So Many questions

[Terra & Ozzie]

Good morning - my baby was just diagnosed on Monday 9/25 and I started ProZinc last night. I have a million questions and after reading a bunch of posts here this morning I feel even more overwhelmed (and honestly a little upset with my vet). I'm sure I will have tons more as I move forward but my brain is on overload this morning. So here goes nothing (questions in italics).


HISTORY:
Ozzie was born a stray 9 years ago under my neighbors wood pile. We fed his momma and eventually she brought him around as well. After many MANY weeks of talking to him while he ate I was finally able to catch him and bring him inside HOWEVER once he was neutered and utd on shots he was always an inside/outside cat. 2 years ago we moved from the country to the city where he went from coming and going as he pleased through a doggie door to a full time inside cat. It was a very rough first few months. In that two years, he has gained 4-5 pounds 12/13 lbs up to 17 back to 14.9 now


NUMBERS & VET:
On Monday, his BG was 401 and yesterday when we went back to the vet they took both a blood sample as well as a urine sample and his number was 376. Very few ketones which my vet said means we are catching it early?
- I see a lot of the other threads talk about testing and monitoring levels. My vet said NOTHING about this. They told me to start the shots and come back in 2 weeks to get a “curve”? and we would adjust his insulin as needed? Should I go see a different vet and get an additional opinion?
- I was told his insulin has to be given at the same time each day, 12 hours apart. Is there any wiggle room in this? I live in Atlanta and a 3 hour commute is always a possibility unfortunately. Is there an acceptable time frame?
- Do you all buy your supplies from the vet or order online? My vets cost appears to be quite a bit higher after quickly comparing to Drs Foster and Smith.


FOOD:
He has had free access to Dry food-Purina One, Tender Selects Salmon as well as 1/2 can of Fancy Feast wet food morning and night (misc flavors but usually something with gravy as he doesn’t eat the food just licks it to death).
- I know now that dry food is bad, and apparently gravy is bad. So how do you get a SUPER finicky cat to eat to maintain is levels when he doesn’t want to eat?
- I have read some suggestions to give them boiled chicken or something similar to entice them into eating. Recommended or no?
- In addition, my vet stated he MUST eat when he takes his insulin. The only way I know to MAKE this happen is to restrict his food intake so he is hungry at that time but everything I read says it is possibly better to make sure they eat multiple times per day to try to keep their levels balanced. I am gone, with commute for 12 hours a day, should I get an automatic feeder for use throughout the day?

EXERCISE:
He hates it. He has tons of toys and a laser pointer and a dog best friend who he snuggles with but won’t play with.
- Suggestions for cat toys that may engage him? How can I get him to lose weight if all he wants to do is sleep and look out the window at the freedom he no longer has?

SELFISH:
- Do any of you go on vacation? Ever? I feel like I’m never going to be able to trust him with anybody else. What happens if I’m gone and the sitter misses a dose? I have a weekend trip scheduled in October and I feel like I need to cancel.
- Is remission real? With proper diet and weight loss can this actually happen or is it insulin forever?

Thank you

 

[Yong & Maury GA]

Oh Terra! I have to get going to work so I can throw my answer to question 1 and 2. and 3
1. Home testing, we would ask those Vets who don't say anything about home testing, "would they blindly administer insulin to a human child without testing each time?" . We think no different for our fur babies. If you test at home, 1. Results are more accurate since Ozzie will be at home, 2. Less money than a clinic curve.
2. The wonderful thing about Prozinc is that it's an in-and-out insulin, meaning after 12 hours, it should be completely out of his system so you have up to an hour of flexibility with shot times. Obviously, 12 hours apart is ideal but with a long commute, you can use this grace period. Can emphasize later
3. Many buy supplies from ADW Diabetes if you're in the states.

Will gladly chime in for the rest later if you'd like

 

[FurBabiesMama]

A lot of vets do not mention (or worse, recommend against) home glucose testing. A lot of vets also know very little about feline diabetes and nutrition. I started educating myself as soon as I got Mia's diagnosis and quickly started to see that I had been given some bad info. It took me three vets to get to one that has enough knowledge/experience that what he says actually matches up with what I have learned for myself. I went through so much frustration and even anger. The time I needed to be able to trust the vet the most, they totally let me down and even misled me.

Lesson #1 for me was the food. I had ALWAYS fed dry food (mine was Purina One, the hairball formula). Catinfo.org, and other sources, make it quite clear that that is not a good idea. (This also made me angry.. why don't we all know this BEFORE our cats get diabetes?!) I had to go through several kinds of low-carb wet foods to find anything that my cats would eat. (The cat food database is so helpful for finding foods to try.) I jumped through all kinds of hoops to entice them. I bought Young Again Zero Mature dry food (which, thank goodness, they liked) and fed that to them during the transition. I added a little to the top of their wet food. I also tried adding a little shredded chicken breast. Eventually, I ended up with Fancy Feast Classic Chicken Feast. They will actually eat that, consistently. I make chicken breast and bone broth for them as treats, and they love it when I add a little to their wet food, but you do not want to do something like that as the primary food since it would not have all the nutrients needed.

Lesson #2 was the importance of home testing. How can you manage glucose levels if you do not know what they are?? Getting started with testing was a little rough, but it got easier pretty quickly. I felt much less anxious once I was able to know what was going on with Mia. Before home testing, I was flying blind and hated it.

I suggest reading the AAHA diabetes management guidelines. Not only do they contain useful info, but they are from a reputable source, so you can quote facts from them to your vet if something he/she tells you conflicts with something there. They recommend feeding your cat four times a day, using an auto-feeder if needed (which it clearly would be with your schedule.. and the fact you have to sleep). They also recommend home glucose monitoring.

If you are home testing, you want to take up any remaining food two hours before shot time (some people have their auto-feeder turn to an empty section at this time so they do not have to be there to take up food). This is so that your pre-shot test results will not be impacted by food. This also helps to make sure they are hungry at shot time since they do need to eat some before getting the shot.

I have read that, with ProZinc, there is a little wiggle room on shot time... it should be as close to the scheduled time as possible, but I think within an hour is supposed to be okay.
I do not buy any supplies from the vet. I have gotten syringes from ADW Diabetes, testing strips from Amazon (I use a pet meter, so you cannot get them in stores), insulin from 1800PetMeds and lancets at a drug or grocery store. You can shop around and get them wherever you want as long as you are getting the right things.
As far as play, my cats have never been big at playing, but the key is that I am involved in their play. In other words, having a bunch of toys does not make them play. If you can schedule a few minutes before and/or after work each day to play with him, maybe he will cooperate.. at least some of the time. My girls have a simple mouse toy with twine for a tail and ears, and I move/throw it around until they get interested. They start trying to get it and bite it. I can even tell how Mia's is feeling by how much energy she has for play.
I have not been on vacation yet. I always take a trip in the fall, but I cancelled this year. I do not feel comfortable leaving Mia until she is regulated (she is proving difficult to regulate, but Ozzie may not be). I still hold out hope that she will go into remission at some point (YES, it is real! Several people here have cats in remission), but I at least need her regulated before I consider leaving her. When I do, I am not sure yet who I will get to take care of her. In the past, my sister always came by each day to take care of my cats when I was gone, but she says she can't give shots.. also, I do not think her schedule will allow her to be here two times each day. I will deal with that when the time comes. I know some people here mention having vet techs come by and take care of their cats.

I hope I helped with at least some of your questions. It is overwhelming at first, but it WILL get better.

 

[Terra & Ozzie]

Thank you both and Yong I will take all the advice you have!!

I called around to a number of additional vets in my area and asked if they had a vet who had familiarity with diabetic cats until I found one, I made an appointment for tomorrow afternoon. I have been with my vet for about 15 years but this is not the time to worry about upsetting him for second guessing him. If he's a good vet he will respect my concerns and if not, I'm glad I'm reaching out to someone else. I need to do whatever I can to make sure my boy is with me for as many years as possible.

 

[Noah & me (GA)]

"and honestly a little upset with my vet"
This is typical. Your vet may think you're too squeamish, uneducated, reluctant about a bunch of things. You'll have to prove you can do many of these simple procedures at home and demonstrate the confidence needed.
- I see a lot of the other threads talk about testing and monitoring levels. My vet said NOTHING about this. That's wrong! We all use meters to test at least twice daily to monitor our cats bsg, blood sugar level. Some vets think meters aren't necessary. The standard reply is "If that was your child would you just pump insulin into him?"
- They told me to start the shots and come back in 2 weeks to get a “curve”? and we would adjust his insulin as needed? A curve is using your meter and getting a bsg every 2 hours over the 12 hour period between shots to see how low his numbers get. The lowest number is called the nadir.
-Should I go see a different vet and get an additional opinion? No if your cat is diabetic. Yes if he treats you like a moron and overcharges you. Curves can be done at home.
- I was told his insulin has to be given at the same time each day, 12 hours apart. Is there any wiggle room in this? I live in Atlanta and a 3 hour commute is always a possibility unfortunately. Is there an acceptable time frame? This is my opinion only. Life interferes with everything, flat tires, children, your job. You can go outside the lines but be very aware of how his numbers correlate. One example; I've had to give Noah his AM shot more than an hour prior to schedule. I take into account his number will be a bit lower than in an hour AND if I'll be gone for more than 12 hours do I want to up his dose by something minimal like 5%.
- Do you all buy your supplies from the vet or order online? My vets cost appears to be quite a bit higher after quickly comparing to Drs Foster and Smith.
Other members will chime in on this. I get my insulin from my vet and everything else from drugstores. Prices can vary wildly.
FOOD:
- In addition, my vet stated he MUST eat when he takes his insulin. He must NOT eat 2 hours prior to his shot, then say a little prayer and hope he does eat.
EXERCISE: Cats were never meant to lay on your bed all day, they're hunters. In 40 years I've never seen a fat cat lose weight. However, some cats can be walked with a harness and some people have ramps and tunnels etc. to keep up their interest in mobility.
SELFISH:
- Do any of you go on vacation? Ever? NO NO NO, not ever.
- I feel like I’m never going to be able to trust him with anybody else. Noah is too terrified to look out the window. He's been diabetic for 3 years and next year we have to do some morbid family thing. Noah will HAVE to be boarded at our vet. If someone comes to the door he's gone to the basement for hours.
What happens if I’m gone and the sitter misses a dose? Cats miss their dose infrequently. It's called a "fur shot" when you "make a tent" and the insulin squirts right out the other side. I've even seen vets do this with vaccinations! Whatever you do DO NOT double his next shot. You knew that already, right?
- Is remission real? Someone always wins the lottery right? It does happen with some cats.
EXERCISE: This is what we want and another member owns. They're as expensive (big) as you want them to be.
Obviously I left some points out. Don't panic, it's not that hard. Noah is our second sugar cat and one member here had either 5 or 7 at one time.

Thank you

 

[Terra & Ozzie]

Thank you Noah - a ton of helpful stuff!

Oh my gosh - 5 or 7...I can't even imagine. But I guess its all about what you know. Once you have a routine and are in it, I suppose it becomes second nature.

As to your other points:
- my vet...lets just say I have felt like I needed to change for some time but this has confirmed it. They did not tell me not to double up the dosage if I mess up but I read it online so I made a giant red flashing mental note.

- Honestly, should I take a week of vacation until he gets balanced out? how long after they eat do you test? I leave the house at 5 am and until now - don't usually get home until 6-6:30 but I told my boss my hours are going to have to change to get me home no later than 5-5:30. If I get home at 5, test him, I'm going to always be late with his injection

- automatic feeder set up to rotate to empty no later than 2:30 so he has 2+ hours with no food before testing

- Exercise - I actually built one of these fancy little cat habitats when we moved. He hates it and hates being trapped in it, went in it only once sadly. He will play with toys as long as I do all the work and he can just roll around on his lazy back and chew on them. He won't chase them or pounce them.

I think I'm to take stock in brown paper bags to breathe into for hyperventilating purposes....

 

[FurBabiesMama]

- Honestly, should I take a week of vacation until he gets balanced out? how long after they eat do you test? I leave the house at 5 am and until now - don't usually get home until 6-6:30 but I told my boss my hours are going to have to change to get me home no later than 5-5:30. If I get home at 5, test him, I'm going to always be late with his injection

It will probably take longer than a week. If you think taking off a week will help you get your head around this and give you time to get used to testing, etc., go for it, but at the end of that, you will still have to work out a schedule that works long-term with your job.
Maybe having to change your hours at work would not be such a bad thing. Those hours sound gross.
If you leave at 5am and can get home by 5pm, you should be fine. You can test, feed and give shot right before you leave and as soon as you get home. You just need to make sure he has eaten some before the shot (not the whole meal). You want to test BEFORE he eats.

 

[Noah & me (GA)]

Yikes! That was a real mouthful on my part. Let me see if I can condense that a bit.
It looks like you're already over the "it's the end of the world" phase which was why I skipped past hand-holding straight into the real world. Our first diabetic cat was Nigel, Noah's brother, and we were both completely freaked out. We were handed a set of rules to follow, some very sharp and pointy things, new food for a fussy cat and focused everything on a cat who was otherwise pretty healthy and sometimes just needed a moment to himself. When he started losing a lot of weight our wise vet changed all the rules. That can be an issue here. I typed too fast once and moved a decimal point and it was another member who potentially saved a cat's life because of my haste. The rules will eventually become guidelines for you but they are there for a reason. On the other hand, N2C, no two cats are the same. You will see "Do not copy dosing" a lot in people's signatures. For their cat, like Noah, no two days are ever the same. Noah is a high-dose "bouncer" with some other serious medical issues so all my energy is focused on keeping him stable. That's why I would never suggest a dose or anything medically specific. I didn't mean to imply the 12-12 cycle is a conspiracy and your vet is an alien. As strange or impossible as it may sound now poking holes in your cat and picking through his poo will get easier. Remember we have a lot of members here in many time zones so there is always someone here to at least make a suggestion. The most important thing? There is no such thing as a stupid question. I feel better now, how about you?

 

[Elinor & Sibon]

HI Terra, I'm no expert, my boy was diagnosed 2.5 months ago but I could relate to your question regarding vacation.
September is the holiday season in Israel and his diabetes put me in such a shock with all of the information I had to learn that I decided to put Sibon first for the time being.
If you look at my spreadsheet, you'd see his glucose levels were high for the majority of the time (some people here had higher levels, but still), but now he's finally starting to drop, and it came out of nowhere.
I'm finally considering a vacation in April if everything goes smoothly.

 

[Noah & me (GA)]

Still thinking about a vacation Terra?

 

[Tracey&Jones (GA)]

I went to Indonesia for 3 weeks about 5 months in. I didn't want to go at first but enjoyed my time away. I got a cat sitter for the testing and injections, DH an DS took care of everything else. Was it always to MY standards? Probably not. Did the job get done? Yes. Was the cat fine? Yes. Did I come back rested? Yes.

It worked out ok. We came up with a dose before I went and for the most part when it was kept to that, things worked out. He did great.
And as a side note...you can't take care of kitty if you are running on empty. Make sure to take care of yourself too.