Abby`s Uncontrolled Diabetes

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Lydia Marshall

Member Since 2019
Good Evening All,

I have been reading these forums for the last week or so with interest wondering what I should do about my recently diagnosed cat Abby. I'll go over the particulars:

Abby is an 11 year old tuxedo cat born to feral parents. We picked her up from a foster mom. About 5 days after we got her we decided to go back and get her brother, Whisky. Abby was NOT happy but after a few weeks they seemed to settle in together. From the day we got Abby she seemed to always be starving. I could never feed the cats together because she would inhale her food and then eat all of his. Over the years Abby has had a series of UTI and more then one vet has said she brings them on herself because she gets stressed out and is a very neurotic cat.

Fast forward to 2019 when in May we began to notice her excessive thirst and urination. At the vet visit he let us know that she has diabetes with a blood glucose level of 588. He also drained a golf ball sized cyst that had blood and proteins in it. The vet does not feel this is contributing to her raised BG levels. The vet prescribed 4 units of losing twice a day with food and prescribed Royal Canine glycobalance dry food to leave out for her and 2 small cans of glycobalance set food. Over the next 14 weeks I have taken Abby to the vet every Saturday to have her glucose checked. It has ranged from 638 to 366 and every where in between. The vet each week raised the insulin units by 1. At the end of 5 weeks she was getting 9 units twice a day. No change. Than the vet changed the insulin to Vetsulian. We went back done to 5 units twice a day until we got up to 9 again and still no change. We even tried giving her 3 shots of 8 units per day and still no change. The vet is now recommending we take the cat to an internist, but I came to this board to see if there are other options.

I just want to add one thing, I see many of you checking keytons and running a test strip through urine, etc. And while I applaud your diligence, I just cannot put that kind of time in.I work a 60 hour work week and just don't have that kind of time.

So my questions are, should I change Abby to a frozen raw diet where she isn't getting any carbs? If so which one do you recommend and can I start her on a better insulin and if so, which is best?

Thanks for all your help!
Lydia
 
Low carb wet food or raw will make it much easier to regulate Abby. It does not have to be zero carb, a lot of us feed in the 3-6% carb range. You definitely do not need to feed the vet suggested food. This food chart lists common ones available in North America. https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

4 units is a huge dose to start with. I definitely would not change her diet until you are home testing. We have had cats go from almost six units to zero when dry food was removed. Without testing, the caregiver would not have known the dose was too high, and the cat would hypo. Cats often test higher at vet, another reason for home testing. I had a non diabetic cat who once tested almost 200 points higher at a vet visit. The vet was worried he might be diabetic. I tested him at home the next day, and he was perfectly normal.

There are some cats that have secondary conditions that cause diabetes and can mean higher doses are needed. My girl got up to 8.75 of Lantus, but I was testing so knew it was a safe amount to give. If for some reason Abby does need higher doses, Levemir is a good insulin.
 
9 units after 5 weeks on insulin is a huge amount in a short time. I think the vet was rushing too fast with increases. We increase by only 0.25 units at a time to ensure we don't go past the best dose for the cat.

I agree with Wendy that the choice of food Abby was put on is not suitable for a diabetic cat.
As Wendy said there are many suitable low carb (under 10% carbs) canned foods available which would be fine.
A raw diet would also be good.
However I would not change the diet from a high carb to a low carb diet without home testing the blood glucose levels.
You would be risking a hypo by just swapping the diet without testing and adjusting the amount of insulin.

It sounds as if you are a very busy person, however it is possible to still test the blood glucose levels as you do that just before you give the insulin to see it is safe to do so. Then when you are at home at night or the weekend you can test sometime during the cycle to see how low the dose is taking Abby.
At the moment it is all a bit of hit and miss and guessing whereas if you are testing, there is no guessing. You will know if you are giving too much insulin. Or not enough.
You also will not have to go to the vet every Saturday if you are testing yourself, which will save time and money.

Lantus and levemir insulins are both very good insulins for cats and as Wendy said if you did need to give a large dose Levemir is a good insulin.

Re ketones....We recommend people test for those if the cat has higher than normal BG levels, has an infection, is not getting insulin or is skipping doses and for kitties that have had ketones before and are prone to them. It is a simple urine test to detect ketones and if treated early can prevent the much more serious ketoacidosis (DKA).

With Abby's anxiety, have you tried a feliway collar?

So in answer to your main question, a low carb canned food diet or a raw diet would both be good for Abby.
BUT do not try swapping over while you are giving the 8 or 9 units of insulin... it I should too dangerous. Your current food is high carb and is probably the only thing saving her from a hypo with that amount of insulin.

My suggestion, and this is only a suggestion for you to think about, would be to learn to test the BGLevels ( it is not hard and it won't hurt Abby), reduce the dose of insulin (but at the same time you will need to test for ketones in the urine to ensure none develop) and start giving the low carb diet. You will just need to test for ketones until the dose and BG are sorted out ( as long as none develop, which hopefully won't happen)
It might sound a lot to do but it's not really and in the long run you will get her sorted. At the moment it does not sound satisfactory and I am concerned about the large amount of insulin being given.

Keep asking questions. If we can help you further or with the transition to a low carb diet we will be happy to do so.
Feline diabetes is a very treatable disease. It can just take time finding the right dose. But cats can live a normal life.
Bron
 
Thank you both for your responses. I think my next course of action is to call the vet and see if he would be willing to change the insulin to Levemir, try a smaller dose, get more information about testing supplies, and gradually change her over to a raw food diet. I'll keep you posted.
Thanks again,
Lydia
 
Lydia Marshall said:
Thank you both for your responses. I think my next course of action is to call the vet and see if he would be willing to change the insulin to Levemir, try a smaller dose, get more information about testing supplies, and gradually change her over to a raw food diet. I'll keep you posted.
Thanks again,
Lydia
Click to expand...
A good starting dose is 1 unit twice a day. Unless you are following the tight regulation protocol, wait at least one week before increasing it. If an increase is needed, raise the dose no more than 1/2 unit. Again wait at least another week before increasing it again. The goal is to find the optimal dose that works best for controlling the glucose levels.

For testing you can use either a pet glucose meter or a human meter. The advantage of the human meter is both the meter and strips cost less than the pet meter. Plus in an emergency, you can get more strips from the pharmacy. With the pet meter, the strips are more expensive and not easily available in an emergency. If you decide to use the pet meter, you may want to have a backup human meter & strips in case you run out of strips and need to test asap

Both types of meters work well for home testing. What you use will depend on your preference and budget.
 
I think it would be interesting to start testing now, with the diet and dose you are on, to see what is happening. Some cats need larger doses of insulin. Starting back at 1 unit if Abby needs more is a waste of time. Been there, done that.
 
Good Evening,

I spoke to Abby's vet and he was willing to have me try the Levemir. I picked up the prescription today and went to fill it and it was $383.00!! I happened to ask about the Lantus and that is $318.00! I was shocked. The Vetsulin I have been purchasing is around $70.00. Are these prices typical for this kind of insulin?

Thanks,
Lelia
 
Priya&Missy said:
I was able to get a Lantus pen at Costco for $65 with a coupon from goodrx
Click to expand...
You don't need the vial (you will end up wasting a lot as it will lose its efficacy before you can use it all). Purchase a pen and use the syringe to extract your dose. I purchase the pens at CVS pharmacy for $96.
 
Lydia Marshall said:
Good Evening,

I spoke to Abby's vet and he was willing to have me try the Levemir. I picked up the prescription today and went to fill it and it was $383.00!! I happened to ask about the Lantus and that is $318.00! I was shocked. The Vetsulin I have been purchasing is around $70.00. Are these prices typical for this kind of insulin?

Thanks,
Lelia
Click to expand...
Marks marine in Canada is great. You can call them and get your questions answered. I wish I had done that from the start. I ended up paying $90 at my local pharmacy for a pen at first. Marks was about $200 for 5.
 
Another vote for Mark's - they ship very quickly too. I'm in California and have gotten orders in three days (this was with the cold ice-pack shipping option). Very friendly people, and once they have your prescription, that's it, you don't even have to renew it each year.
 
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