How long before I go in for a curve?

[EmilyH]

It's been a sad week in our house. My Cosmo was diagnosed with diabetes in December and started insulin in January. His brother, Lockwood, was diagnosed with Kidney disease (or kidney problems) in April, and after a long battle including daily subcutaneous fluids, lots of meds, etc., we lost him on Monday night. The grief is tangible.

But that means that I get to focus on Cosmo now. Lockwood had been on RX Urinary Tract food, then switched to Kidney food, then G/D (Geriatric?) when he wouldn't eat the K/D. I'm going to go shopping this week for food for Cosmo, and though I know it's not the best for him, finances are tight and so I'm going to have to alternate the leftover G/D with new diabetic friendly food. Best I can do right now.

Once he gets fully on food for HIM, how long should I wait before I go in for a curve? I've severely neglected his health (and my own) while caring for his brother and we've committed to taking care of each other now. I don't test at home right now because... well, I just can't at the moment.

Thanks, everyone.

 

[JanetNJ]

It's been a sad week in our house. My Cosmo was diagnosed with diabetes in December and started insulin in January. His brother, Lockwood, was diagnosed with Kidney disease (or kidney problems) in April, and after a long battle including daily subcutaneous fluids, lots of meds, etc., we lost him on Monday night. The grief is tangible.

But that means that I get to focus on Cosmo now. Lockwood had been on RX Urinary Tract food, then switched to Kidney food, then G/D (Geriatric?) when he wouldn't eat the K/D. I'm going to go shopping this week for food for Cosmo, and though I know it's not the best for him, finances are tight and so I'm going to have to alternate the leftover G/D with new diabetic friendly food. Best I can do right now.

Once he gets fully on food for HIM, how long should I wait before I go in for a curve? I've severely neglected his health (and my own) while caring for his brother and we've committed to taking care of each other now. I don't test at home right now because... well, I just can't at the moment.

Thanks, everyone.

so so sorry for the loss of your Lockwood. It really is so hard to say goodbye.

Is the leftover food you have dry or wet?

The good news is, the food that is best for Cosmo is inexpensive. Most of us feed Fancy Feast Classic or Friskies Pate.

What kind of insulin and what dose is he on?

When you start testing at home you will no longer have the vet expensive of curves at the vet's office. When you are ready to take that step we can help you with that.

 

[EmilyH]

Thank you... It's been so hard and we miss him so much.

The leftover food is both dry and wet, though I've only used the dry sparingly, since it's not great for either of them.
He's on the Novalog 2.5 units twice a day.

He doesn't ever ACT like there's a problem. EVER. Diagnosis only happened because he had a sore that refused to heal. I'm really excited about going shopping for the food, honestly. Lockwood was.... a very expensive cat. lol

 

[Julia & Bandit (GA)]

Hi Emily!

G/D is really bad for diabetes--it's 33% carbs (diabetic cats need less than 10% carbs). You should be able to take the cans back to the vet for a refund--Hills prescription is guaranteed for returns.

There's a lot of really inexpensive, diabetic safe foods you can feed--just take a look at this chart, and pick anything under 10% carbs: http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf. You'll find that even the premium foods will be far less expensive than what you were paying for the prescription diets.

I know you seem resistant to home testing, but it is the best way to help Cosmo and yourself--you don't need to take him into the vet for a curve if you can test him yourself (saving you a ton of money), and it's cheaper and more accurate than curves done at the vet because stress raises blood sugar and that leads to inaccurate dosing--that's why home testing is super important and strongly recommended. Home testing seems scary and hard, but it's really easy once you and your cat get used to it! And there's so many tips and tricks here that can help you learn as painlessly as possible. Many people are afraid that it hurts their cats--but cats have fewer nerve endings in their ears than people do in their fingertips. If you approach him calm and confident, he'll let you do it with no problem. Even the most ornery of cats come around with diabetic safe treats after each test--Bandit was terrible the first few weeks we tested (mostly because I was nervous and freaking out), but now he comes running when he hears the glucose meter beep on, plops down right in front of me and purrs through the whole test. That is the power of treats!

 

[JanetNJ]

Thank you... It's been so hard and we miss him so much.

The leftover food is both dry and wet, though I've only used the dry sparingly, since it's not great for either of them.
He's on the Novalog 2.5 units twice a day.

He doesn't ever ACT like there's a problem. EVER. Diagnosis only happened because he had a sore that refused to heal. I'm really excited about going shopping for the food, honestly. Lockwood was.... a very expensive cat. lol

as you move to lower carb food you may want to reduce the dose, esp. since you aren't monitoring at home. I would save a few cans of wet in case you need to steer up if he should go too low. the g/d dry is about 41% carbs... noooooo good to feed on a regular basis, but you could use it for steering. It's important to have higher carb foods/honey on hand for such occasions. YOu could try returning it.

If you want to see how I home test my cat CC I have a video in my signature.

Speaking of signatures, if you set one up it will help people know some info without asking the same questions repeatedly. Click on your screen name in the upper right and go to signature. add info like your cat's name, date diagnosed, type of insulin, food he's on, and any other information you'd like to share.

 

[EmilyH]

G/D is really bad for diabetes--it's 33% carbs (diabetic cats need less than 10% carbs). You should be able to take the cans back to the vet for a refund--Hills prescription is guaranteed for returns.

I know you seem resistant to home testing...

Unfortunately, I bought it online and to send it back I have to ship it back. I have one full case left, plus some, so I'm going to see about shipping back that one case. Praying it's not too expensive.

And I'm not resistant to home testing in general. I actually really wanted to do it when starting to read up on here! My vet was hesitant, actually. She wanted to see something that showed a scientific comparison of the readings between the human meters and the feline numbers. I was going to come here and search for it, and then... Lockwood happened. I ended up doing sub-q fluids every night with him, worrying about him... I ended up with stress hives that are starting to go away now that he's passed. My resistance is simply needing a few days/weeks of simply... breathing. Letting Cosmo and I adjust. Be sad. And then move forward. Thank you!! He loves his treats - so I think he'll be easy to train. hahaha

 

[Julia & Bandit (GA)]

He's on the Novalog 2.5 units twice a day.

Did your vet prescribe the Novalog at diagnosis back in December? That's a very fast-acting insulin that isn't typically used on its own in cats--it has a rapid onset and a very short duration. Cats have metabolisms that are twice as fast as people, so they need long-acting insulins like Lantus, Levemir, or Prozinc. Lantus and Levemir are pricy in the US, but pretty affordable if you order from Canada with a script from your vet.

 

[EmilyH]

as you move to lower carb food you may want to reduce the dose, esp. since you aren't monitoring at home. I would save a few cans of wet in case you need to steer up if he should go too low. the g/d dry is about 41% carbs... noooooo good to feed on a regular basis, but you could use it for steering. It's important to have higher carb foods/honey on hand for such occasions. YOu could try returning it.

Brilliant. I'll save some of this stuff for my boy. This is why I need you all. lol

 

[Julia & Bandit (GA)]

Unfortunately, I bought it online and to send it back I have to ship it back. I have one full case left, plus some, so I'm going to see about shipping back that one case. Praying it's not too expensive.

And I'm not resistant to home testing in general. I actually really wanted to do it when starting to read up on here! My vet was hesitant, actually. She wanted to see something that showed a scientific comparison of the readings between the human meters and the feline numbers. I was going to come here and search for it, and then... Lockwood happened. I ended up doing sub-q fluids every night with him, worrying about him... I ended up with stress hives that are starting to go away now that he's passed. My resistance is simply needing a few days/weeks of simply... breathing. Letting Cosmo and I adjust. Be sad. And then move forward. Thank you!! He loves his treats - so I think he'll be easy to train. hahaha

Unfortunately, many people find that their vets don't know as much about feline diabetes as we would like. If vet resistance is the problem, that's an easy one to fix! I have plenty of research for you to bring to your vet to support the home testing, insulin choice, and diet recommended here at FDMB. Give me a few minutes to gather everything together and I'll post them here for you. It's going to be a lot of information, so please digest at your own pace--I don't want to overwhelm you with everything going on right now!

Most vets who get treatment wrong are not bad vets, just ill-informed. They have to learn a lot about many diseases in many different animals, and the treatments for FD have dramatically changed in the past 7-8 years or so. However, if you bring the information to her and she's still resistant to the current recommended treatments--it may be time to find a new vet.

 

[EmilyH]

Did your vet prescribe the Novalog at diagnosis back in December? That's a very fast-acting insulin that isn't typically used on its own in cats--it has a rapid onset and a very short duration. Cats have metabolisms that are twice as fast as people, so they need long-acting insulins like Lantus, Levemir, or Prozinc. Lantus and Levemir are pricy in the US, but pretty affordable if you order from Canada with a script from your vet.

Yes, that's the one from Walmart, right? I think I need to get a new script from the vet for Canadian pharmacies. I'm staying on everything we have right now, but I want to give Cosmo the best care at the best price. Lockwood's care wiped me out.

 

[JanetNJ]

Unfortunately, I bought it online and to send it back I have to ship it back. I have one full case left, plus some, so I'm going to see about shipping back that one case. Praying it's not too expensive.

And I'm not resistant to home testing in general. I actually really wanted to do it when starting to read up on here! My vet was hesitant, actually. She wanted to see something that showed a scientific comparison of the readings between the human meters and the feline numbers. I was going to come here and search for it, and then... Lockwood happened. I ended up doing sub-q fluids every night with him, worrying about him... I ended up with stress hives that are starting to go away now that he's passed. My resistance is simply needing a few days/weeks of simply... breathing. Letting Cosmo and I adjust. Be sad. And then move forward. Thank you!! He loves his treats - so I think he'll be easy to train. hahaha

I totally get just needing a break and time to grieve. when you're ready to start testing we an help you.

 

[Julia & Bandit (GA)]

Here you go @EmilyH !

American Animal Hospital Association Diabetes Guidelines

See p. 218 (4):

"Home monitoring of BG is ideal and strongly encouraged to obtain the most accurate interpretation of glucose relative to clinical signs. 34 Most owners are able to learn to do this with a little encouragement, and interpretation of glucose results is much easier for the clinician."

"The insulin preparations with the appropriate duration of action in most diabetic cats are glargine [Lantus] (U-100) or the veterinary-approved human protamine zinc insulin [Prozinc] (PZI U- 40). 31 This panel does not recommend the veterinary-approved porcine zinc (lente) [Vetsulin/Caninsulin] insulin suspension as the initial treatment for the cat, because its duration of action is short and control of clinical signs is poor. This insulin should be reserved for cats in which other insulin choices have not yielded satisfactory results."

Levemir has similar duration of action to Lantus, and Novolin/Humulin a similar duration of action to Vetsulin.

Attached to this message are some more articles to print and bring to her. The first two are specifically about the benefits of home monitoring to both the owner and vet, Management of diabetic cats also talks about home testing, insulin choice, diet, and dosing regimen to realistically reach remission in cats. The last article directly compares Humulin/Novolin (isophane) to Lantus and shows that Lantus provides much better control over BG.

 

[Julia & Bandit (GA)]

Yes, that's the one from Walmart, right? I think I need to get a new script from the vet for Canadian pharmacies. I'm staying on everything we have right now, but I want to give Cosmo the best care at the best price. Lockwood's care wiped me out.

Could it be Novolin (isophane) insulin? That one is sometimes used in cats (it's not recommended because it also has a rapid onset and short duration, but it's not as fast acting as Novolog) but prescribing Novolog (insulin aspart) alone would be really unusual and definitely not recommended. If your vet prescribed Novolog, I'd tell you to find a new vet for sure, because that would be just crazy wrong. If it's Novolin, you can work on educating her-that insulin was commonly prescribed several years ago, but there's much better ones for cats now.

 

[Julia & Bandit (GA)]

Oops, looks like there's an attachment limit of 3--here's that Lantus/Humulin(Novolin) comparison.

 

[EmilyH]

Could it be Novolin (isophane) insulin? That one is sometimes used in cats (it's not recommended because it also has a rapid onset and short duration, but it's not as fast acting as Novolog) but prescribing Novolog (insulin aspart) alone would be really unusual and definitely not recommended. If your vet prescribed Novolog, I'd tell you to find a new vet for sure, because that would be just crazy wrong. If it's Novolin, you can work on educating her-that insulin was commonly prescribed several years ago, but there's much better ones for cats now.

Novolin. Sigh. Yes. Have I mentioned it's been a long week? Long... year? LOL

 

[EmilyH]

@Julia & Bandit - THANK YOU. I'm going to take some time looking at all of this and sharing with my vet. She's fabulous and has tried to save me money/time/effort through this process, and was... amazing with Lockwood's passing. I appreciate EVERYTHING and so does Cosmo!

 

[Julia & Bandit (GA)]

Novolin. Sigh. Yes. Have I mentioned it's been a long week? Long... year? LOL

Oh, trust me, I hear you! Diabetes is the least of what I currently have to deal with Bandit--he developed autoimmune disease in 2015 and heart disease this past December. Some days I feel like I'm barely keeping my head above water caring for him. You should see the stack of meds I have to give him twice a day. He used to be really hard to pill--we got over that REAL fast with all the heart meds in play.

I find that a glass of wine works best some nights.

 

[Julia & Bandit (GA)]

One thing that's important to remember with diabetes that's not like heart disease or kidney disease...with the right treatment (food, insulin, home testing) diabetics can go into remission and live perfectly normal, healthy lives. There is a light at the end of that tunnel.

 

[EmilyH]

One thing that's important to remember with diabetes that's not like heart disease or kidney disease...with the right treatment (food, insulin, home testing) diabetics can go into remission and live perfectly normal, healthy lives. There is a light at the end of that tunnel.

And now that we're a one kitty home and it's all about Cosmo... we're going to try for this. lol

 

[Julia & Bandit (GA)]

@Julia & Bandit - THANK YOU. I'm going to take some time looking at all of this and sharing with my vet. She's fabulous and has tried to save me money/time/effort through this process, and was... amazing with Lockwood's passing. I appreciate EVERYTHING and so does Cosmo!

Just one more thing I forgot to say... While some of those articles say that a pet meter is preferred, the strips are expensive and it's more important that you can afford to test as frequently as you need to get his diabetes under control. Human meters work just fine. Dosing Protocols are written for both types.