Hello, new member. 08/04/2023

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Lobster

Member Since 2023
Hello, my cat, Nabee was diagnosed with diabetes in June 28, 2023. He had a steroid shot in May (he just scratched his fur a lot and vet gave him a steroid shot) and we noticed his drinking and urinate habit was different, then we found out he's diabetic after blood work. His glucose was about 490 at the time, we started 1U of Lantus twice a day for 2 weeks, then when we did our first glucose curve at hospital, his level was 580 but we assumed that this happened because of stresses. Our new vet increased insulin dose to 2U, twice a day, and we've been giving 2U since then (it's been about 3 weeks). We bought a glucose meter (AlphaTrak3) and check BG at home now. His level is between mid 300 - high 400 right now but Vet rescheduled our appointment because he thinks we should check and perform glucose curve with only 2 meals / day.

Name: Nabee
Age: ~13 years
Sex: Male/Neuter
Current Diet:
Fancy Feast Classic Pate or Flake (~20g at 6:00am)
Royal Canin Glycobalance (~20g at 7:30am, ~20-25g at 7:30pm). --> Insulin time
Fancy Feast Classic Pate ~15-20g around 1 or 2pm, depends on our cat.
Snack: Air dried pollock as treat, Greenie dental treat (only 2-4 pcs in the morning)
Monitor: Alphatrak3 and Accu-check sometimes.

Medical history: He's been so healthy but he lost some teeth. We actually had to extract 4 teeth in January because he couldn't even eat due to pain. He has gingivitis, about 6 teeth need to be remove 6, but we cannot at the moment.. He scratches his ears and skins a lot, but there's no issues according to vet.

Questions:
I already asked the question in wrong forum, but it's been moved to this forum. So here is the link: 2 meals per day question | Feline Diabetes Message Board - FDMB

I am guessing our Vet might not be familiar with Lantus or maybe he's just following old style, but I was told to feed my cat ONLY twice a day. No lunch and no snacks. Basically, I need to wait another 2 weeks to talk to him. We are going to follow his instruction or try at least. But I see a lot of people saying that we "don't have to" feed him twice/day especially if he's on Lantus. Any thoughts about this? My cat cannot eat a huge meal twice, that's why we didn't even try feeding him twice a day... Any tips or advice will be appreciated.

Thank you!
 
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Lobster said:
But I see a lot of people saying that we "don't have to" feed him twice/day especially if he's on Lantus. Any thoughts about this?
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I'll make a stronger statement. We recommend you do not just twice a day. A cats lowest numbers on Lantus are in the middle of the cycle. The exact time varies based on several things, including the cat. But food is the tool we use to keep the cat safe. Unless you are able to closely monitor and test at nadir time (lowest point of the cycle), you may not know if your cat is going low. Leaving food out, or those smaller meals can help keep him safe. Second point, even human diabetics are encouraged to eat smaller more frequent meals. A cat's pancreas has the ability to heal, and not overwhelming it with two large meals will be easier on that pancreas, maybe even helping it heal.

Just so you know, a lot of us followed our vets recommendations at first. Mine said Caninsulin was best insulin (wrong!), the locum vet showing me how to shoot said I could reuse the syringes 2-3 times (wrong!). Vets don't get a lot of diabetic cat patients or training in diabetes for that matter, or people decide not to treat. Good for you on treating by the way, it's a very manageable disease. Anyway, the people here all have first hand experience with diabetic cats and have lived it 24x7, sometimes for years. The "feed twice" is typical from older vets or those recommending the fast in and out insulins like Vetsulin/Caninsulin. It's not appropriate for Lantus.

Thanks for posting that he got the diabetes as the result of a steroid shot. Quite of few of those cats can heal and go into diabetic remission.

A couple other notes, the Glycobalance is too high in carbs for a diabetic cat. Is that the wet or dry food? The dry is worse. The Greenie treats dental treats are also higher carb.

Is the reason for no dental yet the cost? Some vets say you have to have the cat regulated before a dental, but you can't get a cat regulated if their teeth are bad. Scratching ear and skin could be an allergy to particular proteins. Which flavour/meats Fancy Feast are you giving? What did he eat before the diabetes when he was itchy?

Lobster said:
Basically, I need to wait another 2 weeks to talk to him.
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Someone is here 24x7. We have members from around the world.
 
If you need help setting up the spreadsheet we have someone here that can do it for you very easily. You then can fill in your test results for the past two weeks.
 
Wendy covered a great deal of information. And I agree!!

Did Nabee start scratching since the diabetes was diagnoses or is this something that happened before? If it's since diagnosis, it could be a food sensitivity. Alternatively, it could be a seasonal allergy. Since it was his scratching and steroid shot that got this all started, you might want to talk to your vet about allergy meds. Allerderm is a product my vet recommended and is available on Amazon. Another option is adding Omega-3 to your cat's diet. And finally, something like Zyrtec (also called cetirizine, half of a 10mg tablet twice a day) may help but make sure it's plain cetirizine not a combination medication.

If your cat has gingivitis, it's possible that the inflammation is causing blood glucose levels to be elevated. If you can't afford the dental, I'd ask the vet about an antibiotic to help with the inflammation until you can get the dental work done.

Please let us know if you have questions. We're here to help.
 
Wendy&Neko said:
A couple other notes, the Glycobalance is too high in carbs for a diabetic cat. Is that the wet or dry food? The dry is worse. The Greenie treats dental treats are also higher carb.

Is the reason for no dental yet the cost? Some vets say you have to have the cat regulated before a dental, but you can't get a cat regulated if their teeth are bad. Scratching ear and skin could be an allergy to particular proteins. Which flavour/meats Fancy Feast are you giving? What did he eat before the diabetes when he was itchy?
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We are feeding him with glyco dry food in the morning (~10g) and night (~15g) the rest is all fancy feast pate. He loves dry food so we slowly decreased and still decreasing.

For the teeth issue, no, its not about cost. We didnt want to pull out 10 teeth at once last december but he couldnt even eat for 2 days due to pain, so we extracted the worst 3 teeth. Then left the rest and planned to visit again....but now he is diabetic and have BG around 450-570 depends on the day (sometimes it drops to 350). I was told it has to be regulated or at least around 200 so that he can have anesthesia. My cat is not in pain at the moment so he is eating fine but we know we need to extract some of them sooner or later.

He had Hills Senior indoor dry food before, and fancy feast broth in the morning (one pouch) but we are not feeding him with broth anymore since it contains tapioca. And he had dental treat and hairball treats since he was kitty. (Greenies).

We are feeding him FF pate Ocean White and Cod & Shrimp. He won't eat other flavors.

He started scraching a lot around April, thats why we brought him to a vet and vet decided to give him a steroid shot since nothing really helped... i guess steroid was sort of trigger, but my cat has been always overweights with gum disease so I dont know. But his glucose was about 160 this January before his surgery (teeth) so...=/
 
Sienne and Gabby (GA) said:
Did Nabee start scratching since the diabetes was diagnoses or is this something that happened before? If it's since diagnosis, it could be a food sensitivity. Alternatively, it could be a seasonal allergy. Since it was his scratching and steroid shot that got this all started, you might want to talk to your vet about allergy meds. Allerderm is a product my vet recommended and is available on Amazon. Another option is adding Omega-3 to your cat's diet. And finally, something like Zyrtec (also called cetirizine, half of a 10mg tablet twice a day) may help but make sure it's plain cetirizine not a combination medication.

If your cat has gingivitis, it's possible that the inflammation is causing blood glucose levels to be elevated. If you can't afford the dental, I'd ask the vet about an antibiotic to help with the inflammation until you can get the dental work done.

Please let us know if you have questions. We're here to help.
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Hello, he started scratching a lot this spring, around April. Thats why we brought him to a vet and got a steroid shot. Still scratching a lot so I guess it was not helping... And yes, I will ask about allergy meds or supplements for him.

Nabee had bad teeth since he was a kitty and we had to extract 10 teeth earlier this year but we decided to pull out only the worst ones, because we didnt want to extract 10+ teeth at once. So 3 are gone, about 7 left, but the vet said only 2 of them are pretty bad. (This was January). My cat is eating totally fine so gum or teeth issue is not that bad at the moment.

His BG is easily between 500-400 with 2U of Lantus, so vet said we cant reallt think about teeth atm, but regulating the glucose level..
 
Bron and Sheba (GA) said:
How are things going ?
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Hello! Nabee was doing pretty bad this weekend, so my mom and I had to monitor him pretty closely. His glucose level is elevating for some reason, so we try to decrease dry food even more and try to feed him more wet food although he hates it.
He was really lethargic yesterday so...
His level is 540 this morning on empty stomach (we gave 2U of Lantus 8pm yesterday) so not sure whats going on.

I might talk to a vet since I wanna do another blood work to see if somethings going on? I just hate him saying feeding him twice only. So I am going to ask and if he refuses to see my cat because I didnt do glucose curve with 2 meals, then I will just go see different vet...
 
The glyco dry is pretty high in carbs. There are a couple foods that aren’t. Dr. Elsey’s is one and easily available.
 
Don't just feed your kitty twice a day. You don't need your vets permission to feed more often. Diabetic cats who are fed 2 main meals at shot time and then snacks during the cycles are much happier and more settled and I think do better.
If he is lethargic I would get a bottle of ketostix and test for ketones in the urine. YOu can buy the Ketostix from Walmart or a pharmacy. Then get a urine sample and test the urine. There should be no ketones.
He may be lethargic because he needs more food! Don't neglect his lethargy...
Are you going to set up a spreadsheet and signature? It will make it much easier to help you
HELP US HELP YOU
If you need help setting up the spreadsheet I can ask @Bandit's Mom to help you.
 
Some vets won’t do dentals until a cat is regulated. Some will. Neko’s first dental she was over 300 or 400 a lot, done by her regular vet. Dental specialist vets are another option you can look into, though your ve5 will need to give you a referral. They are used to older and complicates cats.
 
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