Cat newly diagnosed with diabetes in need of help

[Schwa]

Hi!

My cat was diagnosed with diabetes in November.
He should have been before but my vet didn't tell me his glycemy was too high when we tested it 2 years ago and as she didn't tell me I assume the number she gave me was okay.. Anyway.

Now she told me herself she didn't know how to help me because diabetes is not her specialty and I was referred to an internist.

After a lot of exams and lots of money spent, we finally started the treatment.
At the moment we are with Lantus.
We started really low even if my cat is obese.
Now we're at 5 units twice a day and his glycemy is higher than when we started. His urinal puddle are scary huge. I don't know what to do.

We are giving him diet food per the internist recommendations...
And some food with more protein we found thanks to this forum (because the veterinary food seems really not helpful for diabetes!)

Apart from crying I really don't know what to do anymore. He's always hungry! More than he ever was actually and still not losing a gram. He's keeping the same weight or maybe gained a bit, even if I'm really careful on how much I give him.
His glycemy is hitting dangerous records..
(I don't know how to convert my glycemy results in more traditional units! Buy he was 29 this morning. 22 now. The cat in good health should be between 4 and 8...
He never was 29 before. Even at the vet office with stress ++ he was 23-25...)
We are waiting for the results for acromegaly but I fear no one will be able to help us. And I don't have infinite money to go see another specialist then another then another.
I love my cat but I'm really at the end of my mental health and feel helpless.

Anyway sorry for the long and useless introduction.


My main questions are :
-am I the only one with the highest glycemic result on earth?
-what food do you give yours that is not full of flour and other cr*ps that we find at the vet store
-is my cat staying fat because he's keeping "provisions" because he's always starving?
-should I double his insuline dosage as there is no change, and actually it's worse?

Thank you for your time

Have a great day

 

[Sienne and Gabby (GA)]

Welcome to FDMB. Your introduction is by no means useless. I wish I could say that your experience is uncommon. Unfortunately, it's not.

I'm really sorry this has been such an ordeal. I cannot imagine that your vet couldn't have gotten you started on diabetes treatment! Not telling you about your cat's lab results is poor veterinary practice. (Can you imagine your family doctor not telling you that you had diabetes? Or your pediatrician not telling you your child had diabetes?) FWIW, I always get a copy of my cats' lab results. If I ever needed to see another vet or take one of my guys in for emergency treatment, I have their labs.

There are several basics that we can share to get your started. Just for the record, the beginning of this process is overwhelming. So if you're feeling that way, it's very normal. We may also make suggestions that are counter to what your vet or the IM vet is telling you. All I can say is that this board has been here for 25 years and we started using Lantus before it was a recommended insulin for treating feline diabetes. There is a great deal of accumulated knowledge here and it's all about diabetes, all the time. We're also here pretty much 24/7 since this is an international community.

So, to answer your questions:

-am I the only one with the highest glycemic result on earth?

In a word, no. Your cat does not have this highest blood glucose readings on earth! (To convert your numbers which are in mmol/L units to what we use in the US -- mg/dL, just multiply by 18). Once you start looking at other members' spreadsheets, you'll see the range in numbers.

-what food do you give yours that is not full of flour and other cr*ps that we find at the vet store

Good instincts about food! This is a link to a food chart that we use. You want to select foods that are low in carbohydrates. We define low as less than 10% although most people feed their cats in the 5% range. Most people feed their cat Fancy Feast or Friskies pate style foods. The food chart is primarily for US based members. Since you're using blood glucose readings that are based on international reference, I'm guessing you're not in the US. This is a link to food charts from other countries.

-is my cat staying fat because he's keeping "provisions" because he's always starving?

Actually, your cat is starving because he's diabetic. Insulin is the hormone that helps to transport the glucose that results from your cat metabolizing food into his cells. With diabetes, there's not enough insulin to help the glucose get where it's supposed to go. The result is that the glucose is floating around in the blood stream and your cat is then hungry all the time. In addition, if you're feeding your cat a diet that's higher in carbs, it's not a species appropriate diet. Cats are obligate carnivores -- all they need is protein and some additional vitamins and supplements for their diet to be nutritionally complete. They can't metabolize the fruit, veggies, and grain that's in some cat foods.

-should I double his insuline dosage as there is no change, and actually it's worse?

Please do not change your insulin dose. We would need a lot more information before giving you any information about a dose change. We also make changes in dose in a small, systematic way so you don't miss what could be an effective dose for your cat and you don't have a hypoglycemic episode on your hands.

Should your cat be diagnosed with acromegaly, we have members who are experienced with that condition, as well. One of our members, @Wendy&Neko is incredibly current on treatment of feline acromegaly.

Let me make some suggestions to help you get started and begin to feel more in control of managing your cat's diabetes. First, please look over this link to a post on helping us to help you. There's a great deal of good basic information in the link. There are two places to get started. First, set up a spreadsheet. You'll notice we all have links to our cat's spreadsheet in our signature. The spreadsheet will help you keep track of your cat's progress and allow us to follow along and make suggestions. If you need help getting your spreadsheet set up, I'm tagging a member who can lend a hand (@Bandit's Mom).

It sounds like you're home testing. That is a huge first step. If you can transfer your data to the spreadsheet that would be ideal. I'm assuming your meter stores a couple weeks of test data. We ask that your get at minimum, four tests per day. Always test before giving a shot of insulin -- your AM and PM pre-shot tests (AMPS and PMPS). You also need to get at least one other test during both the AM and PM cycle, preferably somewhere around the middle of the cycle. This will tell you how low the insulin dose is taking your cat's numbers.

It will also help us if you can create a signature. It includes some basics like your name, your kitty's name, date of diagnosis, the insulin you're using, dosing method, medical issues, etc. Without that information, we'll keep asking you the same questions over and over again. There are just too many members here to keep all of that information in our heads.

I'm sorry if this is adding to your being overwhelmed. Like I said, we have tons of information here and links to pretty much anything and everything you would need. Please ask questions. The people here are very generous with their time and knowledge. We're here to help.

 

[Schwa]

Thank you so much for your answer.

I'm just starting in home testing.
The first "all day tests" was done at the vet where we left our cat for the day. The second time I did it at home but on the 5th test of the day my cat moved and a little bit of his ear was harmed in the process and now he has a mini hole. I was really sad for 1 week before I could get over it... So today it's more than 3 weeks later because I lost all my confidence. It's going a bit better but still stressful for both of us.

He's a really stressed cat in addition (he can jump when we use the light switch!) and I learned that stress also increases the glycemy result..

Also I will do everything you told me to but it might take some time!

As for the food, he's currently having royal canin satiety (dry food for the night ; humid food during the day), royal canin diabetic (but there's not much protein in that one!).
We gave him ahi tuna & chicken (Tiki cat) ; chicken&duck in gravy sauce (cats in the kitchen) that we found on this link https://allaboutcats.com/best-cat-food-diabetic-cats
And royal canin Weight care (not caloric but not having much in it too!)

Our vet specialist recommended we first try to make him lose weight
(and diabetic food is often high caloric)

Oh and I'd also want to say that I'm French Canadian so I apologize if I make mistakes or if I don't understand some stuff and ask more questions!

Thanks again and have a great day!

 

[Wendy&Neko]

Bonjour from chilly B.C. I fed my girl raw food that was made in Canada, actually some of it not more than 10 minutes drive from me. I hate to say this, but the dry food is not appropriate at all for a diabetic cat. And could be the reason for his high numbers. Get rid of the "veterinary prescription" food, most of it is too high in carbs for a diabetic cat. However, don't remove all the high carb food right away. It can drastically change the amount of insulin needed and you should be comfortable with home testing before you make the change. Lots of tips and video's on this page: Hometesting Links and Tips

Getting rid of excess weight is important, but must be done very slowly. Switching to a higher protein wet food with less carbs will help. More information on weight loss on this page. There is even a french translation on that page for you.

If you do get a diagnosis of acromegaly, we can help you with suggestions for treatment that are a reasonable cost.

 

[Sienne and Gabby (GA)]

Those all day tests that the vet was doing are called "curves." It's expensive to have the vet do the curve. In addition, as you correctly noted, most cats are stressed when at the vet's office. And stress does have an effect on blood glucose levels. (We refer to the tests as blood glucose -- BG -- which is what I think you mean by glycemy.) In fact, we strongly encourage members to do the curves at home. If the vet makes a dose adjustment based on artificially high numbers, there's a good chance that the insulin dose will be too high. Once your cat is home and in comfortable surroundings, his BG levels will drop back and the increase could be dangerous.

It is important to get a curve but this is something you can do at home. It will be far less expensive and far more accurate to do this in the comfort of your home. As for testing, every time your test, give your cat a treat. (Most people here use a freeze dried protein, like freeze dried chicken, which is available at pet stores or online. If your cat likes cooked or raw chicken, you can also use that.) It can help the testing process to have your cat associate testing with a treat. It will also help if you are feeling confident. If you are feeling anxious, your cat will sense your anxiety.

The link about what to feed your cat was fundamentally good. However, the Cats in the Kitchen flavor of Weruva is 14% carbs which we consider a medium carb food. (Low carb is less than 10%, medium carb is 10 - 15% and high carb is over 15%.) The Tiki Cat is 1.3% carb -- it's a good choice. Some members prefer to not feed their cats fish more than once or twice a week. Depending on the fish, there may be mercury which is a common element in fish products and not particularly healthy for your cat. Most of the foods in the list in that article have fish in their ingredients. The Royal Canin foods are all high in carbohydrates. I would take a look at the list of foods available in Canada and try a few low carbohydrate options out. Once your cat's BG is better regulated, it will be easier to work on weight loss.

Please let Bhooma (@Bandit's Mom) help you get your spreadsheet and signature set up. She is located in India and is probably sleeping right now. She will be around in several hours and will leave you a message.

No worries about asking questions. We love questions! We've also made good use of Google Translate when there has been a language barrier.

 

[Bandit's Mom]

Hello and welcome to FDMB!
I can help you set up your spreadsheet and signature. I have sent you a PM with the details I need. Look for it in the Inbox at the top right corner of this page.

 

[Schwa]

Hi! Thank you I will send you as soon as possible my answer!

I have a question meanwhile!
Is it normal that my cat smells insulin after a shot? As we are giving him a pretty high dosage I would notice if I completely miss cause his furr would be wet but it's not the case...
I feel he's rejecting my insulin from his whole body Mr cat doesn't seem to want to heal..

And another question is about the food (again).
He's soooo hungry all the time. He finishes his ration for the night in 5 minutes so wakes us up every single day at 7:30 for a while. Next week it was 5:30.. Today at 3:30 he was meowing..
We changed yesterday his dry food (it's only for the night the dry) to one recommended at the pet shop with way more protein and less grains. The guy told us it would help the cat feel less hungry but first try is quite a fail!
I love my cat but I miss my sleep so much!
O try to ignore him but it doesn't work anymore..
We managed to train him to wait until we wake up, but since his hepatic lipidose remission, he never been so famished.. It makes me sad but we can't do anything...
I will try to leave some zucchini for him during the night but how can we get back out nights?
My hubby is really suffering of the lack of sleep on addition to loads of personal problems we also have in our lives. It begins to be really hard to handle our cat.

Oh and also we heard back from the vet.
He has not acromegalya! Also the vet says it's too early to talk about insulin resistant... So I'm really wondering why she makes us worry for this disease and make us spend so much for a test to early to explore? Anyway it's done now.
Meanwhile his diabetes still is not at all controlled nor his weight
We continue to try foods I guess while decreasing the calories..

Have a great day everyone and happy new year

 

[Bandit's Mom]

You can sometimes smell insulin from the location where you gave the shot. What is the dose he is on now? How many units? Was he tested only for acromegaly or also IAA (Insulin Auto Antibodies)? It's possible that he hadn't reached a good dose yet.

Diabetic cats cannot process their food and are therefore constantly hungry. It helps to feed them small meals through the day and night. Can you get an autofeeder that you can set to open and feed every 3 hours or so? Cats can also be very hungry if they are dropping into low blood sugar numbers.

Most dry food is too high in carbs. The only low carb dry food are Young Again, Dr. Elsey’s Cleanprotein and Wysong Epigen.

It would be great if we can see some test data. It is very hard to help without knowing how much insulin he is getting and how he is responding to each dose.

 

[Schwa]

You can sometimes smell insulin from the location where you gave the shot. What is the dose he is on now? How many units? Was he tested only for acromegaly or also IAA (Insulin Auto Antibodies)? It's possible that he hadn't reached a good dose yet.

Diabetic cats cannot process their food and are therefore constantly hungry. It helps to feed them small meals through the day and night. Can you get an autofeeder that you can set to open and feed every 3 hours or so? Cats can also be very hungry if they are dropping into low blood sugar numbers.

Most dry food is too high in carbs. The only low carb dry food are Young Again, Dr. Elsey’s Cleanprotein and Wysong Epigen.

It would be great if we can see some test data. It is very hard to help without knowing how much insulin he is getting and how he is responding to each dose.

HI!

He's getting 6 unit twice a day since last week. We will most likely increase to 7 units after next blood tests as he's still above 20 mmol and should be under 8 (the vet is aiming 15 at the moment). Meanwhile I feel we wasting so much time as it's almost as if he wasn't getting insuline at all.
If we go past 10 units without any improvements, we'll change the insuline to another one she said.
Atm we are using lantus. The good news is she will make me a Rx so I can buy it at the human drugstore. I'm hoping it'll be less expensive (we re living in Canada).

We looked into auto feeders but they seem less practical for wet food
And for dry food anyway he's eating in less than 5 minutes so it'll be really hard to use
The dry food we bought is made in Canada and supposibly proteins proteins proteins, no grain, low in carbs. The guy told us that with protein, the appetite should decrease a bit as he would feel full.
Knowing my cat, I'm not seeing him feeling full any day soon, he was always very hungry and gourmand, even little we he had no health issues. But we're trying.

He was just tested for acromegaly. The vet said it's too early to test the antibodies one and she wouldn't be able to analyse the results as there's so little information about diabetes and complications/other diseases


I'll try to answer your DM as soon as I can find a moment.
I don't think I'll be able to test his blood every day though cause it's really stressful for everyone! For now I'm just trying to get the measurements every 7-10 days after an increase of the dosage and my own stress level is already up the roof
As I got him injured the first time, I'm afraid to hurt him again and my anxiety is not helping.
At least the shots are getting easier but still stressful.

And also, I don't know if I mentioned this, but my cat is awfully stressed all the time, jumps every time there's a sudden noise. That doesn't help his glycemic levels either.
We tried Feliway but it did nothing and the little pill starting with a Z but nothing.
The vet said we could go see another specialist to prescribe anti depressant same kind than humans but we're not there yet. We're focusing on his weight and glycemy for the moment.
It's hard though cause because of his stress we can't ask anyone to take care of him anymore, so no more vacation for us.. No way he would let anyone else do the shots.. To eat, ok, he'll accept food from anybody. But letting someone approach him, forget about it. It's making me feel super sad
And I'm pretty sure he would never be in remission as we started too late to try the insulin and as he still has no improvement. The remission is rare, and occurs mostly if we treat the diabetes quickly right?
It's not the case for him, we lost months.
So no trip for the next 10 years. That's a big loss for me too to accept that. We had so many projects.
Anyways. I'm off topic.

I'll try to get the max information I can and I'll send you the info

Thanks!

 

[Bandit's Mom]

If you test him only once in 7-10 days, you do not have any idea of how low he is going on a dose. Because without enough tests, too much insulin can look like too little insulin. When a dose is too much and the blood sugar drops low, the pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic. It can be very dangerous to increase the dose by whole units especially when you aren't testing. Like the shots, the testing will also get easier with practise. It is a matter of establishing a routine and making sure it is not stressful for you or him. They can pick up on your stress.

You can buy Lantus at human pharmacies in Canada without a prescription. Just tell them it's for your cat so they don't run it through your insurance. At higher doses, Lantus' acid base stings and we recommend a switch to Levemir.

However, it is counterintuitive to feed high carbs and then increase the dose of insulin. The dry food you are feeding is definitly high carb unless it is one of the 3 brands I listed.

I am sorry your vet is being uncooperative about testing for IAA and also that your kitty is going through so much else besides diabetes. Maybe you need a different vet?

I am tagging @Zorrain who is also French Canadian and her cat Ruckus has acromegaly. She might be able to help you with finding low carb food, auto-feeders etc.


@Wendy&Neko

 

[Wendy&Neko]

Oh and also we heard back from the vet.
He has not acromegalya

Can you tell me the test number from the lab results? Sometimes vets get this wrong.

The vet said it's too early to test the antibodies one and she wouldn't be able to analyse the results as there's so little information about diabetes and complications/other diseases

Again the vet is wrong. We have kitties here test positive with the insulin auto antibodies that are on much smaller doses, like 1-3 units. It's too bad they didn't test the same times as the acromegaly. The blood test is done at the same lab and you would have saved shipping costs. And we likely know more than that vet does about diabetes and other secondary conditions from the sounds of it. We can interpret the results for you.

The good news is she will make me a Rx so I can buy it at the human drugstore. I'm hoping it'll be less expensive (we re living in Canada).

In B.C., and possibly elsewhere in Canada, insulin is over the counter. Just go to the pharmacy counter and say you want to buy insulin for your cat. No prescription needed. Not all pharmacies are like this, you might have to try one or two, though I never had a problem here.

We looked into auto feeders but they seem less practical for wet food

Not true. I used the Petsafe 5 with wet and raw food. There is a little place under the feeder tray you can put a small gel pack or ice cubes. The great thing about the auto feeder is that once your kitty knows it dispenses food, kitty's attention is on the feeder and not on bugging you for food! That was a life saver for me.

So, the key things going forward are getting him on an appropriate diet for a diabetic and home testing his sugars to make sure he's safe. There is no dry food with any grains at all that is good for a diabetic. The Dr. Elsey's dry listed above is the only one you can buy in a store (Petsmart), the others you have to purchase on line. A much better choice for a diabetic is a low carb canned or raw food diet. We bribe our cats with treats when we test them. They always get a zero carb treat afterwards, and soon they associate tests with treats. My cat purred through testing. Good treats are just freeze dried meat treats from the pet stores (only one ingredient), or something like baked or boiled chicken breast pieces.

 

[Schwa]

Hi! Thank you for your answer.

My vet told me to continue the weekly measurements until we reach a better result.

For the dry food we are giving him very little, just 30 g for the night and I always calculate every calory. It contains more proteins than the one before but more fat indeed. It's the brand Orijen
He's allowed to eat 240 cal per day atm, we are giving him between 220 and 240 and he lost 0.3 lbs in 8 weeks. But we need to buy a scale to control his weight at home more regularly!
We are mixing up to have a lot of protein during the day, not so much fat, grain free the most we can
We might schedule an appointment with a nutritionist but it is expensive so we're thinking about it.
I think we're almost there!

 

[Lando demando]

Hi! Thank you for your answer.

My vet told me to continue the weekly measurements until we reach a better result.

For the dry food we are giving him very little, just 30 g for the night and I always calculate every calory. It contains more proteins than the one before but more fat indeed. It's the brand Orijen
He's allowed to eat 240 cal per day atm, we are giving him between 220 and 240 and he lost 0.3 lbs in 8 weeks. But we need to buy a scale to control his weight at home more regularly!
We are mixing up to have a lot of protein during the day, not so much fat, grain free the most we can
We might schedule an appointment with a nutritionist but it is expensive so we're thinking about it.
I think we're almost there!

Sending you tons of well wishes and support!
I wanted to chime in to let you know that the members here ( two on your thread ) helped me TREMENDOUSLY with my cat Lando. I like my vet, so it was difficult to go against his advice and follow the advice of the kind people here, but i have to tell you, it was worth it. The advice given here is fantastic. I am happy to share any parts of Landos journey if that helps with your cats progress! Best wishes

 

[Suzanne & Darcy]

Right now the weight loss is not the most important thing. His body cannot make use of the food he is receiving because of the hyperglycemia - so he is starving. It is not right at this point to withhold too much food as if he were just a regular cat on a diet due to being fat. The hunger he is feeling must be extreme. First, he needs low carbohydrate wet food like Friskies pate (not the gravy foods or shreds, etc) or the low-carb foods from Fancy Feast - the classic ones (see food chart). His glucose will naturally improve. As others have said, do not increase insulin at the same time as making the diet change. I would not waste money on a nutritionist at this point.

It is potentially dangerous for him to be receiving insulin without data to show how low his glucose may actually be going. Especially do not increase the dose without data. Have you considered a Freestyle Libre? I personally have never used one, but others here have used them temporarily while getting used to home testing. I cried a lot the first week that I did home testing. Those curves at the bet must be costing you plenty. Home testing is a much better and cheaper option… but yes it can be scary at first! There are many here who can help you get started. You need to make it a positive experience for your kitty. Your kitty is highly food motivated, right? So the treats will help you there.

Your vet acknowledges that he/she is not an expert in feline diabetes. The experts are right here. You have a group of experts here who are also really nice, caring people. I know you must be so stressed out! I’m sorry. But with the advice of this Board, things will get better!

 

[Suzanne & Darcy]

Also, can you ask for the paper showing the lab result for the acromegaly? What was the number of IGF-1?

 

[April & Quincy]

I also wanted to say I have an automatic feeder and I use it with wet food so don't let that discourage you! It works great and he knows that as soon as the lid pops open there's food for him! So definitely don't shy away from it. I agree with the other members - feed him more; he is starving!

 

[Suzanne & Darcy]

So to start getting comfortable with testing at home, I would start by picking a place where your kitty is comfortable. A favorite bed? A couch? Somewhere where you will do all the testing. We started out on a barstool but later I could test him anywhere. Then just practice by giving treats (low carb, course) in that spot. You could do this several times a day for a few days. You could speak calmly to your kitty and practice touching his ears a bit. Hold the ear for a second or so and give a treat. I would definitely NOT use a lancing device on a skittish cat, but I would learn how to free hand it with the lance and just poking his ear that way. The lancing devices make a click that some cats do not like. This takes a little practice. Remember I said that I cried! Well I also didn’t get blood at first either. (More tears). I gave the treats regardless of whether I got blood or not.

First you need to get some supplies. I am sure that you will get plenty of recommendations for what to buy in Canada. Can someone please send the photos of the ear that shows the best place to draw a drop of blood? I can’t find mine. @Bandit's Mom

 

[Schwa]

Hi everyone. Thank you for your answers!

We had a way better curve last weekend it's encouraging!
It went down from 21 mmol in the morning to 10 in the afternoon! First time he goes under 20!

He lost just a bit of weight.

Also just to clarify when I say my vet, I mean my new vet who is an internist and more specifialist in diabetes. She's the one who talked about possible acromégaly.
My previous vet is the one that "is doing a bit a everything so doesn't know nothing really well", words of her assistant that's scary!

I'll post the igf-1 results I think she sent me them

As for the food I'll check it out. We are giving him Tiki cat and Almo for proteins and some Satiety also that's lower in calories so he'll get more food in the end and also some zucchini to try anc make him feel full
But for the night the wet food is drying quickly and I heard it's not good to leave it more than 4 hours in the air.
anyway when he sees wet food he cannot stop eating until the plate is empty (like me and chocolate cake) that's why we give him dry food for the night tast a bit longer.
We'll look into auto feeders too!

Have a great day everyone!

 

[Zorrain]

Hi everyone. Thank you for your answers!

We had a way better curve last weekend it's encouraging!
It went down from 21 mmol in the morning to 10 in the afternoon! First time he goes under 20!

He lost just a bit of weight.

Also just to clarify when I say my vet, I mean my new vet who is an internist and more specifialist in diabetes. She's the one who talked about possible acromégaly.
My previous vet is the one that "is doing a bit a everything so doesn't know nothing really well", words of her assistant that's scary!

I'll post the igf-1 results I think she sent me them

As for the food I'll check it out. We are giving him Tiki cat and Almo for proteins and some Satiety also that's lower in calories so he'll get more food in the end and also some zucchini to try anc make him feel full
But for the night the wet food is drying quickly and I heard it's not good to leave it more than 4 hours in the air.
anyway when he sees wet food he cannot stop eating until the plate is empty (like me and chocolate cake) that's why we give him dry food for the night tast a bit longer.
We'll look into auto feeders too!

Have a great day everyone!

I cook plain chicken and egg fur ruckus. Hard food really effects them. Ruckus ate hard food puked from another cat and it skyrocketed his numbers.