newly diagnosed, and I have questions please

Hello all

My 13YO - 18.5# male cat, Hurricane was just diagnosed based on blood and urine testing (blood GLU 476 mg/dl). BG curve cannot be done, cat is extremely stressed to put it mildly at the vet

Main reason for our testing was the increased drinking/urinating. had and has ood appetite, good personality, etc

Cat also has a history of kidney stones, and I have always free fed a combination of wet and dry foods. The dry food recently has been Purina UR veterinary with an occasional HILLS SD which is an interim food only, Hills for the kidney stone dissolution, Purina as his kidney stone maintenance food, and I have been told by the vet to switch to Purina Proplan Urinary Health for the dry . The wet food has always been Fancy Feast

I have been reading your forum since 5/28, but am still quite ignorant and scared.

Insulin was started on 6/1
Vetsulin 3 units twicce daily
Vet said no more free feeding, two scheduled feeds only followed by injection
So, I have been feeding 4 am - 1/4 can of a 3oz Fancy feast either sliced or grilled as he does not like classic, and a little less then 1/4 cup of the dry, and same approx 4pm and I follow within 10 minutes with the injection. I was told to follow immediate, but I absolutely have to get a sip or two of coffee first.......

12 hours is a long time for Hurricane to look at his empty dishes, so sometimes i give him a very small amount of wet noonih

Oh, and for 13 years Hurricane has been "treated" with a very small amount (about the size of a pinky nail) shrimp cocktail which he loves and actually talks when he wants. So I have been doing that immediate after the insulin

Questions
am I feeding enough/too much ? I would like to see him safely loose a total of 5lb. I am aware not more than 1% - 2 % body weight per week
Should I try to increase wet and decrease dry? even though the dry is medicinal for the kidney stones? and my Vet does not believe wet is better
why is the diastix showing such an abnormal result, shouldn't this be coming down with 3units x 2? Isnt 3 units quite a large starting dose?
How much harm is the shrimp cocktail? and dont I also have to consider quality of life?
What harm am I doing giving him a nibble at noon time?
What does anyone know about Vetsulin? I cant even find out much on the interne

- and-
Anything else I need to know please

Thanks in advance
I am sorry to ask such silly stupid questions, as from what I have read you are all quite knowledgeable,,,but I really am at the point where I need baby steps. I do hope to progress but baby steps is where I am




The insulin injections are not going too badly, and I hope to eventually learn to BG test (but honestly this is a bit down the road)

I did get some diastix as the vet told me to wait and week and test the urine
Both yesterday and today I was able to collect a morning specimin and the diastix readings (color chart) were at the highest level both times - dark brown +2

I am supposed to call the vet tomorrow wth those results and I am already fearful he will want to increase the doseage

The drinking and urinating are a little bit better however.

 

hi-

Welcome to the forum!

You, like me, have a newly diagnosed kittie, and I'm sure are scared, emotional, and feeling overwhealmed. But you are in the right place!

These pepole on here are AMAZING! I'm sure one of the "pros" will be along shortly to answer your questions, offer tips and advice.

The glucose testing seems intimidating and can be a scary topic. But it's not and you should learn to do it. You may not get the hang of it right away. Perfectly understandable! But, again, the folks here will guide you EVERY step of the way!

I know exacty what you're going through. My only suggestion would be read all you can about cat diabetes. I know your head will feel like exploding. Mine did and made a mess :lol: But after a while of reading and re-reading, you'll understand it.

ANd remember, you are NOT alone in this and this forum is wonderful.

 

Welcome to the best site to help you help your kitty. I posted the link to here, on the vetuslin board. I dont know your insulin or what food for "stones"...But I think dark diastix is not a good thing. Please hang in there for more help.
Good luck and best wishes,
jeanne

 

I'm only addressing your question on the Vetsulin for now. More later.

Vetsulin is one of the intermediate duration insulins. Humulin N and Novolin N are two others. Unfortunately, since a cat's metabolism is so fast, twice that of a human. the duration of the NPH insulins is usually not more than 8-10 hours.

If you feed after the insulin is used up, the food is going to raise the BG levels even higher.

Here are 3 documents you might want to read to learn more:
Vetsulin/caninsulin http://felinediabetes.com/FDMB/viewtopic.php?f=19&t=302 READ THIS ONE FIRST PLEASE
about the NPH insulins. http://gorbzilla.com/nph_101.htm
Humulin primer http://felinediabetes.com/FDMB/viewtopic.php?f=19&t=303

Very few cats in the US are prescribed Vetsulin/Humulin these days because there are at least 4 better insulins for cats, with longer duration, better glycemic control and better chances of remission. Lantus, Levimir, PZI, Prozinc.

The goal for cats these days is remission, not simply regulation. Remission rates for Vetsulin/Caninsulin are only 20-30% per research at the University of Queensland. http://www.uq.edu.au/vetschool/content/clinic-stlucia/feline-dm.pdf

ETA: Unfortunately, The Insulin Support Group (ISG) for Vetsulin/Caninsulin is not an active forum. You will get few responses there, since there is usually only a post every couple of months.

 

Let's tackle your question on the wet vs dry. We advocate a wet food diet, low carb <10% carb for diabetic cats. This is because cats do not need carbs in their diet at all. Getting you cat on a wet food diet only, to have more water flushing through his system, may help with the kidney stones also. Vet, Dr. Lisa Pierson has a good article on urinary tract health you may like to read. http://www.catinfo.org/?link=urinarytracthealth

It never makes sense to me that a vet would have a cat with urinary tract problems on a water depleted diet.

She also has one on Feline Obesity http://www.catinfo.org/?link=felineobesity

 

It takes time to regulate the BG (blood glucose) numbers. The diastix are showing there is too much glucose in the system and the excess is spilling into the urine.

Too much insulin as well as too little insulin can cause high BG's.

Yes, 3U is a high starting dose.

As far as the BG"s coming down with 3U BID, the duration of this insulin may not be long enough in your cat. Are you able to dose every 8 hours? I would not recommend doing this unless you are home testing first.

I'd like to ask, why did your vet prescribe the Vetsulin?

 

To answer your last 3 questions now. (By the way, ask as many as you want and ask for clarification whenever you do not understand something)

The shrimp is fine. It is pure protein and some members here (Carl & Bob, Lklndlady) use the shrimp as a treat at injection time as well as at BG (blood Glucose) testing time.

Quality of life can be long and happy. Cats with diabetes can live 9, 10, 11, 14 years after diagnosis. One member, Hillary & Maui, just celebrated 4 years of having her cat Maui diet controlled. Meaning no more insulin, off the juice (OTJ). My foster cat Wink has been diet controlled for 3 months now and I'm hoping for a lot longer.

The nibble at noon time may be causing his BG's to spike up more. With the short duration of Vetsulin, no food 3-4 hours after the shot would be better. You could split the meals into 4 portions. Feed first breakfast and then a couple of hours later feed a second meal. Repeat in the evening.

We have methods to leave out food if you are gone to work and can't set out the food.

Do you have other cats?

 

Super post. I just love it when someone with a 'recently diagnosed cat' is able to encourage someone with a 'newly diagnosed cat'. That really warms my heart.

Yes, there are some really experienced people on this forum, but sometimes it is just SO helpful to hear from someone who's only very recently been where you are now. Brilliant stuff... :smile:

Eliz

 

Lots of good advice but I will address food only for now..

To better control his diabetes you will need to feed a low carb canned food that has % calories from carbs less than 10%.. but its important you would start testing his blood at home first because this can cause a big drop in blood sugar and need for less insulin.

what flavours of fancy feast does he get- does he like these?

Classic chopped grill?
what about the tender ones? ie tender liver and chicken?
What about the flaked or chunky ones?


Wendy

 

I tried to do the baby steps, but you asked so many questions!

I gave you a ton of information to read, I know. I did try to break it up a bit into categories for you.

Welcome to Hurricane and his mom. What is your name?

 

wow, lots of good info already.

Deb and wink - to clarify. If I feed breafast at 4 am it would be better for a little niblle at say 6 am ish? Then same in the afternoon?

I thought shrimp was high carb, but you believe a kittle bit is ok

And you believe that the 3units "might" be too much, and causing the high diastix?

I believe above is what you indicated

I know that a BG ear prick test would be better and I do hope to get there with your hlp, but for the time beaing how often do you think I should diastix test?

I just read more replies, so

my Name is Carol
Hurricane is an only child
He does loves Fancy Feast, but only sliced, grilled, minced. He does like flaked, but that is mostly fish and I am told by Vet to stay away from because of the kidney stones, your opinions however are sought and respected. (on this issue and on all issues)
Oh and sorry for not clarifying - when I mentioned quality of life I was thinking in terms of Hurricane's love of shrimp, I simply could not take it from him, he would not be happy. Please dont think I consider his diagnosis to be a quality of life issue. I will learn all, I will do all that is necessary. He is the love of my life. My baby steps refer to the fact that right now about all I can handles is,,,,the change in his feeding schedule, the twice daily injections, and the diastix.

I will learn one thing at a time, and obviously the next thing I should learn is BG test, but right now I need to get these 3 things under my belt

I am having a little trouble with the "pull back syringe to make sure there is no blood in the hub". This takes me time and Hurricane gets squirmy, which means right about the time I know there is no blood in the hub, the needles has squirmed out of him, so we start over. and again, sometimes. I need to get better/quicker/more confident.etc

 

I never did this, simply pulled up on a bit of skin to form a tent. Stuck the needle in, made sure it wasn't poking out the other side of the tent. Squeezed the plunger to inject.

 

Yes, that is a good plan.

I can't free feed my cats because two of them are hoovers, scarfers, inhale the food in 60 seconds and look for more. One of them takes longer and I have to watch that the other cats don't steal his food.

I've split their daily calorie needs in to 4 portions. I feed 2 portions in the morning, about 2 hours apart. I feed the other 2 portions in the evening about 2 3 hours apart. The only reason for some later evening feedings are the time I go to bed.

 

Ok let's deal with those three issues first..

Then we move onto home testing and getting him to eat more healthy. It's like a human, as much as we want to, we can't eat only pizza and burgers, and for me, wine and chocolate, if we want to live a long an healthy life. Like with humans, its all about moderation...

He can keep his shrimp treats (you ever tried him with freeze dried shrimp? Those are low carb and he might love them!!) but we need to work on transitioning him to a low carb fancy feast (or other low carb canned) once you start home testing. Even if you just stop the dry and keep the wet, it will help some.

Then you will be better prepared to help get him regulated or even into remission...

 

and how often should I urine diastix test? Oh and I think I am pretty cool, cuz I can collect a urine specimin, that took a bit

How many calerioes should Hurricane have a day if I want him to loose weight safely. I have many times read dr Lisa and I do not believe she breaks this down to caleries per lb of body weight. I have read that a 3 oz can is approx 250 caleries, and a cup of dry approx 300 - I am unable to get good info off of any websites with regard to Hurricanes specific foods

and no, he turns up his nose at shrimp treats or shrimp flavored,,,,,he is a true shrimp cocktail junkie, and yes I do believe in moderation

 

First of all, welcome to the site and please know that there are NO silly questions.
Most people arrived at this site, upset and unknowing, so we know how you are feeling.
Ask whatever questions that you like.

OK, first thing about your insulin. Vetsulin. This insulin was lousy before, did not last long and there were much problems with it.... and it was stopped being produced. The same insulin is Caninsulin in Canada, and I was given it for my first cat. It never lasted longer than 8 hours, and it was OK for dogs but not cats.
Recently, Vetsulin is back, maybe it's supposed to be improved or something but I would not use it for my cats. I think more and more vets may be prescribing Vetsulin or the Prozinc, but you would do better to get a prescription from your vet for Levemir(detemir) or Lantus(glargine), which are human insulins that last the full 12 hours and get much better results with cats. If you stick with Vetsulin, you may have to dose insulin every 8 hours because it is a medium lasting insulin.
here's some article on the release
http://veterinarynews.dvm360.com/dvm/ar ... ?id=811353

Now, for the diet. stop all that dry food; it's ridiculous for a vet to say it's a good food for a cat with stones and such. If you want to know the damage that dry food causes, go to Dr. Lisa Pierson's site and read about Opie and all the rest of the info.
http://catinfo.org/?link=urinarytracthealth
Awesome site which also has a good list for foods to feed a diabetic cat: low carb WET food.
http://catinfo.org/docs/FoodChartPublic9-22-12.pdf
Most people feed Fancy Feast or Friskies pate flavors of wet food as they are decent and low carb.
There are a great deal of cats who are DIET CONTROLLED - once the dry food is removed, they no longer need any insulin!
Sorry, Hurricane, no more sliced or gravies for you, big guy.

I know you want to have some of the extra weight off.... it will happen when you cut out the dry food.
As for feeding only twice a day.... nope, not good for diabetics to eat only 2 times..... you don't have to feed more food, just spread it out into maybe 5 or 6 meals/mini-meals. Human diabetics don't eat twice a day so why make diabetic cats eat that way? By spreading out the food over the day, you will help his numbers be more level.... and how much to feed? Just let him eat more than usual - wet food only - because the body is not able to extract what nutrients it needs to function, so he will seem more hungry until he is regulated. My 2 cats were eating 30oz and 24oz a day until regulated and they dropped down on their own to more like 10oz and 5oz a day. Cats DO self-regulate for the most part, so let Hurricane eat a bit more.

Curves at the vet.... useless. If Hurricane is stressed at the vet, his numbers will be automatically much higher, and so all the numbers the vet gets there will be false. One of my cats was always higher at the vet office... she would jump a good 100 points at the vet, then 30min after being home, her numbers would drop down to her normal range. The best way for you to get trustworthy numbers is to pick up a human blood glucose meter at the vet and test Hurricane at home.... most people around here are home testing - poke on the tip of the ear - and you will safe lots of money and lots of stress to Hurricane. If you are in the US, just pick up a Relion meter, some test strips, and lancets for the lancet device for poking the ear tip.
You mention the diastix, testing urine for his BG levels..... the urine is where he was hours ago and not what he is now, so it's a lousy way to know how he is NOW.
What you CAN pick up when you get a meter is a container of KETOSTIX so that you can test his urine for KETONES. Some cats are more prone to having ketones than others, and it is NOT just when the numbers are high. If a cat is prone to ketones, they can happen at lower numbers as well.

So in summary,
1. Change the diet to NO DRY.
2. Feed 2 main meals at shot times, and 3 or 4 mini-meals/snacks through a day/nite.
3. Cut the dose to 1unit of Vetsulin - once the DRY is removed, he won't need as much or any insulin.
4. No curves at the vet; do your own at home.
5. Pick up a Relion meter, test strips, lancets, and a container of KETOSTIX.
6. Speak to your vet about a longer lasting insulin like Levemir or Lantus.

Whatever difficulties you have, others have had the same before you and can help you resolve.

Gayle

 

Don't worry about calories until you get him regulated.
Any info on cans relates to a healthy cat, and until Hurricane is regulated, you can't think of him as healthy.
Many people who have removed all the dry food have found their cats lost weight; the dry is not good for the cats, and it's fattening plus high carb.

Gayle

 

I am not too sure who is telling people to pull back on the syringe to look for blood; you don't need to do that. Just tent the skin, insert needle, push down on syringe plunger, hold for a second/don't pull out needle too quickly.

As I stated, the DIASTIX tell you where you cat WAS and it's not a number, so it does not really tell you much. The stick tells you about glucose that is in the urine and not what is happening in the cat's body at the time you test. The cat could be much lower now, so there's a chance you may give too much insulin. Testing the blood gives you real time numbers.

Gayle

 

Thanks for everything, everyone who replied, and please keep coming

I already have a notebook page of notes to ask/go over with my vet

and I will ask him to show me/help me learn how to do a BG test, as I will also ask here when I am ready. My DH is a type 2 diabetic, no injections, pills only Metformin and Glyburide, but the good news is we already own a BG human meter - and lancets and strips , Freestyle freedom. Is this going to be useable? Unfortunately my DH is not real religious about testing himself, so plenty of supplies (which he gets at -0- cost)

 

No, do NOT use the freestyle meters as they do not give good readings for cats; it's been found time and time again that they do not register higher numbers, so too many people thought their cats' numbers were not that bad. The problem is not with the meters, but with the new technology in the 'butterfly' strips. The old strips were OK but then the company made changes. All the people who were using these new strips, when they switched to any other meter, found that their cats were at much higher numbers, it was sad.

Do you think you guys can get a different meter? Can he get a Bayer or OneTouch or Accu-Chek or something?

Gayle

 

Carol, the reason I was telling you to feed the 4 separate meals was because of personal experience. This section is from the ISG for Vetsulin:

How and when you feed, with these intermediate duration insulins like Vetsulin, is different than using the long duration insulins like Lantus and Levimir. The feeding strategy that Blue mentioned, feeding mini-meals through out the day, which is appropriate with Lantus and Levimir, is not advised with these intermediate duration insulins.

Your vet had you feeding only twice a day for a reason. The method above is a slight variation on what your vet advised you to do.

The different feeding strategy is because:
1. Onset is fast, often in 1 hour.
2. Peak is sooner, 4-6 hours after shot.
3. Duration is less, 8-10 hours after shot.

Feeding after the peak will simply raise the blood glucose numbers higher and result in bouncing for your cat.

 

Thanks

Hurricane will not snack 1.5 - 2 hours after shot He sleeps for about 4 hours then comes looking for food. What now?

I am leaving the house shortly to go to work,,,calling vet approx 8 am and will return to look for replies and probably ask more questions mid to late afternoon

 

Shrimp is zero carb. Bob and I both think it is nature's perfect food. ;-)

 

Ok, we have to try to work with what Hurricane is willing to do as far as eating goes. ohmygod_smile
Let's try giving Hurricane the bulk of his food at shot time, 2/3 to 3/4 of the morning amount. Leave out the rest for him to eat, 1/3 to 1/4 later for whenever he will eat. If that is +4, then so be it.

ETA: Many cats, if their BG (blood glucose) is dropping fast, will naturally go get something to eat. Let's see if Hurricane will do that by putting the food out around +1.5. Leave it there when you go to work. You can add a little bit of water, a tablespoon or so, to keep it from drying out.

 

Hows things going? Did you ever manage to pick up a new meter? How was the vet visit?