18 Year Old Cat w/Diabetes Help

[Lou&Dexter]

Hello everyone! Newbie here to the forums. I have always been a cat lover and my Dexter, a short haired 18 year old cat has been diagnosed diabetic for just around 5 years now.

Up until recently he has been doing just fine. Lately it looks like he is having issues with hypoglycemia, or at least that is what I am thinking it is. He will stumble, eventually fall, lose control of his bowels and bladder, let out some howls and seize up.

I brought him to my local vet who did bloodwork, no ketones in his urine, no kidney failure or disease and his glucose level from the blood work was 360 at that time. They advised me that they do not think his attacks are from the diabetes but another possible issue like cancer. He went from 8.6 to 6.9 lbs in a few months time. Which is where they believe the cancer comes into play. His kidneys were swollen and he was dehydrated when I brought him to the vet following the attack.

So I switched him to diabetic food...kept him at 2 units of insulin which has been his dose this entire time.

Last night he had a BIG meal...very hungry. That was about 10pm. At 4am he had an attack and it lasted for an hour. He eventually comes to after some maple syrup, grabs a bite, drinks water and then returns to normal.

I am struggling here because hes 18. I dont want him to suffer and I cannot justify the cost to poke and prod him just to find out the cause of these attacks. Cause i have no intention of doing anything crazy given his age. My vet has prescribed me Gabapentin for him, as they believe it might be seizures he is having. I ordered a glucose test kit to test his sugar.

I am debating not giving him insulin cause I think giving him his dose is aiding whatever it is that is throwing off his low sugar levels until I can get a reading during one of these attacks.

I am also debating when it might be the time to say goodbye cause I do not want him to suffer. Any help or advice would be greatly appreciated.

 

[CORKY]

Hello everyone! Newbie here to the forums. I have always been a cat lover and my Dexter, a short haired 18 year old cat has been diagnosed diabetic for just around 5 years now.

Up until recently he has been doing just fine. Lately it looks like he is having issues with hypoglycemia, or at least that is what I am thinking it is. He will stumble, eventually fall, lose control of his bowels and bladder, let out some howls and seize up.

I brought him to my local vet who did bloodwork, no ketones in his urine, no kidney failure or disease and his glucose level from the blood work was 360 at that time. They advised me that they do not think his attacks are from the diabetes but another possible issue like cancer. He went from 8.6 to 6.9 lbs in a few months time. Which is where they believe the cancer comes into play. His kidneys were swollen and he was dehydrated when I brought him to the vet following the attack.

So I switched him to diabetic food...kept him at 2 units of insulin which has been his dose this entire time.

Last night he had a BIG meal...very hungry. That was about 10pm. At 4am he had an attack and it lasted for an hour. He eventually comes to after some maple syrup, grabs a bite, drinks water and then returns to normal.

I am struggling here because hes 18. I dont want him to suffer and I cannot justify the cost to poke and prod him just to find out the cause of these attacks. Cause i have no intention of doing anything crazy given his age. My vet has prescribed me Gabapentin for him, as they believe it might be seizures he is having. I ordered a glucose test kit to test his sugar.

I am debating not giving him insulin cause I think giving him his dose is aiding whatever it is that is throwing off his low sugar levels until I can get a reading during one of these attacks.

I am also debating when it might be the time to say goodbye cause I do not want him to suffer. Any help or advice would be greatly appreciated.

I will tag several well know members that can help you with tour concerns, in the meantime we need you to create your signature, we need to know what insulin you are using and the dose that was recommended by the vet, so we can guide you to the right member to help you, there is a link below to create your signature, we are here to help you, continue to post every concern you have I am sure someone will tag along shortly

@Bron and Sheba (GA)
@Diane Tyler's Mom GA
@Sienne and Gabby (GA)
@Suzanne & Darcy

 

[squeem3]

Welcome! We'll need more info from you. What is the name of the insulin is your cat on? Do you test blood glucose levels at home? If not, is there a reason why and are you willing to learn and manage your cat's diabetes better? You don't need vet approval to test your cat's blood glucose levels at home. What do you feed your cat? Dry, canned, raw, brands?

If your cat had hypoglycemia, the last thing you want to do is give the usual amount of insulin. Low blood glucose levels means the insulin dose is too high. You'll need to reduce the dose by at least half a unit. This is why regular daily testing of blood glucose levels at home is so important, just like it is for Human diabetics.

 

[CORKY]

I will tag several well know members that can help you with tour concerns, in the meantime we need you to create your signature, we need to know what insulin you are using and the dose that was recommended by the vet, so we can guide you to the right member to help you, there is a link below to create your signature, we are here to help you, continue to post every concern you have I am sure someone will tag along shortly
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/


@Bron and Sheba (GA)
@Diane Tyler's Mom GA
@Sienne and Gabby (GA)
@Suzanne & Darcy

 

[Lou&Dexter]

Welcome! We'll need more info from you. What is the name of the insulin is your cat on? Do you test blood glucose levels at home? If not, is there a reason why and are you willing to learn and manage your cat's diabetes better? You don't need vet approval to test your cat's blood glucose levels at home. What do you feed your cat? Dry, canned, raw, brands?

If your cat had hypoglycemia, the last thing you want to do is give the usual amount of insulin. Low blood glucose levels means the insulin dose is too high. You'll need to reduce the dose by at least half a unit. This is why regular daily testing of blood glucose levels at home is so important, just like it is for Human diabetics.

So I have not been tracking glucose levels at home because this is all new to me. My vet was not persistent in telling me that I should. However I am open to learning and know how from watching at the vet.

He is on Novelin N and it is 2 units in the morning and 2 at night. He was recently just switched to Purina DM Pro Plan wet food. Before that he was on just regular wet food with dry food for grazing. Hes a hard-core grazer

 

[squeem3]

Some vets just aren't very experienced with diabetes. You can either seek out a new vet or be more proactive in your cat's care and ask the vet questions and share information you learn online with the vet.

Novolin N isn't a great insulin to use for cats. It's too short acting. Better insulins to use are Lantus and ProZinc.

You don't need the prescription food. There's nothing in prescription food that helps diabetic cats. Note that the DM stands for dietetic management not diabetes management. FDMB recommends low carb canned food and there are many commercially available brands that are suitable from Fancy Feast Classic / Gourmet pates to Friskies to Weruva. Whatever brand your cat likes and you can afford is fine. The food charts are here: https://www.felinediabetes.com/FDMB/threads/links-to-food-charts.174182/ Whatever has 10% or less carbs is good for diabetics. Do keep some higher carb food on hand to use in case of a hypo. Here's the hypo info:

https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/
https://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

Going from dry food to canned can have a big impact on blood glucose levels and insulin need. Testing is so important to prevent a hypo. Here's the testing info: https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/ A basic Human blood glucose meter works just fine. You don't need an expensive pet blood glucose meter.

 

[Lou&Dexter]

Some vets just aren't very experienced with diabetes. You can either seek out a new vet or be more proactive in your cat's care and ask the vet questions and share information you learn online with the vet.

Novolin N isn't a great insulin to use for cats. It's too short acting. Better insulins to use are Lantus and ProZinc.

You don't need the prescription food. There's nothing in prescription food that helps diabetic cats. Note that the DM stands for dietetic management not diabetes management. FDMB recommends low carb canned food and there are many commercially available brands that are suitable from Fancy Feast Classic / Gourmet pates to Friskies to Weruva. Whatever brand your cat likes and you can afford is fine. The food charts are here: https://www.felinediabetes.com/FDMB/threads/links-to-food-charts.174182/ Whatever has 10% or less carbs is good for diabetics. Do keep some higher carb food on hand to use in case of a hypo. Here's the hypo info:

https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/
https://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

Going from dry food to canned can have a big impact on blood glucose levels and insulin need. Testing is so important to prevent a hypo. Here's the testing info: https://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/ A basic Human blood glucose meter works just fine. You don't need an expensive pet blood glucose meter.

I ordered the glucose kit, so I will definitely be testing before eating and monitoring his levels.

What I am trying to get clarity on is the episodes he has, to me it looks like a hypo event. So would it be smart until I can start testing him to withhold the insulin from him? Because obviously something is going on where he is getting too much. Then once I get some testing done at home, I have that written down and presented to my vet, then go from there?

Do i still administer the gabenpetin?

IE changing the type of insulin and possibly the dose per the vets recommendations.

 

[Bron and Sheba (GA)]

Hi and welcome. Novolin n is not a good insulin for cats to be honest. It hits hard and fast and does not last 12 hours.
Are you feeding them waiting 1hour before giving the insulin? If not please do so. He needs food aboard to stop him dropping too low.

I’m glad you are going to hometest. It’s the only way to find out what’s happening and keeping him safe.
In the meantime I would reduce the dose to 1.5 units.
Please do not stop the insulin. You will only create a lot more problems.
Are you giving snacks during the cycles. If not I would recommend you do so.
Please do not think of euthanasia if he is eating and alert and getting around.

 

[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 capillaries 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 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets any brand
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with

Try putting a thin layer of Vaseline on the ear so the blood will bead up


Here is a video one of our members made, just ignore when she has to code it, that's because she is using a pet meter ,with a human meter like the Relion no coding is needed
VIDEO: How to test your cat's blood sugar


You might want to set up our spreadsheet where you can enter your cats BG .
The link will also explain how to use it

https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

 

[Lou&Dexter]

Hi and welcome. Novolin n is not a good insulin for cats to be honest. It hits hard and fast and does not last 12 hours.
Are you feeding them waiting 1hour before giving the insulin? If not please do so. He needs food aboard to stop him dropping too low.

I’m glad you are going to hometest. It’s the only way to find out what’s happening and keeping him safe.
In the meantime I would reduce the dose to 1.5 units.
Please do not stop the insulin. You will only create a lot more problems.
Are you giving snacks during the cycles. If not I would recommend you do so.
Please do not think of euthanasia if he is eating and alert and getting around.

Good morning!

I have not been waiting an hour, the vet informed me to generally wait 15 mins after eating to give injection. Just go make sure he doesnt vomit.

As far as snacks, again by the vet I was advised that he eats in the morning, then eats at night with no snacking in between. However, I cannot do that to him. So there is always dry food out for him as he is a grazer. As for snacks, I have cat treats I can give him.

Is it rule of thumb to test him before and after eats before you give him insulin? Then after the insulin is administered, test him again and how frequently?

I feel like the insulin i am giving him is tanking his blood sugar levels resulting in the hypo episodes. Hes been on the same dose since he was started with no changes.

Hes had weight loss, they believe it's tied to some sort of cancer. Not going to put him through the tests and treatment for that. So the gave me gabapentin to make him comfortable and stress free. Hes 18 and believe me, euthanizing him is the last thing I want. I just want him to be comfortable and not suffer. When cuddles, eating, drinking and him being mobile stops, thats the time.

 

[squeem3]

Diabetics need to snack during the day to keep their blood glucose levels stable-ish. Human diabetics often snack. Diabetic cats are no different. It's really ok to not listen to the vet Many vets aren't experienced in diabetes.

For snacks, a spoonful of low carb canned food is fine. Many people use a programmble timed feeder so their cat has a few snacks throughout the day. Canned food is fine to leave out all day. Dry food is a big no-no, like a sugary cake for a Human diabetic. It keeps blood glucose levels too high. There are some lower carb "good" dry foods to feed if your cat need crunchies but if your cat is ok with not having any dry, then don't feed it. Air dried raw and freeze dried raw are healthier alternatives to dry food.

Make sure to only give low cab treats. The ideal ones are freeze dried 100% meat or fish ones. PureBites is one brand and there are many others. Instead of a teeny cat sized bag, look in the dog treat section. Whatever is just 100% freeze dried meat is fine. The dog version is in a bigger bag with bigger sized treats that can be broken up into smaller pieces. I would avoid jerky-type treats. Plain cooked chicken is also a great treat.

Always test before giving insulin. This is the only way you know what your cat's level is and if it's at a safe enough number for insulin. Newbies are generally advised not to give any insulin if the level is 150 mg/dl or lower. You're not a newbie but haven't been testing before so it would be a good idea to make 150 your no insulin number. After the insulin, when to test again is really up to you. A few random spot checks throughout the cycle is fine if you can get those in. Always test if you think your cat might be experiencing hypo.

If you don't feel your vet is treating your cat's diabetes well enough and you're not getting much help or answers, seek out a new vet.

 

[Lou&Dexter]

Diabetics need to snack during the day to keep their blood glucose levels stable-ish. Human diabetics often snack. Diabetic cats are no different. It's really ok to not listen to the vet Many vets aren't experienced in diabetes.

For snacks, a spoonful of low carb canned food is fine. Many people use a programmble timed feeder so their cat has a few snacks throughout the day. Canned food is fine to leave out all day. Dry food is a big no-no, like a sugary cake for a Human diabetic. It keeps blood glucose levels too high. There are some lower carb "good" dry foods to feed if your cat need crunchies but if your cat is ok with not having any dry, then don't feed it. Air dried raw and freeze dried raw are healthier alternatives to dry food.

Make sure to only give low cab treats. The ideal ones are freeze dried 100% meat or fish ones. PureBites is one brand and there are many others. Instead of a teeny cat sized bag, look in the dog treat section. Whatever is just 100% freeze dried meat is fine. The dog version is in a bigger bag with bigger sized treats that can be broken up into smaller pieces. I would avoid jerky-type treats. Plain cooked chicken is also a great treat.

Always test before giving insulin. This is the only way you know what your cat's level is and if it's at a safe enough number for insulin. Newbies are generally advised not to give any insulin if the level is 150 mg/dl or lower. You're not a newbie but haven't been testing before so it would be a good idea to make 150 your no insulin number. After the insulin, when to test again is really up to you. A few random spot checks throughout the cycle is fine if you can get those in. Always test if you think your cat might be experiencing hypo.

If you don't feel your vet is treating your cat's diabetes well enough and you're not getting much help or answers, seek out a new vet.

Thank you so much! In reality I am a total newbie as compared to you lovely people. I have switched vets a few times as I feel like I could never get concrete answers, I am sort of running out of options of vets near me.

As for the testing and dosing, I am comfortable administering the dose, not an issue. The testing will take some patience and tricks, I've watched so many videos on it.

For the insulin I am using, I see that its bad for cats and someone recommended cutting the dose in half and another said lowering the dose to 1.5 from 2. So should I start out at 1, see where his levels go and then adjust on the following dose?

 

[CORKY]

Thank you so much! In reality I am a total newbie as compared to you lovely people. I have switched vets a few times as I feel like I could never get concrete answers, I am sort of running out of options of vets near me.

As for the testing and dosing, I am comfortable administering the dose, not an issue. The testing will take some patience and tricks, I've watched so many videos on it.

For the insulin I am using, I see that its bad for cats and someone recommended cutting the dose in half and another said lowering the dose to 1.5 from 2. So should I start out at 1, see where his levels go and then adjust on the following dose?

@Bron and Sheba (GA)
@Suzanne & Darcy
[USER=95]@Sienne and Gabby (GA)
@Diane Tyler’s Mom GA[/USER]

 

[squeem3]

I'm not sure about a dose change. Maybe @Wendy&Neko @Sienne and Gabby (GA) @Bron and Sheba (GA) has a better idea on what to do with Novolin dosing.

Ask the vet about a different insulin such as Lantus or ProZinc. Both work better for cats. If the vet doesn't want to discuss other insulin options, well, find a new vet. What general location are you in? We have members all over the world. You can try searching the forums to see if there are any posts looking for vet suggestions in your area.

There are quite a few recent newbies who have successfully done their first blood glucose test Don't be afraid of doing it. The hardest part might be to get the cat to hold still while you mess with the ear. Treats help. There is a meter that attaches directly to the cat's skin and continuously monitors levels, sending results to an app you put on your phone. That might be an option while you figure out testing with a meter and poking the ear. A vet would have to put the initial Libre meter on but you can learn how to put it on yourself after that. The Libre is supposed to last 2 weeks but can fall off before then or malfunction so it's good to know how to hometest by poking the ear as a back up.

 

[Bron and Sheba (GA)]

Can you get a spreadsheet up and running and add BG data? We need that to help you with dosing.
Please do wait the hour after feeding before giving the dose. And to start with because it’s Novolin, I would not shoot if the BG is below 200. If this happens stall, don’t feed and see if the BG is rising after 20 minutes when you test again. And post and ask for help.

Give snacks during the cycles.
I’m going to give you the link to using Novolin n below but please think about swapping to a better insulin for cats…Lantus or Prozinc

 

[Bron and Sheba (GA)]

BEGINNERS GUIDE TO NOVOLIN N

 

[Lou&Dexter]

I'm not sure about a dose change. Maybe @Wendy&Neko @Sienne and Gabby (GA) @Bron and Sheba (GA) has a better idea on what to do with Novolin dosing.

Ask the vet about a different insulin such as Lantus or ProZinc. Both work better for cats. If the vet doesn't want to discuss other insulin options, well, find a new vet. What general location are you in? We have members all over the world. You can try searching the forums to see if there are any posts looking for vet suggestions in your area.

There are quite a few recent newbies who have successfully done their first blood glucose test Don't be afraid of doing it. The hardest part might be to get the cat to hold still while you mess with the ear. Treats help. There is a meter that attaches directly to the cat's skin and continuously monitors levels, sending results to an app you put on your phone. That might be an option while you figure out testing with a meter and poking the ear. A vet would have to put the initial Libre meter on but you can learn how to put it on yourself after that. The Libre is supposed to last 2 weeks but can fall off before then or malfunction so it's good to know how to hometest by poking the ear as a back up.

I am in Toms River NJ

 

[squeem3]

@EvanVanVan is a new member and also in NJ, northern part. There were some NJ vets in their thread: https://www.felinediabetes.com/FDMB...-looking-for-a-new-vet-in-northern-nj.299121/

@Rishi is also in NJ. Thread asking for NJ suggestions: https://www.felinediabetes.com/FDMB...ions-for-a-vet-in-northern-new-jersey.299329/

I found a really old thread from someone in your local area but the person has not posted since that one single post so that's not any help.

 

[Sienne and Gabby (GA)]

Welcome to FDMB!

I think Diane (@Diane Tyler's Mom GA) is in New Jersey but I'm not entirely sure what part. There are cat only clinics. This is a link to search for a practice in your area.

Without the benefit of home testing, the only way to know if Dexter is becoming hypoglycemic is to lower his dose and see if symptoms continue or not. There are a couple of interim options until your glucometer arrives. You can buy Ketodiastix at any pharmacy. These are urine test strips that you swipe through your cat's urine stream or you use with a urine sample. There are a couple of ways to collect urine. You need a fresh sample and you need to follow the directions on the container. Ketodiastix test for BOTH glucose and ketones. (Ketostix test for ketones only.) You will not get the same level of accuracy as you would get with a glucometer but it will tell you if numbers are dropping into a lower range. If you reduce the dose, you want to be sure that ketones aren't developing.

What I find concerning is that your cat has been on the same dose of insulin for roughly 5 years. If you look at any of our spreadsheets, you'll see that the insulin dose changes depending on the cat's needs. Even for cats whose caregivers can't test, they get monthly fructosamine tests at the vet's office to determine if insulin needs have changed. I'm linking the guidelines for diabetes treatment from the American Animal Hospital Association so if you are interviewing a new vet, you have some general information to help you sort out what the vet does or doesn't know. To be honest, my cat was started on Novolin by a critical care vet when she was hospitalized at the time she was diagnosed. (She was really sick.) That was in 2009. When I finally found FDMB and got my wits about me, I discussed a switch to Lantus. My vet's comment about Novolin was that it's a good insulin for dogs and that was a lot of years ago. The AAHA recommends either Lantus (glargine) or Prozinc as others have noted.

It also sounds like your vet did not provide you with much guidance about food. You want to be feeding Dexter a low carbohydrate diet. That means that most dry food is not an option. There are only 2 dry foods that are low in carbs -- Dr. Elsey's Clean Protein and Young Again Zero Carb. On the other hand, there are lots of foods that are under 10% carb to choose from. If you are going to transition food, please do so slowly. Without knowing where Dexter's blood glucose numbers are, a switch to low carb will drop his numbers.

Dexter's symptoms could be hypoglycemia. We've only rarely had cats that have had seizures which would suggest that Dexter's numbers are dangerously low. I'm quite surprised that your vet didn't suggest a lower dose of insulin. If this happens again, can you try making a video? It may help a vet to diagnose what's going on. One other factor to consider is that age can have an effect on how medications are metabolized. At least in humans, often older adults require a smaller dose of a drug than their younger or middle-aged counterparts.

 

[Diane Tyler's Mom GA]

I'm in Northern N.J. Toms River would be approximately an hour and. half away from me