Newly diagnosed diabetic cat

[chuckstables]

Hi folks.

A year ago i moved out of my parents house. I took our 10 year old cat with me (my parents insisted; all he was doing 12 hours a day was sitting outside my old room door crying, i was always the closest with him).

About 5 months ago i noticed he was losing weight, fast. I started giving him wet food which stabilized his weight. Then three weeks ago i realized that the amount he was drinking was 700-800 ml’s per day (and he’d urinate a LOT). I took him to the vet, they did bloodwork and diagnosed him with diabetes.

So i’ve been giving him 2 units of caninsulin twice per day after he had his wet food. He struggles to finish the wet food though (he can’t lick it off the plate once he’s eaten like 60% of it). So i got him purina proplan DM management dry food. Cost 92 for a 10 lb bag. It’s 51% protein by weight, 15% fat, and at most 15% carbs. My old dry food was 33% protein, 16% fat, and 33% carbs. It’s also 650 kcal per cup vs 395 for my old dry food.

He loves this new food. He devours it like he hasn’t eaten in days. Anyways; is this sufficient for his diet? His glucose level when they tested him was 29.97 mmol/l. Interestingly enough it was 11.5 in 2018, which is beyond the upper limit of 8 (but the vet said nothing to us then). 15% carbs is within the suggested range for cats with DM (6% to 22% i believe). He’s gaining weight back; he was 15 lb’s in 2018, and in 2021 he was 12 lb’s, last i took him in he was 9.8 lb’s. He’s now 10.6 again in just 2 weeks.

I’m just super stressed about this. I can’t lose him; he’s the sweetest most affectionate cat my family has ever had. He adores me and follows me around my apartment like a dog. He’s 11.5 years old now, i’m hoping with enough management and care he can live another 3+ years.

Thanks for reading this. This has been financially challenging (vet overcharged me; cost 550 for the exam/bloodwork) and emotionally draining.

 

[Bron and Sheba (GA)]

Hi and welcome to the forum.
2 units of Caninsulin twice a day is a lot of insulin to start a kitty on.
1 unit twice a day or less, is the normal dose.

Are you hometesting the blood glucose yourself or are those BGs from vet visits?
It sounds as if you live somewhere outside the US as you using world BG numbers.
I would encourage you to look at hometesting the BGs yourself as you will have a much better idea of what is happening and how the insulin is working.
Here is a link to HOMETESTING
I would also recommend you buy a human glucose meter and not a pet meter as they are much cheaper to run and are just as good as the pet meters, our dosing methods are also are also based on the human meters.

In regards to the food, diabetic cats should be fed 10% or under carbs. Any higher and they are too high and you will struggle to regulate your kitty. It is like giving a human diabetic insulin but letting them eat sugary foods.
HOWEVER until you are hometesting the BGs yourself, I would not change the food at all because changing over to a low carb diet can drop the BGs significantly and you don’t want to risk a hypo situation. Once you are home testing we can guide you with the dose.

Are you feeding 1/2 hour before giving the insulin? Caninsulin is a harsh insulin and the onset is early and cats need to have food aboard before the dose. And I would recommend giving snacks during the first half of the cycles as well.

HELP US HELP YOU has links to our spreadsheet where you can add all your BG data and then we can help you will dosing, your signature which will tell us all about your kitty and the hypo kit which is most important that you have one set up in case of a hypo. It also has other useful information for new members.

There are much more suitable insulins than Caninsulin. Lantus and prozinc are the insulins recommended for cats..

Beginners guide to Caninsulin https://felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/

Keep asking lots of questions.it is very stressful in the beginning but this is a very knowledgeable community that is very happy to help you.

 

[chuckstables]

Hi and welcome to the forum.
2 units of Caninsulin twice a day is a lot of insulin to start a kitty on.
1 unit twice a day or less, is the normal dose.

Are you hometesting the blood glucose yourself or are those BGs from vet visits?
It sounds as if you live somewhere outside the US as you using world BG numbers.
I would encourage you to look at hometesting the BGs yourself as you will have a much better idea of what is happening and how the insulin is working.
Here is a link to HOMETESTING
I would also recommend you buy a human glucose meter and not a pet meter as they are much cheaper to run and are just as good as the pet meters, our dosing methods are also are also based on the human meters.

In regards to the food, diabetic cats should be fed 10% or under carbs. Any higher and they are too high and you will struggle to regulate your kitty. It is like giving a human diabetic insulin but letting them eat sugary foods.
HOWEVER until you are hometesting the BGs yourself, I would not change the food at all because changing over to a low carb diet can drop the BGs significantly and you don’t want to risk a hypo situation. Once you are home testing we can guide you with the dose.

Are you feeding 1/2 hour before giving the insulin? Caninsulin is a harsh insulin and the onset is early and cats need to have food aboard before the dose. And I would recommend giving snacks during the first half of the cycles as well.

HELP US HELP YOU has links to our spreadsheet where you can add all your BG data and then we can help you will dosing, your signature which will tell us all about your kitty and the hypo kit which is most important that you have one set up in case of a hypo. It also has other useful information for new members.

There are much more suitable insulins than Caninsulin. Lantus and prozinc are the insulins recommended for cats..

Beginners guide to Caninsulin https://felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/

Keep asking lots of questions.it is very stressful in the beginning but this is a very knowledgeable community that is very happy to help you.

You’re amazing. So much information! I am not doing blood glucose testing. I was caught off guard by this. I’m taking him to another vet; the vet i took him too charged me over 600 dollars for an exam/basic bloodwork. The starting dosing regimen for caninsulin is 0.5 IU for kg rounded down to the nearest IU if they’re above 24 mmol/l, so 2 twice daily would make sense. I got a quote from a vet near me which would’ve cost 78 CAD for the exam and 230 for the bloodwork, so around half of what the original vet charged.

And yes; i live in Canada. I have all of his bloodtest results. I feel awful knowing he’s lived with this for 4 years (a test from 2018 showed 11 mmol/l, upper limit is 8, our vet chose to not tell us about this). I’m taking him to another vet next week.

As for blood glucose monitoring; how do i do that? Do i just buy a special one for cats and prick his paw pad for blood? I just got the diagnosis 2 weeks ago. Keep in mind he had 504 mg/dl of blood sugar; that’s a lot. He’s likely had worsening diabetes for some time. He also had high ketone levels in his blood and high fat presence in blood, indicating early stage ketoacidosis. So his diabetes was more severe than the average case i think. He also had high glucose in his urine and high urea, indicating kidney stress from his body trying to get rid of so much glucose.

 

[Bron and Sheba (GA)]

He also had high ketone levels in his blood and high fat presence in blood, indicating early stage ketoacidosis

When did he have the ketones on his blood? Did the vet do anything about them?
Here is what I would suggest you do if there were ketones in the blood and he had early DKA

• Make sure he eats 1 and a half times as many calories as he normally does….food helps keep ketones away
• Don’t skip any doses of insulin. Once you are hometesting and you are not sure if you should give the dose because the BG is lower than normal, you need to stall, dont feed and test again in 20 minutes to see if the BG is rising and post and ask for help. Insulin also helps keep the ketones away
• Give extra fluids. Put a teaspoon of warm water into each snack.
• Test frequently for ketones. You can do this either with a urine test strip(Ketostix from a pharmacy) or buy a ketone meter which is used in a similar way to a glucose meter. Depending on how long ago the ketones were, I would test daily if it was recently then Alternate days and then weekly.

Here is a link to watch one of our members hometesting the BG

You can also see how to do it in the link above called hometesting. (Post 2)
I will tag @Red & Rover (GA) and @Wendy&Neko as they both live in Canada and they can help you with glucose meters and where to buy all the necessary things in Canada.
When working out the dosing, one also needs to look at how low the dose is taking the cat, not just the preshot BG. That is why hometesting is so important.
Would you like to show us all his blood results? You will need to copy and paste them into the thread. We have people here who can look at them and help you.
Unless you want to swap him over to another insulin such as Lantus…which you can get over the counter in Canada and don’t need a vets script…..I’m not sure why you are going back to another vet. You have the diagnosis and now what is needed is for you look at hometesting, set up the spreadsheet and signature and the hypo kit and we can help you with the rest.
But of course it is up to you.

 

[Hendrick Cuddleclaw]

Hi Chuck my name is Kyle that's me in the video fumbling around and poking my cat in the eye lol. Welcome!!! I promise I got a lot better at it, that was way way in the beginning when I had only just barely learned how to do a home BG test.

I will say that when I first was encouraged to do home testing by the people here at the FDMB I thought it was flat out impossible. And at first I felt like it was but people here kept giving me tips and tricks and support and after about a week or so me and my wife learned how, and after some time it became routine. Warming up the ear and using a tiny bit of vaseline were key tips for us.

For home blood glucose testing, many folks use the Relion meter from Walmart as it is inexpensive and the strips are also low price.

Heads up, in your profile settings you can make it so people cannot see your actual date of birth. Yours is visible.

 

[Wendy&Neko]

Hello and waving from the smokey west coast.

The Relion meter from Walmart is not available in Canada, unless you cross border shop. Which I did back before COVID and it was easier to hop across to a post box there. In Canada, the test strips are unfortunately more pricey and are what you go through more often. But you can often get a free meter when you buy a package of test strips. Sometimes you can get good prices on test strips on eBay. You want a meter that needs just a small drop of blood. The Freestyle Lite is one many use but there are others. The cheapest meter available is the Bravo (free meter available, link to test strips here). But with online purchases you want to have a good supply on hand. I got nervous when I had less than 200 test strips. Having a backup meter where you can quickly go to a pharmacy to pick up a pack of strips is a good idea.

Caninsulin is not a great insulin for cats. It's what I had to use first until I learned more from here. Maybe your new vet can get you on Lantus of Prozinc. Lantus is available over the counter most places in Canada. The cheapest place to get supplies depends where you live. Near me, Safeway pharmacy of all places had the best prices on insulin, syringes, and lancets. On your shopping list, add a container of Ketostix, available at most pharmacies, so you can test his urinary ketones.

For food, low carb wet food is best. We say that for diabetics, you don't want to feed a anything over 10% carbs. Most dry foods are way too high in carbs. You can get Dr. Elsey's chicken at Petsmart, and that is the lowest carb dry food available in Canada that is OK for diabetics. Normally dry isn't great at all for diabetics as they can be dehydrated from the drinking and peeing, but some cats are kibble heads. But as Bron said above, don't switch food until you are home testing. When people switch to a suitable food, they find insulin needs drop quite a bit, some cats even go into diabetic remission. Home testing will allow you to safely switch. If you add water to the wet food (a good thing for diabetics), it may be easier for him to eat.

There are two documents that help you find low carb foods in Canada. A lot of the ones listed at the Catinfo.org site (document here) are available in Canada, and there is a separate list someone put together a few years ago. CANADIAN Food Chart

 

[chuckstables]

Well i am pleasantly surprised by the response! Thanks guys. Currently he seems to be almost refeeding; he’s definitely gained weight, and is eating a lot. He loves his new dry food (purina proplan DM management) and i give him the same brand of DM wetfood.

Vet said he had muscoskeletal mass loss when he came in, scaly fur (whatever that means) and seemed to have borderline low kidney function (he said it was literally right on the boundary of normal). Also had glucose in his urine, moderately elevated urea levels, and borderline low potassium. I thought he’d said he had ketones, but i dont see that anywhere on the bloodwork. He had said he might’ve been in early stage ketoacidosis? He had went from 12.5 pounds to 9.8 in about 6 months.

The good news is he's gaining weight! He’s now 10.4 pounds, and his ribs aren’t as pronounced, and he just seems healthier. He’s always been a big cat; 12 lb’s is probably a good weight for him to be at. I feel awful for not taking him in sooner. As for why i was going to go to another vet; i wanted to ask about switching to lantus (and they said they’d need an exam to sell me his insulin).

For blood glucose monitoring; anyone have any suggestions on good ones i can pick up? Much appreciated. I’ll post his bloodwork shortly. If i can buy the insulin without going through a vet then i really have no reason to go to the vet i suppose, so i’ll probably cancel that.

 

[Bron and Sheba (GA)]

blood glucose monitoring; anyone have any suggestions on good ones i can pick up?

Wendy mentioned two glucose meters available in Canada in her post above (post 6).
If you do go ahead and get the Lantus insulin over the counter, I would definitely post here and ask about the starting dose. It is a depot insulin and not an ‘in and out’ insulin like Caninsulin. The starting dose needs to be held for 5 to 7 days unless the BG drops too low.
If you can get the spreadsheet set up and running we can help you with that. ..how to do that is in the Help Us Help You link in post 2 above.

WHAT IS A DEPOT INSULIN

 

[chuckstables]

And sorry; i saw above you guys suggested some meters. Does it have to be a pet meter or do ones for humans also work? Glucose is glucose; it’s a simple molecule (compared to insulin; so many variations in conformations as it’s an actual protein with almost a thousand atoms), so i imagine if it works on humans it’d work on cats?

 

[Bron and Sheba (GA)]

And sorry; i saw above you guys suggested some meters. Does it have to be a pet meter or do ones for humans also work? Glucose is glucose; it’s a simple molecule (compared to insulin; so many variations in conformations as it’s an actual protein with almost a thousand atoms), so i imagine if it works on humans it’d work on cats?

I would recommend getting a human meter…they are much cheaper to run…it is the test strips that cost most of the money. And our dosing methods are based on the human meters.

 

[chuckstables]

I would recommend getting a human meter…they are much cheaper to run…it is the test strips that cost most of the money. And our dosing methods are based on the human meters.

Great! I can pick up one of them. Thanks for your help guys. As for foods; he likes chicken. Is plain chicken breast baked okay for a treat? It’s pretty much just protein i believe.

One more thing; lantus. If he’s on a depot insulin can he eat throughout the day? He’s 10 kg currently; i’ll pick up a glucose meter and some strips in the next week. He had a very high blood glucose; 29 mmol/l, so 550 or so. What would you suggest i start him at?

Also; my vet told me i can reuse a u-40 syringe once, so i store it capped in the fridge. Lantus is u-100 so i’d need a different syringe? Whatever you guys suggest would be great.

 

[Katsallday]

Great! I can pick up one of them. Thanks for your help guys. As for foods; he likes chicken. Is plain chicken breast baked okay for a treat? It’s pretty much just protein i believe.

One more thing; lantus. If he’s on a depot insulin can he eat throughout the day? He’s 10 kg currently; i’ll pick up a glucose meter and some strips in the next week. He had a very high blood glucose; 29 mmol/l, so 550 or so. What would you suggest i start him at?

Also; my vet told me i can reuse a u-40 syringe once, so i store it capped in the fridge. Lantus is u-100 so i’d need a different syringe? Whatever you guys suggest would be great.

No one here really recommends reusing syringes. It's unsafe and they wear quickly and very easily so it could hurt kitty.

 

[Bron and Sheba (GA)]

Great! I can pick up one of them. Thanks for your help guys. As for foods; he likes chicken. Is plain chicken breast baked okay for a treat? It’s pretty much just protein i believe.

One more thing; lantus. If he’s on a depot insulin can he eat throughout the day? He’s 10 kg currently; i’ll pick up a glucose meter and some strips in the next week. He had a very high blood glucose; 29 mmol/l, so 550 or so. What would you suggest i start him at?

Also; my vet told me i can reuse a u-40 syringe once, so i store it capped in the fridge. Lantus is u-100 so i’d need a different syringe? Whatever you guys suggest would be great.

Katrina is correct. No we do not recommend reusing syringes. Apart from infection, you would contaminate the insulin each time you introduced a used needle into the insulin.
If you are just want in to use the chicken breast just as a treat, that is absolutely fine. If you were wanting to use it as part of the main diet you would need to make sure it was nutritionally complete with supplements.

For us to help you with the dosing, we would need to see some data from the previous week or two please. It is not only the preshot BG we need to look at but the nadir or the lowest point in the cycle.
In saying all of that, I would not start at 2 units of Lantus as he has just been diagnosed. The normal starting dose is 0.5 if he is on wet food only OR 1 unit if he is on dry food.
Lantus builds up over the first 5 days….due to the depot as it fills, that is why you need to hold the dose for that long so we get to see the full effect of the dose….unless the BG drops too low.

As far as food goes…always give a meal before the dose …so you test, feed then shoot. Then you can give some snacks during the cycles…try and be consistent with the snacks so that if you give 3 snacks in the am cycles, give the same in the pm cycles.
A timed automatic feeder is a good idea. Just don’t feed foe the 2 hours before the preshot BG as we don’t want the preshot BG to be food influenced.

The syringes you need are U100 3/10 ml 30 or 31 gauge 6 or 8 mm insulin syringes with 1/2 unit markings.

 

[chuckstables]

Katrina is correct. No we do not recommend reusing syringes. Apart from infection, you would contaminate the insulin each time you introduced a used needle into the insulin.
If you are just want in to use the chicken breast just as a treat, that is absolutely fine. If you were wanting to use it as part of the main diet you would need to make sure it was nutritionally complete with supplements.

For us to help you with the dosing, we would need to see some data from the previous week or two please. It is not only the preshot BG we need to look at but the nadir or the lowest point in the cycle.
In saying all of that, I would not start at 2 units of Lantus as he has just been diagnosed. The normal starting dose is 0.5 if he is on wet food only OR 1 unit if he is on dry food.
Lantus builds up over the first 5 days….due to the depot as it fills, that is why you need to hold the dose for that long so we get to see the full effect of the dose….unless the BG drops too low.

As far as food goes…always give a meal before the dose …so you test, feed then shoot. Then you can give some snacks during the cycles…try and be consistent with the snacks so that if you give 3 snacks in the am cycles, give the same in the pm cycles.
A timed automatic feeder is a good idea. Just don’t feed foe the 2 hours before the preshot BG as we don’t want the preshot BG to be food influenced.

The syringes you need are U100 3/10 ml 30 or 31 gauge 6 or 8 mm insulin syringes with 1/2 unit markings.

Thanks so much. You guys have been far more helpful than my vet; you guys have a donation link i can give a few bucks to? Please let me know; i’d gladly donate some money to help you guys out.

I’ll post his bloodwork tomorrow. Thanks again.

Thanks again,

- Chris.

 

[Diane Tyler's Mom GA]

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming

 

[Diane Tyler's Mom GA]

If you do switch to Lantus you will need U-100 syringes with half unit markings

 

[Hendrick Cuddleclaw]

Thanks so much. You guys have been far more helpful than my vet; you guys have a donation link i can give a few bucks to? Please let me know; i’d gladly donate some money to help you guys out.

I’ll post his bloodwork tomorrow. Thanks again.

Thanks again,

- Chris.

https://www.paypal.com/webapps/shop...3065324734_08b4586731887#/checkout/openButton

 

[Diane Tyler's Mom GA]

So i got him purina proplan DM management dry food. Cost 92 for a 10 lb bag. It’s 51% protein by weight, 15% fat, and at most 15% carbs.

Hi I found this question answered on the Chewy site about this dry food
What is the % carbohydrate?
Answer by • Mar 30, 2022
This formula has a maximum carbohydrate content of 18.0%.


If you can set up what we call our signature that would be helpful
Information about your kittyn

To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information

• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.



We also use a spreadsheet to track our cat's BG numbers once you start testing to see how the insulin is working and how low it's dropping and in case you need any advice , if you are interested in setting one up just ask , we have a member who will be happy to do it for you


The spreadsheet is easier than it looks
Just some info about it look at mine at the end of my signature it says Tyler's spreadsheet to get a look at it, you can look at anyone's spreadsheet

About the spreadsheet
AMPS - means AM Pre Shot the first test you take in the AM ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave
+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers


If you want to try and set it up here the link, if you need help just ask we have a member who will be glad to set it up for you
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
this post on helping us to help you. The post is considerably more concise and has everything in one place making it a bit easier if you need to bookmark the information.

 

[chuckstables]

Here's his bloodwork by the way; I'm still looking for a good glucose meter that's available near me.

 

[Wendy&Neko]

@Diane Tyler's Mom None of the Relion products are available in Canada, not syringes, nor test kits. Diabetesexpress is not a good source for syringes, they are expensive compared to most other places.

Check out your local pharmacy for the BD Ultrafine II syringes (purple and yellow box). Those are U100 syringes. If you have a Costco near you, check them out. I found it pays to ask around. Again Safeway pharmacy (maybe Sobey's their owner?) had the best prices near me.

 

[Diane Tyler's Mom GA]

@Diane Tyler's Mom None of the Relion products are available in Canada, not syringes, nor test kits. Diabetesexpress is not a good source for syringes, they are expensive compared to most other places.

Check out your local pharmacy for the BD Ultrafine II syringes (purple and yellow box). Those are U100 syringes. If you have a Costco near you, check them out. I found it pays to ask around. Again Safeway pharmacy (maybe Sobey's their owner?) had the best prices near me.

Sorry Wendy I forgot I'll make sure to book mark this

 

[chuckstables]

Hey folks,

Is drinking a lot normal when he’s gaining 1 lb per week? He’s put on 1lb now in the last week. My vet refuses to talk to me about switching to Lantus. Given that the guy’s awful and i don’t trust him, can anyone suggest a starting dose for Lantus? My cat gets tired and starving when i give him his dose. He’s close to his ideal body weight (up from 9 lbs to 11 in 2 weeks). Thanks again.

 

[Hendrick Cuddleclaw]

A fairly standard starting dose of Lantus is 1.0 U, to answer your question.

but if switching from Vetsulin/Canisulin you would give the same dose of lantus as you are giving of the other insulin, so in your case two units, iirc. I'm not expert though so let's wait for one of the gurus to confirm that.

gaining 1lb a week is great, still drinking a lot is not and indicates he is still not regulated at all. Are you thinking of switching vets? You need a prescription for Lantus of course, so if your vet won't do it, gotta find one that will.

 

[Diane Tyler's Mom GA]

Hey folks,

Is drinking a lot normal when he’s gaining 1 lb per week? He’s put on 1lb now in the last week. My vet refuses to talk to me about switching to Lantus. Given that the guy’s awful and i don’t trust him, can anyone suggest a starting dose for Lantus? My cat gets tired and starving when i give him his dose. He’s close to his ideal body weight (up from 9 lbs to 11 in 2 weeks). Thanks again.

I am going to tag a few members ,You live in Canada correct
I could be wrong probably am but I don't think you need a script to buy lantus in Canada






I did a search on our site and found this posted by one of our members if you live in Canada
She was telling another member that lives in Canada about Lantus. This is what she said

Something you may not know.....If you live in Canada, you can get a MUCH better insulin for Tigger at your local pharmacy. Lantus or Basaglar are the most recommended insulin's for cats and have the most research proving their efficacy....and it's OTC in Canada! You don't need a script (lucky you!). It's also a lot cheaper than it is for those of us in the US where a 5 pack of pens can be over $500.

@Wendy&Neko

@tiffmaxee

@Chris & China (GA)

@chuckstables

 

[Sienne and Gabby (GA)]

If your kitty is eating dry food, you can only use the Start Low Go Slow (sags) method for dosing once you switch to Lantus. (There are two dosing methods -- SLGS and Tight Regulation. TR requires that your cat is exclusively being fed a low carb, canned diet or a raw diet.) If he's still getting dry food, the starting dose would be 1.0u. If you've transitioned to a low carb, canned food diet, the starting dose would be 0.5u.

The DM dry is high in carbohydrates. The canned DM is better. Cats seem to tire very quickly from the DM -- I'm assuming because the ingredients aren't all that great. FWIW, there is no truly prescription diabetic food. In the US, the pet food manufacturers were sued for representing their "prescription" foods as "prescription." They lost the suit. There are many low carb (below 10%) foods your can choose from many of which contain far better ingredients than DM. Most of the members here feed their cats a food that is in roughly the 5% carb range. (We consider over 15% to be high carb.) We have lots of information on food. Please let us know if you would like us to point you in that direction.

One of the cardinal symptoms of diabetes is excessive thirst/drinking (aka polydipsia). I can't tell if you're home testing but my best guess is that your cat is in higher blood glucose (BG) numbers, hence the drinking.

As for your vet, the American Animal Hospital Association publishes guidelines for the treatment of diabetes in both dogs and cats. Perhaps your vet didn't really read the guidelines. While caninsulin may be fine for dogs (hence the name), it is no longer recommended for cats -- and hasn't been for some time. The two types of insulin that are recommended are Lantus (glargine) and Prozinc. This is a link to the guidelines. Perhaps you'd like to email it to your vet. He may be more open to reading something from one of the veterinary professional associations! Of course, the other issue is that your vet is selling you the caninsulin. It's likely that you have to buy Lantus at a pharmacy since it's a human drug. (Prozinc is formulated for cats.)

 

[Hendrick Cuddleclaw]

oh yeah keep forgetting you're in Canada sorry!

in fact I believe, if you go to buy Lantus in Canada, they automatically sell you Basaglar instead and it is quite affordable. The guy at Mark's told me that.

 

[Wendy&Neko]

if you go to buy Lantus in Canada, they automatically sell you Basaglar instead and it is quite affordable. The guy at Mark's told me that.

EPID - each province may be different. It is true in BC, unless you can get a note from your doctor saying it has to be Lantus.

 

[chuckstables]

Hi guys,

Just an update. Couldn’t get lantus from the pharmacy without a script. Took him to another vet close to me; he did a fructosamine test (and confirmed he’s put on weight; he went from 9.8 lbs to 11.3 in a month). His fructosamine was 502, apparently still too high. So he gave me a script for lantus, i just got it. We’ll see how he’s doing on it.

Before i’d feed him, give him a shot, then half an hour later he’s super hungry so i’d give him more food. Then 4 hours later he’d start the excessive drinking again/urination. So definitely a longer acting one is the way to go.

The new vet is super affordable; exam only cost 68 dollars, the blood test cost 39. Old vet charged 200+ dollars for the exam fee, and told me that Lantus is not for cats and he wouldn’t prescribe it. I guess some vets don’t keep up with the literature.

Anyways; i’ll keep you guys posted. He needs to go in in 3 weeks for another fructosamine test.

 

[Wendy&Neko]

Great to hear you got the Lantus. Some provinces/some pharmacies are pickier than others. Sometimes you can ask a different place and get a different answer.

Anyway, good luck with the Lantus. If you start home testing yourself and tracking his blood sugar data, you don't need to go back to the vet for a fructosamine test.

 

[chuckstables]

Great to hear you got the Lantus. Some provinces/some pharmacies are pickier than others. Sometimes you can ask a different place and get a different answer.

Anyway, good luck with the Lantus. If you start home testing yourself and tracking his blood sugar data, you don't need to go back to the vet for a fructosamine test.

Yeah, i might start doing that but he won’t let me anywhere near his ears or paw pads. If after a week his blood sugar was still too high would the protocol be to raise it by 0.5 units?

 

[Wendy&Neko]

If after a week his blood sugar was still too high would the protocol be to raise it by 0.5 units?

Maybe. We dose based on how low the dose takes the cat. A single spot check doesn't tell us that. Even a fructosamine, which is an average, won't tell you if it's been around a certain number, or a lot of lows and highs averaging out to the same number. The latter means a reduction might be needed.

but he won’t let me anywhere near his ears or paw pads.

Can you work up to it? Just touch his ears briefly? Then give him a treat. Do this for several days, lengthening the length of time you touch his years. You want to gradually sensitize him to ear touching. If this still won't work, you might want to talk to the vet about installing a Libre. More information in this post:
FreeStyle Libre: video, demonstration, explanations, tips – discussion!

 

[chuckstables]

Hi folks,

Just an update on Sam. I had bumped him up to 2 units twice per day about 3 weeks ago, after talking to the vet (as one unit wasn't working; he was drinking a lot, super hungry, peeing like a race horse, etc). The fructosamine test today showed 440, down from about 550 or 560 before. We're upping him to 3 units twice daily, and hoping that that's around the magic number. He gained 0.5 kg's of weight in a month, so I'm reducing the amount that I'm feeding him to help maintain his weight where he's at.

I gave him some gabapentin to help calm down his vet anxiety. He's always hated the vet; he freaks out, cries nonstop, and usually has to be sedated when they take blood samples. Gave it to him 3 hours before the appointment as per the instructions. Seemed to work; he still cried a bit, but not nearly as much as he'd usually cry. Little scary seeing him so out of it this morning though; when I woke up at around 8:45 (appt was 9:30, I gave it to him 6:30 then went back to bed) he came stumbling out from the under bed. Unsteady on his feet. Definitely helped at least, so it was worth the 3 bucks.

As for hypoglycemia; he's shown no signs of that whatsoever. I have bottle of carot syrup and a syringe to give to him orally if he showed clear signs of hypoglycemia. Vet didn't seem worried about it. Hopefully 3 units 2x daily will help him.

 

[Wendy&Neko]

On the fructosamine scale, 440 means he's in good control. Reference Ranges for Fructosamine Test. I don't think I'd rush to 3.0 units. Here we do smaller increases, like 0.25 units at a time. And if he's considered in good control, I would not increase until you can home test, or even get a Freestyle Libre put on him.

Stumbling and unsteady on his feed are also symptoms of a hypo. How to treat HYPOS - THEY CAN KILL! Print this Out!!

 

[chuckstables]

On the fructosamine scale, 440 means he's in good control. Reference Ranges for Fructosamine Test. I don't think I'd rush to 3.0 units. Here we do smaller increases, like 0.25 units at a time. And if he's considered in good control, I would not increase until you can home test, or even get a Freestyle Libre put on him.

Stumbling and unsteady on his feed are also symptoms of a hypo. How to treat HYPOS - THEY CAN KILL! Print this Out!!

Definitely was the gabapentin; hadn’t changed his dose yet. He did seem hyper this morning; he was freaking out. I gave him food which calmed him down. He gets that way sometimes, especially with the fireworks this morning.

How much is a freestyle libre in canada? If i don’t have to prick him thats worth it

 

[Wendy&Neko]

Check out this discussion:
FreeStyle Libre: video, demonstration, explanations, tips – discussion!
There are some posts around #42 onwards, specifically #47 that give tips for shopping Canadian.

Food will usually calm down a cat that is in low blood sugars.