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lilycat
Starting Member
2 Posts |
 Posted - 07/25/2010 : 09:42:30 AM
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Hi - I would greatly appreciate any advice/feedback/help/support. My 14yo indoor calico (Lily) was diagnosed with FD exactly one month ago today. Over the past year or so, we began noticing that she was slowing down relative to her litter mate who is also in our family and that she was having trouble walking. We thought she had arthritis and that she was just growing older. She started to lose weight and began drinking more, and in early June, I actually thought I was on the verge of having to euthanize her (I've waited too long with an elderly cat in the past, and didn't want to do that again). She had been a lifelong dry food eater, but I switched her to wet food when she started to lose weight. I decided to take her to the vet just to see if there was something that we could do that would be palliative to help her be more comfortable with the back leg pain, and they tested her and her glucose was at 382. She's always been around 13 lbs, and she was down to 10.1 at this point.
It was late Friday afternoon, and they gave her on IU of glargine and asked me to bring her back on Saturday a.m. so that they could give her another dose and monitor her levels. BG was 386 upon arrival and they gave one IU. They closed at noon, so they tested her again at that time and she was at 362. They said that the level was high enough that they felt save with us giving her one IU Sunday a.m., but that we needed to return her to the vet on Monday for full day glucose testing. Side note: This is exactly how I didn't want her to spend the end of her life - in and out of vet's offices being poked and prodded. She's high anxiety, and while she loves us dearly, has never been friendly to other or comfortable around them. We have no children and a very quiet household with just her litter mate and us. I talked to my husband and we decided to do it, but neither of us was very happy about it because of the toll that it takes on her to be at the vet.
We did the glargine 1 IU Sunday a.m., and 1 IU Monday a.m. at 7:30. They tested her as soon as we got her in and BG was 462 at 7:45 a.m., 370 at noon, 270 at 3 pm, 216 at 4 pm, 241 at 5 pm. At discharge, they said to increase BG to 1 IU twice a day and to bring her back in two weeks for another curve (argh - I couldn't believe I was going to have to do this again). They also sent us home with both wet and dry MD and directions not to do insulin if she didn't eat immediately prior. Over the next two weeks, we cajoled, hand fed, and did whatever it took to get her to eat enough to take her insulin.
Fast forward two weeks with 1 IU twice a day. BG at 423 at 8:05 a.m., 387 at 10:05 a.m., 469 at 12:05 pm, 432 at 2:25 pm, and 438 at 5 pm.
Told us at discharge that she had refused food all day and that it was likely stress hyperglycemia causing erratic curve. Recommended increasing glargine to 2 IU twice a day. It was at this time that we told the vet that we were relocating to Charleston and needed medical records (which is why I have such detailed info). By the way, we got her home, and she immediately began "stress eating" so we were able to give insulin.
We've moved and she's been getting better at eating (both wet and dry MD - I know, I'm gagging about that now that I've read this site) and on 2 IUs twice a day for two weeks now. We also started urine testing and the strip always goes to the darkest color within 10 seconds indicating that there is still very high levels of glucose in the urine. Since I work outside the home, I usually catch her urine near the time that I'm giving insulin and it goes straight to dark very quickly, but on weekends, when I can catch it in the middle of the day, it still goes dark by the end of the 10-second count, but not as quickly. Behaviorally, we've been noticing improvement though. She's urinating only two or three times a day now (instead of 6-8 times), the quantity is smaller (although not as small as my other cat who I've also urine tested and who's strip doesn't change color at all), so I can still tell the urine apart. She's also getting fiestier, play fighting with her sister much more, and actually doing some things that I never thought I'd see again, like easily walk steps, jumping up onto furniture, and initiating play with paper balls, etc.
My challenge is probably obvious. I'm in a new city with a diabetic cat. Now that I've read this site, we're doing exactly the wrong thing for her, but that's what her medical records show. I'll put aside my own anger about the MD routine and the sub-standard glucose and assume that it was ignorance and not intentional, but now what do I do?
I had already talked to my husband about doing home blood testing, and will go and buy a meter today, and switch to better wet food, but any advice about how I safely get out of this cycle and to a new vet in a new city that will do the right thing is much appreciated. This is especially a concern since the "right thing" won't involve much treatment or intervention from the vet because my real need is a script for PZI that will allow us to do TR and get her off of this stuff. We're two weeks into 2 IUs twice a day of glargine, and I hesitate to change anything about her insulin until I can figure out the best way to do it.
Thanks for listening and any support you can give and please excuse the long post.
--Laura
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Gail Stickle
Starting Member
USA
3 Posts |
Posted - 07/25/2010 : 10:39:44 AM
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Dear Laura -
Hello and welcome to the forum.
You have certainly come to the right place....though I am not the person who has any knowledge to help you since I am only with TR for two weeks. But what a difference in those two weeks.
Don't be so upset with yourself and with the decision to work with your vet...you did it for only one month....I dragged my feet for one year. However, despite one year of inferior caring for my
cat, Bruno, he is a new cat in these last two weeks. In fact, I saw a change inside of two days of just changing to wet food and totally taking the dry food away. Two days!!! Can you imagine.
His bathroom habits of drinking and peeing all day long stopped. I hardly was cleaning the litter box...I was used to cleaning it all day long. And going thru 25 lb. bags every two-three days.
You will have someone helping you through this journey. Take care.
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lilycat
Starting Member
2 Posts |
Posted - 07/25/2010 : 1:59:21 PM
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Gail - Thank you for the encouragement. I just saw that you are doing TR with vetsulin and haven't gotten the PZI yet. I'm worried about finding a vet that will do the BCP PZI with me. And, it looks like I can't do TR with the lantus/glargine. Am I right about that everyone?
Thanks!
--Laura |
Edited by - lilycat on 07/26/2010 4:11:43 PM |
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Debbie and Greta
Average Member
USA
1501 Posts |
Posted - 07/25/2010 : 6:12:24 PM
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Laura, I thought there was a sticky at one time that listed vets recommended by some of our users, but can't find it now. You may want to start another post titled something like recommendations of a vet in Charlston, SC.
A lot of us here just use our vet to get the RX of PZI. Just call around and explain that you know your kitty is diabetic and you want to make sure the vet will prescribe PZI prior to making an appointment. There is a sticky in the basics forum for info. you can discuss with your vet.
If you kitty still has neuropathy (trouble walking) you should order methyl B. You can get this through the internet. Be sure it's methyl and not the cobol version of B.
The wet food should be of the pate variety, no gravies, veggies and under 10 carbs. The info. sticky in the basics forum has a list and a carb calculator.
We try to get our kitties to stay under 100 for as long as possible. This is the healing range. 100-150 isn't doing harm to the pancreas but it isn't helping heal. Over 150 the kitty needs insulin.
PZI is much easier to work with than Lantus. You test prior to each shot and shoot to scale. Each shot can be a different amount. You shoot anytime your kitty is 150 or more and it's been 6 hours since the last shot. I believe with Lantus the change can only be made after several days of the same dose. |
Debbie and Greta(GA), dx 3/06,BCP PZI, in remission 9/06 - raw food-civies:Jake, Shadow, Buddy(GA), Maggie
http://www.yourdiabeticcat.com/forums/topic.asp?TOPIC_ID=51 |
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Gail Stickle
Starting Member
USA
3 Posts |
Posted - 07/26/2010 : 5:20:10 PM
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Hello Laura -
I originally started on Vetsulin, but Bruno has been on BCP PZI now for approximately 10 days. I also changed from certain canned wet foods to generic Fancy Feast. I have been feeding Bruno the new canned food
for about two days. Take care. |
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pleimanlb
Average Member
USA
2221 Posts |
Posted - 07/26/2010 : 9:12:39 PM
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Laura, call around to some different vets, ask if they will prescribe BCP pzi to you. If they tell you it's discontinued, tell them that you have the contact info for it(it's in the sticky's) and this is what you want to use. There may be a vet who is willing to work with you. Even Prozinc will be easier to use than Lantus (glargine). So if you find a vet who uses Prozinc, give that a try. You can use it with TR as you would pzi, and since your cat is newly diagnosed she may take to it well.
I had already talked to my husband about doing home blood testing, and will go and buy a meter today, and switch to better wet food,
Before you take her off the dry food, learn how to test the glucose levels. Once you feel comfortable with testing, you can start the transition to wet food only. But during the first 24 hours you must stop insulin, and test her during this 24 hour period. The bg's can drop by 100 points or more with the dry food gone, so you do not want to continue with the same doses as you are giving now. It could be too much insulin and could drop the bg's too low. Read all the sticky's over a few times, so you feel comfortable with the transition.
After you have transitioned to wet food, start back with half the dose or even less, and work your way back up by increasing in small amounts (a fat to 0.25u per increase) every 3-4 shots if needed. With Lantus you can dose every 10-12 hours if the bg is 150 or higher. No sooner. Lantus has a "build up" affect in the system so it takes a 3-4 doses to see what the insulin is doing. Dosing before +10 could build up too much insulin and end up sending her low. So with Lantus it takes patience and waiting to see any effects it's having. BCP pzi or Prozinc is so much easier to use.
Here's an example of a starting scale for lantus, after the 24 hour detox from dry food.
BG
US ( mg/dl) Metric (mmol/L) Dose
150 - 250...... 8.3 - 13.9..... 0.50u
251 - 400...... 14.0 - 22.0..... 0.75u
400 + .......... 22.2 +............ 1.00u
Here's the link for info on prozinc and BCP Pzi. If you get pzi ask for the U40 insulin. It's the most standard size, and will be able to measure more accurately.
http://www.yourdiabeticcat.com/faqs/insulin.htm |
Lindsey
Kitty's Numbers Feb/Mar 09 http://www.yourdiabeticcat.com/forums/topic.asp?TOPIC_ID=8355
Kitty's Numbers Jan 09 http://www.yourdiabeticcat.com/forums/topic.asp?TOPIC_ID=8081
Kitty's Numbers Dec 08 http://www.yourdiabeticcat.com/forums/topic.asp?TOPIC_ID=7861
http://s244.photobucket.com/albums/gg24/pleimanlb/?action=view¤t=125ec684.pbw |
Edited by - pleimanlb on 07/27/2010 10:23:56 AM |
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Carri
Starting Member
Australia
36 Posts |
Posted - 07/28/2010 : 7:36:32 PM
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| Hi Laura, My cat Mia went OTJ using glargine(Lantus) I live in Australia and we can't get any PZI insulin here. If we could have I would have given that a go but I couldn't. I did practice Tr with glargine, it does require more patience and a different scale but has worked for Mia. Lindsey has posted that starting scale for you. |
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Approaching a new vet
