Teelawn & little Bluey from Melbourne, Australia

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Teelawn

Teelawn

Member Since 2018
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Hi everyone!

New member here.

Our little 16 year old Tonkinese cat, Bluey, was diagnosed with diabetes just over a week ago when he was rushed to the hospital with what we now know was DKA.

He was kept in for a few days and was on insulin & fluids as he was so dehydrated. He’d also lost about 500g in weight since his last visit, which was just a general health check up, a year ago. He now weighed just 2.5kg, slightly more than a bag of sugar.

He was sent home with Lantus SoloSTAR pen (2 units, twice a day), & we were told to feed him the Hills prescription diet tinned & dry food only! I’ve since learned that the Hills stuff is NOT actually low carb, which came as a bit of a shock!

They also gave us duo diastix & asked that we test Bluey’s urine, for ketones & glucose, and note down the results on a chart that they provided us with. This proved to be problematic, as we have 2 cats that share the same litter box. However, I managed to get a result when Bluey pee’d in a plastic bag that was lying around (totally unlike him to do that!), & I took advantage of the situation. The ketones were zero, but the glucose was 28!

He was due back at the vets the next day and, as his BG was still high, we were told to increase the insulin to 3 units, twice a day and return 2 days later. We gave him the increased dose later that evening &, thinking nothing more about it, went to bed, as usual, remembering to set the alarm for Bluey’s next shot.

The next morning my husband found little Blue, lifeless, collapsed on the floor, lying in a pool of his own urine! We were both beside ourselves and In floods of tears thinking our beautiful boy was a gonna. In panic & not knowing what to do, we did as we’d been told & gave him his morning dose of insulin, still at the new increased level of 3 units, & called the vet for an emergency appointment!

Our usual vet wasn’t available, so we saw someone new this time. Luckily, they were able to see Bluey straight away, plus we only live a short 5 minute drive from there.

This time our poor little soldier had had a hypo, due to the increased insulin, most likely.

This was on Wednesday morning. Since then Bluey has been in the hospital. At first he was on a glucose drip and fluids too, as he’s dehydrated. Then his BG levels went too high again, due to the glucose, so they put him back on insulin at 2 units. They are still feeding him the Hills prescription diet btw.

Little Bluey is due home Saturday afternoon but they want to see him again on Monday.

I am so overwhelmed and scared right now. This is such a huge responsibility. I love my darling little man so much and I want to do the best by him.

This is our story, so far.
Thank you for being there
 
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Welcome! You are in the right place for help. There are many very knowledgeable people here! My kitty Zoey has had diabetes for about 3 and a half years, and I have learned so much from this great group of people! She is doing well now, so there is a lot of hope.

First, I would suggest that you learn how to test Blue's blood sugar at home. I never give Zoey a shot without knowing what her current BG level is. That is how hypos happen, and as you have seen they can be deadly.

I know there are people here who will contact you with videos and assistance in home testing, food, and lots of other information, but I just wanted you to know that someone you have found the right group! For the time

Blue is a beautiful kitty, and he will soon be home with you. Everything seems so difficult now, but believe me, it becomes almost routine after a while! Hang in there!

Until someone else chimes in, I would suggest you peruse the website and read some of the stickies to gather as much information as you can.
 
Welcome, you really are in the right place. I'm so sorry about the circumstances, and that Bluey has been so ill. Do read the info and stickies, as Carol said. Hugs.
 
Hello :cool:

Teelawn said:
I am so overwhelmed and ,scared right now. This is such a huge responsibility. I love my darling little man so much and I want to do the best by him.
Click to expand...
I know it’s overwhelming and scary-I’ve been there.

The first order of business is to get a human glucometer and plenty of strips, along with some ketostix to monitor his urine daily for the presence of ketones.

Getting little Blue safety past the DKA is the top priority and will require some intensive care on your part.
Teelawn said:
This time our poor little soldier had had a
hypo, due to the increased insulin, most likely.
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Without a doubt.
As you have now learned first hand, it’s critically important to test BG before giving insulin. To not do so is akin to playing Russian roulette.

The recipe for ketone development is :
Not enough calories +. Not enough insulin + infection/inflammation/some other systemic stress

You see the way DKA works is that when there is not enough energy from food making it into the cells, the body will breakdown it’s own fat and protein to try and fulfill the need for more metabolic energy. The excessive breakdown of these stored reserves creates a toxic by-product - ketones. As ketones build up in the blood stream, the resulting pH and electrolyte imbalances can very quickly develop to life threatening levels , a state of DKA.

You will therefore have to find the balance of insulin and calories that will deliver enough metabolic energy to his cells to stop the formation of ketones while at the same time keeping his blood glucose levels above 50.

In general, 1.5x the calories required to maintain optimal weight is required. Stock up on wet food with a carb content in the 4-9% range along with some higher carb wet food (above 15%) to be used as needed for keeping the BG above 50. Hydration is important as well so add as much water to his food as he will tolerate.

I’ve got to drop off for now as I’m traveling later today. I will be watching this thread and respond when I can. Hang in there and hang in here. You can do this.
 
Hi Tina and Bluey:) welcome to FDMB.
I live in Sydney.
Bluey is a very handsome boy! I used to have a beautiful tonkinese girl who lived to 22.
My goodness you have had a very scary time, but you have definitely come to the right place to get help and support. This is a wonderful forum with very caring and experienced people who look after their diabetic cats 24/7 and will be able to help and support you on Bluey's diabetic journey.
Firstly diabetes is a very treatable disease and once you get the hang of it you will find it much less stressful and easy. At the moment you are on a steep learning curve....we all were....and know exactly how you feel at the moment.

As the others have said above, the first thing you need to do is get a blood glucose monitor and start testing the blood. Bluey won't mind it...it will only take a few days for you both to get used to it....and then you will know what his blood sugar is doing and you will be able to keep him safe.
There is no need to buy the pet specific monitor as the test strips are very expensive and that will be one of your biggest buys.
Here is the monitor I bought and found it great. It is the Abbott Freestyle Neo
https://www.ebay.com.au/itm/ABBOTT-...ETONE-READING-MONITOR-METER-KIT-/181682283855

Here are the strips that go with it. Make sure you are buying only these if you buy the above monitor and that there are 100 strips in the box. I always bought on eBay and found it very reliable. Buying them at the chemist is twice the price.
https://www.ebay.com.au/p/Abbott-Fr...Test-Strips-100-No-Coding-Required/1729127665

These are the lancets that fit the device
https://www.amcal.com.au/abbott-thi...MIuq7v8JaK2wIVVx0rCh2e9QHeEAQYBSABEgITTfD_BwE

He is the link to test the blood sugars.
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

We recommend you set up a spread sheet (SS) to enter all the blood glucose readings....BSL... on it. That way we can help you with dosing and you will be able to see how he is going. If you run into trouble setting it up just tell us and someone will help you.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

What is the dose of insulin they are recommending you give now?. I hope they have reduced the dose.
It is important to test the BSL in the middle of the cycle because that shows how low the insulin is taking the BSL. It is also important to take a preshot reading to see that is it safe to give the insulin.
We choose the dose on how low the insulin takes the BSL not on what the preshot is. Vets usually base the dose on the preshot level which does not show how low the BSL has gone during the cycle.
We only increase or decrease the dose by 0.25 unit at a time and don't increase for at least three days. This gives the insulin time to work. Most vets increase the dose by 1 unit at a time which we consider to be too much.
Also most cats get stressed at the vets and this makes their BSL rise,so the level at the vet is an inflated one. Testing at home is far safer for Bluey.

I am going to give you a link to another new Australian member post I wrote in the other day. It has more information in it that you might be interesting in.
http://www.felinediabetes.com/FDMB/threads/australia.195644/#post-2192184

If you are going to swap to low carb food you need to be careful as that in itself will lower the BSL. Make sure you are testing before swapping over unless you already have swapped over and the vet has retested the BSL and adjusted the dose.

Do you have any honey in the house.? Please keep some always handy as a few drops will raise the BSL if they go too low. Also a high carb food will do the same although not as quickly.
BTW the Hills canned M/D diabetic food is low in carbs although the dry is not. But you will be able to get much cheaper canned food which is just as good, or better.

You will notice that the US people use a different system of numbers to test the BSL than we do. FYI. Our normal range of BSLs is approx 3 to 7 where the US is 50 to 120. A bit confusing but you will get used to it. To get the US number you just multiply by 18.

Please ask lots of questions and post as often as you like. There are no silly questions and we are all very happy to help.
Hang in there!
Hope to hear from you soon.:)
Bron
 
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Hi Bron,

It’s wonderful to hear from a fellow Aussie! As you say, so many things are different here, (as in food, meds, testing equipment, scale readings etc.), to how things are in the US, Canada, the UK & Europe &, on top of everything else, that has been a bit of a mine field too!

Bluey is now back to 2 units, twice daily, of the Lantus SoloSTAR pen & he’s having about 2 tins of the Hills prescription diet glucose/weight management m/d. He’s not drinking much water, though, that I’ve noticed, since he’s been on insulin. It’s a bit of a worry as each time he’s visited the vets he’s been dehydrated! Any tips on how to get fluids into him? We can’t afford to keep having him admitted to hospital to be put on a drip every few days. It’s already cost us $2,000.00 in vet bills in the past week and a half! :arghh:

Thank you so much for all the wonderful information. :)

Tina
 
Because diabetic cats pee more often and more of it, it is common for them to be a bit dehydrated until you get things under control....which may take a while. Insulin is not a magic bullet like antibiotics, it's a hormone, so the body has to get used to it and how it will react to it.
I always gave Sheba extra fluids to ensure she was hydrated.
One thing you can do is add a little warm water to the food and mix it around so it has some "gravy". Most cats will accept this but some won't.
Another thing I did was always have chicken stock cubes in the freezer and gave a few each day to Sheba. She loved them.
To make up the stock, I bought 6 chicken drumsticks and put them in plain water, nothing else added. I simmered them for 3 or more hours.....you can take the meat off the bone when it is cooked and just leave in the bones in cooking. Don't use too much water as you want to have the stock to be slightly jelly like if possible. After it is finished, drain the stock and throw out the bones, cool the stock and put in the frig until cold then skim off the fat.
Keep some in the frig for immediate use and put the rest in ice cube trays and freeze. When frozen put into small plastic bags. Use as needed. The meat can be frozen and be given to Bluey with a bit of stock as it has no carbs, but don't make it more than about 20% of his diet as it is not a complete food for cats. I used the meat for Sheba as she was feed homemade with all the added supplements .....but you could use it for yourself as well.
It might be trial and error to get the right consistency of the stock but I found it invaluable. Don't add anything except chicken and water to the pot.

If he's dehydrated, he might just need to have some subcutaneous fluids which the vet can do during a routine visit. It only takes about 10 minutes. Sheba was never admitted for IV fluids when dehydrated. The vet just gave her some subcutaneous fluids there and then and then I took her home. Cost about $30/$60
Many of us used to do it at home ourselves, but that was mainly when the cats had kidney disease.

Almost everyone uses syringes not pens here as you can go up or down in 0.25 units increments. Do the pens have 1/2 unit markings on them? I would not advise going up 1 unit at a time. As you only have the pen, 1/2 unit is safer than 1 unit increase or decrease but I would recommend you think about changing over to syringes that can be bought from the chemist. As far as I know the insulin in the pen is the same as we use and can by used to draw up insulin with a syringe. If you do decide you want to change to syringes I will tell you what to buy.

When they are first diagnosed it can be very expensive, especially if DKA is in the mix. @Sandy and Black Kitty gave you an excellent explanation and what to do to help Bluey to ensure he does not get it again.
If you are testing the BSL and ketone levels yourself, you will save a lot of money on vet visits.
Because you are giving Lantus, I would like to invite you to join the Lantus and levemir forum. People post a new condo each day with any issues they might be having with their kitty and there are always people there to help. They all use Lantus or levemir and are very knowledgeable.
http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/

Keep asking lots of questions.:bighug:
 
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Thanks, again for all that, Bron.

He’s had the subcutaneous fluids as well, but, as he was kept in the other 2 times, they hooked him up with iv fluids whilst he was there.

The stock sounds like a good idea. However, I am pretty much bedridden, due to a chronic health condition, and would not be able to make it myself. Do you know of any suitable stock I could buy, here, in Australia?

Cheers :cat:
Tina
 
Teelawn said:
Thanks, again for all that, Bron.

He’s had the subcutaneous fluids as well, but, as he was kept in the other 2 times, they hooked him up with iv fluids whilst he was there.

The stock sounds like a good idea. However, I am pretty much bedridden, due to a chronic health condition, and would not be able to make it myself. Do you know of any suitable stock I could buy, here, in Australia?

Cheers :cat:
Tina
Click to expand...
I am so sorry to hear you are bed ridden. That must be pretty tough for you.
I don't think you could buy stock with no additives in any of the supermarkets but it might be worth checking.
The only one I can see is the one in this link which is pretty expensive but it could be watered down by half I am sure. Not sure where it is sold or if you have to buy it online and then the postage might be too much.. might be worth asking them.
Maybe health food shops might have some. Is there anyone who could look for you?
Otherwise try some warm water in his food and see if he will eat it.
https://purestock.com.au/products/chicken-stock
Bron :bighug:
 
Cheers, Bron :)

My husband usually does all the shopping, so, as long as I find out what he needs to get & where to go, he’ll fetch it for us. He’s a real gem.

Yes, it’s been a difficult journey, health wise, for me. I’ve been battling an autoimmune condition since I was a child. After almost 40 years, I have reached a stage where I am no longer very mobile, in constant pain & reliant on others for most basic needs!

Little Bluey has always been there for me, with lots of cuddles & endless love & instinctively knows when I’m struggling. It’s breaking my heart knowing he’s going through all this right now. He’s such a very special little soul. :cat:

If we can’t find any suitable stock, we’ll definitely give the water a go, though.

Thanks again. You’re an angel :bighug:

Tina
 
You are certainly doing it tough.
Your husband sounds wonderful helping and supporting you the way he does.
I am sure Bluey is a great companion for you. It is hard seeing our pets unwell but remember this is a very treatable disease and once you get it all sorted and under control he will be his old self again.
Don't forget to post on the L and L forum.
Bron
 
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