New to this forum and have a few questions

[Fiona1]

Hi, I am new to this forum upon finding out that my cat has diabetes.

Tinkerbell is a 10 years old indoor cat. She was eating half a pouch of Sheba in the morning (she wouldn't take to any other pouches) and Royal Canin biscuits the rest of the time (which I was under the impression were good for her until I began researching).

She dry heaved a few times so I took her to the vets. He thought it was an allergy as I told him that she had had some new treats. He gave her a steroid and antibiotic. He then said to bring her back two days later. As a precaution he gave her another steroid and antibiotic. After this she became lethargic and wasn't eating or moving much. She went back to the vets where she had another steroid and antibiotic. The next day was a Sunday and my normal vets was closed so I took her to an out of hours emergency vets where she stayed in. They phoned me to say she has ketoacidosis and diabetes. I collected her the next morning and took her back to my normal vet. She has been there since. She is now over the ketoacidosis but they are now stabilising her blood sugar levels, so she is staying there for the moment

I have begun researching online and this is what I have read so far, which you may or may not agree with:
*Cats with diabetes should eat wet food only.
*The wet food should be 7% or lower in carbohydrates.
*Vets will try to push Hills/Royal Canin but these are not good for cats with diabetes.
*If you go for a low carbohydrate diet, you need to be available to home test blood sugar levels.
*Steroids can induce diabetes sometimes. If this is the case, remission is more likely.

Please help me with a few questions I have:
*If I am not going to go along with the food the vet will most likely suggest (Hills/Royal Canin), would I be out of the house for too long to be able to home test? I currently work shifts. It will be anything from 8-4 to 12-8. My boyfriend is home from work around 3.30pm on weekdays so would be available to home test. For example, on my earliest day that I start at 8am, I leave at 7.15am and my boyfriend gets home at 3.20-3.30pm. I only do this shift once per week.
*I have 2 cats. The other cat is 2 years old and is also an indoors cat. Should I be looking to get her onto a low carbohydrate diet too? I read this is healthier but I don't want to risk her health. I should be able to separate them for eating, which would not be a problem.
*Given that they are both indoors cats, would it be worth potentially buying a cat wheel/treadmill for them to go on?
*Would switching to a raw diet be beneficial for a cat with diabetes?
*Which are the best UK brands of cat foods for cats with diabetes?
*Is it worth buying a pet feeder for when I am out, so they can eat little and often? Unfortunately I wouldn't be able to separate the 2 cats for this.
*Is it worth phoning round vets to see if they agree with a non Hills/Royal Canin diet? Are there any that would agree or is it not worth it?

I am currently going to start reading up on this thread. http://www.felinediabetes.com/FDMB/threads/feline-diabetes-faq-newcomers-start-here.2502/

 

[Diana&Tom]

Hi again Fiona, glad you found your way here. You're asking all the right questions and I'm going to leave others to respond now as I have to run... and I will also tag @Elizabeth and Bertie who is our UK food guru, and @Monica Lewis who is another UKer and has done a great job of getting to grips with FD and treating her cat... she has a good way of explaining things!

Will look in again later.

Diana

 

[Sylvie]

have 10 cats, only ones that ride the cat wheel pretty much every day are the two youngest who were 5-6mth old kittens when i bought it but, it has to apparently be in a spot where we walk by a lot (kitchen to living room area) for every time i moved it to a less crowded area, they ignore it 90% of the time!! the others from 3yrs & up will not use it at all and i can only get 2 of them to use it for like a minute when i use a toy to entice them. that's not to say that if you have active cats and time to constantly entice them to use it the first few weeks that they won't take to it though. for my older ones, i get better results making them active with a stationary laser toy that goes back & forth in room in a slightly slow mode (not the ones with laser that goes in a circle though, they just sit there and watch that one).

-looking at your schedule, i would make injection times somewhere around 6-7am & 6-7pm. you test BG, feed & give injection at 6-7 and boyfriend could do the same at 6-7pm so that should work for you.
-yes switch both cats to same low carb foods, most of us do.
-raw food is very good for diabetic & non-diabetic cats but, be sure to add needed supplements.
-don't know live in US but, think there is a link somewhere on here for UK foods, someone UK based should share it when they see your thread.
-pet feeder for when working, yes good idea if not leaving out extra low/zero carb dry. i personally would set it to open for around +4 after injections when most cats BG's start going low but, that also depends on insulin you will be using. if not going to be able to test BG often, you should consider a long lasting insulin instead of a short acting one i think.
-my guess is if you phone around, most vets would agree with a prescription diet, its what they know! but, low carb wet foods like canned fancy feast pates and even low carb dry foods like young again zero/wysong espigen 90/dr. elsey clean protein if you have to use dry, is better than the prescription ones most time!

 

[tiffmaxee]

Which insulin are you using? It does sound like the steroid shot brought on diabetes.

 

[Fiona1]

Thanks for the reply Sylvie. I will definitely have a look into the laser toy.

Thanks for the reply also tiffmaxee. I'm not sure which insulin is being used. She has been at my vets since yesterday. He is due to call me shortly or in the morning so I will ask this and post it on here. The veterinary nurse said her levels are currently not stabilising. Is this normal? Could it ever be that a cats levels won't ever stabilise?

 

[Kris & Teasel]

Thanks for the reply Sylvie. I will definitely have a look into the laser toy.

Thanks for the reply also tiffmaxee. I'm not sure which insulin is being used. She has been at my vets since yesterday. He is due to call me shortly or in the morning so I will ask this and post it on here. The veterinary nurse said her levels are currently not stabilising. Is this normal? Could it ever be that a cats levels won't ever stabilise?

It can be difficult to get the levels stabilized with a bout of ketoacidosis because of the body wide biochemical imbalances that happen. It doesn't mean that her BG won't be stabilized later on after she's recovered and has been on insulin a while. The best place for her right now is at the clinic.

 

[Fiona1]

The vet phoned and i asked which insulin she is having and he said caninsulin.

 

[Diana&Tom]

The vet phoned and i asked which insulin she is having and he said caninsulin.

Yes it would be Caninsulin. There's a recently updated Beginner's Guide that would be useful reading for you to read... sorry I can't do links but it's near the top of the Caninsulin/Vetsulin forum on this board.

You asked about food yesterday too - there is a UK food list that @Elizabeth and Bertie put together, a very comprehensive list, but generally, you want to feed wet food in jelly (not gravy, which has sugars) - supermarket brands such as Whiskas and Felix are ok, or for higher protein content try HiLife or Sainsbury's Delicious or Natures Menu. There are many others, some available only online from companies such as Zooplus. Poultry varieties are usually a good bet - some cats are allergic to beef, and too much fish isn't recommended either. But when you start giving insulin you may want to have a selection of foods to offer - it's vital that the kitty eats so if she goes off one food or loses her appetite, you may have to try another.

Best of luck!

 

[tiffmaxee]

That’s good that you know which insulin. Can you add a signature and put it in there so you don’t get asked over and over. I used lantus so don’t have knowledge to help you as it works differently. I hope she comes home soon.

 

[Fiona1]

Hi Diana, thanks for the reply. I did notice Natures Menu and thought this would be a good one. Thanks, I will check that list out.

Thanks tiffmaxee, hope this is updated now.

My cat is still in the vets. She went into the emergency vets on Sunday and she has been at my normal vets since Monday. Is there anything, other than food, that I should be buying in preparation for when she gets home? Will vets usually sell a home testing kit? I'm out of my mind with worry at the moment.

 

[Diana&Tom]

Hi Diana, thanks for the reply. I did notice Natures Menu and thought this would be a good one. Thanks, I will check that list out.

Thanks tiffmaxee, hope this is updated now.

My cat is still in the vets. She went into the emergency vets on Sunday and she has been at my normal vets since Monday. Is there anything, other than food, that I should be buying in preparation for when she gets home? Will vets usually sell a home testing kit? I'm out of my mind with worry at the moment.

Natures Menu is a good choice, Fiona. Try looking at www.fetch.co.uk for some good prices. They do a "variety box" that you could try as a starting point, both in the standard NM range and the slightly dearer Country Hunter range. Bear in mind that a new food may not be to a fussy kitty's liking at first but it is worth persevering.

As for vets selling a testing kit - that's rather unlikely, sadly. Many vets are just not very clued-up on FD and don't really want you to test your cat's bg at home - completely disregarding the possibility of insulin overdose. It is vital to test bg before giving each insulin shot to know that the "number" is a safe number to shoot. You will become familiar with this and lots of other stuff as you go along and read as much as you can here.

We all understand how hugely worrying this is at first. It's completely unknown territory to most of us. But after a matter of days you'll see the logic of everything we say here for yourself, and you can post as often as you like and there will always be people ready to help. For specific queries, start a new thread with an appropriate title.

So ok as for meters - there are several available in the UK which members here use successfully. The key is to buy one with test strips that don't cost the earth - the strips will be your main outgoing as you go forward. There have been several threads recently from newbies asking about meters - if you do a search for "UK meters" or similar you should find the discussions on those meters and decide which one might suit you best. And btw - if you have pet insurance, the policy should cover things like strips... worth investigating.

ETA I've searched for threads re meters in the UK and can't find them... I do recall though that one is called Accu-Check Performa Nano, another is the Code-free and another is the One Touch Ultra. If you search for those names in the search box here you should find more info.

Keep asking questions - we really do know what this is like.

Diana

 

[Monica & Josie]

Hello and welcome Fiona and Tinkerbell

I think most of your questions will be answered by trial and error such as which food, shooting time and feeding schedule.. etc.
Vets will always recommend you prescription food cos they have to but if you look at the ingredients list you will see the 'red flag' ingredients that diabetic kitties should stay clear from.
Just tell your vet you would like to try out something else that's highly recommended by diabetic cat owners.
Fairly popular Supermarket choice is Sheba Fine Flakes in Jelly due to high meat low carb content. You didn't mention which type of Sheba you're feeding her currently..
My cat liked it very much until she got pancreatitis and we had to go through yet another round of trials until happily settled for Nature's Menu regular ones. We feed Josie 3 pouches a day little and often and strictly no dry food.
She got used to it and a happy kitty now.
Not the cheapest but very high quality product and apparently very close to raw feeding..
Natures Menu also have a frozen raw feed ready to eat line. If you're interested you might want to try it once you became a little more experienced in testing/ shooting/monitoring and settled into some kind of a routine.

I do sympathise with you, when you start your sugar kitty journey things can be very overwhelming trying to change and learn everything all at the same time but eventually things will all fall into place.
In my experience it's easier if you just focus on the most important things first such as testing Tinkerbell at least twice a day before her insulin shots so you'll now it is safe to give her the insulin and just write it all down first in a diary until you got your spreadsheet up and running. Also try to reduce the carbs in her diet by eliminating dry food gradually as that can make a significant difference in those blood sugar levels. Some kitties go into remission just by a change of diet and getting rid of dry food completely.

To answer some of your questions:

Yes pet feeders are brilliant in my opinion, I would recommend this one as it has rotating slots so you can feed kitty for longer periods - the digital timer is so easy to set up ( even I can do it!

https://www.amazon.co.uk/Mate-Automatic-Pet-Feeder-Digital/dp/B01AUYLVU8?tag=felinediabetesfdmb-20
I think you could feed both of your kitties the same food, a low carb-high meat content diet can only improve a kitty's overall wellbeing, healthy or diabetic.

As for glucose meter we bought ours off the shelf in Boots alongside with the boxes of test strips, it's an Accu Check Performa Nano. Can't compare to any others as this is the only one we ever tried but it's been consistently very reliable with the need of a small amount of blood so I can recommend. Also very convenient cos when you need more test strips you just go into Boots and can buy it straightaway off the shelves.
If you have pet insurance they should cover both the monitor and the strips. If no insurance look online, you can get great deals there.
Oh one more thing, the blood testing kit comes with a lancet pen. Give it a go see if you can get on with it when testing. If not don't worry, most of us use free-hand single lancets to poke kitty's ear so we can see better what we're doing. We ditched the lancet pen on the first day!

Hang in there Fiona, I'm not going to 'sugar-coat' it, it's going to be a bit of a rollercoaster ride at first so brace yourself but eventually you will get there with determination, TLC, support from the board and a positive attitude with a good sense of humour to keep your sanity!

 

[Fiona1]

Natures Menu is a good choice, Fiona. Try looking at www.fetch.co.uk for some good prices. They do a "variety box" that you could try as a starting point, both in the standard NM range and the slightly dearer Country Hunter range. Bear in mind that a new food may not be to a fussy kitty's liking at first but it is worth persevering.

As for vets selling a testing kit - that's rather unlikely, sadly. Many vets are just not very clued-up on FD and don't really want you to test your cat's bg at home - completely disregarding the possibility of insulin overdose. It is vital to test bg before giving each insulin shot to know that the "number" is a safe number to shoot. You will become familiar with this and lots of other stuff as you go along and read as much as you can here.

We all understand how hugely worrying this is at first. It's completely unknown territory to most of us. But after a matter of days you'll see the logic of everything we say here for yourself, and you can post as often as you like and there will always be people ready to help. For specific queries, start a new thread with an appropriate title.

So ok as for meters - there are several available in the UK which members here use successfully. The key is to buy one with test strips that don't cost the earth - the strips will be your main outgoing as you go forward. There have been several threads recently from newbies asking about meters - if you do a search for "UK meters" or similar you should find the discussions on those meters and decide which one might suit you best. And btw - if you have pet insurance, the policy should cover things like strips... worth investigating.

ETA I've searched for threads re meters in the UK and can't find them... I do recall though that one is called Accu-Check Performa Nano, another is the Code-free and another is the One Touch Ultra. If you search for those names in the search box here you should find more info.

Keep asking questions - we really do know what this is like.

Diana

Thanks again for your reply.

So are these meters that are specifically for cats? Or are they for humans and you can use them on cats? I am going to go to Boots today and see what they have. I unfortunately don't have pet insurance but that's not a problem. I just want a machine that will definitely work well.

She's still in the vets and I am going to visit her there today. I will find out if she's able to come home tomorrow but it's all dependent on her blood sugar levels today, the vet said. He did say they could still be all over the place at the moment because her 10 day steroid wears off tomorrow.

 

[Fiona1]

Hello and welcome Fiona and Tinkerbell

I think most of your questions will be answered by trial and error such as which food, shooting time and feeding schedule.. etc.
Vets will always recommend you prescription food cos they have to but if you look at the ingredients list you will see the 'red flag' ingredients that diabetic kitties should stay clear from.
Just tell your vet you would like to try out something else that's highly recommended by diabetic cat owners.
Fairly popular Supermarket choice is Sheba Fine Flakes in Jelly due to high meat low carb content. You didn't mention which type of Sheba you're feeding her currently..
My cat liked it very much until she got pancreatitis and we had to go through yet another round of trials until happily settled for Nature's Menu regular ones. We feed Josie 3 pouches a day little and often and strictly no dry food.
She got used to it and a happy kitty now.
Not the cheapest but very high quality product and apparently very close to raw feeding..
Natures Menu also have a frozen raw feed ready to eat line. If you're interested you might want to try it once you became a little more experienced in testing/ shooting/monitoring and settled into some kind of a routine.

I do sympathise with you, when you start your sugar kitty journey things can be very overwhelming trying to change and learn everything all at the same time but eventually things will all fall into place.
In my experience it's easier if you just focus on the most important things first such as testing Tinkerbell at least twice a day before her insulin shots so you'll now it is safe to give her the insulin and just write it all down first in a diary until you got your spreadsheet up and running. Also try to reduce the carbs in her diet by eliminating dry food gradually as that can make a significant difference in those blood sugar levels. Some kitties go into remission just by a change of diet and getting rid of dry food completely.

To answer some of your questions:

Yes pet feeders are brilliant in my opinion, I would recommend this one as it has rotating slots so you can feed kitty for longer periods - the digital timer is so easy to set up ( even I can do it!

https://www.amazon.co.uk/Mate-Automatic-Pet-Feeder-Digital/dp/B01AUYLVU8?tag=felinediabetesfdmb-20
I think you could feed both of your kitties the same food, a low carb-high meat content diet can only improve a kitty's overall wellbeing, healthy or diabetic.

As for glucose meter we bought ours off the shelf in Boots alongside with the boxes of test strips, it's an Accu Check Performa Nano. Can't compare to any others as this is the only one we ever tried but it's been consistently very reliable with the need of a small amount of blood so I can recommend. Also very convenient cos when you need more test strips you just go into Boots and can buy it straightaway off the shelves.
If you have pet insurance they should cover both the monitor and the strips. If no insurance look online, you can get great deals there.
Oh one more thing, the blood testing kit comes with a lancet pen. Give it a go see if you can get on with it when testing. If not don't worry, most of us use free-hand single lancets to poke kitty's ear so we can see better what we're doing. We ditched the lancet pen on the first day!

Hang in there Fiona, I'm not going to 'sugar-coat' it, it's going to be a bit of a rollercoaster ride at first so brace yourself but eventually you will get there with determination, TLC, support from the board and a positive attitude with a good sense of humour to keep your sanity!

Hi Monica, thanks for the reply.
My cats currently eat Sheba Fine Flakes, so I will keep a box in stock in case my cat chooses not to eat the Nature's Menu. Might take some time.
With the gradual elimination of dry food, is there a specific dry food I should give (while trying to eliminate it)? I already have Royal Canin light weight, hairball and oral but should I go with the dry food my vet suggests while I am trying to eliminate it? Or is there a better one?
Thanks I will try to buy that in Boots today if they have it.

 

[Fiona1]

1 other question I have is, I am relocating from Bournemouth to Worthing next month (roughly 2 hours in car). Is there anything that I should do differently seeing as Tinkerbell has now been diagnosed? I did buy Nutri Calm previously. Would this be dangerous to use?

 

[Diana&Tom]

Hi Fiona. The meters we have suggested are human meters, yes, but that's what the majority of people here use for various reasons, one being that the cost of strips is much lower and more accessible. They certainly work well - they have to, if humans are going to use them reliably! Vets sometimes try to push you to use a pet meter such as Alphatrak but this is not necessary.

Yes I can imagine that Tinkerbell's bg is all over the place so in a way she's at the best place for now where the vet team can monitor her. If she does come out tomorrow, make sure they explain fully to you how to inject insulin and what dose to give. Usually cats on Caninsulin would start off at 1u (1 unit) twice a day and stick with that for a couple of weeks, and then increase if necessary dependent on bg test results.

The dry food issue is a bit of a dilemma as if you stop it at the same time as giving insulin, bg may drop more than you might anticipate. We want a normal bg, not a too-low one. It's best not to feed dry at all to a diabetic cat, but until we know what Tinkerbell's numbers look like when she comes home, and what dose insulin has been prescribed, it may be best to play safe and give a small amount of dry. That would be my suggestion, but others here may be more ruthless and say ditch the dry straightaway! But as I say, we can advise more when we know more.

If a two-hour car journey is going to be stressful for Tinkerbell you may want to ask the vet about Nutri Calm - I haven't used it and don't know but it may be similar to Feliway? I agree that some sort of calming measure is a good idea. Stress can raise bg and you certainly don't want to do that if you can help it.

Good luck with getting a monitor. I'd suggest trying it out on yourself before you use it for Tinkerbell. It's not difficult but there's a knack to it that you will quickly pick up - but come here and ask for tips if you need to... there's a wealth of info on testing that might be helpful. Then we'll suggest how you go about recording results on a spreadsheet and attach that to your signature so we can see at a glance how things are going.

You're doing great!

 

[Tilou]

Which insulin are you using? It does sound like the steroid shot brought on diabetes.

Wow! I wasn't aware that steroid shots could do that and that info has now opened up a window for me regarding Bob's diabetes as our (old) vet was always using steroid shots to stimulate Bob's appetite when we took him up there to get treated for his (pseudo) feline flu symptoms.

In fact our new vet was mortified when she heard that a steroid shot was given to Bob the week before we switched to her practice. The "treatment" given by the old vet was not working in clearing up Bob's infection, and instead sent his BG through the roof - as a consequence he spent two days on a drip being treated for high BG.

 

[Tilou]

Hi Monica, thanks for the reply.
My cats currently eat Sheba Fine Flakes, so I will keep a box in stock in case my cat chooses not to eat the Nature's Menu. Might take some time.
With the gradual elimination of dry food, is there a specific dry food I should give (while trying to eliminate it)? I already have Royal Canin light weight, hairball and oral but should I go with the dry food my vet suggests while I am trying to eliminate it? Or is there a better one?
Thanks I will try to buy that in Boots today if they have it.

Hi Fiona

Just to give you an idea of the effect of the dry food that vets promote us to buy from them - if I give Bob 10g of Royal Canin diabetic biscuits (which, ironically he loves!), I will see a significant jump in his blood glucose level as opposed to feeding him a wet low carb food. Check out my SS for 9 & 10 April... Bob got dry food (Hills Metabolic) from the vet to eat on those days. I switched him to a wet food only regime on the 11 April. Note: his numbers are still high as he's on a new insulin and has, in the words of our vet "a complicated diabetes", but I think you'll get the gist.

Check out zooplus.co.uk as they provide the list of nutritional values on the food they sell and ideally you're looking for a low carbohydrate option (less than 10%). You can get a simple app to calculate the carbs in cat food called "Carbohydrate calculator for cat food" if you're unsure.

It is very difficult to get the likes of Royal Canin etc to tell you what their carb content is in their specialist diabetic foods, but it is definitely higher than 10%. I've heard the biscuit carb content is as high as 30% so you need to wean your little one off the dry food and onto the wet food.

My Bob is an extremely fussy eater (despite being a turned feral!) with a delicate digestive system. I bought some Animonda Integra Protect diabetic wet food for him originally (7.5% carb) and have slowly introduced other brands in the last couple of weeks with carb content as low as 2.5%.

Keep up the good work. This forum has been a life saver for me - as I'm always being told treating diabetes in cats is a marathon, not a sprint (I'm really impatient, lol).

 

[Fiona1]

Thanks for the replies. Sorry i havent updated you all. Had a very stressful weekend! Saw tinkerbell on friday in the vets and she looked well. Vet promised a call with an update on saturday but forgot to call and i ended up thinking the worst, so hardly slept saturday night. He did phone on sunday though said she is bright and well. Blood sugar levels are coming down but he thinks it will be another couple of days in the vets.

 

[Monica & Josie]

Hi Monica, thanks for the reply.
My cats currently eat Sheba Fine Flakes, so I will keep a box in stock in case my cat chooses not to eat the Nature's Menu. Might take some time.
With the gradual elimination of dry food, is there a specific dry food I should give (while trying to eliminate it)? I already have Royal Canin light weight, hairball and oral but should I go with the dry food my vet suggests while I am trying to eliminate it? Or is there a better one?
Thanks I will try to buy that in Boots today if they have it.

Thanks for the replies. Sorry i havent updated you all. Had a very stressful weekend! Saw tinkerbell on friday in the vets and she looked well. Vet promised a call with an update on saturday but forgot to call and i ended up thinking the worst, so hardly slept saturday night. He did phone on sunday though said she is bright and well. Blood sugar levels are coming down but he thinks it will be another couple of days in the vets.

Glad to hear Tinkerbell is doing well, hopefully she can come home soon!

 

[Monica & Josie]

Hi Monica, thanks for the reply.
With the gradual elimination of dry food, is there a specific dry food I should give (while trying to eliminate it)? I already have Royal Canin light weight, hairball and oral but should I go with the dry food my vet suggests while I am trying to eliminate it? Or is there a better one?

Hi Fiona,
As for dry food they say that it's not recommended for diabetic cats. I will always remember that someone here said giving your cat dry food is like feeding them donuts!

There are lower carb ones available in the UK such as the freeze-dried Ziwipeak varieties so if Tinkerbell is currently nuts about dry food you might want to give those a try in the meantime then eliminate gradually..?
We took away dry food completely from one day to another with Josie and gave only the Sheba fine flakes. Although must say she started on insulin a few days afterwards so the dry food did not influence her blood sugar levels anymore and the drastic diet change was already in place when we started monitoring and giving Caninsulin..

Keep us posted, fingers paws crossed, you must be very eager to have kitty back home with you!

 

[Sue (Mo's Mum)]

Hi Fiona,

My cat is newly diagnosed too and has the added complication of pancreatitis.

The vet has suggested ProZinc for Morrissey, and I'm off to collect it in a bit.

I think I'll pop to boots and buy a testing meter there - I thought I had one but can only find the empty box!

I hope Tinkerbell is home with you soon.

 

[Tilou]

Hi Fiona,

My cat is newly diagnosed too and has the added complication of pancreatitis.

The vet has suggested ProZinc for Morrissey, and I'm off to collect it in a bit.

I think I'll pop to boots and buy a testing meter there - I thought I had one but can only find the empty box!

I hope Tinkerbell is home with you soon.

Hi Sue

Head over to the ProZinc part of the forum - lots of helpful info on there.

My Bob was put on PZ recently (previously on Caninsulin and Lantus) and is getting on quite well with it.

Welcome

 

[Monica & Josie]

Hi Fiona, how are you and Tinkerbell doing?

Hope you're both ok, give us an update when you can

 

[Fiona1]

Hi Fiona, how are you and Tinkerbell doing?

Hope you're both ok, give us an update when you can

Hi Monica,
She is still in the vets. Her blood sugar tends to be high in the morning, around 28. It then dips in the afternoon to around 20. My vet didnt give her insulin today to test for the somogyi effect and her blood sugar was still high. Before that, she was up to 4 units. I went to visit her tonight and he gave her insulin this evening, 4 units again. She was hissing and growling when he tested her blood sugar and gave her insulin. I am really upset and deflated at thw moment about this. We are coming up to 2 weeks of her being in the vets. My vet says he will get her levels down. He is also feeding her wet only food. Im just so scared that her levels are never going to stabilise.

 

[Monica & Josie]

Hi Monica,
She is still in the vets. Her blood sugar tends to be high in the morning, around 28. It then dips in the afternoon to around 20. My vet didnt give her insulin today to test for the somogyi effect and her blood sugar was still high. Before that, she was up to 4 units. I went to visit her tonight and he gave her insulin this evening, 4 units again. She was hissing and growling when he tested her blood sugar and gave her insulin. I am really upset and deflated at thw moment about this. We are coming up to 2 weeks of her being in the vets. My vet says he will get her levels down. He is also feeding her wet only food. Im just so scared that her levels are never going to stabilise.

Hi Fiona,
I'm so sorry to hear your news, it must've been very upsetting to see Tinkerbell like that.
Unfortunately as there were complications at the beginning sadly I guess it is not a straightforward case.

Although to me 4u sounds like a high dose for the second week. Caninsulin website suggests a starting dose of 1 unit and increase by 1 unit per week if necessary.
It might be different for DKA cats, must admit I don't have any experience in dosing a kitty with a history of ketoacidosis and steroids ( hopefully someone else experienced will see your post and give their opinion..)

Is your vet experienced in treating diabetic cats?
Here is the link to the official Caninsulin page in more details if you'd like to read up a bit more about dosing and maybe ask your vet some questions?
http://www.caninsulin.com/insulin-dosage-cats.asp

Usually there's a good chance that cats can be regulated, just takes a bit of time to find the right type of insulin and the right dose..

Hang in there Fiona!

 

[Diana&Tom]

So sorry to hear that there's not better news, Fiona. We all know what it's like to have a poorly kitty and how upsetting it is to visit them in hospital... my heart goes out to you.

Do keep us informed and please ask any questions about anything you're not sure of... there are some very experienced members here with similar experiences to yours who we can tag to look at your thread and get their thoughts.

Thinking of you.

Diana

 

[Diana&Tom]

It can be difficult to get the levels stabilized with a bout of ketoacidosis because of the body wide biochemical imbalances that happen. It doesn't mean that her BG won't be stabilized later on after she's recovered and has been on insulin a while. The best place for her right now is at the clinic.

Fiona - just read through other posts here... Kris's explanation above makes sense, ie it may take a while to get this sorted...

 

[Tilou]

I agree with the others. It's difficult if there are complications. Bob's bloods rocket up and down (as can be seen on his SS). Even after being kept at the vet for treatment he came home with a BG reading of 30+

His dose has been increased this week to 3ui am & pm, which saw a dramatic fall to 7.7 at the nadir yesterday... only to be back up to 25.9 this morning

My vet has said I only need to test at the daily nadir point (+5) but given Bob's erratic - and what she calls "complicated" - FD, I'm still testing when I can... and like your little darling, Bob is a hisser (& fighter) when it comes to getting prodded and poked

I don't want to sound flippant, because I know (as we all do on this forum) how upsetting this is - but stick with it and try not to let your stress vibes pass on to Tinkerbell.

We're all here to help

 

[Elizabeth and Bertie]

My vet didnt give her insulin today to test for the somogyi effect and her blood sugar was still high.

Hi Fiona, if the high blood glucose is due to too high a dose of insulin it can take a while for it to drop back down again. On this forum we've found that it can take up to a few days. So, one day without insulin may not be sufficient to determine whether the dose is too high.
The reason for this is that as well as the cat's body raising its own blood glucose level (by releasing stored glycogen) it can also release counter-regulatory hormones, the purpose of which is to keep the blood glucose high. That effect can take up to a few days to wear off in some cats.

What is the situation with Tinkerbell now? Does she still have DKA, or ketones at all?
Do you know how often the vet is testing her blood glucose?

If your vet thinks Tinkerbell's case is problematic it might be worth him or her giving the RVC's feline diabetes clinic in London a call. The RVC has run a couple of very useful feline diabetes research projects, including looking at 'diabetic remission' in cats (several members here have volunteered their cats in the past) and also research into a condition called 'acromegaly' (which causes high blood glucose but which isn't caused by diabetes). There are some very clued up vets there, and they have been helpful on more than one occasion by kindly having a chat with an FDMB member's vet...

Hang in there, Fiona....

(((Hugs))) from Surrey,

Eliz

 

[Kris & Teasel]

Hi Fiona, if the high blood glucose is due to too high a dose of insulin it can take a while for it to drop back down again. On this forum we've found that it can take up to a few days. So, one day without insulin may not be sufficient to determine whether the dose is too high.
The reason for this is that as well as the cat's body raising its own blood glucose level (by releasing stored glycogen) it can also release counter-regulatory hormones, the purpose of which is to keep the blood glucose high. That effect can take up to a few days to wear off in some cats.

What is the situation with Tinkerbell now? Does she still have DKA, or ketones at all?
Do you know how often the vet is testing her blood glucose?

If your vet thinks Tinkerbell's case is problematic it might be worth him or her giving the RVC's feline diabetes clinic in London a call. The RVC has run a couple of very useful feline diabetes research projects, including looking at 'diabetic remission' in cats (several members here have volunteered their cats in the past) and also research into a condition called 'acromegaly' (which causes high blood glucose but which isn't caused by diabetes). There are some very clued up vets there, and they have been helpful on more than one occasion by kindly having a chat with an FDMB member's vet...

Hang in there, Fiona....

(((Hugs))) from Surrey,

Eliz

Great idea to call RVC!

 

[Diana&Tom]

Great idea to call RVC!

www.rvc.ac.uk and look at "small animal referrals"

 

[Fiona1]

Hi,

Thanks for all your replies and thoughts
My vet said he has treated diabetic cats and has had a few cats that aren't stabilising.
Tinkerbell does not have DKA or any ketones at all. She was diagnosed with DKA on 15/04/18 and on 17/04/18, the vet said there were no ketones in her urine. I will ask him if he has still been testing this. Do you think that's a good idea?
The vet said he is testing her twice a day. Once in the morning and once in the evening.
I did ask my vet (after researching BG levels not stabilising) whether it could be acromegaly or cushings disease and he said "no, she definitely has diabetes". Should I ask why he is certain?
Thanks for the link to RVC, I will give them a call. From your experiences, have other vets been offended when suggesting they call them? I don't think my vet will because when we mentioned the wet food and other things, he didn't mind at all. I will start by giving them a call and seeing what they suggest.
I am moving on 23/05/18 and I am leaving my job on 11/05/18 so I will be around to monitor her all the time. We are now temporarilly moving in with my mum when we relocate, due to the vet bills (relocating to live near her anyway). I will be looking for a job once I move, but the good thing is, my mum only works 3 days a week, so there will likely be someone around a lot for Tinkerbell.
I've done an order today of about 15 different cat foods from the spreadsheet.
I am looking to order a BG meter. I did have a look at the Accu Check Performa Nano but I read that it takes 0.6. My vet had to put the needle in her arm twice to get blood so perhaps it might be difficult. I saw there is an Accu Check Mobile which is 0.3. Does anyone know much about this one? Is the only thing I need to buy to go with the meter I pick the strips or is there anything else that I need to buy?

Thanks again everyone

 

[Fiona1]

I just phoned the RVC and they said they won't discuss it with me, only with vets. I did phone the small pet owners number. I will ask my vet to call them instead.

 

[Diana&Tom]

Hi Fiona
You certainly seem to be taking this seriously and have learned a lot in a short space of time, good on you! All your knowledge will stand you in good stead for when Tinkerbell comes home. To answer some of your questions:

If bg remains high it is a good idea to test for ketones, yes. I'm not sure what the suggested intervals are - maybe @Kris & Teasel or others can advise?

Twice-daily bg tests are not really enough - we need to see what effect the insulin dose is having on bg to understand the full picture. Caninsulin is a fast-acting insulin and may drop the bg quite quickly, and be "used up " well before the end of the 12-hour cycle. Ideally the vet should perform a curve which means testing every two hours from pre-shot to pre-shot... by plotting those results on a graph you can see what's going on. We'd expect to see a gentle "smile" shape curve, ie starting at the highest bg number, dropping gradually about halfway through and then gradually rising again...that's the ideal although often with Caninsulin you will see a steeper drop and faster rise, ie a "curve" with straighter lines if that makes sense. I'd have a word with the vet if I were you about doing a curve, and then discuss the results.

As for "definitely diabetes" v possible acro or Cushing's - I think the vet must be saying that Tinkerbell's diabetes is steroid-induced, which does seem to be the case if there are no other obvious symptoms. As for your vet calling the RVC, you could certainly suggest that he does this if Tinkerbell doesn't show signs of improvement... sometimes just a chat on the phone with a real expert can be useful to the vet. Vets are like our GPs - GPs treat all kinds of problems but don't necessarily have specialisms and often refer patients to specialists, so vets shouldn't feel any differently if they have reached a stage where they need some support.

As for meters - good idea to get one needing a very small sample of blood but I'm not familiar with the one you mention. Accu Chek is normally a good brand though so I'd probably go for it and start reading how to use it (and there are loads of links we can give you to learn how to get blood, normally from kitty's ear) before Tinkerbell comes home. Do you know when that's likely to be?

 

[Elizabeth and Bertie]

The vet said he is testing her twice a day. Once in the morning and once in the evening.

Twice-daily bg tests are not really enough - we need to see what effect the insulin dose is having on bg to understand the full picture. Caninsulin is a fast-acting insulin and may drop the bg quite quickly, and be "used up " well before the end of the 12-hour cycle. Ideally the vet should perform a curve which means testing every two hours from pre-shot to pre-shot...

Fiona, I was a little surprised that your vet is only testing twice a day...
As Diana says above, that is not sufficient to understand how the insulin is working in the kitty's system. It's important to know what is happening in between insulin shots (especially at the lowest point of the cycle). Without that info, it is not possible to tell whether the insulin dose is appropriate...
Is the vet taking blood from the edge of the ear? Or trying to get it from her leg...? (Most people use the edge of the ear, which shouldn't really bother the kitty much at all...)

I feel as though I'm being a bit thick because, since there's now no ketones, and no evidence of other illness (is that right?) I'm not sure why Tinkerbell is still at the vet...
Is the vet doing anything at the moment that you couldn't actually do yourself at home...? (I do realise that you are out a lot of the time at the moment, so is that the reason..?)

Eliz

 

[Diana&Tom]

Fiona, I was a little surprised that your vet is only testing twice a day...
As Diana says above, that is not sufficient to understand how the insulin is working in the kitty's system. It's important to know what is happening in between insulin shots (especially at the lowest point of the cycle). Without that info, it is not possible to tell whether the insulin dose is appropriate...
Is the vet taking blood from the edge of the ear? Or trying to get it from her leg...? (Most people use the edge of the ear, which shouldn't really bother the kitty much at all...)

I feel as though I'm being a bit thick because, since there's now no ketones, and no evidence of other illness (is that right?) I'm not sure why Tinkerbell is still at the vet...
Is the vet doing anything at the moment that you couldn't actually do yourself at home...? (I do realise that you are out a lot of the time at the moment, so is that the reason..?)

Eliz

Exactly as Eliz says, Fiona... why exactly is Tinkerbell still at the vet's? She is out of danger now so should be ok for you to look after her at home...?

 

[Fiona1]

Thanks for your responses.
I've just listened to my stored answerphone messages again and he said that he tested in the afternoon. I will ask him to clarify when he is testing when he calls me today.

I have been looking at some videos online that show it being taken from the ear so was planning to do so. One video I watched, a lady had the cat on her lap in a cat bed, so I've bought a small one to assist with that.

The vet said she will be staying there until her blood sugar levels are stabilised. On Friday just gone, when I went to visit her, he asked if I want to take her home for the weekend (first time I've been offered) but said he would advise against it until she is stabilised, so I thought it better that she is at the vets? To be honest, I'm not keen to take her out this week, if she isn't stabilised, as I'm working Monday-Friday but come Friday evening, I could collect her, especially seeing as it's the bank holiday weekend. I was under the impression that she needs to be there until she is stabilised. If I did take her out this week, the longest day that there would be nobody home is 7.45-3.30. Do you think this could be dangerous?

Also, when I give my other non-diabetic cat the same food, do I need to give it to her gradually? Could it be dangerous to suddenly change it? She is 2 years old with no health conditions. She once had a seizure when she was around 10 months but hasn't had one since. Luckilly, both my cats are more keen on wet food, so I shouldn't have a problem with getting them to eat it.

I'm also a bit worried about the cats being re-introduced while I'm at work. They generally get along fine but I wouldn't want Tinkerbell's BG to increase due to stress.

 

[Kris & Teasel]

I've been following this thread and will share my thoughts. I'm not a vet so am going by what I've learned here on FDMB and with treating my own very hard to regulate kitty (2 years, 3 different insulins):

• Is your vet keeping your kitty there until Tinkerbell stabilizes/regulates/shows good control of BG? This can take weeks if not months and is something that you can undertake at home with the help of people here.
• If DKA is past a daily check for urine ketones can be done at home quite easily and we can give you some tips on how to do it.
• If your vet is basing his/her opinion on Tinkerbell's level of BG control on two tests a day AM and PM that isn't sufficient. She might well be a lot lower in the middle portion of the cycle and higher at the ends. If that's the basis for the vet's dosing decisions, she could be on the wrong dose - maybe too high.
• I'm not sure why the BG test requires a more painful, intrusive blood draw from a leg vein when a quick ear prick will do for their pet meter.
• She could possibly have acromegaly or Cushings at the same time as diabetes although you have no evidence of that yet and no testing has been done.
• If her diabetes was steroid induced, stopping steroids can sometimes lead to remission. If steroids are essential to treat another serious condition, then the insulin can be dosed around that.

This is from the US Vetsulin website. That's what Caninsulin is called in the US:
http://www.vetsulin.com/vet/Cats_Monitoring_About.aspx

If this is possible for you now, here's what I'd suggest:

1. If Tinkerbell is well enough to go home with you, take her home.
2. Buy yourself a supply of low carb wet food (the UK members here can advise).
3. Get a human blood glucose meter and a good supply of test strips from a local pharmacy. Ask for one that needs only a tiny blood drop to give a result. UK members here can advise.
4. Buy a bottle of urine ketone test strips from the same pharmacy.
5. Read this excellent guide to using Caninsulin and ask a ton of questions: http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/

 

[Kris & Teasel]

And I'll add: we all had to struggle with doing things differently from what our vet wanted. I know I did and I like my vet a lot. She even has a special interest in feline diabetes although she's a general practitioner. However, my cat confounded her and she didn't know what to do. When I finally took matters into my own hands he made a lot of progress - still a very tricky kitty but doing well.

FYI: there's a member on the Lantus forum who's a small animal vet herself with a hard to regulate kitty. She's put aside her vet hat and has been willing to learn from the very high level of member expertise on that forum. It's amazing to follow her threads (Janine and Floyd).

 

[Diana&Tom]

Fiona, Kris's comments above are exactly right. You don't have to keep Tinkerbell at the vet. You are well able to care for her at home. But if you feel she is being better looked after there for the time being, and you can afford it (has the vet given you an estimate of costs?) it is your decision. I'd say that you are pretty well informed now, and in a position to discuss with your vet exactly what the overall situation is... and make a decision. We will support you whatever you choose to do. And keep asking questions!

 

[Tilou]

Thanks for your responses.
I've just listened to my stored answerphone messages again and he said that he tested in the afternoon. I will ask him to clarify when he is testing when he calls me today.

I have been looking at some videos online that show it being taken from the ear so was planning to do so. One video I watched, a lady had the cat on her lap in a cat bed, so I've bought a small one to assist with that.

The vet said she will be staying there until her blood sugar levels are stabilised. On Friday just gone, when I went to visit her, he asked if I want to take her home for the weekend (first time I've been offered) but said he would advise against it until she is stabilised, so I thought it better that she is at the vets? To be honest, I'm not keen to take her out this week, if she isn't stabilised, as I'm working Monday-Friday but come Friday evening, I could collect her, especially seeing as it's the bank holiday weekend. I was under the impression that she needs to be there until she is stabilised. If I did take her out this week, the longest day that there would be nobody home is 7.45-3.30. Do you think this could be dangerous?

Also, when I give my other non-diabetic cat the same food, do I need to give it to her gradually? Could it be dangerous to suddenly change it? She is 2 years old with no health conditions. She once had a seizure when she was around 10 months but hasn't had one since. Luckilly, both my cats are more keen on wet food, so I shouldn't have a problem with getting them to eat it.

I'm also a bit worried about the cats being re-introduced while I'm at work. They generally get along fine but I wouldn't want Tinkerbell's BG to increase due to stress.

I can see many others helping with your questions, so I will keep this brief...

Don't worry about feeding your non diabetic cat the same as Tinkerbell. I put my other 20 year old cat on the same regime as Bob and he's loving it!

 

[Monica & Josie]

Hi Fiona,
It seems that you are getting some really good all round advice from the ladies above, I could only repeat and back up their great suggestions and questions raised.

There was one thing I thought of that might make things a little bit easier and less stressful for you both at the beginning..
You said previously that Tinkerbell was eating Sheba fine flakes in jelly.
This is actually on the approved UK cat food list for being very low in carbs and it contains a decent amount of meat so if Tinkerbell is still happy to eat it maybe you could carry on feeding this.
Once you feel more confident about the whole testing, injecting and monitoring routine maybe then you could start trialling out all the various food you ordered..?
Might help you having to deal with one less thing straightaway and you can focus on the most important ones..

Fingers and paws crossed you will be able to give us some good news soon!

 

[Monica & Josie]

Oh and more thing, never be afraid to challenge your vet if you have any questions or something doesn’t feel right.
They can give their opinion and suggestions but as owner and 24/7 caregiver the ultimate decision should be yours.
I had to ditch my first vet because he was clueless and was guessing doses and treatment.. I had no idea as I trusted my vet always but after telling the FDMB board members the things he said and he was doing they made me realise that Josie wasn't in good hands and had to take her away.
Our current vet is specialised in Feline Diabetes so much more knowledgable and has a good idea about what she’s doing.
We still locked horns at the beginning as she was adamant about putting Josie on prescription food and I refused it! We disagreed slightly on treatment and dosing as well but mostly we've been on the same page.
One year later she told me that she’s never come across any pet owner who became as confident and knowledgeable about feline diabetes as I am and she very much respects that. She was also very impressed with the online spreadsheet we all use to keep a prompt record of kitty's BG readings..
She also admitted that I was right about certain things yay! and she even learnt a few things from me! We have a mutual respect for each other now and an understanding of having Josie's best interest at heart.
A year ago I knew nothing about Feline Diabetes and what it involves. All my knowledge comes from spending endless nights reading up about Feline Diabetes and Feline Nutrition online and the posts here, asking questions and getting support from the very knowledgeable ladies here on the board and gaining experience day by day after a very overwhelming, stressful and shaky start.

All in all what I’m trying to say is that don’t be shy to disagree with your vet if your gut feeling ( or the board members..) say otherwise because at the end of the day you are in charge.. and don't worry, in time you will be a pro at this sugar dance!

 

[Diana&Tom]

Good advice from Monica above, who I have to say is a shining example of how a newbie to FD and this board can read, research and make considered, confident decisions about how to treat her cat in quite a short space of time. Take note of all the points Monica is making and you won't go wrong.

In fact, Monica has done so well that she has recently graduated in BA Feline Nutrition and is now studying for her Masters in Advanced Feline Nutrition.

(Yes that last para is a joke but it's not a million miles from fact!!!)

 

[Fiona1]

Thanks again for the responses.

Kris, she doesn't need steroids. Initially I took her to the vets as she dry heaved a few times. This coincided with me giving her new treats that I came in a cat subscription box. The vet gave her a 2 day steroid and antibiotic and said to bring her back 2 days later as he thought it was an allergy. I took her back 2 days later and she hadn't dry heaved since. He gave her another antibiotic and this time a 10 day steroid, as a precaution he said. 4 days later, she was extremely lethargic (which I now realise was the ketoacidosis) so I took her back. He gave her another 2 day steroid and antibiotic. The day after, she was even more lethargic so I took her to the emergency vets as it was a Sunday and they kept her in. They then phoned me to say she has diabetes and ketoacidosis. So there should be no need at all for her to have steroids and the vet confirmed he hasn't given her any more.

Do you think it's ok to take her home seeing as I'm going to be working this week?

Diana, my vet hasn't given me an estimate of costs yet. He said he would this weekend but didn't when he called. It was £520 for the night in the emergency vets, so I'm hoping it won't be anything like that per night!

Monica, that sounds a good idea about starting with the Sheba fine flakes, so I will do that. I've got 3 boxes in stock currently. Any idea of the amounts I should be feeding? She is 4kg. That's very encouraging to hear that you've picked all that up in the time you've been here.

Just to update you all, my vet phoned and said he is testing her BG twice per day. He said he tested it yesterday morning and it was 30.1 in the am so he gave her 5 units of insulin! In the evening, it was 8.7 (before this, the lowest has been around 19) so he didn't give any more insulin. He tested her this evening and she was 22.8 so he gave her 5 units again.

If I take her home tomorrow, should I lower this amount because it seems quite high in a short space of time from what you've all said?

 

[Diana&Tom]

Hmmm interesting bg readings... the 8.7 is a lovely number, not normally shootable (by which we mean, not safe to shoot - we usually say withhold insulin at a pre-shot number of 10 or 11) so I'm very glad the vet didn't give insulin then. The good news is that she is clearly responding to the insulin, but as we said earlier, without mid-cycle numbers we can't comment usefully on whether the dose is about right or not. I'm very interested to know why the vet isn't doing a curve.

5u is a high dose and personally I would lower that by quite a bit if you do decide to take her home. Even at a very high number of 30 or so we don't know if a dose that high is justified. But on the subject of taking her home - have you got a meter yet and tried it out? You need to get yourself kitted out with testing supplies before you bring her home and if you're giving insulin. One of our golden rules here is that we NEVER shoot without testing first and making sure that the bg is a shootable number. So although we're all saying that you can look after her at home, you do need to know what to do to keep her safe, first.

 

[Fiona1]

No I didn't buy one yet. I wasn't sure whether to go for the Accu Check Performa Nano or the Accu Check Mobile. If I get her tomorrow, I'll just head to Boots (got one that opens late on an industrial estate) and buy both and test both on myself first. Absolutely dreading it as I can't usually stand needles/injections to myself and can't usually watch when given to cats but I will do it!

 

[Fiona1]

Also, I've read that it's not good to give treats. I don't eat meat or fish myself, so can't give a bit of mine as a treat, but could I for example, cook a cod fillet and give her a bit? Or is it best to strictly stick to cat food?

 

[Diana&Tom]

No I didn't buy one yet. I wasn't sure whether to go for the Accu Check Performa Nano or the Accu Check Mobile. If I get her tomorrow, I'll just head to Boots (got one that opens late on an industrial estate) and buy both and test both on myself first. Absolutely dreading it as I can't usually stand needles/injections to myself and can't usually watch when given to cats but I will do it!

I strongly advise that you get whatever meter you think asap, test it on yourself and watch videos showing how to test your cat. It might take a bit of practice.
Believe me, many of us here don't like needles either but as you say, we will do it for our cat!