Your cat has diabetes… now what?

DON’T PANIC! The FDMB provides a lot of information that you should read through as soon as you can but below are a few quick and useful links - especially if using Lantus or Levemir.

READ ME FIRST

• A message from your cat
• Are you sure its diabetes? Double check before starting any insulin.

TEST

Home testing is key to regulating and keeping your cat safe.

• How to home test blood glucose – very important to help regulate your cat. Also read  29+ ear testing tips.
• Meters – many FDMB use the Walmart Relion or Arkay- cheap and reliable.
• Testing for ketones –  important to do often if high blood glucose, or cats with a history of ketones/DKa. Also read catching urine tips
• Secondary monitoring tools - Useful tools, especially for those who don’t test blood glucose.
• When to test? - You want to test 3-4 times a day ideally:

• ALWAYS before every shot (preshot test) to make sure he isn't too low - as a newbie that too low number is 200. But as time goes on and you get more data and he comes more into a normal blood glucose range we reduce your no shot number.
• Mid cycle -5-7 hours after the shot to see his "nadir" (or low point). The low point is what you base dose changes on, not the preshot level. This test can be hard for people who work during the week but it can be done overnight and/or at weekends.
• Before bed - 2-3 hours after your evening shot. If this number is lower than your preshot number you may want to set the alarm for a later test that night as it implies an active cycle

FEED

To better regulate your cat, and have a better chance at remission you should transition your cat to a low carbohydrate (under 10%) wet canned food. If you do this it is critical you home test since the cats insulin requirements may drop significantly and fast.

• Basics of feline nutrition - why to feed a low carb wet.
• Foods

• Worldwide foods and nutrition - North America, Europe, Australia and beyond.
• North American :Carbohydrates in cat food list (PDF)  and Binkys food lists – Many North American FDMB use grain-free Wellness, Fancy Feast Classics Pates or Friskies Pates. Vets prescription diets are not required. Low carb dry: Innova Evo Cat & Kitten 8%, Nature's Variety Raw Instinct chicken 7%, and Young Again zero Carb 0%.
• Low carbohydrate treats – such as the popular freeze dried chicken!

• Tips to get them off dry food–  help them transition to canned.
• How much to feed? Required calories per day = [13.6 X ideal weight in lbs] + 70
• Enticing your cat to eat - Tips to get them to eat if they are off their food.

SHOOT

Many people use Lantus or Levemir twice a day – these are effective insulins in cats which may encourage remission. These insulins last 12 hours.

• Choosing the right insulin
• Storing and handing Lantus and Levemir  

• Pens last longer than vials and are less breakable: (SoloSTAR pen (Lantus) or FlexPens (Levemir))
• For U-100 syringes (Lantus, Levemir), get 3/10 cc, half-unit marked, short needle, 30-31 gauge ie  Relion 3/10cc 30 & 31 gauge short, BD Ultra fine 3/10cc short, Terumo Thinpro Insulin Syringe 31G 3/10cc, Kroger 0.3cc 8mm, 31 gauge
• Lantus/levemir Discount Coupons
• How to inject the insulin
• Shot placement diagram - where to shoot and the importance of rotating injection sites
• How to measure low doses (pictures)

• 0.25IU
• 0.1IU
• “Some insulin”

• Choose a regimen – here are 2 recommended protocols

• Tight Regulation Protocol – get him regulated fast - more aggressive method.
• SLGS – Start Low go Slow – slow and steady towards regulation.

• Handling low numbers

• How to handle low numbers - dont panic!!
• Shooting and handling low numbers – what to do when you see a low pre-shot number.

• Hypos – these can kill  - print this out! Plus set up your hypo kit now! – see below 

USING THE FDMB

The boards are here to help – the more active you get in the board, the more they can help you.

• Getting started on the board with Lantus and Levemir
• How to create a spreadsheet
• How to create a profile
• Buy stuff through us - Help the FDMB- when you use these links FDMB gets a %
• Acronym Guide - lol.
• Freebies/donations - short of cash or want to donate? Or request support from Diabetic Cats In Need

Getting the hang of it.. now what?

So you have made the switch to canned and are home testing. You have set up a spreadsheet and a profile.  

Here is some more advanced stuff to consider.

1. Bounces - what are they and is my cat doing them?  
   When a cat isnt regulated, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.
2. The insulin depot   - what it is and why it effects your cat’s BG numbers.
3. CRF - Guide to feline chronic kidney disease. and Low phosphorous foods list.
4. Reports

1.  AHA Diabetes Management Guidelines for Dogs and Cats