Conference misery::feline

    Karen, You know better than to get worked up! He maybe wanted to just
    chat with you or tell you good news!.... Of course I would do just what
    you are doing!!:'}  Hope all is well when you talk to the doctor. We
    will be thinking of you!
    Karen

    Oh Karen,,,kitty prayers coming your way.  Try not to work yourself
    up.....but I've been there and no exactly what your going through.
    
    Keep us posted...and hugs and kisses to your furballs.
    
    Sandy

    
    Karen,  I'll be sending "good vibes" from The City....
    
    M
    
    

    Karen,  I'm sending good thoughts for your kitties.  Don't panic
    yet.  When Amelia went in for one of her ear checks I was asked to
    wait 'cause Dr. Shanker wanted to talk to me.  The vet that had 
    checked her that day was Dr. Leland.  Anyway, I waited and waited
    wondering what the heck he wanted while he worked on an emergency.
    Come to find out that he just wanted to update me since he was the
    vet that originally worked with Amelia on her ear thing.  Maybe
    it won't be so bad.
    
    Keeping our fingers and paws crossed for you,
    
    Jan (Bailey, Amelia, Carrie, Onyx...Ariel, Molly and Torti)

    Oh Karen,
    
    MANY thoughts are with Sweetie and Holly.  These two babies have a
    place in my heart because of my namesake and my sweetie's namesake as
    well!  Don't get too worked up about it until you actually hear from
    the vet.
    
    Please keep us posted!!
    
    Holly
    

	Hi Karen - good wishes for Holly and Sweetie from us, too!

	Sandy + a crowd

Hang in Karen!!  Beth has her paws crossed for you, too!!

Mary

keeping all paws and fingers crossed....keep us updated!  Good luck to you
all....

				D-and-the-4-terrorists

    Karen,
    
    Fingers and paws crossed here.  Sending good thoughts your way.
    
    Steffi + 4
    

    Karen,
    
         Everything crossed here too (I just *had* to be different ;^) )!
    
    					- Andrea

    Things are better than I had thought.  Sweetie has diabetes, not kidney
    disease;  he's in at the vet's today and I have to bring him in again
    tomorrow so they can determine the correct dosage of insulin, and then
    I'll be giving him a daily shot, and presumably he'll be going back in
    pretty often to have his progress monitored.
    
    Holly's biopsy has been sent off to a specialist to look at;  the vet
    thinks it is probably okay, but he wanted a second opinion on a
    questionable area.  The results should be back the end of this week or
    the beginning of next.
    
    The vet told me to get some Karo syrup around in case Sweetie has a
    problem with extreme weakness, etc.  I'm wondering what the other folks
    in this file with diabetic cats have found in terms of the likelihood
    of this happening?  My impression is that it can be quite dangerous?
    Can you "overdose" the cat with the Karo and have something bad happen
    in the other direction?  I'll be asking the vet this stuff, of course,
    but some real life info would be helpful.  Thanks for everyone's good
    thoughts.
    

    Karen,
    
    Prayers and kitty hugs for Sweetie and Holly.  Hope Holly's tests come
    back negative.
    
    Pat & Clan
    

    
    Nothing like coming into this after the fact, but Karen---I'm happy
    to hear it is not so bad as you expected.  My thoughts will be with
    you, for Holly AND Sweetie.
    
    Nancy

    Hi Karen,
    
         First I want to send good vibes to Holly that her biopsy will test
    out okay!  Good luck Holly!!
    
         I was hoping Sweetie had diabetes and not kidney disease.  As one
    with a diabetic cat (Loki), I can tell you that diabetes is a treatable
    disease, just like in people.  Sure, there are a few "extra" things to
    worry about, but nothing that can't be handled.
    
          We have some Karo syrup around for Loki, just in case.  The "just
    in case" is in case he gets his insulin and then doesn't eat.  That
    could cause *low* blood sugar, in which case I'm told that the cat will
    stagger around, become listless and generally look sick.  A little bit
    of Karo syrup will raise his blood sugar back to normal.  I don't
    remember what the time-frame is for this to happen, maybe an hour or
    two.  But Loki has never had a problem (he eats like a pig!).
    
         That's something to really watch in diabetic felines (like
    diabetic people) - he *must* eat after his shot.  Loki refuses to eat
    at the vets, so I hope he doesn't get sick.  Diabetics are more prone
    to infections.  But these are relatively minor things, especially for
    Loki who never goes outdoors.
    
         Loki's regimen is one shot of 3� units of NPH Iletin I insulin at
    6:00AM (we have chickens, so we're up early anyway), then 45 minutes
    worth of food (it was an hour, but he's pigging ;^) ).  He gets another
    shot of 3� units, same insulin, at 6:00PM and 45 minutes worth of food. 
    *No* snacks, *no* kitty treats - Loki is on dry W/D in the morning and
    wet W/D in the evening.  You'll need to ask your vet what kind of food
    s/he recommends, but our vet recommended the same diet (no different
    flavors or brands) and highly recommended the W/D.  We find that
    everyone is eating the W/D (okay, only the felines ;^) ) and we give
    Bigfoot and Midnight "snacks" of dry food during the day/evening.  Loki
    seems to know that he cannot snack, although he occasionally will try
    ;^) .
    
         We tried Humulin (genetically-created human insulin!), but that
    did absolutely nothing for Loki - he couldn't metabolize it.  The NPH
    is a beef-pork (I think) insulin, and his system can handle this much
    better.
    
         Loki originally went in overnight so that the vet could get a
    glucose curve on him.  I believe his sugar is highest mid-afternoon,
    which is generally when he's h*lling around with the other kitties. 
    The vet did this so we could figure out the best timing for his shots;
    he could probably stand to be shot at 4:00, but I'm not getting up at
    4:00AM for anyone ;^) !  It's bad enough that I have to be up by 6:00AM
    every morning for the rest of Loki's life, but that's okay - for him
    I'll do almost anything!
    
         Now that Loki is in maintenance mode, we test his urine sugar
    about once a week.  He's such a sweetheart - he lets me come up to him
    while he's peeing and pass the strip under his urine stream.  Hope
    Sweetie can be as good!
    
         BTW Loki is 11 years old and doing *fantastic* - you'd never know
    that he had diabetes!  And it's funny - he's associated the shot with
    food.  I prepare the shot then go over to the couch, he jumps up, gets
    his shot (once in a while I hit a sore spot but I minimize that by
    shooting him on his left in the morning, on his right in the evening)
    then runs to the food dish ;^) .  So for him the shot is something to
    look forward to!  And I think I've done pretty well too - I *hate*
    needles.  I keep telling my husband that if *I* ever get diabetes,
    *he'll* have to give me insulin ;^) !!
    
         That's about all I can think of off-hand.  If you need to
    talk/write, please feel free!  I *love* to talk about Loki, makes me
    feel like an expert ;^) !
    
    					- Andrea     
                                          

    Thanks for the info, Andrea.  The vet did put Sweetie (and consequently
    Holly and LB) on WD dry and wet.  Sweetie has never exhibited a problem
    in eating :-) which might have actually helped bring on the diabetes,
    so folks with chubbies, put them on a diet.
    
    If Loki doesn't eat in that 45 minutes, what do you do?  Give him Karo
    syrup just in case, or keep an eye on him, or leave for work with your
    fingers crossed?
    

         Well so far Loki has never failed to eat in that 45 minutes.  In
    fact he usually eats so much so fast that he spends the next two hours
    burping ;^) !  
    
         I would say, though, that if Loki didn't eat, I'd either stay home 
    (if I had that option, it would depend on meetings and other icky stuff) 
    or I'd give him some Karo syrup.  Just a little, maybe a teaspoon?  
    I'd rather his blood sugar be too high than too low.
    
         Loki was down to 12� pounds by the time we had stabilized the
    diabetes.  Now, since he is no longer starving (diabetes is really a
    form of starvation), he's back up to 15+ pounds 8-( .  He was
    originally getting a 1-hour feed; that's why the feed-time was cut to
    45 minutes.  I think even if we cut it to 15 minutes, he'd eat just as
    much, just gorge and burp more ;-) !
    
         The best theory we have as to why Loki became diabetic (other than
    his obesity) is that about a month before he came down with a sudden
    fever and virus; he was treated at the vet but they never could figure
    out exactly what it was.  Seems that virus may have attacked his
    pancreas, as a couple of weeks after he started exhibiting the signs. 
    I think people with no genetic pre-disposition to diabetes can
    sometimes get it this way too.
    
         Hang in there, Karen, and please feel free to write if you have
    any questions or just want to talk!
    
    					- Andrea

    We all send good thoughts to you, too.

    How old is Sweetie, Karen? My Junie was almost 18 when he developed 
    diabetes, and he had some kidney failure also. I'm sure that and his 
    age complicated things for us, but it still went pretty well. I can 
    tell you how my vet and I handled Junie's diabetes, but things may 
    have changed in the past 5 years and different vets do some things 
    differently anyway. Some comments...

    > The vet told me to get some Karo syrup around in case Sweetie has a
    > problem with extreme weakness, etc.  I'm wondering what the other folks
    > in this file with diabetic cats have found in terms of the likelihood
    > of this happening?  My impression is that it can be quite dangerous?

    My vet gave me a syringe to feed Junie the Karo, and it was much easier 
    than trying to get a spoon in his mouth. 

    Junie would get low blood sugar occasionally (once every couple of 
    months or so). The early signs are subtle, so you have to learn what to
    look for and train yourself to watch for them. Junie used to get wobbly 
    on his feet and would ask for food. If it got worse, he would cry, then
    yell. I was awakened in the middle of the night a few times by his 
    yelling. I don't know if non-Siamese cats do this.

    Not to alarm you, but yes, low blood sugar can be dangerous (in fact 
    fatal) if no one's around to give him Karo when this happens, like if 
    you were gone for hours after the attack started. I think you (and
    the vet) should be able to predict about when this would happen. Junie, 
    for example, would eat at 6:00 (a.m. and p.m.) and would get his shot 
    at 8:00 (a.m. and p.m.). When he had problems with low blood sugar it 
    was usually around 2:00, give or take an hour. He was a nibbler (as 
    opposed to wolfing his food in a few minutes), so I had leave food in 
    his room when I was not at home. If I was home he would let me know if 
    he needed to eat. He would also usually let me know if he had low blood 
    sugar. I would give him 1/4 to 1/2 teaspoon of Karo and he would recover 
    in a short time, about 15 min. or so.  

    The first time Junie had a low blood sugar attack I was scared nearly
    witless. I came home from work about 5:15 and found him in his room 
    yelling loudly. He was lying on his side and looked like he had fallen 
    over. He was very stiff-looking, with his forelegs stretched straight 
    out. I quickly gave him some Karo and rushed him to the vet, where 
    they gave him some glucose subcutaneously. He had started to recover on 
    the way to the vet's and after the glucose he was fine.

    > Can you "overdose" the cat with the Karo and have something bad happen
    > in the other direction?  

    If the cat is having a low blood sugar attack, NO, he cannot overdose on 
    Karo. But he only needs a little to bring his sugar level up. 

    > If Loki doesn't eat in that 45 minutes, what do you do?  Give him Karo
    > syrup just in case, or keep an eye on him, or leave for work with your
    > fingers crossed?
    
    This is why it's important to keep track of the blood sugar level. The 
    insulin peaks x number of hours after the shot. This is when a problem 
    may occur and when he would need the Karo. I don't think you should 
    give him Karo if his blood sugar is not low, though I agree with 
    Andrea in that it's less dangerous for his blood sugar to be a little
    high than for it to be low. 

    Junie went to the vet once a month to have blood drawn to check the 
    sugar level. Between vet visits I would do the (less accurate) urine 
    test (a couple of times a day, if possible) and keep a record of it. 
    If I noticed the sugar level was consistently low for a day or so 
    (as opposed to a one-time low reading out of a couple of days) I might 
    just skip the next insulin shot. 

    I hope this doesn't sound overwhelming. Once you get used to the routine 
    and get a feel for things it'll probably be pretty ho-hum.

    Good luck with both "sweeties"!

    Linda

    P.S. Andrea, I'm glad to hear Loki's doing so well! 

         Thanks, Linda!  We had a friend come over Monday night and she
    couldn't believe that Loki has diabetes 8-) !
    
         Loki goes for blood monitoring once every 3 months.  Probably
    because of his age (he's 11, young) and the way we watch the "kids" 
    like hawks, our vet feels that this is enough to put him through (he 
    gets really stressed out at the vets - another "bad" thing for diabetic
    kitties).  We do urine tests about once a week (which keep coming out
    negative, which is good), and watch him in case he acts like Linda
    said.  If he were to have an attack, we would of course take him to the
    vet and then consider lowering his dosage.  But for now, everything's
    a-ok and yes, it does get kinda routine 8-) .
    
         Now if only my HMO would cover insulin and syringes ... 8-)
    
    					- Andrea
    
    P.S.  Oh, mentioning the syringes ... if you can, get �CC syringes
    (Loki's are made by Terumo, U-100 insulin syringes, �CC, up to 25 units
    per syringe).  It's a *lot* easier to measure out 3� units with these
    that have the � units marked clearly, than the �CC syringes (up to 50
    units) that are marked, but not as boldly.
                          

    Sweetie is 10 or 11 years old.  Andrea, has Loki ever had a low blood sugar
    attack?  This 2 pm business worries me, since I would still be at
    work for hours.
    

         No, Karen, he never has.  In fact, he's never had a low blood
    sugar attack at any time.  That's one reason why the vet did a glucose
    curve, to determine when he would be most vulnerable.  For Loki, I
    think it was 2:00-4:00, but since I'm usually home by 4:00, it's not a
    problem for me.
    
         You might ask your vet if s/he has any suggestions.
    
    					- Andrea

Take heart, Karen!  

My furface - Bacardi - was diagnosed with diabetes
four years ago.  I can feel part of the anguish you're going through, 
because I was a wreck.  (see note 87.13 for details).  The most
callous comment I got from a *friend* regarding the careful monitoring
and insulin shot routine was, "Why don't you get another cat?"  He
is no longer my friend.

She's in remission now - but I know, as she gets older, the risk 
increases for her requiring insulin again.  I watch her eating,
drinking, and - thanks to Andrea's comment - check her blood sugar
level (strips) weekly.  BTW if you have difficulty getting *samples*
try shredding wax paper into about 1/2 inch strips, crumple them up,
and put them in a litter box.  If you know Sweetie's urination habits,
make this the only litter box available at *that* time.  Could be
difficult in a multi-cat household - but it worked for me.  I keep
a regular litter box and the wax paper one I switch to when I need 
to check Bacardi's sugar level.  She isn't wild about it - but she's
so fastidious she uses it.

I was scared to death about giving her too much insulin - especially
as her need for it declined.  She never had a reaction, but I had 
an eye-dropper (vet supplied) and honey available at all times, just
in case.  It was tough knowing I would be at work if a reaction set
in, too.  But it never did.  

Terrorize your local pharmacist for *good* urine testing strips.  
I tried several different brands - and different pharamacies - 
until I found something I was comfortable with.

It sounds like you caught it early - good for you!  I wish I had been
as savy then.  Bacardi got real sick.  

Best of luck with Sweetie.  Kitty licks in your ear.

Lori  

    Thanks for the waxed paper idea.  Fortunately Sweetie lords it over one
    box and uses it first thing each morning, so if he accepts the waxed
    paper this would work.
    
    What brand of urine testing strips do you buy?  (I haven't gotten this
    far with the vet yet.  He's still trying to find the right insulin
    dose, and feels that it will take awhile to do that.  His "conservative
    dose" yesterday lowered whatever it is that they measure from 440 to 380
    yesterday, so he's trying a double dose today.  It's supposed to be
    under 200.)
    
    He suggested using my finger to apply the Karo if I needed to;  my
    feeling is that that would work well if I put it in that space on the
    side of the teeth.  
    
    

         I use Keto-Diastix - they test both urine glucose and urine
    ketones.  Ketones are bad things - indicators of organ damage.  I'm
    probably scaring you, but Loki has never had ketones; it's just another
    monitoring device.
    
         Those are glucose numbers.  Loki's worst was in the 400's, so take
    heart that Sweetie's is about the same.  Right now he's running around
    120, which means that we could drop his dosage a tad, but we're going
    to wait until his October test.
    
         My vet recommended the twice-a-day routine as it gives Loki's
    system a lower jolt - 3� units twice a day rather than 7 units once a
    day.  Every vet is different on this, however I feel that the lower
    dosage more often is more stabilizing and less like to produce a low
    blood sugar.  At least it's worked for Loki.
    
         And we too had an aquaintance who, when she heard what we were
    going through, said "No overnight trips anywhere?  No going out to
    dinner? (we eat around 6:00, Loki's time) Why don't you just have him
    put to sleep?".  Some people just don't understand.  Everyone does what
    they can, depending on their (and their animal's) personalities; for
    instance Bigfoot is a real terror and if he were ever to develop
    diabetes, I don't know if we could treat him.  But just a blanket
    oh-it's-too-much-trouble-just-get-rid-of-him attitude I can't
    understand!
    
    					- Andrea

    Re: Bigfoot is a terror
    
    One thing I've found is that more and more my "success" with treating
    my cats medically is founded on determination.  Originally I thought
    I'd never be able to give a pill to a cat, until Holly needed to have
    them for something crucial a few years ago (I've actually forgotten for
    what).  Partly it seems to be being determined to do it, and partly it
    seems to be that the cat senses that s/he can't avoid it.  Probably
    only a completely feral cat (and even there I'll bet the wrapping in a
    towel would work, if there's some way to get the towel on....) is
    untreatable.
    

         Well, you know that I would do *anything* for Bigfoot (my $2K
    surgery kitty) 8-) .  But he does have "vicious" on his vet records and
    one of my vets is actually afraid of him (just because he growls and
    snarls and can open her arm up with his 7 toes while muzzled and
    blindfolded?!?!? ;^) ).
    
         The Tufts vet is better - she is determined and gets one or even
    two assistants to help ;^) !
    
         Plus I have my husband to help.  I must say that if it were just
    me, alone, it would be tough, tough, TOUGH.  Them critters are STRONG!
    
         But I won't think of that.  Maybe Loki will be a good example to
    the others ;^) .  May Sweetie be as cooperative (try to make the
    connection between the shot and the food real strong ... the best
    motivation is a kitty's stomach ;^) ).  
    
    					- Andrea
                                          

Karen,
    
Re:  What brand of urine testing strips do you buy?  

Geez, I can see the container, but don't recall the brand
name.  I'll look when I get home - Andrea's suggestion
sounded good.  

Also, I hooked up with a local American Diabetes outlet after
Bacardi was diagnosed.  I didn't even get laughed at when
I told them it was my cat - and not my child (as they assumed)
that was ill.  Alright - they wanted to know why I named my
kid Bacardi.

The information they provided - and the pricing they had on 
syringes, test strips, etc. was about 65% (or more) below what 
I was paying at the pharmacy.  Bacardi needed 1.5 units, twice a 
day - so I bought a box of .25 graded syringes - 100 of them -
for $10.  I had been paying $2.50 for five .50 syringes.

Insulin, as I understand it, is intermusculartory (sp?).  No need to
find a vein, just get it under the skin.  Keep in mind you have
9 layers to go through, though.  In B's case, I pulled loose skin 
up from just under her neck, cotton swap with alcohol, and she never 
reacted like she felt it.  

Of course this is the cat that whimpers slightly - without moving -
then looks at me (that get-me-the-h*ll-out-of-here look) when the
vet draws blood.  No restraints either.  He is amazed every time.
Probably because my sister's cat (same vet) is the vet's nightmare -
yes, labeled *vicious* also.  He looks relieved to see this Johnson
walk in - and not the other one.

I'll try to get back to you tomorrow on the strips - but it's
my last day at Digital, and it could get crazy.

Sounds like Andrea has alot more experience at this.  But heed her
words - every cat, and every owner, is different.

Good luck, 

Lori

         Best of luck to you, Lori, and to Bacardi too!
    
    					- Andrea

    Well, it has turned out to be a piece of cake to give Sweetie his
    insulin shots.  Now he's in at the vet's again to see if this is the
    right dosage.  Holly's biopsy results came back and are not malignant.
    

    YAY!!!  Glad to see that BOTH are doing well!!
    
    HOlly
    

    So so happy.....that news made my bleak Monday a bit happier!
    
    Sandy

         Hurray!  Great news all around!
    
    					- Andrea

    YIPPEEEE!
    
    I hope they both continue to improve.
    
    Steffi

    YIPEE!  A good-news Monday!
    
    Mary
    

    
    
    Yeah!  Some good news for a rainy day!

    Thanks so much for all your good thoughts.  The vet is still "mapping"
    Sweetie's response to insulin and waiting for it to stabilize so he
    can decide if he needs one shot a day or two, and the exact dosage, but
    the good news is that S does respond to the insulin, his blood sugar
    level is mostly in a reasonable range, and he doesn't have to go back
    to the vet until Friday (today - Friday is a stabilization time).
    
    For anyone who might have to do this in the future and is worried about
    giving injections, let me note that for Sweetie at least, it is much
    easier than giving a pill.  The needle is quite small and the whole
    thing can be hidden in your hand.  If it's injected in the not very
    sensitive area in the upper back/lower neck (not into the "body" but
    into a fold of tissue held away from the "body") as it is in Sweetie's
    case, he basically doesn't seem to feel it.
                                                                    

         Congratulations, Karen, on doing such good work!  
    
         I *definitely* agree with you - the injection is *much* easier
    than the pill.  When Loki needs (other) medication, I prefer to get a
    liquid (I can squirt that into his mouth).  With pills, he somehow gets
    in into the side of his mouth and pretends to swallow about 60% of the
    time, then proceeds to walk about 10 feet away, spit out the pill and
    give me an "I dare you to try it again" look 8-) !
    
         BTW insulin is destroyed by digestive juices, and is too large a
    molecule to be absorbed through the skin, so if you "miss" like I have
    a couple of times (when I *thought* I had gotten the needle into his
    skin but it just went into the fur or went through the skin fold), you
    can give him another injection.  Even if he licks the spilled insulin
    from his fur, his stomach will destroy it.  And I've found the best way
    to tell if I've missed is that I rub where I injected him then smell my
    finger.  Insulin has this odor that smells like a laundry marker -
    can't miss it!
    
    					- Andrea
                                                

    Hm.  My vet said never ever absolutely never give him another shot if I
    think I've missed.  He is more concerned about an insulin overdose than
    Sweetie's missing a day.  So far, I've been totally sure that the
    needle has gone into the skin.
    

         Hmm.  I asked in the Diabetes notesfile, and that's the
    information I got.  In fact, after asking that question and then one
    morning missing with the needle, I gave Loki another shot with no ill
    effects.
    
         I'll have to ask my vet in a couple of weeks when Loki goes in for
    a glucose check ...
    
    					- Andrea

    Sweetie is down to needing just 2 units(?) of insulin a day;  he was at
    11 for awhile there.  I'm beginning to hope that eventually just diet may
    control his diabetes.  As someone said, magic works.
    

         Great!  It certainly is easier to control by diet, and I'm hoping
    that you can do that with Sweetie.  Just don't forget to check his
    urine 2-4 times a month, so that if/when it "recurs", you can catch it
    quickly.
    
    					- Andrea

    He's down to 0 insulin now, and maintaining on just the special food.
    He's still  going in to be checked once a week or so
    until it's clear he's stabilized.
    

    
    That sounds encouraging, Karen.  What day does he go in this week for
    check up?
    
    Pat & Clan
    

    Thursday.