25/9/25 New member, difficult situation | Feline Diabetes Message Board - FDMB

25/9/25 New member, difficult situation

K

Kipling

New Member
Hi all, I have a difficult situation and wonder if any guidance could be given to help my family navigate the next week as safely as possible.

Our family cat Finn was diagnosed with diabetes Monday this week and started treatment Tuesday. He is approx 11lbs/5.2kg, neutered, 14 yo.

The diagnosis arose at a very awkward time. I am currently catsitting Finn for relatives who are overseas until 2nd Oct. However I must return to work 28th Sep (I live 200 miles away) and so the plan was originally for a family friend to feed and check in on Finn twice daily for the last 4 days.

I took Finn to the vet just after my relatives left, as I had seen that he had suddenly lost 1kg in 1 month (mostly muscle loss in his back and hind quarters) and was very slow, weak and not engaging. Relatives knew he wasn’t himself but didn’t recognise how dire the situation was. He had been to the vets a month prior and tests were inconclusive at that time.

Now the vet has said to start treatment immediately to get his diabetes (400 fructasamine, 28 glucose) under control. From there, there may also be a possible hyperthyroidism issue to address (he is in the grey zone with his T4 levels, so it is uncertain but I am told it seems likely; so I’m also concerned he’s not being treated for possible hyperthyroidism but that’s another matter).

Finn has been prescribed 2 units Caninsulin twice a day. I started his shots Tuesday AM, it’s hard to tell how it’s affecting him so far. The family friend is happy to feed him and administer his shots on schedule when I leave.

My concerns are:
1. I’m very nervous about 2 units being his starting dose. He has recently lost so much weight and while he still has some fat on his ribs, he is very thin in places.
2. He was previously on approx 80% dry food, but then would not eat any dry food in the few days before I came and could get him to the vets. While awaiting diagnosis and treatment, I was scared he would lose more weight, so I started feeding him about 6 x 85g wet food a day totalling about 350-420 calories (low carb high protein wet food only (no dry food)), and his weight loss has stalled, and his condition improved a fair bit. I would hope to continue this with diet using a timed feeder, but also worry the insulin dose will be incompatible with it. I also worry the fructosamine results don’t reflect this change of diet.
3. I am trying to take a blood sample following all guidance on here for home monitoring, but he is a fidget and also apparently not a bleeder :( all attempts have produced no blood beyond the minutest speck so far. I also can’t see family managing to do this going forward. I don’t know if giving 2 units blind is inherently dangerous or a safe dose for his size and diet.
4. There’s no way for me to stay longer and no way of my relatives returning sooner. When being cared for by the family friend, they will only be with him perhaps 15 minutes twice a day. He will not be monitored. If he goes hypoglycaemic no one is there to see nor help him.
5. The vets were quite blasé when I asked about diet (they just suggested Royal Canin diabetic 85g wet pouches and to give him 2 feeds a day only), but I can’t see how I stop his weight loss that way, or would have to give 250g of food per feed which he would probably wolf down and then vomit up tbh. Also I imagine that wouldn’t be a great way for him to rebuild muscle.
5. The vets also suggested we continue with the 2x 2 unit shots even without supervision as their priority was to take him in for a glucose curve in a week or so. As much as I agree the ideal would be to stabilise him and check him ASAP, realistically it seems negligent to force this plan?

I just don’t know what to do. Would it be safest to reduce his dose while he’s unsupervised? That’s all I can think of. Is it safe for me to lower it from 2 now we’ve already started? Would 0.5 or 1 be appropriate..?

Sorry for the long one, really appreciate any suggestions.
 
Last edited:
Welcome to FDMB, for starters, Caninsulin is a dog insulin best insulin for cats are ProZinc and Lantus, plus home testing is very important, especially before each shot, I will tag members that can assist you on dosing, and other of your concerns, also for a curve you do not need to stress the cat through a vet visit and cost, curving is simply home testing every two hours for 1 cycle ( 1 day),
@Diane Tyler's Mom GA
 
Kipling said:
Hi all, I have a difficult situation and wonder if any guidance could be given to help my family navigate the next week as safely as possible.

Our family cat Finn was diagnosed with diabetes Monday this week and started treatment Tuesday. He is approx 11lbs/5.2kg, neutered, 14 yo.

The diagnosis arose at a very awkward time. I am currently catsitting Finn for relatives who are overseas until 2nd Oct. However I must return to work 28th Sep (I live 200 miles away) and so the plan was originally for a family friend to feed and check in on Finn twice daily for the last 4 days.

I took Finn to the vet just after my relatives left, as I had seen that he had suddenly lost 1kg in 1 month (mostly muscle loss in his back and hind quarters) and was very slow, weak and not engaging. Relatives knew he wasn’t himself but didn’t recognise how dire the situation was. He had been to the vets a month prior and tests were inconclusive at that time.

Now the vet has said to start treatment immediately to get his diabetes (400 fructasamine, 28 glucose) under control. From there, there may also be a possible hyperthyroidism issue to address (he is in the grey zone with his T4 levels, so it is uncertain but I am told it seems likely; so I’m also concerned he’s not being treated for possible hyperthyroidism but that’s another matter).

Finn has been prescribed 2 units Caninsulin twice a day. I started his shots Tuesday AM, it’s hard to tell how it’s affecting him so far. The family friend is happy to feed him and administer his shots on schedule when I leave.

My concerns are:
1. I’m very nervous about 2 units being his starting dose. He has recently lost so much weight and while he still has some fat on his ribs, he is very thin in places.
2. He was previously on approx 80% dry food, but then would not eat any dry food in the few days before I came and could get him to the vets. While awaiting diagnosis and treatment, I was scared he would lose more weight, so I started feeding him about 6 x 85g wet food a day totalling about 350-420 calories (low carb high protein wet food only (no dry food)), and his weight loss has stalled, and his condition improved a fair bit. I would hope to continue this with diet using a timed feeder, but also worry the insulin dose will be incompatible with it. I also worry the fructosamine results don’t reflect this change of diet.
3. I am trying to take a blood sample following all guidance on here for home monitoring, but he is a fidget and also apparently not a bleeder :( all attempts have produced no blood beyond the minutest speck so far. I also can’t see family managing to do this going forward. I don’t know if giving 2 units blind is inherently dangerous or a safe dose for his size and diet.
4. There’s no way for me to stay longer and no way of my relatives returning sooner. When being cared for by the family friend, they will only be with him perhaps 15 minutes twice a day. He will not be monitored. If he goes hypoglycaemic no one is there to see nor help him.
5. The vets were quite blasé when I asked about diet (they just suggested Royal Canin diabetic 85g wet pouches and to give him 2 feeds a day only), but I can’t see how I stop his weight loss that way, or would have to give 250g of food per feed which he would probably wolf down and then vomit up tbh. Also I imagine that wouldn’t be a great way for him to rebuild muscle.
5. The vets also suggested we continue with the 2x 2 unit shots even without supervision as their priority was to take him in for a glucose curve in a week or so. As much as I agree the ideal would be to stabilise him and check him ASAP, realistically it seems negligent to force this plan?

I just don’t know what to do. Would it be safest to reduce his dose while he’s unsupervised? That’s all I can think of. Is it safe for me to lower it from 2 now we’ve already started? Would 0.5 or 1 be appropriate..?

Sorry for the long one, really appreciate any suggestions.
Click to expand...
@Suzanne & Darcy
 
CORKY said:
Welcome to FDMB, for starters, Caninsulin is a dog insulin best insulin for cats are ProZinc and Lantus, plus home testing is very important, especially before each shot, I will tag members that can assist you on dosing, and other of your concerns, also for a curve you do not need to stress the cat through a vet visit and cost, curving is simply home testing every two hours for 1 cycle ( 1 day),
@Diane Tyler's Mom GA
Click to expand...
Thanks Corky, I wish it were as simple as you say. I’ve watched numerous videos and read all about glucose monitoring, and have emulated the videos as best I can, but after pricking Finn’s toe pads and ears in the sweet spot and elsewhere repeatedly there is no blood droplet forming (even with heat, massage and vaseline). He is also very stressed by it despite my efforts to keep him calm, and I eventually have to let him go after several fruitless attempts.

The vet made insulin treatment sound so simple, but the more I learn the more overwhelmed I get, and the more concerned about the lack of advice I was given. They didn’t really even go into hypo advice until I asked, no mention of home monitoring, they just implies that he would be safe on this dose but now I’m truly second guessing
 
Kipling said:
Thanks Corky, I wish it were as simple as you say. I’ve watched numerous videos and read all about glucose monitoring, and have emulated the videos as best I can, but after pricking Finn’s toe pads and ears in the sweet spot and elsewhere repeatedly there is no blood droplet forming (even with heat, massage and vaseline). He is also very stressed by it despite my efforts to keep him calm, and I eventually have to let him go after several fruitless attempts.

The vet made insulin treatment sound so simple, but the more I learn the more overwhelmed I get, and the more concerned about the lack of advice I was given. They didn’t really even go into hypo advice until I asked, no mention of home monitoring, they just implies that he would be safe on this dose but now I’m truly second guessing
Click to expand...
I understand your frustrations, perhaps you should seek for another vet that has knowledge on Feline Diabetes, you may want to consider to be able to check glucose numbers, especially before shooting the Libre monitor and sensor, this can help your stress and your cat’s and save him from hypoglycemia, Caninsulin is for dogs and very hard on the cat, I tagged several members, I am sure one of them can attend these concerns, that as you have read previous posts from other members, are also concerned on the high dose, Caninsulin, and hypoglycemia without testing, we have been there as well, I know I have, take a step back, breath in and breath out, cats are very sensitive to stress, you stress they stress!
@Sienne and Gabby (GA)
 
Hometesting tips: Hometesting Links and Tips

What gauge lancets are you using? If they're too thin, you won't get any blood. 27 gauge is an ideal size. If you're using the lancet device, press it firmly against the ear. Hold the rice sock or a folded piece of cotton square / ball on the other side of the ear to provide a firm surface to poke against. If the device has adjustable depth settings, try all of them. You can also freehand the lancet without the device.

Get that ear super warm. What is your method of warming the ear? Rice socks are popular. Heat in microwave until just comfortably warm enough for you to hold for a good minute. Wrap the sock around the edge of the ear and firmly hold in place for a minute or more. If the cat flinches and tries to get away, the sock is too hot. Let it cool and try again in a few minutes and use less microwave time next time.

Unregulated diabetic cats are literally starving so it's best to just feed them as much as they want. Several small meals daily works for many cats. What country are you in? The food charts for some popular countries are here: Links to FOOD CHARTS Any canned / pouched / tinned food under 10% carbs is best. Food is one thing you can disagree with the vet about.

If you don't feel comfortable with anything the vet recommends, it's ok to tell the vet that. If 2 units of insulin is too much, and it can be, say so and do just 1 unit twice a day. Better to not see any effect on blood glucose levels than to start too high and risk a hypo in a few hours.
 
squeem3 said:
Hometesting tips: Hometesting Links and Tips

What gauge lancets are you using? If they're too thin, you won't get any blood. 27 gauge is an ideal size. If you're using the lancet device, press it firmly against the ear. Hold the rice sock or a folded piece of cotton square / ball on the other side of the ear to provide a firm surface to poke against. If the device has adjustable depth settings, try all of them. You can also freehand the lancet without the device.

Get that ear super warm. What is your method of warming the ear? Rice socks are popular. Heat in microwave until just comfortably warm enough for you to hold for a good minute. Wrap the sock around the edge of the ear and firmly hold in place for a minute or more. If the cat flinches and tries to get away, the sock is too hot. Let it cool and try again in a few minutes and use less microwave time next time.

Unregulated diabetic cats are literally starving so it's best to just feed them as much as they want. Several small meals daily works for many cats. What country are you in? The food charts for some popular countries are here: Links to FOOD CHARTS Any canned / pouched / tinned food under 10% carbs is best. Food is one thing you can disagree with the vet about.

If you don't feel comfortable with anything the vet recommends, it's ok to tell the vet that. If 2 units of insulin is too much, and it can be, say so and do just 1 unit twice a day. Better to not see any effect on blood glucose levels than to start too high and risk a hypo in a few hours.
Click to expand...

Thank you so much, following your directions I was able to start home testing! His first reading was 26.3 nmol/L so definitely not low and I feel safer giving his shot, what a relief. To answer your question the lil mog is British, I’ve found some good low carb food for him and he’s eating the lot :)

I’m trying to do a glucose curve today to see what effect the insulin is having, and then he will most likely have to go to the vets for his next curve unless my relatives are able to manage it.

Are there any good examples of what to hope for in a glucose curve for twice daily injections (I’m doing 1.5u for both at the moment)? Looking online I’m seeing results like this which makes no sense to me as the 2nd shot would then be given at the lowest point but the glucose then rises..? Surely this can’t be right. Shouldn’t there be 2 troughs?
IMG_6677.webp

Also thanks to everyone for giving me the confidence to advocate on Finn’s behalf with the vets, I feel immensely more confident going forward.
 
Welcome to FDMB.

First, I hope your relatives appreciate how wonderful you've been. I'm not sure that most "catsitters" would have done what you have or would be as worried about someone else's cat. You likely saved this Finn's life.

One immediate thought is can you take Finn home with you until your relatives are back in town? I suspect this would all be a lot easier if Finn had started treatment well before you were caring for him. When I travelled, I had an incredible cat sitter who would stop by twice a day to give shots and feed my cat. She hung out for a bit but Gabby was home alone (well, with my other cat). I also lowered her insulin dose to avoid any problems with hypoglycemia. Your thought about reducing the dose if no one can keep an eye on Finn makes perfect sense.

I agree - 2.0u is a large starting dose. It's especially a large dose for an insulin that acts fairly rapidly and can drop numbers fast. The other reasons that Caninsulin isn't a great choice is that is doesn't last 12 hours. The American Animal Hospital Assn no longer recommends Caninsulin for the treatment of feline diabetes. The insulins that are recommended are either Lantus (glargine) or Prozinc. This is information on Caninsulin. It used to be that in the UK, vets had to start a pet on Caninsulin. That's no longer the case. Prozinc is a much better alternative.

Good job on switching Finn over to a canned food diet. What are you feeding Finn? Not all high protein food is low in carbs. This is a link to a UK food chart that may help with your choices. We consider low carb ase under 10% although many of the members here use a food that is in the neighborhood of 5%. I'm also tagging one of our long time members who's in the UK. @Elizabeth and Bertie

The graph you posted is truly an "ideal" curve. Not all cats read the instruction manual. They tend to not like to be predictable! Also, the graph goes from 12 AM to 12 AM. It's a 24 hour curve. When you do a curve for a cat, you are looking at a 12-hour period due to their having a fast metabolism. Insulins, such as Prozinc or glargine, have a duration of 12 hours or a bit more although there can be variability based on an individual cat. Ideally, the nadir (lowest point in the curve) is at around 6 hours after injecting insulin. Again, there are individual differences. For example, my cat had a very early nadir (except for those times where she didn't).
 
Sienne and Gabby (GA) said:
Welcome to FDMB.

First, I hope your relatives appreciate how wonderful you've been. I'm not sure that most "catsitters" would have done what you have or would be as worried about someone else's cat. You likely saved this Finn's life.

One immediate thought is can you take Finn home with you until your relatives are back in town? I suspect this would all be a lot easier if Finn had started treatment well before you were caring for him. When I travelled, I had an incredible cat sitter who would stop by twice a day to give shots and feed my cat. She hung out for a bit but Gabby was home alone (well, with my other cat). I also lowered her insulin dose to avoid any problems with hypoglycemia. Your thought about reducing the dose if no one can keep an eye on Finn makes perfect sense.

I agree - 2.0u is a large starting dose. It's especially a large dose for an insulin that acts fairly rapidly and can drop numbers fast. The other reasons that Caninsulin isn't a great choice is that is doesn't last 12 hours. The American Animal Hospital Assn no longer recommends Caninsulin for the treatment of feline diabetes. The insulins that are recommended are either Lantus (glargine) or Prozinc. This is information on Caninsulin. It used to be that in the UK, vets had to start a pet on Caninsulin. That's no longer the case. Prozinc is a much better alternative.

Good job on switching Finn over to a canned food diet. What are you feeding Finn? Not all high protein food is low in carbs. This is a link to a UK food chart that may help with your choices. We consider low carb ase under 10% although many of the members here use a food that is in the neighborhood of 5%. I'm also tagging one of our long time members who's in the UK. @Elizabeth and Bertie

The graph you posted is truly an "ideal" curve. Not all cats read the instruction manual. They tend to not like to be predictable! Also, the graph goes from 12 AM to 12 AM. It's a 24 hour curve. When you do a curve for a cat, you are looking at a 12-hour period due to their having a fast metabolism. Insulins, such as Prozinc or glargine, have a duration of 12 hours or a bit more although there can be variability based on an individual cat. Ideally, the nadir (lowest point in the curve) is at around 6 hours after injecting insulin. Again, there are individual differences. For example, my cat had a very early nadir (except for those times where she didn't).
Click to expand...
Thank you for your kind words and advice :)

Finn is eating Sheba flakes in jelly and Harringtons wet food in gravy - both should be very low for carbs (under 5%) if the packaging is honest. I’m also supplementing with boiled chicken and the occasional meat stick as a treat. He is eating 350g+ a day and barely maintaining his weight.

Is it normal for glucose to remain high after switching to a carb free diet? I know this sounds stupid, but I’m wondering where he’s getting all this glucose from in the first place haha. I’ve asked the neighbours not to feed him, but think my relatives might benefit from buying a litter tray and keeping him in a day or two to see whether that changes anything. Then again, that might stress Finn out.

Will definitely be asking about Prozinc or Lantus, but unfortunately I’m leaving shortly so it’s Caninsulin until my relatives return. As much as I was concerned about 2 units being too much, the Caninsulin appears to have only dropped his glucose by 10 mmol/L, so not even in the good zone which I understand is 6-16 mmol/L?

1758984913349.jpeg


Still, I know a small change in dosage can have big effects, so do you think it’s safer to keep him at this dose while he’s not under constant supervision?

Thanks all
 
It does look like what you're feeding is low carb. Both foods are on the UK list I linked. There was a note with the Harrington's that because it contains tapioca and caramel syrup, some cats who are very carb sensitive may not do as well with that particular food.

We tend to not use graphs to gauge how a cat is responding to insulin. We use a spreadsheet. It's much easier to see trends and we don't have to extrapolate to know what the numbers are. The spreadsheet template is is this post on helping us to help you. I can understand if you don't want to go to the trouble of setting up a spreadsheet since your relatives will be taking over in a few days.

It looks like you're seeing a decent drop in Finn's numbers from pre-shot to nadir (lowest point in the cycle). With a spreadsheet we can see trends which we can't evaluate based on a graph. It also may take a bit for Finn's system to get used to insulin and handle lower numbers. This is not something you want to rush, especially if no one is going to be around to keep an eye on him.
 
Before I left wanted to see how he was doing on an evening. Today’s numbers have been so confusing. I’m fairly confident I injected him correctly as the needle went in, came out empty, there was no wet fur. Yet his results were as follows:

19:00 - 24.6 mmol/l
(19:45 - injected 1.75 units insulin)
22:00 - 25.0 mmol/l
01:08 - 23.8 mmol/l

So no drop? Very strange. Or if I forgot to swirl the insulin could that account for it?
 
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