Cat needs hefty diet chage- need some advice (gallstones, potential diabetes?)

cocheezie

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I just get my lantus from my local pharmacy. However ... I'm in Canada (where lantus is apparently  cheaper, and where you don't need a prescription). The feline diabetes website has a list of suppliers for people in the US. I'd look into ordering it soon, so that you don't get stuck with a $300 charge again. I just use the 10ml vials and regular insulin needles. I've also found insulin needles are cheaper online than at the vet. Terumo is a very good needle. Hope you get a good curve at the vet.
 
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khayr

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@LTS3 @cocheezie Thank you for the heads up on that, I'm definitely going to look into that when I need to get more insulin for sure.

As for his curve, we just got back from the vet! She said that in general he was looking way better than his last visit, and he's definitely gaining back some of the weight he lost. He was 5.6kg (12.3lbs) the day they diagnosed the diabetes (like 10 days ago now) and today he's up to 5.9kg (13lbs)! Still a little ways to go to get him back up to the 6.4kg (14.1lbs) he weighed before everything happened, but definitely progress.

So as for his curve, let me just type what the vet wrote on his discharge summary since I'm still reading that website (I'm making an account right after I post this) and learning which numbers and ranges are best. They tested every two hours from 8 until 4 (he received his insulin at 7:30 this morning). The vet writes:

"The blood sugar curve was as follows:

308

295

215

156

129

We would recommend continuing the insulin at the current dose and recheck a curve in 2-3 weeks. We may need to titrate the dose downwards by a 1/2 unit depending on the next curve."

He's already on just one unit, so that's good news? I have my own meter in the mail right now so I'll be able to do more frequent checks at home once it arrives... for now I'm going to stick with the same food ratio he's been eating for the past two or three days until I get the meter so that his blood sugar doesn't drop too low. (Although he definitely does not want to eat kibble as much any more, hahaha)
 

cocheezie

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I don't know a lot about curves. I can see why they may want to redo the curve. 308 to 129 is a big jump on only 1ml of lantus. Anything under about 50 is hypoglycaemia and time to start the protocol. Factors that can throw off a curve are eating/not eating/stress at the vet levels. If your cat is comfortable at the vet for the day, you get a more accurate curve.

After your cat is stabilized on an insulin dose (and after you've managed the food change), it is still good to check your cat's glucose on a regular basis. The vet will rely more on a fructosamine test which shows what the overall glucose is like over a couple of months. At the beginning of a diabetes diagnosis, there are lots of vet trips. Once your cat is stabilized, the vet trips are few unless there is a problem. Right now, a curve is all the vet has to go on.

You may eventually be able to control his diabetes by diet alone. A few people have had some success with this. It's a lot of work and monitoring. Worth reading about it on the diabetic forums.
 

LTS3

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So as for his curve, let me just type what the vet wrote on his discharge summary since I'm still reading that website (I'm making an account right after I post this) and learning which numbers and ranges are best. They tested every two hours from 8 until 4 (he received his insulin at 7:30 this morning). The vet writes:

"The blood sugar curve was as follows:

308

295

215

156

129
Was a blood glucose tset done at 7:30 am before the insulin was given? Keep in mind that a curve done at the vet'soffice is often inaccurate because a cat may be so stressed out that the blood glucose levels are elevated really high.

Here's the Lantus board over on FDMB: http://www.felinediabetes.com/FDMB/viewforum.php?f=9&sid=c8646342be28082b25297329d17141b2 Read all of the stickies at the op of the page to understand how Lantus works in cats. I've used Lantus and Lvemir for my previous cat. Lantus never quite worked well enough for him so the vet switched him to Levemir after going through the huge spreadsheet I had to keep track of daily blood glucose levels.
 
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khayr

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@LTS3 The first one was done after he had eaten and had his insulin shot at home (about half an hour after)... the vet had just told me to feed him and administer his dose before dropping him off in the morning. Shylo is pretty shy so I don't doubt that the levels are a bit off from being stressed out. This will be a lot easier once my own meter gets here and I can just do it here at home. (I sort of wish the vet had told me from the get-go that I would probably be better off getting a meter that day)

I've slowly been making my way through the forums over there, I'll start tackling the Lantus forum next!
 

LTS3

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FDMB has two Lantus boards, the "tight regulation" one and the "relaxed" one. Start with the tight regulation one to give your cat the best chance for well controlled diabetes, possibly even remission.

I was lucky - the vet who diagnosed my cat with diabetes encouraged home testing. I think it was partly because she didn't want to deal with my fractious cat on curve days
 

cocheezie

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You will want to calibrate your meter with the meter at the vet. Just get them to use your meter as well as their own during one of the testings. Each meter is slightly different. Mine reads a bit higher than the one at the vet.
 
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khayr

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Ok well good news is the meter will be here tomorrow, so I can at least start testing before meals/doses and then on my next day off at home I'll be able to do a more accurate curve! The one that my mom was able to get for me is actually a human one, so I'll just need a hand from the people on the forum with the ranges until I get comfortable (but from what I understand most people over there are using human meters because they're cheaper anyway at least).

The vet that diagnosed him wasn't the same vet we had been seeing for his gallbladder problem (since I brought him in on a weekend), and he mentioned doing the curves myself at home to save money but didn't stress how important it was, especially for this kind of insulin? The normal vet loves Shylo hahaha, although he just seems mildly tolerant of her poking and prodding. I'm glad I took the time to do a little more research, at least!
 
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khayr

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@cocheezie Yep! I've also been reading and came across a helpful tutorial with pictures and everything on the feline diabetes board, too. When I get the test strips I'm gonna grab a sock to stuff rice in too so I can use that to warm the area. (:
 
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khayr

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Finally got my testing supplies! About to test it on myself so I can get the hang of it before I work on his, haha.

In other news, discovered that Shylo does NOT like venison. P: He's been clearing how bowl every single meal until I mixed some in there for him this morning... picked around it and left a bunch in the bottom of his bowl. Scratch that one off the board, hahaha. Rabbit is still a hit though, at least.
 
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