Test in any of the back paw PINK FOOT/ PADS?

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Re: NEED HELP ASAP- Rocky's Insulin dosage for tonight?

Tina,
Believe it or not, we will see cats go from that high a ps number to lower than 50 in 2-3 hours sometimes. The dose he is on is just too high, and will need to be modified, which it looks like Marje and Julie have been discussing for you. Also, because he went so low, he is surely going to bounce high. This happens because Mr. Liver panics. It is all things you will see as 'normal ongoings' in a short period of time. Lows and hypos are no light subject, and when it comes to a kitties safety that is our #1 most important job. And I am not underplaying his episode today, but if his numbers are ok right now, I don't think you need to bring him in. As for the DKA, I have no advice or experience to offer, but others will. Please hang tight for Marje. She will be here shortly to help you with this and talk about maybe holding off on tonights shot or reducing. Did you recheck his bg recently since coming back home?

ETA: Ooops. I see Marje and Suzanne beat me at the typing race :lol:
 
Re: MARJE- sent all info you asked for in PM to you

Hello there and welcome :cool:

Rocky sure knows how to make an entrance. . . . . :shock:

Once the dust settles, I'd like to hear more about the DKA episode.

Someone has already mentioned Ketostix, which you can get at the pharmacy. Please get them at your earliest convenience.
(call first to make sure they carry them and that they are in stock)

The importance of monitoring Rocky for the presence of ketones at this time can not be overstated.

You came to the right place :cool:
 
Re: BG 91mg - Rocky at 7PM.. dinner is a little before 8PM

Rocky's BG is 91mg for 7PM.

His dinner is usually served between 7:45PM and 8PM. Shot after that.

I have 30 other cats I need to feed in my house right now- 14 are mine, sort of.. The others in two other rooms are around 6 months old, (5 kittens though), all fully vetted and waiting to go up for adoption at PetSmart and Petco. Just not enough room in those pet store windows lately. Adoptions were really slow through Thanksgiving and Christmas.

Keytone strips: Can't get anyone to answer phone or tell me anything at Walmart. Walmart doesn't sell Ketostix. What other brands of keytone sticks do I need to look for? Will check CVS. No advice from pharmacist likely as pharmacy closed at 7PM on a Saturday.
 
Re: BG 91mg - Rocky at 7PM.. dinner is a little before 8PM

Most pharmacies like CVS and Walgreens sell them. They might be called Clinistix. You only want the ones that test for ketones. You don't need the dual strips that check ketones and glucose but in a pinch, they are better than nothing.

We don't want you to feed him before you test him. So if you can test him a little before 8 and post, we will let you know and then you can feed him once e decide whether you should shoot and what you should shoot.

One question.....are you able to stall his shot...can you be off schedule for an hour? You would have to make it up 30 mins a day so you'd be back on schedule Monday night if you stalled an hour.

Do you have a lot of supplies...test strips, high carb food, syrup?

I know you are really tired and we will probably suggest you shoot a reduced dose only because of the DKA in the equation. But because his depot is likely full, he could come back down. We're discussing the skipping vs stalling vs shooting reduced dose.

So please check back a little before 8 and don't feed him or shoot ok?
 
Re: NO keyton strips on hand- need to run to store

I could wait to feed him and to give him the shot. I need to run to the store and get the keytone strips right now.

What if he hasn't peed to be able to tell if he has keytones? I dumped his litter and shredded a small bit of newspaper into the box, just in case he decides to use it.
 
Re: NO keyton strips on hand- need to run to store

You can also put Saran Wrap in the box to catch the pee. Just do the best you can.

I think it is fine for you to test when you get home, post, and then we will decide.
 
Re: HOME: Re-tested. At 8:10PM BG 110mg

Home.

Tested at 7PM was at 91mg.

Tested at 8:10PM was at 110mg.

Called vet again. They said even at 110mg it's still too low to give insulin. They have no appointments available tonight and they would charge me an emergency room visit to evaluate him. Money is a huge concern right now.

Vet tech who talked to the vet said that they wanted to evaluate him. That I should bring his food and his insulin.

He hasn't peed. He is waiting to eat.

Vet tech said that if I wasn't going to bring him in that I should skip the insulin dose because 110mg is too low.

What happens if it skyrockets overnight? Remember I did feed him that high carb food this afternoon during the hypo episode.
 
Re: NO keyton strips on hand- need to run to store

In the event the ketone test strips are behind the counter and the pharmacy is closed for the night, for 2 of 3 ketone types, there is an odor like nail polish remover or a fruity smell. Sometimes (not always), you may smell this in the urine or on the breath.

In conjunction with other signs the cat is not doing well, such as inappetance, dehydration, and/or lethargy, you should go to the vet. Ketones form as a by-product of fat breakdown for calories.

My signature link Secondary Monitoring Tools has a number of assessments you may make to supplement the blood glucose testing and assess the health of your cat.
 
Re: HOME: Re-tested. At 8:10PM BG 110mg

Yes, too low to shoot tonight.
Yes, he may be high tomorrow from no glucose and reacting to going so low.

Better too high for a day, than too low for a moment.

Grit your teeth, test and post here in the morning.

You did well today for your trial by fire.
 
Re: HOME: Re-tested. At 8:10PM BG 110mg

Tina

We don't consider this afternoon a hypo. He had no clinical symptoms. Were his numbers lower than we'd prefer for a newly dx cat? Yes. The 37 was lower than I like my cat to be but Rocky did not show any hypo symptoms, thankfully.

If I was working with any other new member and their cat at this point was 110, I would advise them to skip the shot. As I've said before, the DKA issue is a concern because not enough insulin + infection + not enough food/water can lead to DKA. So whether you shoot or not is up to you.

I wouldn't blame you for skipping because you don't have much data and the 2u was absolutely too much insulin. If you decide to not shoot, please be sure he eats really ell tonight, drinks, and you test his ketones a couple times.
 
Re: Taking Rocky to the vet

Taking Rocky to the vet now with his food, monitor, and insulin.

He has been drinking more water in the past three days and scratching himself very bad again. I don't want to take any chances for another DKA episode.
 
Re: We're home! BG was at 210mg by 10PM

We're home!

BG was at 210mg by 10PM. Rocky tested negative for keytones. :thumbup

Because I couldn't get Rocky's keytone test done at home it really stressed me out. That and the fact that he has been drinking a little bit more water, and scratching is face a WHOLE lot more.

They put us in a room and they had me feed him his normal evening meal, except for that he was eating it at 9PM instead of at 8PM. I said prayers and pet him, talked to him. He seemed fine. Still acting frisky and alert. Devoured the food and wanted more. BTW he's put on one pound and a half since his DKA episode, which is good. He weighed 11 pounds then. He should weigh more like 13-15 pounds.

About 40 minutes later we saw the vet, and the vet tech took Rocky away to do his BG reading with their machine and with my Relion. Their machine read 210mg and mine was 20 points lower. We talked about my Relion and it seems that it is consistently running on average about 20 points LOWER than their machine.

Of course we didn't give Rocky any insulin after his evening meal tonight.

They told me to not take his BG reading again, but to do another BG Curve in another 7 to 10 days. They said if I was going to randomly take a reading that I should do it about 6 hrs after a dose.

They told me to give him the 1.5 units in the morning, instead of the 2.0. I guess I'll feed him his morning meal and give him his shot at his regular time since he didn't get any insulin tonight. I wonder if I should test him, just in case, before I feed him? :roll: It might be a good idea but if he has a really high number I'll probably freak out.

I'm exhausted after last night and all of today, but feel I can go to bed feeling safer about Rocky boy tonight.
 
Re: We're home! BG was at 210mg by 10PM

honestly, tina, i don't know what they're thinking about not checking his blood sugar for a week. if you hadn't checked him today, where would he be right now? Did the vet suggest that he wasn't in danger when he got in the 30's?

the fact that you gave him 3/4 of a can of 19% carb food and he barely nudged up makes me think he was coming down like a freight train. most cats take literally one teaspoon of food to raise their blood sugar. you saved his life. i really don't think i'm being overly dramatic with that. as always, the decisions are up to you, but because we want to educate you as best as we can, i feel like i need to point this out. none of us want any harm to come to you sweet boy and if you hadn't tested today we don't know if he'd still be here tonight.

the reason your vet's glucometer is 20 points higher than yours is because they are calibrated to pets. We use human meters because the strips are a fraction of the cost of the pet-calibrated meters. Those strips are about $1 each and we can get people test strips for just a few cents. the tight Regulation Protocol that we refer to is using the human meters. There is a section with numbers calibrated to pet meters, but most people ditch the pet meters because of the cost.

the difference isn't important - we "speak" and test with human meters.

I've gotta go to bed, but i'm so glad everything turned out ok today. Probably 1.5u is ok in the morning, but i hope you will still test. I hope you'll test him before shooting his insulin and post it here if you have any doubt about whether it's safe to shoot or not. anything over 200 is ok, if it's less than that, though, give a shout so someone can help you.

sleep well! see you tomorrow.
 
Re: We're home! BG was at 210mg by 10PM

Thanks for all of your support today Julie. We really needed it. I will take his BG in the morning before he eats to see where he is at and then post it. I think it will be over 200.

I'm headed to be too right now. So tired. :dizcat Goodnight.
 
Re: We're home! BG was at 210mg by 10PM

Hi Tina,

What a rough night for you!

I understand wanting to follow your vet's instructions. I did too when I first got here. She told me to only test when I was doing a curve for her and that it wasn't necessary any other time. She also told me I could keep Cobb on his "diabetic" dry food. His numbers consistently stayed in the 500/600 range. Her advice put Cobb at risk of developing DKA, especially since she said there was no need to test for ketones.

When I found FDMB, these "crazy cat people" wanted me to do ketone tests, get a spreadsheet started, text Cobb at least 4 times a day AND switch him to wet food!! Had the vet suggested that I don't know what we would have done. It would have been even more overwhelming.

But, if you look at Cobb's spreadsheet you can see the marked improvement he's made. You can also see times where he dipped into low numbers and then bounced high. What if that was the day I picked to send a curve to the vet? She would have increased his insulin. (You can see another good example of this with Ole this week.) The vet had us blindly shooting 10 units of insulin twice a day. If I had made a food change and not home tested, I could have killed him. And since I wasn't home testing I wouldn't be able to catch a potential dangerous drop, like I did tonight when Cobb dipped into the 60s.

As Julie said, of course it is your decision. We all want Rocky to be safe. Home testing has given me peace of mind when increasing the dose because I can see what is and is not working.

Hope you get some sleep! And keep asking questions! There is a lot of experience on this board!

~Suzanne
 
Re: We're home! BG was at 210mg by 10PM

Hi Tina,

You had a rough night. I am glad Rocky is home and negative for ketones. The vets like to wait about 7-10 days to do a curve on a pet to give the pet's body time to acclimate to the dose. However, if a dose is too high for the pet, it is possible that the pet could go too low and be put in a dangerous situation. I don't think a vet or anyone can predict exactly how an animal will react to a certain dose. Obviously the 2 units was too much for Rocky. His body reacted right away with a very low reading. Some pets require smaller doses of Lantus than others.

So it is always good to do some checks for the purpose of preventing hypo situation. Another problem with only looking at one curve is the fact that it is only one sample of the pet's reaction. It is possible for a cat to go low one cycle and then high the next. If the curve happens to take place during a high cycle, the vet may say increase the insulin when it could be dangerous. Having more data always helps to make a better decision for the pet because you may be able to see patterns. It does take Lantus a little while to build up in the system. So you won't know the full effect of a dose until several cycles. If you get an unsafe number, you know to reduce and then try the next dose.
 
Re: We're home! BG was at 210mg by 10PM

I'm glad Rocky was OK.

When I first joined FDMB, like many people, I spent some time lurking on the Health board. In a comment to another new member who's vet, like yours, was discouraging home testing multiple times a day, the member pointed out that if this vet had a child who was diabetic, would he test only once a week or less? That is not the advice that is given to any human diabetic. It would be irresponsible on the part of an MD to tell a diabetic to only test their BG every 7 - 10 days. I would be as attentive to my cat's well being as I would be for a child.

As for testing at +6, that's fine providing your cat has read and follows the Lantus "rule" book. A +6 reading presumes that every cat has a nadir at midcycle. That would be great but it's not accurate. Just like everything feline, ECID. My kitty, for example, has her nadir at +3 or +4 and, she prone to very exciting dives (e.g., she's dropped from 243 to 98 at +2 this morning). If you look at Gabby's SS, you'll see I test hourly for the first few hours of her cycle because this is her pattern. Some cats have late nadirs. In other words, if you always test only at +6, you could easily miss the lowest point in your cat's cycle.

Most vets don't see the number of diabetic cats that we deal with here. Clearly, you vet did great at helping Rocky recover from DKA. Many vets have limited experience with managing feline diabetes. We eat, breathe, and live the condition. It's just got to be impossible for a vet to be completely proficient in every, single illness that can effect every, single type of animal they care for in their practice. A dear friend who's an MD/PhD pointed out that when you do the work to learn about one illness, you can develop a great deal of expertise in that area. We don't have the breadth of knowledge a vet has but we do know feline diabetes and will help you to become just as informed so you can effectively manage Rocky's FD.
 
Re: We're home! BG was at 210mg by 10PM

Oh that's great news that Rocky is home and Neg on the ketones.. Yeahhhh!! I'm glad you're here :smile:
I don't know what I would have done with out the wonderful expertise of all who helped me with Tommy, and still are. Rocky is a very lucky kitty to have you as his bean :YMHUG:
 
Re: We're home! BG was at 210mg by 10PM

Comparing a human glucometer to a pet-specific glucometer is like reading temperature in Celsius vs Fahrenheit. Both are correct. You just need to know the reference ranges to interpret what the numbers mean.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]


* * * * * * * * * * * * * * *​

How to use the glucose reference values chart:

When you get a test, look for the number on the chart that either equals, or contains, the test value you have. Read the information. As needed, make a decision and act.

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)
 
Re: We're home! BG was at 210mg by 10PM

Hi Tina,
I just read through your thread and wanted to say how glad I am that Rocky is OK. To add to the discussion of home testing: I am guilty (because of ignorance) of shooting my first diabetic kitty, Stu, without testing for 4 years before I found this board. He was using a PZI insulin that was later discontinued. When the PZI insulin became unavailable, a new vet switched him to Lantus. However, this vet did not realize how different a "depot" insulin like Lantus is from an "in-and-out" insulin like the old PZI. He continually raised Stu's dose (every 2 weeks, because I was instructed to come in for a blood-glucose test every 2 weeks). We were up to 8 units twice a day and poor Stu looked and acted awful. His blood glucose went up and up, the vet was raising his dose by 2 units at a time, and then, at 8 units, his blood glucose came crashing down. That was when I found this board. FDMB saved Stu's life. I learned to home test. I learned a lot about FD (still learning).

Please don't blindly accept everything your vet tells you about caring for a feline diabetic. The protocol we use here on the Lantus Forum is tested and safe. You will learn so much here, and you will have help whenever you need it. Many of us have excellent relationships with our vets, and trust them to treat our kitties when they are ill, but we take responsibility ourselves for the everyday dealing with Feline Diabetes and do not involve the vet in our decisions with regard to dose, testing, feeding, etc.

Welcome to Lantus Land!

Ella & Rusty
 
Re: 356mg - Sunday Morning BG, 7:45AM

Good morning,

Rocky's BG this morning at 7:45AM was 356mg, with my Relion.

Rocky had no insulin last night insulin and he even had been fed 3/4 of a can of high carb Friskies Beef and Gravy food yesterday afternoon.

His last insulin was 2.0 Lantus on Saturday morning, at 8AM.

Saturday morning BG was 405mg. Sunday morning BG is 356mg.

I left Rocky's insulin from 12/21/2013 at the vet last night! DOH! @-) Thank goodness I had just bought a new bottle two days ago and it is in the fridge. I am going to give Rocky his 1.5 units this morning.
 
Re: 356mg - Sunday Morning BG, 7:45AM

yesterday was such a flurry, i didn't ask you - do you go by Tina or Tina Marie?

i hope you slept well! this stuff can be very exhausting.

he'll come back down - don't worry about the high number this morning.
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

I go by Tina, my middle name is Marie. Some people do call me Tina Marie in person.

I am HAPPY with Rocky's 356mg, especially since he went without insulin last night.

To everyone, yes, I did not trust increasing Rocky's Lantus dose to 2.0, and then not testing him at all for 7 to 10 days. I knew I wasn't going to follows doctor's orders. LOL

I'm not sure, but Rocky may not have been in the 100mg - 250mg range since the first week that he came home from the hospital. I did test him for the first 3 days that he was home, and he was there..

I need to talk more about what to feed him, (currently eating Nature's Variety canned Instinct Venison because it has zero carbs). But I don't want to mess up your Lantus thread.

I also must find out something to do about his intense itching. He scratches himself so hard that it leaves patches and makes him bleed. He was dosed with Revolution when in the hospital for DKA. He was also on Tresaderm.

FYI- Rocky went into the hospital for the first time DKA and had a TERRIBLE ear infection at the same time. I suspected that not being treated for that ear infection kick-started the entire DKA episode. Three vets who looked at him said Rocky's ears were so dirty that they could see either of his ear drums. I did a lot of online research and learned that most of the time, when HUMAN diabetics who go DKA, it's when they have an INFECTION :!:

The vet wanted to give Rocky a Covenia shot last night for his skin/fur condition. They are worried he is going to get an infection. I don't care for Covenia because if he has a reax to it, there is nothing I can do about it. I have Clavamox in pill form at my house and I suggested to the vet that I give him that instead.

But I wonder what is the BEST antibiotic for skin problems in cats? :?: :roll:

They also want me to start using the Tresaderm on his raw skin spots, besides putting it inside of his ears. We did several different types of skin scrape tests on Rocky in the hospital when he was DKA. He has no skin fungal infections and does not have mites.
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

this is a good place to talk about his skin problems. i have a lot of allergies myself and when i eat things i'm allergic to, i wear it on my skin. hives, rosacea, rashes like poison oak - all from foods i'm allergic to. i've heard a number of people here say their cats are allergic to various foods, even chicken, so they try novel proteins like duck or kangaroo. i don't have experience with it, though, so will let others help you on that one.

we did have a dog that ate holes in her skin, she itched so badly. the vet said she was allergic to fleas and we kept treating her (for years) for that. the Willamette Valley is like flea heaven - the perfect climate for them. once i happened to be in a small pet store and asked a clerk about her skin and she had us switch to Innova, which was a hypoallergenic dog food. that was the end of years of terrible skin problems.

so food is the first place i'd start with his skin issue. there is a great list on http://www.catinfo.org of canned foods and their carb value. you want his main food to be less than 10% carbs. most people feed in the 5% range and you want something high carb (over 15-20%) for days like yesterday. i'm sure people will suggest foods to help you explore some different options.

eta - i don't know the best antibiotic for skin if it's infected, but you were smart to avoid the Convenia. it lasts 2 weeks in the body and if he's allergic to it . . . that's a long time to deal with an allergic response.
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

Good morning Tina ~O)
Not sure if you have had time to read Dr. Pierson's feline nutrition info yet. Here is the link.
I'm definitely wondering if all the scratching isn't due to a food allergy of some sort? Also, how were his teeth when he was at the clinic?

ETA: And again, my typing skills are shown to be inferior :lol: (Good morning Julie! ~O) )
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

Good morning, ~O)

Vets said Rocky's teeth were OK. It was his ears that are/were the problem.

Rocky had been eating Meow Mix kibble before I took him in. I switched him immediately to grain-free canned Merrick Bistro Chicken. I don't know how many carbs it has so while he was in the hospital for DKA I switched Rocky to Nature's Variety canned Instinct Venison. Dr. PIerson's chart says it has zero carbs. It's a novelty protein I'm sure he has not had before. I am committed to feeding it to him for at least 4 months.

He wouldn't eat it the canned venison, so I crumbled 1/2 of a sardine that was packed in natural spring water over it, both for breakfast and for dinner. He ate the venison fine after that. (A naturopathic vet told me that it was fine to give a cat (1) whole sardine packed in spring water per day to a cat. It has Omega 3s.)

I also found that when I gave Zobaline to Jomo, a pancreatic cat that I had for 3 and 1/2 years that it increased her appetite. (Although she was not diabetic she walked on her hocks. After giving Zobline for 7 days she walked like a normal cat again for the rest of her entire life.) I give Zobaline to Rocky instead of vitamin B12 shots. Those vitamin B12 shots hurt and sting the cat at the infection site. I was hoping that the zobaline might help with the skin condition too.

I now suspect that they itchy skin is due to his diabetes still not being regulated. Too many highs and lows. :-(
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

Hi Tina, what a baptism of fire you had yesterday. We are all so glad that Rocky is OK.

As others have said, vets don't always have enough trainging in one specific disease, we concentrate on FD. Telling you not to test doesn't make sense, as Sienne said, human diabetics would never fail to test before shooting or even eating. Why would you not test a cat, when a cat is even less able to communicate how it is feeling. Many owners will not want to be bothered w/ testing, insulin, proper food, but that is no reason to discourage those who are willing. Also, in the last few years Lantus has been getting a lot of attention in the veterinary community. it is the new go to insulin, great results for cats who are notoriously hard to regulate. but too many vets don't really take the time to learn how different Lantus is from the older quick acting insulins and it is very different! Especially that Lantus dose is determined by how low the cat goes at nadir, not on how high the BG is at preshot!Lantus forms a depot, a reserve, and the full effect of the dose is often not seen for 3 to 5 day, but that doesn't mean you don't need to test. A cat can still go low and that needs to be dealt with immediately as you saw yesterday. Dosing is also done in much smaller increments, usually .25U not 1U or even .5U.

4 tests a day are necessary:
  • - before each shot (Preshot tests): this lets you know that the cat is not too low to safely administer insulin, like last night, Rocky was still low, so by testing, you knew it was not safe to give insulin. For new members we tell you to ask for advice if the preshot test is below 200. As you get more data and can predict Rocky's cycles, you will be able to shoot lower numbers. We've been doing this a while and frequently shoot numbers in the 50s, but we know Tess's cycles and that she has avery lat nadir (between +10 and +12.)

    - checking for nadir in each cycle ECID (every cat is different) some have early nadirs and some late. The nadir is also not fixed, today it can be at +4 and tomorrow at +10.

    - Many of us do other tests regularly too:
    • -- a +10 or +11 lets you know if the BG is going up or dropping at shot time, this can make a difference as to how you shoot.
      • A fairly low number at preshot may be safe to shoot if you see that it is up from the +10 or +11.
        A higher number may not, if you see that it is a dropping number!
      --If you know your cat tends to drop early, like Sienne's Gabby, you may want to test at +2 or +3 to see how quickly the insulin is taking effect.

BG tests at the vet can also be elevated from stress, cats get scared at the vet and BG rises! A vet seeing this often says "oh, high BG, increase the dose!" and it may not be needed. Also, if a cat goes lower than it is used to, not even close to hypo range, the liver can react and dump glucagon and other regulatory hormones into the blood stream to counteract what is perceived as dangerously low BG. This can take up to 72 hours to clear and you don't want to increase insulin for high Bg numbers due to this type of "bounce."

The vet tech said that your meter and their's was off by about 20 points, not unusual. But every time you tell them Rocky's numbers be sure to remind them of the difference! Often it is forgotten that we use human meters, they aren't used to it.

I hope now that you have had a little rest you can take more of this in. A lot of information was given to you and there is still more for you to read! I hope this helps to explain things a little more.
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

Our beloved late Tinkerbell off and on had Rodent Ulcers (eosinophilic granuloma complex) the last couple of years before she died recently. They would stop, start, get treated, go away & come back sometimes a few months later. They were usually around her beautiful little face, on her cheekbones and neck. She usually took clavamox for it which usually cleared it up in a couple of days if I caught it at the first sign of an itchy breakout. I once had another cat (civvie) that was allergic to fleas & w/out regular flea treatment she would get scabs all over her body, in fact she was covered w/them when adopted, it took a few months of regular flea treatments to clear it all up finally & as long as she got regular flea treatments (about every 3-4 wks) she never had a problem again.

Also there is a lot of info on covenia here in a lot of old threads, you might want to do a search for "covenia" and see what has been said about that issue over the years. I can tell you that my vet has standing orders to never give any of my cats covenia, ever, but to be honest I don't remember why, I only remember reading all about it here and then making that decision accordingly. Somebody else might have the covenia threads link, I am sorry I don't have time to search it all out & post the link(s), I just wanted to post a quick post about the rodent ulcers but I have to go fight w/my tractor now (won't start) and fix the fence that is coming down around the corral (today is the only day I can do it, I have to go back to tbp tomorrow).

Good luck w/Rocky, you have definitely come to the right place and you are doing great, nothing like getting thrown into the thick of it all of a sudden, you are doing/did great!

Desi
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

Sorry I have no idea why my post posted twice so in this what used to be the duplicate I have obliterated it, it was exactly the same as above.

I will only add thanks Barbara for the convenia link.

Desi
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

The one indication that Convenia has is for skin problems. However, you are absolutely correct -- because it lasts for over 2 weeks, if there's a reaction to the drug, it's a huge problem.

Are you still giving Rocky a sardine? If so, lots of cats have allergies to fish. If you can eliminate the sardine and see if the itchiness subsides and his skin improves, that will be a clue. There are also other novel proteins you can try if this is a food allergy.

You might ask the vet about some alternatives for treating allergy. This is what my vet recommended:
There are several options—there is a product called Allerderm which is applied once weekly to the skin which can be quite helpful for itchy or dry skin. Additional fish oil omega-3 fatty acids, 200-250 mg daily, are often helpful, but may take up to 2 weeks to really have an effect. Antihistamines are often helpful—we seem to have the best success with Zyrtec, which is over-the-counter, or hydroxyzine which is a prescription medication.

We have Allerderm here, but you may be able to order it online. Zyrtec dosage is ½ of a 10 mg tablet by mouth (in food…) twice daily, or about every 12 hours, try for 7 days. Watch for drowsiness or restlessness, although side effects from Zyrtec are not likely or are very mild. Use plain Zyrtec, or cetirizine, only—no combo meds. The fish oil product we use is AllerG3, or you can use human products.
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Provided it's not a fish allergy that's causing the problem, Nordic Naturals makes a high quality brand of fish oil and the dropper is calibrated for small animals (e.g., cats).
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

Hi Gabby,

Thank you for the helpful information. My hunch is that he is not allergic to fish but still may be a food allergy, and from the diabetes. I only gave him that sardine for about one week to get him accustomed to eating the venison. Because he likes it so much I thought I should reserve it for emergency situations where he refused to eat, but I'm not sure about doing that because I want him to have the Omega-3s.

In general, I believe in giving the food that has the vitamin in it rather than the pill form. The only time that is not true for me is when we are trying to rebuild our intestinal flora. There are some great probiotics out there that can help very fast.

I suspect that Rocky is having a problem with both his pancreas and his liver too. This is probably due to age, genes, and having been on a very bad diet for several months. At the first hospital where he was DKA, they did an ultra-sound and saw that his upper intestinal tract was inflamed but the bowels were unaffected. In addition, they said his liver looked like that of a diabetic cat.

Even though Rocky is on high protein, no carb food, (canned Instinct Venison), he is still pooping large grey colored poops. I know from feeding my other cats high protein foods that those poops should be small and nearly black colored. When my kitty Jomo who had chronic pancreatitis was feeling well her poops where normal in color and size. When she was not feeling well they would be large and grey, or tan colored.

I suspect Rocky might be having some type of infection in his bile ducts, maybe from the food allergy, but that I am probably feeding him too high of a protein food right now. I think I need to feed him one that has a better balance to it with a lower protein number to reduce the load on his liver. (Tests showed his kidneys were functioning fine.)

I am going to start giving him the broad spectrum antibiotic Clavamox as well. Are pill pockets OK for a diabetic cat? I would need to give them to him 2x a day.

Any suggesting for a lower protein canned cat food with very low carbs? I know Dr. Pierson's list and have it printed out but wanted to now what your cats like to eat.

Hey, those of you who have cats who are OTJ, what were you feeding them when they went OTJ? What are you feeding them now?
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

the dog pill pockets that are Duck and Pea pill pockets are the only ones safe for a diabetic. you just use as much as they need. the others have sugar in them.

many people here feed their cats the Wellness, Friskies, or Fancy Feast varieties that are low carb. I fed punkin FF chicken feast or turkey and giblets. they are fairly high in phosphorus, so when he began developing kidney issues i switched to Friskies Special Diet Turkey and Giblets, which is both low carb and low phosphorus. All of those had carbs about 4-5%.

There isn't a single cat food that is best - it has to do with your budget and what your cat will eat.

Pancreatitis is common among diabetic cats. There is a great post Marje put together on the New to the Group sticky, near the bottom in the links that is on pancreatitis, symptoms and how to treat it. Any inflammation, pain or stress can raise blood sugar.
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

TinaMarie8 said:
...Even though Rocky is on high protein, no carb food, (canned Instinct Venison), he is still pooping large grey colored poops. ... When my kitty Jomo who had chronic pancreatitis was feeling well her poops where normal in color and size. When she was not feeling well they would be large and grey, or tan colored. ...
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The pancreas also produces digestive enzymes. Pancreatitis, especially chronic pancreatitis, may impair the ability to produce these enzymes. In that case, the feces may be light colored, frequent and/or voluminous, and may smell quite foul.

Discuss this with your vet. It may be possible to do empirical therapy, that is, treat "as if" that is the diagosis. If it isn't the correct diagnosis, though, using enzymes won't help and could harm.

Additional diagnostic possibilities I can think of are bacterial overgrowth, Inflammatory Bowel Disease, or a GI cancer of some sort.
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

Thank BJM,

That's right. I forgot about that pancreatic pork enzyme powder. I used it with Jomo and OMG, it was so expensive. It sort of burns their both a little too so they are not crazy about eating their food. I had Jomo on and off of it. Sometimes her pancreas would recover and she wouldn't need it. Other times I had to supply it.

I will check the color of his stool again and make sure that it is really light, pale colored. If it is, I will ask them if they would consider giving me a prescrp for this powder without all of the testing. Do you know where i can order it for less expensive than my vet would sell it?

My vet wouldn't let an online pharmacy fill Rocky's insulin order because they only sell 10mL bottles of Lantus and couldn't sell smaller quantity. One 10mL bottle is about $169. My vet sells me 2mL bottle for $65 plus tax. I think that is outrageous but it looks like I'm stuck. :-(

I was going to buy the 100 box of monoject 3/10 syringe with 1/2" needle from Thrivingpets.com for $22.00. Any place to get them even cheaper?
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

Tina, check the price at WalMart for syringes. I can't remember what I paid last time, but they were the cheapest I could find. Their brand is ReliOn.

My vet told me to only test every few days, too. She also kept raising the insulin dose when Cinco didn't improve. Thank God for the board - they had me testing multiple times a day, reduced the dose, got his BG down, and eventually OTJ. When I first took Cinco to the vet, he was severely dehydrated, very lethargic, and his BG was off the charts - literally. He was basically near death. In fact, before I found the FDMB, the vet told me it was time to put him out of his misery. We had actually made up our minds to do so, when suddenly he stood up in his cage and started meowing at the top of his lungs! He wasn't ready to give up, so we didn't, and two and a half years later, he's still here, thanks largely to the wonderful people that are giving you advice today. I'm not telling you to ignore your vet's advice. I'm just saying you need to consider ALL the info you are being given. Only a vet that specializes in caring for diabetic animals knows as much as the people here, and I don't know where you are going to find one like that (except at UC Davis in CA). Please trust these people - they REALLY care, and they know what they're talking about.

Good luck! I'll be watching your progress and cheering for you and Rocky. :RAHCAT Bless you for all you do for so many kitties that need help. cat_pet_icon
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

Mercola makes over-the-counter digestive enzymes for pets.

Do be sure to ask if they could harm the cat if given and not needed.
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

I am not a big fan of giving pancreatic enzymes unless you know your cat has an exocrine pancreatic insufficiency.

A light colored stool can be indicative of liver issues or a bile problem. I'm not sure what your vet was trying to communicate when he said that Rocky's liver looked like that of a diabetic cat. Some cats with DKA can be experiencing hepatic lipidosis if they aren't eating. However, I would expect this to have resolved. You may want to get a copy of the ultrasound report.

I would check American Diabetes Wholesale to compare prices on syringes. Be aware if you're purchasing syringes on-line, many states will require your vet to fax a prescription for the syringes.

My vet wouldn't let an online pharmacy fill Rocky's insulin order because they only sell 10mL bottles of Lantus and couldn't sell smaller quantity. One 10mL bottle is about $169. My vet sells me 2mL bottle for $65 plus tax. I think that is outrageous but it looks like I'm stuck. :-(
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Ummmm...... This is a problem. Your vet is repackaging Lantus. That's illegal. Lantus is still on patent. It is not permitted to be sold in any form other than it's original container -- either a 10 ml vial or in the Solostar pens. Each pen contain 3ml. The pens can be purchased as a box of 5 or, if you call around, you may be able to find a pharmacy that will sell a single pen. Sam's and Costco will fill prescriptions even if you aren't a member. Also, if you're going to call around, remember to call hospital outpatient pharmacies. They are very likely able to sell single pens.

From Marvista Vet website re. exocrine pancreatic insufficiency:
Powdered enzymes (Viokase-V, Pancrezyme) seem to work the best; tablets are available but do not seem to break down consistently. If the pet finds the taste of the enzymes objectionable, a compounding pharmacy can fill gel capsules with the powder. Again, enteric-coated tablets simply do not seem to work well.

In the past, it was suggested that incubating the enzymes in the patient’s food would help initiate the digestion process in the food bowl but this has not been found to be true; the enzymes can be fed immediately mixed with the patient’s regular pet food. Some patients respond best when an H2 blocker-type antacid (such as famotidine) is given concurrently with the enzymes.

It is important to thoroughly mix the enzyme powder into the food, because if it is sprinkled on top, it can be abrasive and actually lead to ulceration in the pet’s mouth. If ulceration has already occurred in this situation, incubating the food with the enzymes can help resolve the problem.
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Re: Rocky's skin condition- bleeding, scratchy- Need help

BJM- I just checked Rocky's stool and it is a nice and dark brown, nearly black color. Exactly what I wanted to see. It doesn't smell awful either. (Can't believe I'm examining and smelling cat crap again)

Those Mercola enzymes are different than the Tumil-K type and Viokase-V type, if Rocky is really deficient in the enzymes. I don't think that product from Mercola will work to help him absorb the nutrients he needs. Jomo used this one: http://www.thrivingpets.com/index.php/viokase-v.html

Julie- Those syringes look great. I'll order them right now. The monojet 3/10s I got from the vet are sticking a bit. They are charging me over $5.00 for 10 syringes with needles. :shock:

I know A LOT about pancreatitis because I managed Jomo's very well for nearly 4 years, but I'd like to read what the FDMD board says too. Can someone send me the link about pancreatitis? I spent about 1/2 searching for it. Also, can someone please post the link for terminology? What is nadir? The falls? Etc..

FYI- Haven't checked Rocky's BG since this morning. Will re-check Rocky's BG at 2PM, (that's in one hour). That will be 6 hrs after his morning shot.

How does one add photos here? I haven't been successful at it.

Thank you! :YMHUG:
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

Hi Sienna, (you are Sienna and the cat is Gabby?)

I am not going to give him the enzyme stuff just yet. His stool looks good today. Still on tad bit on the large size, but Rocky is a big boned, but not fat, boy. He weighed 12 pounds last night.

Can you please tell me where I can buy those pens? I used to buy Jomo's fluids from Costo and I'm a Costco member anyway. Unfortunately, I had buy another 2mL bottle from my vet about 2 days ago because I was nearly out the insulin they originally sold to me. I want to be prepared to purchase when I need to get him more insulin, the next time.
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

Champ developed a food allergy when I did some experimenting when he had a bout of what I presumed was pancreatitis a couple years ago. On the advice of one of the members here (I can't remember who), I used witch hazel on the affected areas (I could see hives under his fur around his neck area). It cleared up the itching and hives in a matter of hours. Of course, I had also gone back to feeding him only his regular Fancy Feast again, but I'm sure the witch hazel helped the itchiness. Just make sure you get 100% witch hazel, soak a cotton ball with it, and pat the affected areas under they're saturated. It's nontoxic so safe if he licks himself.
 
Re: Rocky's New BG reading

Rocky's BG reading at 2PM was 297mg.

Not great, but we can live with that.

What kind of treats can I feed Rocky after he has to have the ear poke?

Thanks, Tina
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

There are a number of good foods, Wellness is a popular one. Calories only come from carbs, protein and fat. Since you are trying to go w/ low carb if you also want to decrease the protein, that leaves fat for calories. Higher fat foods tend to cause more digestive upsets than the higher protein, so I don't think reducing the protein is the way to go.

We use Total-zymes an Total-biotics. Our civvie Emma had really soft smelly poop and it has helped her enormously. NWC's probiotics have many more strains than the other pet probiotics that we were using. I have both Tess and Emma on both products now. 1/8tsp or less twice a day mixed in their food. The price is very reasonable. There is some research into digestive enzymes helping w/ food allergies as well, since the help to better digest food and leave fewer waste products to be eliminated.
 
Re: Rocky's skin condition- bleeding, scratchy- Need help

What we do for our cats! (Sniff)

Its great that the stool is normal in appearance and that makes it unlikely to be EPI. As I noted checking with the vet is always prudent.

Tumil-K is the mineral potassium, not an enzyme.

Pancreatic enzymes such as the VioKase (porcine pancreas) include lipase, protease, and amylase to break down fat, protein, and starch, respectively.
The Mercola product includes some pancreatin (with lipase, protease, and amylase) as well as ox bile extract (to help breakdown fat, betaine HCl and some plant-based enzymes (papain, bromelain) which break down proteins).
So slightly different products and the VioKase is Rx only, which suggests it is more likely to cause a problem if taken incorrectly.
 
Re: Rocky's New BG reading

most pharmacies carry the Lantus pens, but you will need a Rx for them, if you buy a 5 pack it is a greater original outlay, but you get a total of 15 ml, not just 10. Each pen acts as a mini vial and the unopened ones will last longer than an opened 10 ml vial. Check out goodrx.com they can show what prices are for various pharmacies in your area. Some members have found that Target will sell single pens. It pretty much depends on the individual store though. There is a coupon that Lantus offers a good discount, you need to fill it out as if for a human though.

For treats most of us use freeze dried treats, chicken, liver, shrimp. There are several makers, just be sure it is single ingredient.

We'll look for the links for you. for now nadir is the lowest BG point in a cycle, typically about mid way through. The Falls is our term for when a cat goes into remission. Sorry, we have a lot of verbal shortcuts. ;-)
 
Re: Rocky's New BG reading

You want the New to the Group starred sticky for most of this.

The specific links, ie, to pancreatitis or other single topics are at the bottom. I"m seeing BJM just posted and gave you the link to the pancreatitis post. you might want to look at the rest - but another day works too!

ECID - every cat is different - which is not a slogan, but very true.

She is Sienne and her diabetic cat is Gabby. Her civvie (non-diabetic) boy cat is Gizmo, who is known for his antics. he can catch things thrown to him. :lol:

Regarding his blood sugar this afternoon, he has 2 things going on - the low numbers yesterday plus last night's skipped shot. he'll get back on track.

we do have one slogan, but it's also true: "it's a marathon, not a sprint." there are no quick fixes to feline diabetes, so we have to think in terms of the long haul!
 
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