New Diagnosis, Will Insulin Really Be Necessary

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rainking430

Member Since 2023
So my cat Ollie (about 12 years old) just got diagnosed with diabetes and my vet wants to immediately start insulin shots and monitoring. I was devastated at first, but after doing some research I am now suspecting that it was a recent diet change that caused this, and another diet change back max fix it? Here is some (a lot?) of background on this:

For most of his life Ollie had been on a pate wet food diet, low 10% carbs or less consistently (basically Friskies pate or the like). Then last year our other cat Lily got diagnosed with kidney disease and was put on an advanced kidney disease dry food diet. The doc said that it is a great food that he feels should be given to all cats due to their proneness to kidney issues, and recommended we start giving it to Ollie too. So we did.

And then he started to change. Clumsy, difficulty climbing and balancing, drinking and peeing a lot, loss of definition in his hind legs, and walking on his hind haunches. So we brought him in for a checkup. Excellent weight, everything looked good, vet at first thought it was arthritis. Bloodwork taken with results next day (today).

That's when we got the diabetes diagnosis ("very high glucose levels") and I started doing the research. Turns out, the advanced kidney disease diet food is like 36% carbs. So now my question is this: I wonder if that kidney disease dry food is to blame? And if going back to something like Friskies pate will be enough to curb this? Better yet perhaps going to an ultra-low carb higher quality wet food like what is listed here? A Full Low Carb Cat Food List for Healthy Eating in 2023 (simplycatcare.com)

Would love your folks thoughts. I want to avoid having to do twice daily insulin injections if at all possible.
 
Speaking from my personal experience with what happened to us, if you do try diet change first, I would be careful not to hold off the shots for too long because then you risk your cat developing DKA and losing a chance at remission.
 
Hi and welcome to you and Ollie.
It is possible that if you swap back to a low carb diet again, the blood glucose (BG) will drop, but whether it can drop to normal levels ….you will have to wait and see.
However…if you are wanting to trial a food change first there are a couple of things you need to do.
  1. Ask the vet if there were any ketones in the urine at diagnosis. If there were, then you need to start insulin straight away.
  2. If there were no ketones, or the vet did not test for them, then you could do a food trial for a week as long as you buy some Ketostix from Walmart or a pharmacy and test the urine daily for ketones.
If the food change does not bring the BGs down into normal levels you will have no choice but to start insulin. I would not wait much more than a week of trialing the food.
Ask the vet to start him in Lantus or Prozinc insulins. They are much bette than any other insulins. My preference is Lantus and the starting dose is 1/2 to 1 unit.
To see if the food trial is working I would recommend you get a human glucose meter and learn to test
Walmart has the ReliOn pemier meterr which is not expensive and is reliable. We can give you links to how to test

Unless you other kitty with the kidney disease has very advanced kidney disease, the prescription dry food you are using is not necessary. You would be better to use a wet low phosphorus food for Lily. Weruva has a new range of low phosphorus, low carb wet foods.
Also I would look at this excellent link about treating cats with kidney disease. They also have a support group you can message about Lily
https://www.felinecrf.org/
 
I was in a very similar situation with Tessa. She was on a prescription diet for GI issues and it was very high carb, part wet and part dry. Initially, I felt like the diet caused the diabetes but now, I don't think that's the case. I think she was always going to be diabetic, the dry food just made her symptoms far more visible to me which prompted a vet visit where we found the diabetes.

I switched Tessa to low carb canned about a week in to giving her insulin and it honestly didn't make much of a difference in her numbers. Feel free to look at my spreadsheet in the signature below, I notated when I changed her diet.

But your experience may different so you MUST be tracking your cat's blood glucose levels when you are making diet changes like that while also giving insulin. Do not change blindly because there's a chance that it could make a difference for your kitty.

As far as cost goes, look at GoodRx. I paid ~$125 for 5 biosimilar (generic) Lantus pens at Meijer pharmacy in the Midwest USA and I have only opened 2 of the pens since starting in late November 2022.
 
Like Bron said you can get the generic version of Lantus. There are discount coupons you can use at the pharmacy for it too. A lot of us order our Lantus from Canada because it’s 1/3 of the cost than in the US. I was paying $189 with shipping for 5 pens and that would last me over a year. Unopened pens last longer than 6 months
 
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rainking430 said:
I just looked up how much insulin will cost just in a month. Holy cow, I will not be able to afford this. :-(
Click to expand...
This is the generic for lantus if Ollie needs to start insulin and you will need U-100 syringes with half unit markings
Check this out
https://www.goodrx.com/insulin-glargine?dosage=five-3ml-prefilled-pens-of-100-units-ml&form=carton&label_override=insulin glargine&quantity=1
One pen would last me about 3 -4 months . we use the pens just like a vial, you would just insert the syringe it the gray rubber stopper on the pen and draw out your insulin
Its generic lantus



Or this one also

I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens
Posted by another member
One members posted this
. I paid $175 for a box of 5 pens at Walmart pharmacy, but GoodRX coupon says you can get it for around $90 if you have a Rite Aid pharmacy near you.

We don't use the pen because you can only adjust the dose by full units, we adjust the dose by 0.25 units at a time. Are the U-100 syringes you already have do they have half unit markings


Just take the cap off the pen and use a U100 syringes and pull the insulin out of the pen!
syringe-in-pen-pic-jpg.45006



If you have a Walmart by you they also carry the U-100 syringes half unit markings you have to go into the store to buy them
Or these
https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct
You might need your vet to fax over a script for them to ADW Diabetes. Just call them and tell them what syringes you want and they will contact your vet. Give your vets office a hesfs up and ask for refills so you can go to their web site and order them.
Set up an account with them

Relion syringes either box



84ebbd9e955b4348939878c2f671b8ed.jpg


relion-insulin-syringes-png.37311


They are $12.58/100
 
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Thanks for the comments everyone, very helpful. I felt so overwhelmed by the implications of this yesterday because the voicemail from the doc with the diagnosis came at the very end of his workday and I have yet to be able to reach him so he can go over specifics with me. So I was sort of left to my own devices last night trying to figure out how to navigate all of this. But now, after some sleep and your encouraging comments, I am feeling better about things.

And yes, I am seeing now that I can get generic glargine for somewhat reasonable. This is good news.
 
Vets are not always up to speed on feline diabetes. Some treat cats like they would dogs but they have different metabolisms. When I’m doing about what your vet is recommending, please post here and ask for advice :cat:
 
The box of 5 glargine pens will last a LONG time. Obviously, how long the insulin lasts depends on the size of the dose. A pen would last about 3 months with my cat.

I'd recommend a different list of foods. The foods on the list you linked are not all what we consider low carb. We consider low carb to be less than 10%, although most people feed their cat around 5%, give or take. This is a great site, written by a vet, pertaining to feline nutrition. There's also a chart that contains a huge number of canned foods along with the percent of carbs on the website.
 
No update yet from the vet, however I have already decided to return him to a pate diet. I'm not sure if it's just my hopeful imagination but I think I already see an improvement in his behavior over the last 22 hours or so. He has not drunk much water, nor craving it like he was, and only urinated once this morning about 7 hours ago and that's it. And he seems to be looking more confident on his hind legs, jumping and climbing up my legs like he used to.
 
Ok so just got off the phone with the vet. Very relieved. He said the glucose figure was 340, and 500-600 is really what they typically see in a very diabetic cat that requires insulin. He said that since this figure is not astronomical, and we have already seen a big improvement just in the last 24 hours with switching him to a low carb high protein wet food diet, he is totally supportive of holding off on insulin for now in favor of just trying the diet at first. We will then bring him in to test again for glucose figures.
 
H
rainking430 said:
Ok so just got off the phone with the vet. Very relieved. He said the glucose figure was 340, and 500-600 is really what they typically see in a very diabetic cat that requires insulin. He said that since this figure is not astronomical, and we have already seen a big improvement just in the last 24 hours with switching him to a low carb high protein wet food diet, he is totally supportive of holding off on insulin for now in favor of just trying the diet at first. We will then bring him in to test again for glucose figures.
Click to expand...
How long is he happy to trial the food?
Did he say if there were ketones in the urine?
I have to say that a cat with BG of 340 is a diabetic cat. Diabetic cats are diabetic cats...the BG reflects what is happening that hour/day
The BG fluctuates daily and from hour to hour.
While I think it is OK to do a trial of low carb food, I would only do that if there were no ketones at diagnosis and if I was going to test daily for ketones while on the trial.
We have had cats arrive here after having had DKA (diabetic ketoacidosis) because they were left too long without starting insulin.
I am not trying to scare you. I am just giving you the facts so you can take all the precautions while you do the food trial.
I would also think about hometesting so you can see what is happening daily with the food trial.
 
340 is still well outside of normal blood glucose levels. By all means, see if the food continues to lower your cat's levels but if they are over 120, it's likely your cat will need insulin.
 
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