Vet tells me the insulin won't be as expensive as diabetic food. I'm hoping it will be short term and so not going to worry about cost right now. But we'll see in a few months. If I get a meter, how long should I test before deciding on the insulin? Vet says if we start her, they'll keep her for 24 hours to regulate. Now wonder if that stress will have her sugar level artificially high?
This worries me a bit, because the insulins that work well in cats are expensive, and do cost more than food. The insulins that are not expensive (Vetsulin and Novolin) are good for dogs, but not cats. If your cat needs insulin and your vet wants to start on one of these, I think you have a choice to make. You can start on the inexpensive insulin and hope that it's enough for a short time to bring her into remission, and if it doesn't work (i wouldn't stay on it longer than 4 weeks, at most) you can start on one of the better insulins that have been proven to work well in cats. Or you can start with the better insulin from the beginning and know you have the best odds of remission with it. If it were me, I'd start with the better insulin (Lantus or Levemir, and Prozinc is ok if you can't get one of those) because it's not that more expensive than the others if you order from Canada. A single pen (It's like a mini-vial) is about $75 after shipping, I believe. If the other insulin doesn't work, you'd be out the cost of both. Also, Vetsulin and Novolin are far more dangerous to use with cats than Lantus or Levemir due to the steep drops they cause, so you'll have to be very vigilant about keeping an eye on her blood sugar and watching for hypoglycemia. Lantus and Levemir can also cause hypoglycemic incidents, but the drops are milder and aren't nearly as dangerous. Some vets are hesitant to prescribe them because of the cost (and they are worried the owners will flip out from sticker shock), but they may not know you can order from Canada for far less than it costs in the US.
I would test her a couple times a day for a few days. Depending on what numbers you see, you may decide to wait and test more, or start insulin right away.
If you're home testing, your vet wil not need to keep her for 24 hours. A cat cannot be regulated in 24 hours--it usually takes weeks or months. Because cat's blood sugar is inflated at the vet, it is recommended that the owner test at home because it is more accurate. Adjusting the dose with tests from the vet alone is dangerous--it often leads to chronic overdosing!
Here's a link to the current American Animal Hospital Association guidelines for diabetes:
https://www.aaha.org/professional/resources/diabetes_management.aspx. I would strongly urge you to print it out and give to your vet. I've also attached an article below for you to print and give to your vet. They discuss the things I've mentioned to you in this thread--keeping your cat on a low carb, canned diet, the correct insulin choices, and home testing vs. clinic testing. Unfortunately, some vets are not up to date with feline diabeties--it doesn't mean they are bad vets, just that they haven't read the current research. Most vets are good vets and are very happy to learn the latest treatment recommendations! The only bad vets are the ones who do the reading, and then still insist on the wrong treatments either because of ego or greed.
Also, have another cat with no problems. Before this, we travel alot and have a neighbor come over to feed them both wet food in the a.m. and then we have a timed auto kibble feeder for the rest of the day. Hubby is hoping she can go back on kibble because it would be hard to have neighbor come over 3 times daily to feed cats. Has anyone put cat back on kibble after steroid induced diabetes and what is recommendation?
A diabetic cat is always diabetic, even in remission, which means she will need the low carb, canned diet for the rest of her life to keep the diabetes from recurring down the road. It would be easiest to get rid of the dry for both of your cats and just feed them the same low carb, canned diet! Cats (and diabetic cats especially) do well with smaller, frequent meals. I feed both my cats (Bandit is a diabetic in remission, Orpheus is a young, healthy cat) the same food, and they eat 4x a day (every 6 hours). When I am not home to feed them, or if I am in bed at their late meal time, I freeze portions of their food and I have two auto feeders that I set to release the canned food. If your cats aren't food crazy like mine, you can just freeze portions of canned and leave them out for the cats to eat when they thaw. Mine will both sit and gnaw at the frozen meatsicle, so I have to use the feeders. When I'm traveling, I usually have someone come over twice a day to feed and then they set the feeders for then next meal, but there have been times when that wasn't possible and I've used icepacks and set the feeders with 3 meals (for the whole day).
