Bonnie - Recently Diagnosed

Samantha J

Samantha J

Member
Hi,

So Bonnie (11 this yr) was recently diagnosed with diabetes as of yesterday 2/24. Her glucose level is 530. All of her other labs were within normal limits from the blood draw. I’m currently waiting on the results from the blood sample to determine the next steps regarding insulin.

The vet that I go to is a low cost clinic and limited with specialists so they recommended a specialist. The specialist appointment is next month on 3/25. They currently don’t have any earlier appointments when I called today, but I’ll keep trying.

Do I wait for that specialist appointment or move forward with taking her to a hospital to get treated with insulin instead of waiting for the results from the blood draw?

I already had to put down my other senior cat Clyde unexpectedly earlier this month, so I would prefer to not have to do this again for obvious reasons.

Bonnie is on meds for a UTI. She was already transitioned to wet foods earlier this month in light of everything that happened this month. She’s eating and using the litter box like normal. Any feedback is appreciated.
 
Did the vet suggest a follow on test called a Fructosamine? It tests the average blood sugar over two weeks, so you can rule out the one test as an outlier. Though 530 is pretty high for that. Was a urinalysis done that also showed urine in her sugar? Blood draw results the vet gets within a day. You paid for them, they owe then to you now. My vet emails them to me.

You don't need a specialist to treat diabetes. What you do need is a good insulin (Lantus and Prozinc are the best), a low carb diet, preferably wet food, and home testing of blood sugars to make sure kitty is in safe blood sugar numbers. We can help you figure out the best diet and help you learn how to home test and use that data to make decisions about the insulin dose. You do need the vet for a prescription for insulin. But not a specialist.

The sooner you can get a cat on insulin, the better for their health. Meaning, don't wait for the specialist. First, the sooner you can get a cat regulated, you can increase the chances of them going into diabetic remission. Second, being in high numbers for a long time is not good for their health, and if there are any other conditions present (infection or inflammation), that can lead to a potentially deadly condition called DKA (diabetic ketoacidosis). A UTI present is a worry. Did your vet test for ketones? You can get urine testing strips and test yourself for ketones at home. Anything above a trace level is a concern that means going to the vet. Tips to catch and test a urine sample.

How is Bonnie's appetite and energy level now? What brand of food is she eating?
 
Hi,

Yes they checked her urine. She did have glucose in her urine. I can’t recall the test for the blood sample they sent off. I’ll look back at her lab results.

Her energy level is the same. She does act very hungry when she knows it’s time to get food (esp with the wet food now). I’m also not leaving dry food out anymore.

I’m not seeing where she is lethargic or low Energy. She seems fine. She and Clyde were together most of her life so I was worried about how she would be.

And so prior to this, she (and my other cat Ringo (4) ) were eating royal canin digestive dry food. Since all of This has happened, I’ve increased the wet food via the different purina pro plans (like urinary health or vital systems etc.) or wet foods that are protein focused only since carbs aren’t necessarily good for Bonnie. Mostly purina pro plan and I did try a tiki with her.
 
Welcome to FDMB.

Not all of the Purina foods are low carb. We consider low carb food as under 10% although most members here feed their cat in the 5% range. This is a link to a website that discusses feline nutrition. On the menu bar on the right side of the page is a link to a chart that lists most of the canned cat foods available in the US and includes information about the carbohydrates in the food. You have lots of options!

You may want to consider having both cats on the same food. There's a reasonable chance they may want to eat each others' food and if Ringo is not eating a low carb food, Bonnie will be chowing down on the food she's not supposed to be eating or annoyed that you are moving her to a separate location to eat.

As Wendy noted, most of the members here do not see a specialist for managing their cat's diabetes. The question seems to be whether your current vet would be comfortable with prescribing insulin. If so, Lantus (the generic/biosimilar is glargine and is much less expensive than the name brand and their are discount cards available for Lantus) or Prozinc are the two insulins that are recommended by the American Animal Hospital Assn for the treatment of feline diabetes. We do encourage everyone to learn how to home test. It's the best way to ensure that your cat is in safe blood glucose numbers. Walmart's Relion brand glucometers are very popular here given that the cost of the strips are the least expensive around.
 
Okay thank you both.

And yes, I’m having both cats eat the same so that there are no issues. Ringo could benefit since she’s a petite and a little butterball lol.

Thank you for the link to the foods. I did look at her labs and the ketones were negative. Positives showed for leukocytes (+++), protein (+), and glucose (++)

The test that’s pending is for the Fructosamine.
 
The fructosamine results shouldn't take long to get. In the mean time, you might want to pick up some Ketostix (urine test strips), available at most pharmacies and start testing at home. Ketone levels can change quickly.
 
Welcome here is the food chart
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/page-3#post-3242965

Here is the link for the meter and test strips so you don't have to search for them. Most of us use human meters
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197
At least if you need more test strips you canrun into Walmart and pick them up or if you're running low you can just order them from Walmart


Testing, the only way to keep Bonnie safe
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
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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

If you can get Lantus or the generic
Walmart, you can get U100 insulin syringes with half unit marks for $12.58/100.
You need to go into the store to get them

Either of these 2 boxes are the ones you want (with a purple stripe). You have to go into the store , can't buy them on line
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This was posted by a member and copied it for you
If you're going to Walmart, ask for Relion 3/10ml, 31 or 30 gauge insulin syringes. (Don't mention half unit marks because this tends to confuse them and they think you don't know what you want and will try to convince you that you need 1/2ml syringes---you DON'T)

ALL of the 3/10ml Relion syringes at Walmart have half unit marks. Trust me on this. You will want one of these boxes of syringes (the difference is the needle length...blue box are shorter needles than white box but both work fine). As long as the box has the purple stripe, they are the correct syringes.

You can definitely get 5 pens of Lantus or the generic Glargine

You can Check
CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens either Lantus or the generic Glargine , plenty of members use the generic
Just call around and see who has the cheapest price , it's really not that expensive
With the pens just keep them in the fridge middle shelf , they all have the expiration date on them .

Also
The 5 pens will last about a year, 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

If you use the Good Rx
GoodRX has a 1-800 number to assist you in using their services to get your pets prescriptions filled if the pharmacy gives you any issues.

I think I found it for you
GoodRx / Customer service

1 (855) 268-2822


GoodRx coupon.
https://www.goodrx.com/lantus?label...d-pens-of-100-units-ml&quantity=1&slug=lantus
Make sure that the Match your prescription pull down menu says generic glargine 1 carton of 5 3ml pens.


Also
A membersaid she followed this prescription info exactly and it worked perfectly. Hope this helps!
Then go to the Lantus site to generate the coupon as in second image.
upload_2023-12-1_6-57-52-png.68163

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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
 
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Found this posted by one of our members

Getting the Lantus Savings Card:

Lantus changed the wording on their offer to say it’s only good for a 30 day supply so it’s important to have your vet write the script in a specific way.
It should be written: Lantus Solostar Pen, Quantity 5
Ask your vet to write it “Lantus Solostar Pens (5 pack) - Give twice a day as directed for 30 days”
If not already printed on the script, ask your vet to give his DEA number. This is because there is a number that only human doctors can get but the DEA number is usually accepted at the pharmacy.
If the script says something like “give 1 unit twice a day”, that only adds up to 60 units a month...and you can’t get just 60 units of lantus

The Lantus Savings Card is a loyalty card offered by the manufacturer of Lantus (Sanofi ) You can use it at some pharmacies to get Lantus pens or vials at a discount. You can get 5 Lantus Solostar Pens for as low as $35 a month (10 refills a year) and it’s renewable for another year of 10 refills. The pens are the better buy. A vial contains 1000 units and most cats are going to be on less than 2U twice a day and the insulin will lose efficacy before you can use it all. Nobody likes to throw away insulin! The pens each contain 300 units and a box of 5 will last most people at least a year....sometimes longer! Keep all insulin in your refrigerator on a stable shelf, not in the door (the door temperatures vary more)

To apply go to: https://www.lantus.com/sign-up-for-savings
Chose “I Want a Savings Card” then “Continue”
It’s important to answer the questions correctly. Here’s how to answer them:
  • I am a patient over the age of 18 and a resident of the United States, Puerto Rico, Guam, or the US Virgin Islands NO
  • I am a caregiver/legal representative of the patient who is a resident of the United States, Puerto Rico, Guam, or the US Virgin Islands, and I am over the age of 18. YES
  • The patient currently has a prescription for Lantus. YES
  • Please select the statement that applies regarding patient's insurance coverage: Choose “No insurance plan is paying for the prescription”
  • What would the patient like to do? Choose “Enroll for a Lantus
    Savings Card”
  • Finally, please provide us with the patient’s information (you can use your cats name or your name...it shouldn’t matter but if your cat has a somewhat “human” name, I’d use it)
  • Agree to the answers and hit “Submit”.
Since the new rules went into effect, CVS, WalGreens and Costco seem to be the most successful in using the card. More and more members are reporting successfully using these cards at various pharmacies so it’s worth a shot.

Some pharmacies (even those listed above) will still refuse the cards so try another pharmacy

Some retailers are asking for the Vets NPI, (a number that vets can’t get) however if your vet writes prescriptions for controlled substances, they must have a DEA number and this should be sufficient but many places will still not accept them (as well as some vets don’t want to give out their DEA number
 
Thank you all so much!

The waiting was getting to me so I’m at a vet hospital
With her. Her levels went down to the 300s from what they just updated me on.

Just waiting to see the doctor now
 
Hi,

So from Bonnie’s appt her glucose was 304 (from the 530 on this past monday). They also flushed her with fluids before we left Wednesday night.

She has glycobalance from Royal Canin (wet and dry) prescribed and I was given scripts for vitsulin (give 1 unit, 2x day) and the syringes for them. I was given some syringes and insulin to start. I’ve actually gotten the hang of using the syringe with her, just had to get over the nerves of sticking her.

I just need to get a glucose monitor. When I went To get the pet food, the staff in PetSmart (ban field hospital) mentioned to get the one for pets online w/ chewy vs using ones for humans due to the conversion (?). But I’ll go to Walmart tonight based on what was recommended in the above posts and also get the strips. I imagine the conversion isn’t hard? Or is it the same reading?

I do have a specialist appt on 3/10 I want to keep
To rule out if anything else is needed moving forward. The vet from the previous night wanted to keep
Her overnight and test for her pancreas and liver and kidneys but the price quoted was a lot. All her labs were normal prior from Monday (unknown for pancreas) so I’ll wait for the 3/10 appt.

Bonnie has been in a really good mood, actually more playful last night. She’s almost done with her UTI med. I’m feeding her 2x day (AM and PM). She just acts VERY hungry, which I worry about since normally dry food was out for them to graze on. She’s 7.5 lbs so based on wt I give her a 3oz can 2x day. It’s an adjustment but I think we’re in a good spot.

Thank you all again for the feedback.
 
Hi, I’m jumping in late but couple quick points.

You should ask your vet for a different insulin (Lantus or ProZinc). My understanding is Vetsulin is not recommended for cats anymore.

Also, by your wording, it sounds like you’re giving insulin without testing blood glucose. It’s very important to check the BG before giving insulin to know if it’s safe to shoot.

Yes, there are human and pet glucometers. They read differently (human meter reads lower) and there isn’t a conversion per se. Most members here use human meters for cost reasons, and the one sold at Walmart called Relion is a human meter, so you’re good.

You can feed during the day, it’s actually recommended here to feed some small meals during the day. Take some of that pre-shot meal and spread it out over the first half of the cycle. You still want to withhold food 2 hours before insulin though.
 
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I called the vet hospital tonight before going to Walmart to be clear about the glucometer and the staff said nothing was mentioned in the notes. The vet who saw me has a diabetic cat and never mentioned getting one which hindsight is strange. I’ll get one tomorrow just to have and get familiar with that process.

and ok. I will ask about those 2 brands of insulin at the appt.

and thanks. I go home for lunch to check on her and Ringo. I’ll spread out her food more and make note about the 2 hrs to hold any food before giving insulin.
 
The glycobalance food is too high in carbs for a diabetic. 14% for the wet food and even higher for the dry. You can always return it for your money back, saying your cat didn't like it. The Purina Pro Plan urinary wet foods are low carb if you want to keep feeding them.

In the rest of the world, Vetsulin is called Caninsulin. That'll give you a clue which species it was designed for. Dogs have much slower metabolisms than cats. Vetsulin doesn't last long enough in cats, but Prozinc and Lantus do.

You don't need to get the vet or vet staff approval before getting a glucometer. You should get one that is easy to get and with inexpensive test strips. Which the Relion from Walmart is one such. FYI, I was debating switching vets when Neko was diagnosed, to one that prescribed Lantus (we started on Caninsulin) who also had a diabetic cat. Then I found out she wasn't home testing and the cat had died from a hypo. I stuck with my vet at the time cause we had a good relationship.
 
Wow ok. That’s really frustrating. Why would they even recommend RC?? She does like their wet and I can understand about the dry. (Keep thinking these are the right things to do based off the vet’s feedback)

And Of course the insulin would be for a dog lol. I’ll ask about the prozinc.

She’s been more herself and happy. I have the other canned wet from purina and some tiki I can give her.
 
Okay. Thank you all again. I read the glycobalance thread on here that’s in another post. That’s so sad. Our healthcare system for us as humans is already a struggle. I guess I shouldn’t be surprised for our furbabies.

I’ll take those foods back.

and her results came back for the fructomasine - 368 umoI/L
 
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368 is above normal range, but not by a lot.

Vets have to take care of many different diseases in lot of different animals. It's a LOT to learn. Diabetes and nutrition training is typically less than a day worth of classes. Sometimes the nutrition training is done by the vendors. :banghead:
 
Hi,

Wanted to update. Bonnie saw specialist on Friday. She’s had a few incontinence episodes (no more than 5) over the last couple of weeks in the kitchen (feel
Like it’s more so her and ringo sharing the downstairs box) but they ordered another UA (results tomorrow) and also ordered another fructomasine, which is also pending. Friday was a lot of with all the expenses (I’m sure you all know how it all starts to add up). Kinda had to break up some of what they wanted but it’ll work out. Just hoping this isn’t at every visit.

but the specialist plans to suggest a new insulin based on results (vetsulin not the best and glycobalance being high in carbs) so I have Scripts for hills and purina (they’re DM or MD) that they emailed me. Been feeding her wet foods (purina) and will get the scripts filled tomorrow.

She did mention about me getting a libre soon to help with monitoring vs doing tests at home. Bonnie’s still 1 unit 2x/day. Still eating like normal (still wanting more food lol). I do go home for lunch so they’re getting 3 meals a day. Hoping everything is on the up with the visit and changes to be made.

Does anyone travel a lot? If so, how do you manage with your kitties? Do you board or get a sitter? My sister offered to keep her (just have to meet her halfway to drop off). There’s trips coming up in the next couple of months so want to take the best route with it.

I looked at getting an auto feeder with set times with the script food but haven’t fully invested in it yet.
 
The DM is again, not good quality and not specific to diabetes. It is called dietetic management - not diabetes management. The ingredients are frankly, not very good quality. MD is good as a medium carb food, but does not qualify as a low carb food, which is what diabetics should eat. Don't bother filling those scripts, stick to what she's eating now. Hardly anyone here uses the so called "prescription" foods. They's just too expensive and don't provide value above commercially available low carb foods.

If you are home testing and have enough data, you really don't need to keep getting fructosamines done. Home testing is better real time data, and cheaper.

I'm curious what that name of the insulin the specialist suggested.

If you are able to home test, and can get 4 tests a day, I'd stick with that. The Libres are relatively new, and we did fine with regular metres for years. The Libres also aren't so accurate in lower numbers so you'll have to double check any Libre low numbers with a hand held meter anyway. Also, your mileage may vary on whether the cat will keep the Libre on.

Some people here travel, we've even had people travel with their diabetics. I did a week long car trip with Neko, did another almost week long that involved an airplane, and done weekend car/ferry trips with her. Some have gone camping or rented an RV with their cat. Other people leave their cats and get a petsitter. One suggestion is to check if your vet has any staff that make a little money on the side doing petsitting. That way you know the insulin shots will work. I have a petsitter now who has given insulin shots before. If you do go with a petsitter, make sure you can watch them giving shots before you go. We also have a bunch of other tips for petsitters if you end up doing that.

4 meals a day might be better for Bonnie, at least two meals AM and PM.
 
Okay. Lol so no script food.
And thanks for the feedback on the travel.

I cant recall the insulin but it’s one of the more better ones from what she said that’s long lasting.

And vet just called. UA is good. it’s now pending the curve results. she recommends the alpha track for home testing vs doing another fructomasine at this time. So I’ll need to get that and start that soon to get her the results. She wanted me to do one of the days when I’m home more for the curve.
 
You also don't need the Alphatrak - the test strips price is astronomical compared to human meter test strips. And harder to get in a pinch. Most of us use human meters cause they are so much more economical, and our dosing methods were created well before the AT was invented. Back when I started, no on (not even vets) used pet meters. If they push on the AT, only use it on curve days for the vet, use a human meter the rest of the time. It is good to have a back up meter anyway.
 
Wendy&Neko said:
The DM is again, not good quality and not specific to diabetes. It is called dietetic management - not diabetes management. The ingredients are frankly, not very good quality. MD is good as a medium carb food, but does not qualify as a low carb food, which is what diabetics should eat. Don't bother filling those scripts, stick to what she's eating now. Hardly anyone here uses the so called "prescription" foods. They's just too expensive and don't provide value above commercially available low carb foods.

If you are home testing and have enough data, you really don't need to keep getting fructosamines done. Home testing is better real time data, and cheaper.

I'm curious what that name of the insulin the specialist suggested.

If you are able to home test, and can get 4 tests a day, I'd stick with that. The Libres are relatively new, and we did fine with regular metres for years. The Libres also aren't so accurate in lower numbers so you'll have to double check any Libre low numbers with a hand held meter anyway. Also, your mileage may vary on whether the cat will keep the Libre on.

Some people here travel, we've even had people travel with their diabetics. I did a week long car trip with Neko, did another almost week long that involved an airplane, and done weekend car/ferry trips with her. Some have gone camping or rented an RV with their cat. Other people leave their cats and get a petsitter. One suggestion is to check if your vet has any staff that make a little money on the side doing petsitting. That way you know the insulin shots will work. I have a petsitter now who has given insulin shots before. If you do go with a petsitter, make sure you can watch them giving shots before you go. We also have a bunch of other tips for petsitters if you end up doing that.

4 meals a day might be better for Bonnie, at least two meals AM and PM.
Click to expand...

any tips on testing? I am doing a curve all day for the vet tomorrow. I ended Up getting a alphtrak. The video in one of the posts was very helpful from one of the members and her cat. Just still hate having to do testing every 2-3 hours (hope Bonnie tolerates it)
 
Wendy has said everything that I would have posted!!

I'm going to encourage you to set up a spreadsheet and create your signature. The information is in this post on helping us to help you. The spreadsheet will allow you to track Bonnie's progress. We can also follow along and offer input. Your signature contains some basic information about Bonnie so we don't keep bugging you with the same questions (e.g., the insulin you're using).

Like Wendy, I'd encourage you to get a human meter. The cost for the AlphaTrack strips is about $1.00 each. The cost for the Relion strips is about 17 cents. That's a huge savings.

If you are going to give treats, please make sure they are low carb. Most members use freeze dried protein (e.g., freeze dried chicken). There are also jerky style treats that are only a protein.
 
Okay thanks. . . I’ll start her spreadsheet tonight

did 3 tests so far. Tricky finding the right spot in her ear but looks like more so around the tip of her ear along the edge.

her readings are high -424 before meal and 1st insulin shot . . . then 316, then 317.I know vet’s goal is to switch her insulin.

I’m in PetSmart so I’ll look for the dried jerky
 
Encourage your vet to prescribe either Lantus (glargine -- it's now available in a generic/biosimilar form) or Prozinc. Both are endorsed for diabetes management by the American Animal Hospital Association. This is a link to their guidelines.
 
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