New Member - Vet strongly against home testing.

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Butters & Lyla

Member Since 2020
Hi all!

I stumbled across this forum three days ago and I am so grateful and happy that I did. I have read through so many threads and I have already gleaned pieces of helpful information from them! Thank you for being so generous with your knowledge and experiences.

I was wondering if you could help me? My cat Butters was diagnosed as Diabetic about 9 days ago. She had gone for a checkup three months earlier and was deemed to be in perfect health. I noticed she started begging for food in mid April but initially chalked it up to me being home a lot more due to the pandemic. She has longish thick fur and it took me a while to realize that she felt thinner. What stood out for me was her hind quarters seemed to be weak. I feel super guilty about taking so long to clue in, but I cannot change it.

So the vet did a fructosamine test which was 649 mol/L, and her glucose was 19.2 mmol/L. Her chloride came back low, 102 mmol/L (not sure if this is related?), everything else was in normal range. He told me to give her 2 units of Caninsulin 2x a day immediately after she eats her meals. Like do not wait any number of minutes. Inject right away. We have always fed her 2 meals per day so I was fine with that. But he tried to do a very hard sell on the Hill’s diet for diabetes, including dry food. He told me it was the only way he would be able to regulate her. I refused by saying she is extremely picky. I told him the exact wet food we were going to feed her, Feline Natural canned, and that it was pretty much no carbs. She was on raw food previously. So he told me just bring her back in 3 weeks for a follow up fructosamine test and sent me away with syringes and insulin. He briefly mentioned hypoglycaemia.

Fast forward to now and with all the new info I have found here, I am starting to worry. Butters is not getting any carbs in her food. She has really been playing a lot, running around the past three days (for her), 15 to 20 minutes after her meals. I don’t feel confident that the insulin dose took these things into account and I don’t know what to do. But also, the vet told me to give her extra food cos she had lost around 1.5 lbs. she was 8lbs 12oz but normal for her is 10lbs 4oz. She is getting around 60 additional calories per day right now. I am overall worried about hypoglycaemia. Thinking about it all the time. Should I be this worried? I have read the post on hypos.

I gather the best thing I can do is home testing. So I called the vet yesterday to ask if he would help me home test her blood glucose and compare results. I was told absolutely not, it is completely unnecessary. I was totally shut down. I am feeling pretty defeated and worried I cannot trust this vet. I bought a Freestyle Lite tonight and I am just going to figure it out myself I guess. I am confused by the preshot test, though. If i test her right before her shot, that would be after she eats, or do I do it before she eats?

Also it sounds like Caninsulin may not be the best option. But I would not dare ask my vet to consider anything else. I asked if he had a higher gauge, and shorter, needle (he had me buy a box of 100, 28 gauge 1/2 inch long), and he dismissed my concerns.

Anyways, thanks so much for listening and I appreciate any advice you are willing to share!

Lyla
 
Hi all!

I stumbled across this forum three days ago and I am so grateful and happy that I did. I have read through so many threads and I have already gleaned pieces of helpful information from them! Thank you for being so generous with your knowledge and experiences.

I was wondering if you could help me? My cat Butters was diagnosed as Diabetic about 9 days ago. She had gone for a checkup three months earlier and was deemed to be in perfect health. I noticed she started begging for food in mid April but initially chalked it up to me being home a lot more due to the pandemic. She has longish thick fur and it took me a while to realize that she felt thinner. What stood out for me was her hind quarters seemed to be weak. I feel super guilty about taking so long to clue in, but I cannot change it.

So the vet did a fructosamine test which was 649 mol/L, and her glucose was 19.2 mmol/L. Her chloride came back low, 102 mmol/L (not sure if this is related?), everything else was in normal range. He told me to give her 2 units of Caninsulin 2x a day immediately after she eats her meals. Like do not wait any number of minutes. Inject right away. We have always fed her 2 meals per day so I was fine with that. But he tried to do a very hard sell on the Hill’s diet for diabetes, including dry food. He told me it was the only way he would be able to regulate her. I refused by saying she is extremely picky. I told him the exact wet food we were going to feed her, Feline Natural canned, and that it was pretty much no carbs. She was on raw food previously. So he told me just bring her back in 3 weeks for a follow up fructosamine test and sent me away with syringes and insulin. He briefly mentioned hypoglycaemia.

Fast forward to now and with all the new info I have found here, I am starting to worry. Butters is not getting any carbs in her food. She has really been playing a lot, running around the past three days (for her), 15 to 20 minutes after her meals. I don’t feel confident that the insulin dose took these things into account and I don’t know what to do. But also, the vet told me to give her extra food cos she had lost around 1.5 lbs. she was 8lbs 12oz but normal for her is 10lbs 4oz. She is getting around 60 additional calories per day right now. I am overall worried about hypoglycaemia. Thinking about it all the time. Should I be this worried? I have read the post on hypos.

I gather the best thing I can do is home testing. So I called the vet yesterday to ask if he would help me home test her blood glucose and compare results. I was told absolutely not, it is completely unnecessary. I was totally shut down. I am feeling pretty defeated and worried I cannot trust this vet. I bought a Freestyle Lite tonight and I am just going to figure it out myself I guess. I am confused by the preshot test, though. If i test her right before her shot, that would be after she eats, or do I do it before she eats?

Also it sounds like Caninsulin may not be the best option. But I would not dare ask my vet to consider anything else. I asked if he had a higher gauge, and shorter, needle (he had me buy a box of 100, 28 gauge 1/2 inch long), and he dismissed my concerns.

Anyways, thanks so much for listening and I appreciate any advice you are willing to share!

Lyla

hi Lyla and welcome!

you’re not alone in the fact that a lot of us have to advocate for our cats with vets. I’ve personally switched vets 3 times for that reason.

to address your question, test first then feed then shoot. Test is important to know your cats BG level. Then you need food in their system so the insulin doesn’t take them too low too fast and that’s the reason you do the shot last.

I agree with your instinct that caninsulin is not the best insulin for cats. It was made for canines hence the name and your vet seems very old school, in other words not very knowledgeable about feline diabetes. Good for you for saying no to the food and deciding to home test yay!! Most of us feed FF pate as it’s low in carbs and totally fine. You want food that it’s less than 10% carbs and there’s a great chart here somewhere that I’m sure another member will link for you

as for the weakness in the hind legs it’s called neuropathy and it’s a common side effect of diabetes. My Minnie had very severe neuropathy but once her diabetes was under control she recovered completely. There’s a great supplement that helps called Zobaline or b12 methyl. I still give it to her daily and a lot of members here have their cats on it. I get mine from vitacost and I discovered the site here. It comes in capsules and I just add it to her food. It’s pink but tasteless and odorless

the last thing I want to say is you do NOT need another fructosamine test. Don’t waste your money especially if you’re going to start home testing. That test only gives you a 3 week average and it’s pretty useless as a way to regulate the diabetes. I’d consider another vet. I had some success asking for referrals on my Nextdoor app and then screening them.

welcome again and you’ve come the best place for help when it comes to feline diabetes. I feel some of the members here deserve honorary veterinary degrees! :bighug:
 
Hi all!

I stumbled across this forum three days ago and I am so grateful and happy that I did. I have read through so many threads and I have already gleaned pieces of helpful information from them! Thank you for being so generous with your knowledge and experiences.

I was wondering if you could help me? My cat Butters was diagnosed as Diabetic about 9 days ago. She had gone for a checkup three months earlier and was deemed to be in perfect health. I noticed she started begging for food in mid April but initially chalked it up to me being home a lot more due to the pandemic. She has longish thick fur and it took me a while to realize that she felt thinner. What stood out for me was her hind quarters seemed to be weak. I feel super guilty about taking so long to clue in, but I cannot change it.

So the vet did a fructosamine test which was 649 mol/L, and her glucose was 19.2 mmol/L. Her chloride came back low, 102 mmol/L (not sure if this is related?), everything else was in normal range. He told me to give her 2 units of Caninsulin 2x a day immediately after she eats her meals. Like do not wait any number of minutes. Inject right away. We have always fed her 2 meals per day so I was fine with that. But he tried to do a very hard sell on the Hill’s diet for diabetes, including dry food. He told me it was the only way he would be able to regulate her. I refused by saying she is extremely picky. I told him the exact wet food we were going to feed her, Feline Natural canned, and that it was pretty much no carbs. She was on raw food previously. So he told me just bring her back in 3 weeks for a follow up fructosamine test and sent me away with syringes and insulin. He briefly mentioned hypoglycaemia.

Fast forward to now and with all the new info I have found here, I am starting to worry. Butters is not getting any carbs in her food. She has really been playing a lot, running around the past three days (for her), 15 to 20 minutes after her meals. I don’t feel confident that the insulin dose took these things into account and I don’t know what to do. But also, the vet told me to give her extra food cos she had lost around 1.5 lbs. she was 8lbs 12oz but normal for her is 10lbs 4oz. She is getting around 60 additional calories per day right now. I am overall worried about hypoglycaemia. Thinking about it all the time. Should I be this worried? I have read the post on hypos.

I gather the best thing I can do is home testing. So I called the vet yesterday to ask if he would help me home test her blood glucose and compare results. I was told absolutely not, it is completely unnecessary. I was totally shut down. I am feeling pretty defeated and worried I cannot trust this vet. I bought a Freestyle Lite tonight and I am just going to figure it out myself I guess. I am confused by the preshot test, though. If i test her right before her shot, that would be after she eats, or do I do it before she eats?

Also it sounds like Caninsulin may not be the best option. But I would not dare ask my vet to consider anything else. I asked if he had a higher gauge, and shorter, needle (he had me buy a box of 100, 28 gauge 1/2 inch long), and he dismissed my concerns.

Anyways, thanks so much for listening and I appreciate any advice you are willing to share!

Lyla
Hi Lyla wow I don’t like the fact that you feel like you can’t ask your Vet about concerns you have . I’m going to let the more experienced members answer your exact questions. I can’t understand why your Vet would tell you testing is not needed . Personally I Do not know why some Vets are for Hills diet when there are so many better choices . Lyla hang in there I’m sure you will be getting answers shortly
 
Sounds to me like you need to find another vet who will work in partnership with you for the best outcome for Butters. The FD journey is just beginning and you need a vet who knows a bit about FD and is willing to work with you.
I'm so glad you are going to home test. ..we can help you.
You don't need to tell the vet. Butters is your cat, not his and you pay the bills.

The routine with caninsulin is test, feed, wait 30 minutes and then inject the insulin. And offer snacks during the first half of the cycles both am and pm.
Have you seen this link
http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/

Make sure you have some honey or Karo and high carb food in your tool box in case of low numbers. If you are hometesting and have high carb food and honey at home you are in control.
Here is another useful link
http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
Setting up a spreadsheet will let us help you.

I would look at changing over to something like Lantus insulin. It is a much better insulin for cats.
Good luck. Keep asking questions.
 
https://catvets.com/public/PDFs/Toolkit/Diabetes/010920/diabetes-toolkit-full-web-010920.pdf

You may want to show him this document. On page 5, there are monitoring protocols. The first one is intensive, advising owners to check the BG at home 3 times a day.

And you don't need his permission to do the hometesting.

thank you for this document. It is helping me a lot. I may try and show it to the vet but my gut tells me I need to find a new one, rather than try to get this one to help me.

I wonder if it is ok to ask people on here if there is anyone in the Toronto area if they have a vet they love?
 
Thank you all for your replies! I will reply to them but I want to update with the latest first, and a question. But please know how much your responses have given me a boost and helped me in my resolve to do what is best for Butters. And I will do a spreadsheet.

She woke me up 90 minutes early and was heaving like she was trying to vomit (not a normal furball sound) but was then seemingly perfectly fine after. Hopefully it was nothing. I tried a preshot test this morning. I was successful in jabbing her ear about four times but many jabs and treats later, I unfortunately could not get a blood droplet to form. Not enough for the monitor. I ended up feeding her 20 minutes later than normal. So no AMPS reading.

I have now read the article on Caninsulin and am going to delay the insulin for 20 minutes after her meal, which is about 10 minutes from now. Is it worth trying to test her post-food but pre-insulin? Would that tell me anything? In the absence of no test readings, think I am going to have to just proceed with the normal dose. I have to go out in 3 hours and will be gone for about 3-4 hours. I don’t want to leave her alone if it is not safe.

Should i just try and test whenever I can while I try to get the hang of it?

Thanks!
 
hi Lyla and welcome!

you’re not alone in the fact that a lot of us have to advocate for our cats with vets. I’ve personally switched vets 3 times for that reason.

to address your question, test first then feed then shoot. Test is important to know your cats BG level. Then you need food in their system so the insulin doesn’t take them too low too fast and that’s the reason you do the shot last.

I agree with your instinct that caninsulin is not the best insulin for cats. It was made for canines hence the name and your vet seems very old school, in other words not very knowledgeable about feline diabetes. Good for you for saying no to the food and deciding to home test yay!! Most of us feed FF pate as it’s low in carbs and totally fine. You want food that it’s less than 10% carbs and there’s a great chart here somewhere that I’m sure another member will link for you

as for the weakness in the hind legs it’s called neuropathy and it’s a common side effect of diabetes. My Minnie had very severe neuropathy but once her diabetes was under control she recovered completely. There’s a great supplement that helps called Zobaline or b12 methyl. I still give it to her daily and a lot of members here have their cats on it. I get mine from vitacost and I discovered the site here. It comes in capsules and I just add it to her food. It’s pink but tasteless and odorless

the last thing I want to say is you do NOT need another fructosamine test. Don’t waste your money especially if you’re going to start home testing. That test only gives you a 3 week average and it’s pretty useless as a way to regulate the diabetes. I’d consider another vet. I had some success asking for referrals on my Nextdoor app and then screening them.

welcome again and you’ve come the best place for help when it comes to feline diabetes. I feel some of the members here deserve honorary veterinary degrees! :bighug:

Thank you so much for the warm welcome and advice. The amount of info on this site is both overwhelming and an absolute godsend. People here are indeed amazing.

I ordered a bottle of Zobaline. The food she eats doesn’t have carbs listed on the label, but when I add up all the other percentages (protein, moisture, etc.) I get to over 98% so there cannot be much in the way of carbs in her food.

My goal is to try to find a vet who can better support her. It seems very challenging right now with COVID. I don’t know of the NextDoor app. This vet is the local neighborhood vet, though. So good to know that she shouldn’t get another fructosamine test. It was very expensive.

I tried hometesting this morning! It was a huge challenge and a failure. Not enough blood drawn. I will try again, though.
 
Sounds to me like you need to find another vet who will work in partnership with you for the best outcome for Butters. The FD journey is just beginning and you need a vet who knows a bit about FD and is willing to work with you.
I'm so glad you are going to home test. ..we can help you.
You don't need to tell the vet. Butters is your cat, not his and you pay the bills.

The routine with caninsulin is test, feed, wait 30 minutes and then inject the insulin. And offer snacks during the first half of the cycles both am and pm.
Have you seen this link
http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/

Make sure you have some honey or Karo and high carb food in your tool box in case of low numbers. If you are hometesting and have high carb food and honey at home you are in control.
Here is another useful link
http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
Setting up a spreadsheet will let us help you.

I would look at changing over to something like Lantus insulin. It is a much better insulin for cats.
Good luck. Keep asking questions.

Hi, and thank you! I have thoroughly read the links you posted and delayed her shot this morning as a result. I will set up a spreadsheet. I am seeing a lot of “start on a low dose and work your way up if needed” on other threads. I’m wondering if two units twice a day sounds like too much?

I am constantly worried about Butters going hypo, especially at night when I am asleep. I am trying to do home testing. Abysmal failure thusfar. I have honey but will go purchase some high carb wet food.

The test strips cost a fortune in Canada it seems, $90 for 100 but they threw in the monitor for “free” lol.
 
Hi Lyla wow I don’t like the fact that you feel like you can’t ask your Vet about concerns you have . I’m going to let the more experienced members answer your exact questions. I can’t understand why your Vet would tell you testing is not needed . Personally I Do not know why some Vets are for Hills diet when there are so many better choices . Lyla hang in there I’m sure you will be getting answers shortly

Thank you for the encouragement! I appreciate it. My vet is definitely old school, as it turns out. We have only used him about 18 months since we moved. And you really do not know exactly who you are dealing with until there is a crisis. Now I know!
 
Welcome to FDMB. You are absolutely correct -- it's an overwhelming amount of information absorb at the beginning of this sugar dance. You'll be surprised at how quickly it all becomes routine!

It is absolutely fine to post and indicate you are looking for a vet in Toronto. We have a number of Canadian members. I would suggest starting a new thread indicating the city in the subject line so people can easily see what you're asking.

Home testing is the ONLY way to insure your cat is safe. Vets will tell you it will ruin your relationship with your cat. That's nonsense. Cats begin to understand that what you're doing helps them to feel better. (Read Gabby's legacy in my signature.) They will come to be tested because you give them treats and food at test time. It's rare that we have a member whose cat continues to rebel with testing and usually this is a cat who is a newly indoor cat who has been feral.

You are also correct that Caninsulin is a less useful insulin for cats. As the name would suggest, it was developed for treating diabetes in dogs. As cats have a faster metabolism than dogs, you don't get good duration. Caninsulin (Vetsulin in the US) hits hard and fast and doesn't last 12 hours. The American Animal Hospital Assn hasn't recommended Canisulin for years. This is a link to their most recent set of guidelines where they recommend either Prozinc or Lantus for the treatment of feline diabetes. To be a bit sarcastic, it sounds like your vet needs to do more continuing education in the treatment of feline diabetes since cats are not small dogs.

Do not assume what you're feeding your cat has no carbs since it's not listed on the label. There are only a handful of foods that list carbs on the label or even on their website. It's not a requirement to list carbs. There is a link to Dr. Lisa's food chart at the top of this forum. This is a link to cat foods that are available in Canada. I can't vouch for how up to date it is. Also, calculating the carb content is more complicated than adding up the percentages of all the other "stuff" in the guaranteed analysis you find on the can. You actually need the "as fed" data since the guaranteed analysis is usually in either minimums or maximums.
 
Hello and welcome!

I believe @Noah & me (GA) is in the Toronto area, don't know if he is at your end of the city or not, but he might also know who else on the board is from around there. I also definitely vote for a change in vet!

Congrats on your first attempt at hometesting! Bummer it didn't actually give you a number, but that will come. It's a steep learning curve at first, but gets a lot easier over time. A couple of tips:

1) use a thicker lancet (26 or 28 gauge) to start. Eventually you can move to the smaller 30+ size, but only after a few weeks of poking has caused more capillaries to grow in the ear.

2) warm the ear before poking to encourage blood flow. You can do this with a little massage, or you can make a little sock filled with rice that you warm up in the microwave (test to make sure it's not too hot on your own ear!).

3) no matter the outcome, Butters gets a treat! Doesn't take long for them to associate the pokes with treats, in the meantime you want to make sure he's on board for the new activity

Is it worth trying to test her post-food but pre-insulin? Would that tell me anything? In the absence of no test readings, think I am going to have to just proceed with the normal dose. I have to go out in 3 hours and will be gone for about 3-4 hours. I don’t want to leave her alone if it is not safe.

Should i just try and test whenever I can while I try to get the hang of it?

Thanks!

I think it's definitely worth making another attempt before giving the shot, and again before you have to leave. Especially since she did the heaving this morning-- it's likely completely unrelated, but until you can get the hometesting up and running, keeping an eye out for unusual behavior is your best safety tool.
 
Thank you so much for the warm welcome and advice. The amount of info on this site is both overwhelming and an absolute godsend. People here are indeed amazing.

I ordered a bottle of Zobaline. The food she eats doesn’t have carbs listed on the label, but when I add up all the other percentages (protein, moisture, etc.) I get to over 98% so there cannot be much in the way of carbs in her food.

My goal is to try to find a vet who can better support her. It seems very challenging right now with COVID. I don’t know of the NextDoor app. This vet is the local neighborhood vet, though. So good to know that she shouldn’t get another fructosamine test. It was very expensive.

I tried hometesting this morning! It was a huge challenge and a failure. Not enough blood drawn. I will try again, though.

Are you warming up the ear? For me it’s key to get that ear really warm and then a squeeze the puncture site to “milk” the blood kinda like popping a pimple. Here’s a pic of where you should be aiming for, and make sure you’re using the lancet’s bevel side up :)

CEB5EACE-6CB4-43A0-9270-449D6F745B3B.jpeg
 

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Hi, and thank you! I have thoroughly read the links you posted and delayed her shot this morning as a result. I will set up a spreadsheet. I am seeing a lot of “start on a low dose and work your way up if needed” on other threads. I’m wondering if two units twice a day sounds like too much?

I am constantly worried about Butters going hypo, especially at night when I am asleep. I am trying to do home testing. Abysmal failure thusfar. I have honey but will go purchase some high carb wet food.

The test strips cost a fortune in Canada it seems, $90 for 100 but they threw in the monitor for “free” lol.
What meter are you using? Can you add that to your signature? Thanks :cat:
 
Hi, and thank you! I have thoroughly read the links you posted and delayed her shot this morning as a result. I will set up a spreadsheet. I am seeing a lot of “start on a low dose and work your way up if needed” on other threads. I’m wondering if two units twice a day sounds like too much?

I am constantly worried about Butters going hypo, especially at night when I am asleep. I am trying to do home testing. Abysmal failure thusfar. I have honey but will go purchase some high carb wet food.

The test strips cost a fortune in Canada it seems, $90 for 100 but they threw in the monitor for “free” lol.
Hi! Just a heads up that if you think that's expensive, watch out for anyone who tells you that you need an AlphaTrak monitor (or any other monitor designed for pets). You pay for the meter and then the strips are twice as expensive. Also, I bit the bullet and went with my vets recommendation to try Hills and am regretting it. I say trust your instincts and stick with food that meets the criteria for macronutrients and look at the appropriate supplements if needed.
 
Hi Lyla,

It is fortunate that you come to this wonderful place to seek help.This is one of the best decision you can make for your cats.

I am no expert but I am sure that BG testing is important if not essential if you want your cats to get better from diabetes.

Again I am not expert and many people here are experts who are my qualified to help you, but let me tell you my story:

Two months ago my cats Monkey and PenPen, were in a situation that I believe worse than Butter. They have amazing recovery and one of them is very near to remission.

The success is due to we monitor their BG and fine dose the insulin, if we do not monitor their BG, there is NO way to fine dose the insulin. The best dose of insulin ensures the cats benefit from the optimal level of blood sugar, and protect them from the danger of hypoglycemia. As other people have said

Although my vet is ethical and competent, it is impossible for him to monitor my cats every day. And many vets are not trained to work with clients who proactively monitor their cat's blood sugar.

Regarding to your vet, in my humble opinion (I would want try to be humble :banghead:). That vet is not only old school but also outdated. Dry food with the high carb to cats wity DM, is not recommended by AAHA (organization that accredits veterinary practices in the US and Canada). See the 2018 AAHA Diabetes Management Guidelines for Dogs and Cats.

upload_2020-6-1_0-35-6.png
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upload_2020-6-1_0-36-20.png


I speculate that the reason your vet is misinformed, because vet receive "education" from seminars that is sponsored by big brands company. For example, according to 2010 AAHA Nutritional Assessment Guidelines for Dogs and Cats,
upload_2020-6-1_0-46-12.png
.

I find the source of that statement. It is a research that use "telephone questionnaire" to collect the data of ONLY 94 diabetic cats, which I think my 12 years old nephew can design a better research method. AHAA quote that as "a recent study" in a professional GUIDELINE for vets. The reason was clear, as I found
upload_2020-6-1_0-52-26.png


You can see how powerful the big companies to influence even AAHA. Therefore, I would not blame my vet (who is ethical) for genuinely recommending dry food to my diabetic cats, he his information outdated.

Btw, now you see in 2018 EVEN the sponsored AAHA recommended low carb diet for cats, I think it is pretty safe to say carbs is not good.

Your vet hard sell dry food to you, I have doubt for his ethics. Also, he may be too close minded to say BG monitoring is useless. My vet is very happy with my monitoring because he can use the data to make better judgement, also to keep the cat safe.

Regarding to Caninsulin, the vet gave me Caninsulin, but we found it cause the BG to fluctuate more, which is undesirable. Now I use Lantus, and it is obviously better. Also, I agree on your choice of Feline Natural. I give Feline natural to my cats because they are relatively safe and high quality compare to other brands. (And relatively high price:facepalm:)
 

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Hi and welcome! You have been given excellent advice from so many smart folks that I really don't have much to add except my support. I will say, that I switched vets 4 times to find someone who would support me in the way I chose to treat Phoebe Squeak (after getting educated by the very wise people on this FDMB).
Also, in terms of warming the ear before you test, I not only put rice in the small sock (I buy socks for newborns) I add a tiny amount of of catnip and try to rub her face with it a bit before warming her ear each time I test.
I know you may not believe this (I would not have believed it when I first started testing) but Phoebe Squeak now purrs through her tests most of the time. You will get the hang of it. Don't give up!
 
Thank you all for your replies! I will reply to them but I want to update with the latest first, and a question. But please know how much your responses have given me a boost and helped me in my resolve to do what is best for Butters. And I will do a spreadsheet.

She woke me up 90 minutes early and was heaving like she was trying to vomit (not a normal furball sound) but was then seemingly perfectly fine after. Hopefully it was nothing. I tried a preshot test this morning. I was successful in jabbing her ear about four times but many jabs and treats later, I unfortunately could not get a blood droplet to form. Not enough for the monitor. I ended up feeding her 20 minutes later than normal. So no AMPS reading.

I have now read the article on Caninsulin and am going to delay the insulin for 20 minutes after her meal, which is about 10 minutes from now. Is it worth trying to test her post-food but pre-insulin? Would that tell me anything? In the absence of no test readings, think I am going to have to just proceed with the normal dose. I have to go out in 3 hours and will be gone for about 3-4 hours. I don’t want to leave her alone if it is not safe.

Should i just try and test whenever I can while I try to get the hang of it?

Thanks!
My cat was in vetsulin when diagnosed which is the same as caninsulin. She actually did really well in it and went into remission after 4 months. (Stayed in remission for a year). It works for some, for others a longer acting insulin is better. I now use ProZinc because she's a high dose kitty.
ProZinc stings less at high doses.
Testing is definitly the way to go. I didn't test the first 6 weeks and was constantly waking up in the middle of the night to check on her. Testing took a lot of the guesswork out of it, and has literally saved her life, including last night. I have a video in my signature showing how I test my cat CC at home.

She might have been choking on stomach acid from being. Most find a few smaller meals are better than just two big meals. Just no food 2 hours prior to the preshot test so the number is not food influenced.
 
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Hi, and thank you! I have thoroughly read the links you posted and delayed her shot this morning as a result. I will set up a spreadsheet. I am seeing a lot of “start on a low dose and work your way up if needed” on other threads. I’m wondering if two units twice a day sounds like too much?

I am constantly worried about Butters going hypo, especially at night when I am asleep. I am trying to do home testing. Abysmal failure thusfar. I have honey but will go purchase some high carb wet food.

The test strips cost a fortune in Canada it seems, $90 for 100 but they threw in the monitor for “free” lol.
The recommended starting dose is 1 unit twice a day. I would lower until you really get the hang of testing. If through testing you find its not enough you can raise it in 0.25-0.5 increments.
 
Hi Lyla,

It is fortunate that you come to this wonderful place to seek help.This is one of the best decision you can make for your cats.

I am no expert but I am sure that BG testing is important if not essential if you want your cats to get better from diabetes.

Again I am not expert and many people here are experts who are my qualified to help you, but let me tell you my story:

Two months ago my cats Monkey and PenPen, were in a situation that I believe worse than Butter. They have amazing recovery and one of them is very near to remission.

The success is due to we monitor their BG and fine dose the insulin, if we do not monitor their BG, there is NO way to fine dose the insulin. The best dose of insulin ensures the cats benefit from the optimal level of blood sugar, and protect them from the danger of hypoglycemia. As other people have said

Although my vet is ethical and competent, it is impossible for him to monitor my cats every day. And many vets are not trained to work with clients who proactively monitor their cat's blood sugar.

Regarding to your vet, in my humble opinion (I would want try to be humble :banghead:). That vet is not only old school but also outdated. Dry food with the high carb to cats wity DM, is not recommended by AAHA (organization that accredits veterinary practices in the US and Canada). See the 2018 AAHA Diabetes Management Guidelines for Dogs and Cats.

View attachment 53920View attachment 53921View attachment 53922

I speculate that the reason your vet is misinformed, because vet receive "education" from seminars that is sponsored by big brands company. For example, according to 2010 AAHA Nutritional Assessment Guidelines for Dogs and Cats, View attachment 53926.

I find the source of that statement. It is a research that use "telephone questionnaire" to collect the data of ONLY 94 diabetic cats, which I think my 12 years old nephew can design a better research method. AHAA quote that as "a recent study" in a professional GUIDELINE for vets. The reason was clear, as I found View attachment 53927

You can see how powerful the big companies to influence even AAHA. Therefore, I would not blame my vet (who is ethical) for genuinely recommending dry food to my diabetic cats, he his information outdated.

Btw, now you see in 2018 EVEN the sponsored AAHA recommended low carb diet for cats, I think it is pretty safe to say carbs is not good.

Your vet hard sell dry food to you, I have doubt for his ethics. Also, he may be too close minded to say BG monitoring is useless. My vet is very happy with my monitoring because he can use the data to make better judgement, also to keep the cat safe.

Regarding to Caninsulin, the vet gave me Caninsulin, but we found it cause the BG to fluctuate more, which is undesirable. Now I use Lantus, and it is obviously better. Also, I agree on your choice of Feline Natural. I give Feline natural to my cats because they are relatively safe and high quality compare to other brands. (And relatively high price:facepalm:)
I agree with JT thanks for this great info Peter! It’s what I said they’re just like human doctors trying to push certain meds on us :arghh:
 
Hi and welcome! You have been given excellent advice from so many smart folks that I really don't have much to add except my support. I will say, that I switched vets 4 times to find someone who would support me in the way I chose to treat Phoebe Squeak (after getting educated by the very wise people on this FDMB).
Also, in terms of warming the ear before you test, I not only put rice in the small sock (I buy socks for newborns) I add a tiny amount of of catnip and try to rub her face with it a bit before warming her ear each time I test.
I know you may not believe this (I would not have believed it when I first started testing) but Phoebe Squeak now purrs through her tests most of the time. You will get the hang of it. Don't give up!
That’s truly a great idea!!
 
Hi Lyla, I'm actually out in Milton and not Toronto. It's been 20 years so I don't know any vets in Toronto and I know of only one member in Etobicoke who has been absent for some time. We use two clinics and both our vets would be shocked by what your vet suggested. You did the right thing by learning to test. It's your life and your cat, you're not obligated in any way to obey what this guy tells you to do or not to do. It's a long story but we hear this too often, vets who just cannot accept there is something you know that they don't.
We've had two sugar cats but they're both gone now so I'm not much for medical advice or reading spreadsheets but you're off to a good start and in the right place. Diabetes isn't a tragedy, it's just an inconvenience. If you're desperate enough to travel this far I can recommend two great vets out here, one of them even boards diabetic cats. Just tag or PM me, we generally don't name our vets here and I have some privacy concerns from a past life.
 
"The test strips cost a fortune in Canada it seems, $90 for 100 but they threw in the monitor for “free” lol."

Hi Lyla,

I also use the Freestyle Lite monitor. You can get the strips much cheaper on ebay - about 1/2 the cost. I'm also in Canada, and in several provinces, you do not need a vet prescription for insulin for your pet. Even though I spoke to several vets and pharmacists who said I needed a prescription, they were misinformed. I had to contact the provincial pharmacy association to get confirmation. Prior to me knowing this, my vet was charging me $15 to get the prescription for insulin.
 
"The test strips cost a fortune in Canada it seems, $90 for 100 but they threw in the monitor for “free” lol."

Hi Lyla,

I also use the Freestyle Lite monitor. You can get the strips much cheaper on ebay - about 1/2 the cost. I'm also in Canada, and in several provinces, you do not need a vet prescription for insulin for your pet. Even though I spoke to several vets and pharmacists who said I needed a prescription, they were misinformed. I had to contact the provincial pharmacy association to get confirmation. Prior to me knowing this, my vet was charging me $15 to get the prescription for insulin.
What?!?! Charging you for a prescription?! I never heard of such thing :mad::mad::mad:
 
Welcome to FDMB. You are absolutely correct -- it's an overwhelming amount of information absorb at the beginning of this sugar dance. You'll be surprised at how quickly it all becomes routine!

It is absolutely fine to post and indicate you are looking for a vet in Toronto. We have a number of Canadian members. I would suggest starting a new thread indicating the city in the subject line so people can easily see what you're asking.

Home testing is the ONLY way to insure your cat is safe. Vets will tell you it will ruin your relationship with your cat. That's nonsense. Cats begin to understand that what you're doing helps them to feel better. (Read Gabby's legacy in my signature.) They will come to be tested because you give them treats and food at test time. It's rare that we have a member whose cat continues to rebel with testing and usually this is a cat who is a newly indoor cat who has been feral.

You are also correct that Caninsulin is a less useful insulin for cats. As the name would suggest, it was developed for treating diabetes in dogs. As cats have a faster metabolism than dogs, you don't get good duration. Caninsulin (Vetsulin in the US) hits hard and fast and doesn't last 12 hours. The American Animal Hospital Assn hasn't recommended Canisulin for years. This is a link to their most recent set of guidelines where they recommend either Prozinc or Lantus for the treatment of feline diabetes. To be a bit sarcastic, it sounds like your vet needs to do more continuing education in the treatment of feline diabetes since cats are not small dogs.

Do not assume what you're feeding your cat has no carbs since it's not listed on the label. There are only a handful of foods that list carbs on the label or even on their website. It's not a requirement to list carbs. There is a link to Dr. Lisa's food chart at the top of this forum. This is a link to cat foods that are available in Canada. I can't vouch for how up to date it is. Also, calculating the carb content is more complicated than adding up the percentages of all the other "stuff" in the guaranteed analysis you find on the can. You actually need the "as fed" data since the guaranteed analysis is usually in either minimums or maximums.

Hi Sienne! I read Gabby's legacy and I may have had a tear or two (or more) roll down my cheeks as I did. Your tribute to her is a wonderful way to honour her memory by sharing your story and it definitely helps me as a newbie. It was all shocking at first but I am 100% committed to revolving my entire life around making sure that Butters lives her best life, including home testing.

I am going to take your advice and do a post for vet recommendations. I have done a bit of internet research. My vet may be an awesome dog vet. Come to think of it, I have only ever seen dogs in his office, but that may just be a coincidence.

That food chart is amazing and go figure that Butters' favourite food is not recommended because the company would not provide the TNA. Sigh. I had no idea how complicated it is to figure out the amount of carbs in a can of food. I'll have to do some more research. Thanks for all the advice!
 
Hello and welcome!

I believe @Noah & me (GA) is in the Toronto area, don't know if he is at your end of the city or not, but he might also know who else on the board is from around there. I also definitely vote for a change in vet!

Congrats on your first attempt at hometesting! Bummer it didn't actually give you a number, but that will come. It's a steep learning curve at first, but gets a lot easier over time. A couple of tips:

1) use a thicker lancet (26 or 28 gauge) to start. Eventually you can move to the smaller 30+ size, but only after a few weeks of poking has caused more capillaries to grow in the ear.

2) warm the ear before poking to encourage blood flow. You can do this with a little massage, or you can make a little sock filled with rice that you warm up in the microwave (test to make sure it's not too hot on your own ear!).

3) no matter the outcome, Butters gets a treat! Doesn't take long for them to associate the pokes with treats, in the meantime you want to make sure he's on board for the new activity



I think it's definitely worth making another attempt before giving the shot, and again before you have to leave. Especially since she did the heaving this morning-- it's likely completely unrelated, but until you can get the hometesting up and running, keeping an eye out for unusual behavior is your best safety tool.

Hi! Thank you! It was a bummer, and another bummer when I tried again before the shot as I still couldn't get blood. Butters got so many treats, but I think we were both a bit stressed. I tried again about 90 minutes after the shot and got a HUGE drop of blood, so I think I actually hit the vein, which I didn't mean to do. I read somewhere not to go direct through the vein, so I felt bad. But I did get my first reading and I set up the spreadsheet! She seems none the worse for wear, now.

The monitor came with 28 gauge lancets, so I'll use those for now. I will create a little rice sock. What a great idea. I was using a tea towel.
 
Hi! Thank you! It was a bummer, and another bummer when I tried again before the shot as I still couldn't get blood. Butters got so many treats, but I think we were both a bit stressed. I tried again about 90 minutes after the shot and got a HUGE drop of blood, so I think I actually hit the vein, which I didn't mean to do. I read somewhere not to go direct through the vein, so I felt bad. But I did get my first reading and I set up the spreadsheet! She seems none the worse for wear, now.

The monitor came with 28 gauge lancets, so I'll use those for now. I will create a little rice sock. What a great idea. I was using a tea towel.
CONGRATULATIONS ON YOUR FIRST TEST!! Testing will get easier after a week or so when the capillaries start growing in.
 
Hi! Thank you! It was a bummer, and another bummer when I tried again before the shot as I still couldn't get blood. Butters got so many treats, but I think we were both a bit stressed. I tried again about 90 minutes after the shot and got a HUGE drop of blood, so I think I actually hit the vein, which I didn't mean to do. I read somewhere not to go direct through the vein, so I felt bad. But I did get my first reading and I set up the spreadsheet! She seems none the worse for wear, now.

The monitor came with 28 gauge lancets, so I'll use those for now. I will create a little rice sock. What a great idea. I was using a tea towel.

That happens unfortunately some times. Apply pressure for a few seconds so the spot won’t bruise and you can also apply a little Neosporin to help it heal
 
Are you warming up the ear? For me it’s key to get that ear really warm and then a squeeze the puncture site to “milk” the blood kinda like popping a pimple. Here’s a pic of where you should be aiming for, and make sure you’re using the lancet’s bevel side up :)

View attachment 53917

I am going to make a rice sock to help with warming the ear, and I have been doing it bevel side up. She does not like me touching her ear after and she absolutely hates staying still. I think I got enough blood from one of my earlier tries, but when I tried to get the droplet she shook her head and it went flying.
She is so squirmy about everything, though. My biggest issue is trying to get her to stay still so that I can jab her ear in the right place and get the droplet. If I try to hold her too much, she fights me. I mostly just ply her with treats and hope I have her enough to keep her distracted.
 
I am going to make a rice sock to help with warming the ear, and I have been doing it bevel side up. She does not like me touching her ear after and she absolutely hates staying still. I think I got enough blood from one of my earlier tries, but when I tried to get the droplet she shook her head and it went flying.
She is so squirmy about everything, though. My biggest issue is trying to get her to stay still so that I can jab her ear in the right place and get the droplet. If I try to hold her too much, she fights me. I mostly just ply her with treats and hope I have her enough to keep her distracted.
Sometimes it helps to get them used to you touching the ears without testing. Just throughout the day touch then and massage them a little. I heard a while back that massaging the cat’s ear is a good way to relax them so I’ve been doing it to mine since they were kittens :cat:
 
Added! Thanks. Freestyle Lite. I think I have everything in my signature now.
Some people save up their PC points to buy FreeStyle Lite strip sat Shoppers Drug Mart. If you are a senior or have one handy, make use of Shopper's Seniors Days. Also, check out Costco if one is close by. I'm told you don't need to be a member to use the pharmacy. I'm also told they have a decent price for Lantus if or when you switch insulins. Only humans need a prescription in Ontario. Cats are superior beings.

Edit: but don't go chasing around for the best available price right now in the GTA. Not worth it.
 
Hi Lyla,

It is fortunate that you come to this wonderful place to seek help.This is one of the best decision you can make for your cats.

I am no expert but I am sure that BG testing is important if not essential if you want your cats to get better from diabetes.

Again I am not expert and many people here are experts who are my qualified to help you, but let me tell you my story:

Two months ago my cats Monkey and PenPen, were in a situation that I believe worse than Butter. They have amazing recovery and one of them is very near to remission.

The success is due to we monitor their BG and fine dose the insulin, if we do not monitor their BG, there is NO way to fine dose the insulin. The best dose of insulin ensures the cats benefit from the optimal level of blood sugar, and protect them from the danger of hypoglycemia. As other people have said

Although my vet is ethical and competent, it is impossible for him to monitor my cats every day. And many vets are not trained to work with clients who proactively monitor their cat's blood sugar.

Regarding to your vet, in my humble opinion (I would want try to be humble :banghead:). That vet is not only old school but also outdated. Dry food with the high carb to cats wity DM, is not recommended by AAHA (organization that accredits veterinary practices in the US and Canada). See the 2018 AAHA Diabetes Management Guidelines for Dogs and Cats.

View attachment 53920View attachment 53921View attachment 53922

I speculate that the reason your vet is misinformed, because vet receive "education" from seminars that is sponsored by big brands company. For example, according to 2010 AAHA Nutritional Assessment Guidelines for Dogs and Cats, View attachment 53926.

I find the source of that statement. It is a research that use "telephone questionnaire" to collect the data of ONLY 94 diabetic cats, which I think my 12 years old nephew can design a better research method. AHAA quote that as "a recent study" in a professional GUIDELINE for vets. The reason was clear, as I found View attachment 53927

You can see how powerful the big companies to influence even AAHA. Therefore, I would not blame my vet (who is ethical) for genuinely recommending dry food to my diabetic cats, he his information outdated.

Btw, now you see in 2018 EVEN the sponsored AAHA recommended low carb diet for cats, I think it is pretty safe to say carbs is not good.

Your vet hard sell dry food to you, I have doubt for his ethics. Also, he may be too close minded to say BG monitoring is useless. My vet is very happy with my monitoring because he can use the data to make better judgement, also to keep the cat safe.

Regarding to Caninsulin, the vet gave me Caninsulin, but we found it cause the BG to fluctuate more, which is undesirable. Now I use Lantus, and it is obviously better. Also, I agree on your choice of Feline Natural. I give Feline natural to my cats because they are relatively safe and high quality compare to other brands. (And relatively high price:facepalm:)

Hi!
Thank you for sharing your "humble" opinion. ;) It certainly makes a lot of sense to me! I have always been so cautious about what I consume as a consumer, and wary of studies that big corporations are sponsoring. I never thought about it happening in the pet food/veterinary industries until now.

I also am questioning my vet's ethics and honestly after hearing everyone's opinions on here mirror what my own voice in my head is saying, I am hyperfocused on finding a vet asap who will support home testing and switching to Lantus, perhaps.

Nice to find someone else feeding Feline Natural to their cats! I had done a lot of research and thought they were pretty high quality and safe. Butters' food expenses are higher than mine, though!
 
Hi and welcome! You have been given excellent advice from so many smart folks that I really don't have much to add except my support. I will say, that I switched vets 4 times to find someone who would support me in the way I chose to treat Phoebe Squeak (after getting educated by the very wise people on this FDMB).
Also, in terms of warming the ear before you test, I not only put rice in the small sock (I buy socks for newborns) I add a tiny amount of of catnip and try to rub her face with it a bit before warming her ear each time I test.
I know you may not believe this (I would not have believed it when I first started testing) but Phoebe Squeak now purrs through her tests most of the time. You will get the hang of it. Don't give up!
Thanks and what a great idea with the catnip!
It is hard to imagine that Butters will ever purr through her tests like Phoebe Squeak, but I'm going to try!
 
My cat was in vetsulin when diagnosed which is the same as caninsulin. She actually did really well in it and went into remission after 4 months. (Stayed in remission for a year). It works for some, for others a longer acting insulin is better. I now use ProZinc because she's a high dose kitty.
ProZinc stings less at high doses.
Testing is definitly the way to go. I didn't test the first 6 weeks and was constantly waking up in the middle of the night to check on her. Testing took a lot of the guesswork out of it, and has literally saved her life, including last night. I have a video in my signature showing how I test my cat CC at home.

She might have been choking on stomach acid from being. Most find a few smaller meals are better than just two big meals. Just no food 2 hours prior to the preshot test so the number is not food influenced.

Hi Janet!

I watched your video and then tried for a PMPS test and it worked! Your kitty was so calm through the whole process. Butters was definitely better tonight. Oh and I can tell that the Caninsulin stings for her. She always jumps when it goes in.

I am holding back some of her dinner for her tonight to eat 1.5 hours after insulin, as a starting point. Butters inhales any food that is put in front of her immediately. My vet was so adamant about feeding her only twice a day and that's it. Of course, he has already proven himself to be untrustworthy to me.

But yeah, I hear you. I will not be sleeping well until we have the whole testing thing down.
 
My vet was so adamant about feeding her only twice a day and that's it.
My vet wanted me to do the same thing. Freckles has a voracious appetite too. I found that by feeding smaller meals more often, she was much more content. I use an autofeeder so I don't have to remember about the time, so she gets 5 small meals during a 12 hour period.
 
Hi Janet!

I watched your video and then tried for a PMPS test and it worked! Your kitty was so calm through the whole process. Butters was definitely better tonight. Oh and I can tell that the Caninsulin stings for her. She always jumps when it goes in.

I am holding back some of her dinner for her tonight to eat 1.5 hours after insulin, as a starting point. Butters inhales any food that is put in front of her immediately. My vet was so adamant about feeding her only twice a day and that's it. Of course, he has already proven himself to be untrustworthy to me.

But yeah, I hear you. I will not be sleeping well until we have the whole testing thing down.
Congratulations!!! I'm so glad you were able to get a reading. 250 is not a very high number for a newly diagnosed cat at shot time. You may find you need to lower the dose. Try to get a reading about 4 hours after a shot to see what the shot is doing. Caninsulin trends to peek 4-6 hours after injection.
 
Congratulations!!! I'm so glad you were able to get a reading. 250 is not a very high number for a newly diagnosed cat at shot time. You may find you need to lower the dose. Try to get a reading about 4 hours after a shot to see what the shot is doing. Caninsulin trends to peek 4-6 hours after injection.
Thanks for your continued advice! 250 was actually at +1. I wasn't able to get any blood for the AMPS yesterday. In the evening, I watched your video and then successfully did the PMPS and the reading on that was 360. This morning's AMPS reading was 304. I am going to try to do one at the four hour mark or so.

I did reduce the dose a little bit starting last night, to 1.75 u approximately. I am using U-100 needles and doing the conversion so it is a little trickier. But I am making sure to align the stopper in the exact same position each time. I'd reduce the dose more though if it looks like I should, now that I am getting a few home testing numbers.
 
Hi! Just a heads up that if you think that's expensive, watch out for anyone who tells you that you need an AlphaTrak monitor (or any other monitor designed for pets). You pay for the meter and then the strips are twice as expensive. Also, I bit the bullet and went with my vets recommendation to try Hills and am regretting it. I say trust your instincts and stick with food that meets the criteria for macronutrients and look at the appropriate supplements if needed.
I hadn't even considered supplements. I am going to try her on Zobaline, though, for a start.

I'm sorry you went with your vet's recommendation and regret it. Our instincts are important when it comes to our furbabies. It is so hard to know what to do, though, when the vets are telling you what to do since they are supposed to be the experts! Butters had dental issues a year ago and at that time he pushed a bag of Hills dental diet on me to use for treats. She became completely addicted to them. I definitely have regrets over that.
 
The recommended starting dose is 1 unit twice a day. I would lower until you really get the hang of testing. If through testing you find its not enough you can raise it in 0.25-0.5 increments.

I think I do want to lower it more. I got a 70 reading about 4.5 hours after administering the 1.75 u of insulin. I think that's a bit of a low reading, but I am not knowledgeable enough to know for sure. I thought somewhere on the forum I read that you should only increase/decrease by .25 u at a time, so I didn't want to decrease too fast. Would it be safe to go down to 1.5 tonight?
 
My vet wanted me to do the same thing. Freckles has a voracious appetite too. I found that by feeding smaller meals more often, she was much more content. I use an autofeeder so I don't have to remember about the time, so she gets 5 small meals during a 12 hour period.

I think Butters would be more content with multiple feedings, too. Your signature shows you feed Freckles wet? Do you have an autofeeder recommendation for wet food? I have only seen them for dry.

How do you space out her five meals relative to when you give insulin, and are they all the exact same amount of food?

Thanks!
 
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