testing indicates. But you can't get the insulin out of the cat once shot, and dealing with low numbers in the beginning of the sugar dance is especially stressful for you.

We put together a protocol for ProZinc. It is in my signature in blue.

Continue to ask questions and research. We'd love to help you help your sweet Hotch.
 
I will talk with my vet about lowering the unit and see what he says. I just want to help Hotch. Uh oh.. Is the only recommended spot to test on the ear? He is sensitive about them and I'm not sure if there is enough left to test on. What do you think? Maybe that is why he didn't mention home testing to us. Here are a couple better pictures of his ears.
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Lys7 said:
I will talk with my vet about lowering the unit and see what he says. I just want to help Hotch. Uh oh.. Is the only recommended spot to test on the ear? He is sensitive about them and I'm not sure if there is enough left to test on. What do you think? Maybe that is why he didn't mention home testing to us. Here are a couple better pictures of his ears.
View attachment 20950 View attachment 20951
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I exclusively test Carter on his back paw pads. Not because he's bad for his ears, but I find the process easier and quicker. It usually takes me 20 seconds from the time I grab him, put him in my lap, put the lancet in the lancing device, prick and test. Particularly, I try to get the area on the side of the paw pad, because his feet do touch everywhere, and it's less likely for any cat litter/bits etc to get into the teeny tiny holes I make when I test. He hardly notices it's happening, usually purrs and sometimes even falls asleep! With testing the ear, I felt like it took me longer to get in a good position for him and get a good yet gentle grip, which in turn made him fidget.

PS he is so precious!!
 

  1. Lys7
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    Hello,
    Hope you don't mind me messaging you. I just have a few more questions before I finally sign off for the night. I have done a lot of reading tonight am still concerned with a few things, mainly food. Sorry if this is all over the place, my head is a little sore.. Last night and tonight I gave Hotch the canned Purina. Tonight he had a little bit of dry after. (His bowl still had kibbles in it this morning from his Merrick brand.) I am wondering about tomorrow morning. If I only offer him the wet food from here on out, would that be sufficient enough to ask my vet to lower the starting unit of 2.0? Maybe to 1.0? I have read that if a low carbohydrate diet is being followed then the range starting out should be from .5-1. I realize that food intake is directly linked with glucose/insulin levels, but would such a fast change be okay and warrant the lower unit? I think I would rather an upset stomach over levels which are out of my control. I also don't want to shock Hotch's body too much, by changing another important variable. Alex wants to mix wet and dry food - I've been slowly filling him in on why dry food isn't good. Eventually, I would like Hotch to be off of the dry completely. Another reason I am worried about switching later instead of now is because I am not sure if I will be able to do the at home testing. I will certainly try. Tonight I just touched Hotch's pad a couple of times and he growled at me. :( I could do the urine testing but I know that is no where near as effective as the blood. I guess I am just wondering what the best course of action is for tomorrow's breakfast... Thanks for any insight you can offer.


    I am answering the private message here from _________ (what's your name?)

    I wish we knew what the number from the vet test was. If it isn't terribly high, you might make the diet change first and see how much of a difference it makes. It is usually best to change over slowly to avoid diet changes (25% new food, 75% old and then 50/50 etc.)

    I'd start slowly with the paws. Find a low carb treat he loves (PureBites and Bomito flakes are popular at my house) and give it only at test time. Pick a place to test, take him there, give him a treat, pet and praise and play with his paws a little. Do that a few times and then add warming, treat, praise and release.. Meanwhile practice with the lancet and meter so you know how it works. Finally, after he is used to having is paws touched and interested in a treat, try a poke.

 
Hotch looks like a real sweetheart!!! Sues advice is good. Try to desensitize Hotch to your touching his paw pads using treats. Take your time and remember to take a deep breath and relax because he can sense your nerves. Some people find that singing to their kitty while they prepare for and execute the test helps. Good luck and please keep us posted and ask any questions you have.
 
I will be asking for the number when I take Hotch in tonight for his first shot. I am really hoping they test him again before they inject the insulin because I have been giving him the canned food (as well as a little kibble). I know that a no shoot range should be 200 for beginners, correct? I am terrified of blind injecting but I think that will be the case for the first few days :'(. I have tried touching his back paws again.. it seems better when he is sleepy, so that is a plus. He is a smart kitty (sometimes too smart for his own good), so hopefully once he realizes we are helping him he will be better about it all. I am also going to print off some of the information from this site to show my vet. I have decided I am going to ask about lowering the unit to 1.0 to start - especially if his diet has changed. The meter I purchased was the OneTouch with the Delica. The only two options were the 30 and 33 gauge. The pharmacist suggested the 33 to me. I now know that the 25-27 is best starting out. I can either return the 33 and get the 30 if you think that will be sufficient and easy to use on the paws or I can return that meter and go to Walmart this afternoon to find a different one which has the 25-27 gauge. I also need to pick up some low carb treats. We were giving him the Head to Tail Daily Cat Supplements as treats, with the odd Greenie Dental but the vet said to stop. Thanks again for all of your insight and advice.

Alyssa
 
Welcome Alyssa & Hotch!!!!
Fritz my kitty is on Prozinc.
Not sure if anyone mentioned not to feed Hotch 2 hours before his AM&PM insulin shot. If you do feed him in that time frame you could get a wrong reading as food effects his BG.
I use Pure Bites freeze dried chicken and Cat Man Do Bonito flakes. I found chewy.com has good prices on both treats cheaper to buy the large bags they say for dogs but they are the exact same treats made for cats just less $.
There are some good U tube videos on injection insulin. I just googled giving insulin to my cat.
Hotch is so cute:cat:
 
Thank you! Yes, someone had mentioned that to me in a message. At first, the vet had said that insulin is given 30 minutes after eating but he said with ProZinc, we can give it to Hotch while he is eating. I think that will be a good distraction. Do you inject while Fritz is eating? I will let Hotch eat a bit first before we inject. He does love the canned food though. I am just thankful the vet is giving him the first injection as I am home alone tonight. I will have to try on Saturday morning by myself.. maybe before once I see how easy it is. :p
 
The 25-27 lancets are usually called alternate site lancets. You might call around a few drug stores to ask if they have them

While he is sleepy is a good time. Maybe pick your poking spot in a sunny window. Take him there, lots of petting and praise and treats, touch his paws and let him go. Desensitize him over time with lots of treats

I think I would be honest with the vet. You are nervous about a hypo and would be most comfortable with a
low starting dose
 
Ask the vet to shave a patch for injections, it does make it much easier to start with if you can see where the needle goes in. In time you will get the 'feel' when the needle has gone in so you can just grasp a bit of cat and go for it! I draw up insulin just after I put the food down as cold insulin fresh from the fridge can feel a bit uncomfortable, I leave it out in the syringe while she eats. At first I injected my kitty as she was finishing her meal but now I inject afterwards as she started to object to having her meal time interrupted once her sugars were coming down and she was less starving hungry. I take her blood sugar readings from the paws so if you need any tips on how to do it please just holler.
 
With ProZinc you need to roll the syringe gently in your hand, as it is a suspension. That helps warm up the insulin

I never realized until I got a cold flu
shot that it can really sting!
 
Off to the vet in a bit, but Hotch just threw up canned food. He did have a little bit of kibble this morning before I took it away and gave him the canned. Any advice on what I should bring to the vets for his dinner with his first insulin shot???? I have his old kibble, the new purina kibble and the purina canned.. I am thinking of mixing a bit of his old Kibble with the new since his stomach is clearly upset.. Perhaps we can try a late night snack of the wet
 
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Lys7 said:
Thank you! Yes, someone had mentioned that to me in a message. At first, the vet had said that insulin is given 30 minutes after eating but he said with ProZinc, we can give it to Hotch while he is eating. I think that will be a good distraction. Do you inject while Fritz is eating? I will let Hotch eat a bit first before we inject. He does love the canned food though. I am just thankful the vet is giving him the first injection as I am home alone tonight. I will have to try on Saturday morning by myself.. maybe before once I see how easy it is. :p
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Yes I let Fritz eat some and while he is finishing I slip up next to him and then make the little tent with fingers and shoot
 
How to take blood from the paws (in response to a PM from the OP) NB the towel and floor are optional - use what works for you.

First set out your equipment. A large towel on the floor, some alcohol gel or wipes - something to clean the paws. Some vaseline or neosporin, whichever you have to hand. Cotton wool wipes. An old sock with a handful of rice in it and then knotted to make a little bag. Load up the lancet machine. Push the strip almost into the meter but not far enough to activate it. Make sure you have spare strips to hand in case the blood doesn't go onto it the first time. Everything should be in easy reach for when you sit cross legged on the towel with the cat. Warm the sock in the microwave for 30 seconds, throw it down on the towel then go get the cat. Have good light to work by.

Sit cross legged on the floor, cradle the cat between your legs and on her back, and grasp one of the back paws, apply a tiny blob of alcohol gel and rub in well.

Place the warm sock over the pads and while the foot is warming up make a big fuss of the cat so she associates this with getting good attention.

Once the pads are warm place the lancet machine firmly onto the rear large pad, I have the alphatrak set on 4 which goes nicely into the pad. Press the button and hold for 2-3 seconds before withdrawing and as you put the lancet down push the strip all the way into the meter.

Gently squeeze the paw pad until you see a little blob of blood, the meter should now be ready to read.

Hold the very edge or end (depending on which meter you use) of the test strip onto the top of the blob and it sucks it up and beeps, put the meter down.

Press gently on the paw pad for several seconds with the cotton wool pad to prevent bruising, then rub a small amount of vaseline onto the pad whilst making a fuss of the cat. Using this regularly softens the pad and helps with the blood letting.

By this time the meter should have given you a reading.

Let go of the cat and reward her with a food treat and more fussing.
 
Lys7 said:
Off to the vet in a bit, but Hotch just threw up canned food. He did have a little bit of kibble this morning before I took it away and gave him the canned. Any advice on what I should bring to the vets for his dinner with his first insulin shot???? I have his old kibble, the new purina kibble and the purina canned.. I am thinking of mixing a bit of his old Kibble with the new since his stomach is clearly upset.. Perhaps we can try a late night snack of the wet
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Did Hotch throw up the food immediately after he ate? How much canned food are you feeding at a time? Bandit will sometimes eat so fast he vomits, so I feed him 4 small meals a day--about a quarter of a 5.5 oz can per meal, or a half of a small 3 oz can. If this is the case, you can try feeding in smaller portions at a time, and that should solve the problem. Diabetic cats do best on small, frequent meals throughout the day anyway--it helps level out their blood glucose a bit.

Sometimes cats will have a little GI upset no matter what you do--keep slowly phasing out that kibble. Sometimes Fortiflora (a kitty probiotic) can help with this. I would stick with his old kibble and not bother to try getting him on the Purina kibble (is it DM?). If the Purina kibble you got from your vet is the prescription DM, you should be able to return it to the vet and get a refund. Just say your cat wouldn't eat it.

The goal is to get him off all kibble, so there's no point upsetting his system with a new dry food.
 
Sharon14 said:
@Lys7 how's Hotch, what did the vet say?
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The vet wasn't comfortable starting last night because of the vomit and they would be closed if anything happened. The closest emergency vet is 30 minutes away. His original number a few days ago was 28.1 and we tested at the vet last night while he was stressed and it was 24.7 (yay for canned food?!) They had a hard time with the paws and ended up taking blood from his leg. Hotch had his first dose this morning which was 1 unit. He seems more alert already, but still has been napping off am on. We tried poking just a little while ago but were unsuccessful. Going to try again before his evening dose.

I have a side question.. Does the anxiety of leaving your cat ever go away? I am a fairly anxious person as it is. I feel like I need to be home forever now. Today was my first day back to work this week and I was worried about him all day. It's going to be a heck of a lot worse when my partner is on days as well and neither of us are home throughout the day. The peak times are going to be when we are sleeping and during the middle of the day :(. Is there only a big concern when you are starting a new dose or could going low really happen at any time? Any time meaning, he has been good on the 1.0 for a few days???
 
I'm glad he's feeling better! As for the anxiety, I can only speak for myself, but I still feel a twinge when I'll be gone all day. The best thing you can do to calm those fears is learn to test. I test as soon as I get up, then feed and shoot. That way I can get an out the door test @+3 (3hours after the shot). That tells me a lot about how his day will go. I give a small, or larger snack depending on the number. Also getting an automatic feeder that will open around nadir time will help. After you do this for awhile and have a spreadsheet with some numbers on it, you will begin to see a pattern and that will also help allay your fears.
 
Julia & Bandit said:
Did Hotch throw up the food immediately after he ate? How much canned food are you feeding at a time? Bandit will sometimes eat so fast he vomits, so I feed him 4 small meals a day--about a quarter of a 5.5 oz can per meal, or a half of a small 3 oz can. If this is the case, you can try feeding in smaller portions at a time, and that should solve the problem. Diabetic cats do best on small, frequent meals throughout the day anyway--it helps level out their blood glucose a bit.

Sometimes cats will have a little GI upset no matter what you do--keep slowly phasing out that kibble. Sometimes Fortiflora (a kitty probiotic) can help with this. I would stick with his old kibble and not bother to try getting him on the Purina kibble (is it DM?). If the Purina kibble you got from your vet is the prescription DM, you should be able to return it to the vet and get a refund. Just say your cat wouldn't eat it.

The goal is to get him off all kibble, so there's no point upsetting his system with a new dry food.
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Not immediately after he ate. Well, still trying to get the hang of the food. I believe his weight was 1 can but I need to double check. Yesterday for breakfast he had 1/3 and a little kibble. I tried giving him a snack of wet for lunch , but wasn't really that into it. That used to happen with Hotch too!

Ideally, I wish we could do 4 meals but it definitely will be tricky with us sometimes both gone during the day and having another cat around. I have read about some neat feeders so will look into purchasing one of those. I think the idea of freezing the food is neat. If we have to, we can always move a litter upstairs and separate the cats during the day.

The Purina was DM. I think I just tried to switch a little too fast. It's been 3 days now and I am still debating about his dinner, and if I should add a few kibbles or just be done with it. His stool this morning was semi-solid. We are also trying to figure out what we want to do with the cans. Leaning toward some of the purina diabetic in the am and then maybe fancy feast at night so he can have some variety.. I was going to write down the "good" ones and go to the pet store tonight.

That is very true. We are actually thinking about giving our other cat some wet too. She goes crazy for it. I had no idea of the dry vs. wet before coming to this forum. If we can afford it, maybe Elvie will eat it full time too :).
 
Until you are able to start testing, I would not change his food. If he's been getting some kibble keep giving it to him, taking it out and giving only low carb wet food can lower his BG's and he would need a lower insulin dose. I have multiple cats too and getting them all on the same food is the easiest. There are many low cost low carb foods such as Friskies Pate and 9 Lives.
 
scoobydoox said:
Fancy feast Classics are very popular. I use the sheba patetes. Did you start insulin?
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We started today and he just had his second dose about 1.5 hours ago. He didn't even flinch or make a sound (that was the first home injection). We tried and tried to get a paw reading and were unsuccessful :(. We gave it one last quick try right before we put his food down and actually managed to get a little speck of blood, but I don't think it was enough without pressing on the pad and as soon as it happened, Hotch jumped up. We tried lifting him up so I could get under his foot and collect the blood but it was gone. I am going to bed soon but we are going to try a couple more times for a reading. Alex will be up tonight to keep an eye on him.
 
scoobydoox said:
I am not sure if your vet would even consider this but I came across this vet website and another option they explored for monitoring diabetes in pets. Maybe your vet would be willing to contact them and find out more. Considering your cat doesn't have ears for testing on and the paws aren't working that well maybe this would be an option.
http://news.uga.edu/releases/articl...ffers-take-home-glucose-monitors-for-diabeti/
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That is very interesting!!! I wonder if there is anything like that here in Canada. Thanks for sharing! :)
 
Abbot have introduced a new product, the Freestyle libre, which is a continuous monitoring system with a sensor pad worn for 14 days and a scanner which gives readings and trends of levels. It looks very interesting and I wonder if they have a similar pet product. It looks very expensive but seems ideal for children in particular. No strips, pricking or fiddly meters. Worth checking out?
 
New always = expensive, but here in the UK all medications and monitoring supplies are free for people being treated with medication for diabetes so I am expecting to see requests for them soon, I have seen them supplied for children who are on insulin pumps. Sadly not free for our feline friends and any pet product developed is likely to be more even expensive but - clinical trials are always looking for volunteers so - free supplies.
 
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