Cat diagnosed with diabetes, vet does not want to start insulin, starving 24/7. HELP!

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Haniwa09

Member Since 2021
Hello all,

I am at my wits end! My 9yo cat Plato (13 lbs) was just diagnosed with diabetes. When we took him in initially, he was at around 450 blood glucose. We changed his diet and when we went to learn about insulin at the second appt, the blood sugar was down to about 300. The vet recommended not starting insulin and sticking with the diet. At first we were giving him about 2 1/2 small cans of Merricks, Fancy Feast, Purina One (all low carb approved). However, he was starving 24/7, so we took him in again thinking maybe it's time for insulin. The blood sugar was again a little lower around 300, so the vet said give him more food. Now we are up to 4 small cans a day, and he is still waking us up at night and earlier and earlier every morning. He almost always eats the whole can in one sitting. I am also worried that when I am no longer working from home, no one will be home during the day to feed him as much as I do. The vet seems to not want to start insulin since he is on a downward trend, which I am okay with if we can avoid. With the diet change, his intake of water has also dramatically decreased, leading me to believe the diet is kind of working. BUT, what do I do in the meantime? PLEASE help me! Will he just end up gaining weight eating almost 5 small cans a day? It has been about a month like this. I love him, but he is starting to drive me crazy. He just always wants more and more.... :( I want to help him and I am not sure what the right thing to do is.
 
I'd recommend home testing to see what his BG is actually doing. It's highly possible that your vet isn't seeing the FULL picture of what's happening.
My guess is he's figuring the stress of the vet visit is pushing the BG. While possible, since you're seeing other signs, highly unlikely.

If home testing reveals high numbers - which it should - that really doesn't give your vet any legitimate leg to stand on to argue with you.
DO NOT be afraid to tell your vet what he is going to do... I learned that fact this week myself in getting my cat's insulin switched to a different type.
 
I think you need to find another vet ASAP. The normal BG of a cat is 50-100 on a human meter, 70 - 120 on a pet meter. Your vet was right in suggesting a food change to a low carb diet before starting insulin since some cats manage to become diet controlled and don't need insulin. I don't think Plato falls into that category.

Please get a meter like @Denver suggested and test him yourself at home. However, going by the clinical signs, it looks like he does need insulin.

You also want to get ketostix and test him for ketones. Was he tested for ketones at diagnosis and each time you went to the vet? If he has ketones, not starting him on insulin immediately can lead to a life-treatening condition called Diabetic Ketoacidosis (DKA).

Please do not delay. Either insist that your vet give you a script for insulin or find another vet who will. You want a cat friendly insulin like Prozinc or Lantus (Insulin Glargine) and not one like Vetsulin/Cainsulin/Novolin that is better suited to dogs.
 
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If you can tell us where you live we can suggest a meter
We can show you how to test his BG
Are you feeding any dry at all
When you go back to work you can buy an auto feeder and set it certain times to open
I see a lot of members use this auto feeder comes with 2 ice packs for wet food

https://www.chewy.com/cat-mate-c500-digital-5-meal/dp/154556?utm_source=google-product&utm_medium=cpc&utm_campaign=hg&utm_content=Cat Mate&utm_term=&gclid=Cj0KCQjwmIuDBhDXARIsAFITC_63x-luggpCkFZRkS8gkKWhzRbyN2QiluSdQbUAVg-nyE2iitAjCY4aAjTmEALw_wcB


Extra ice packs
https://www.amazon.com/Mate-Replace...8EYNZ1RBTQP&psc=1&refRID=AQNY433XJ8EYNZ1RBTQP
of 5 stars Identical to original ice packs that came with my Cat Mate C500
 
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I agree that you need to start home testing and possibly finding a new vet.

I adopted Charlie a couple weeks ago. According to the shelter he was in he was "diet controlled". I could tell as soon as I got him they were wrong. As soon as we got home I tested him and verified my suspicions. Fortunately I already had insulin at home and started him on it. I am already seeing improvements in his numbers and physical signs, including how much he is eating.

The insulins you want are ProZinc, Levemir or insulin glargine (Lantus, Basaglar or Semglee). These are all long acting insulins that cats do well on. Avoid Vetsulin, Caninsulin and Humulin. These are short acting insulins and can cause steep drops in glucose levels.
 
Lantus is very expensive in the US, Where do you live
I would consider getting Semglee, it is a generic Lantus, and was approved by the FDA last June. The cost is compatible with Lantus from Canada.
https://www.goodrx.com/semglee
Here is a coupon above
Just call any pharmacy to see if they have the 5 pens, they will last you a year or more
With pens you can only adjust by full units so we buy syringes with half unit markings and increase or decrease by 0.25 units. You insert the syringe in the rubber stopper and draw out the insulin from there. We can tell you what syringes to purchase
Let us know which insulin your vet prescribes , you don't want vetsulin , even though its cheaper it's actually used for dogs, not to say some cats do ok on it but Lantus is much more
gentle , vetsulin has a tendency to drop their BG hard and fast
We can tell you where to get syringes and what size lancets to
 
Thank you all for your advice. We have a prescription for Lantus pen needles (I am okay with this for simplicity use, despite the cost), but again the vet recommended waiting to see if he gets better with just diet change and re-eval in one month. So there is no risk for things like insulin shock at his current BG of 300? I will purchase ketostix. Please recommend a meter for at home checking. I live in the Chicago area. If I start him on the Lantus, I *think* she said to administer 1cc twice a day when he eats (does this sound right?) Is there anything else I need to check for? How often do I check his BG if we start insulin? Would I feed him two cans, twice a day, with insulin when he eats? Any food throughout the day? We bought Hills Glucosupport M/D dry food which he loves, but the vet recommended no dry food since he is eating so much canned food. Thank you all again!
 
Most of us use human meters from Walmart, our numbers are based on human meters,
The Relion Prime is 9 dollars
17.88 for 100 test strips
Get 26 or 28 gauge lancets
Cotton rounds to put behind the ear
You vet probably uses a pet meter Alpha Trak , the strips are expensive plus you have to order them off the internet. They are about 54.00 for 50
It's up to you
 
Most of us feed Fancy Feast Classic Pates or Friskies. We try to stay under 10% carbs Here is the food chart
https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

We feed a bigger meal when you test his AMPS ( AM pre shot) and at PMPS
Then feed smaller meals during each 12 hour cycle
Maybe about a tablespoon @+2, +3 or +5.
+2 means 2 hours after giving insulin and so on
You always want to withhold food 2 hours prior to testing in the AM and PM because you don't want it to be food influenced

Is Plato at a good weight
The rule thumb is about 20 calories per pound of ideal weight. If 15 lbs is a good weight for him she should be eating 300 calories a day
15x20= 300
 
Haniwa09 said:
Thank you all for your advice. We have a prescription for Lantus pen needles (I am okay with this for simplicity use, despite the cost), but again the vet recommended waiting to see if he gets better with just diet change and re-eval in one month. So there is no risk for things like insulin shock at his current BG of 300?
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How long have you been doing the diet change? Typically if diet change alone is going to work, you would be able to tell within a week or two. Yes 300 is lower than the initial 450, but those numbers are still incredibly high, considering the higher end of normal on a pet meter is somewhere around 120-150. His blood sugar will likely be higher at the vet than at home, but if he’s still showing the symptoms of diabetes at home after the diet change, ie peeing a lot, drinking a lot, acting starving then it’s likely his blood sugar is still too high and waiting a month to start insulin for a cat that’s diabetic can be risky. Diabetic cats cannot process nutrients properly which is probably why he’s acting starving, because he likely is. There is also the risk of ketones, which is why others recommended earlier to get the ketone test strips.

If you are testing his blood sugar at home, then there is very little risk to starting insulin, as you will be able to know if his blood sugar starts to come down :cat:
 
Haniwa09 said:
We have a prescription for Lantus pen needles (I am okay with this for simplicity use, despite the cost), but again the vet recommended waiting to see if he gets better with just diet change and re-eval in one month. So there is no risk for things like insulin shock at his current BG of 300? I
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Just a heads up the Lantus pens a five pack may run you well over 300.00
Most pharmacies won't cell one pen
You can also order from Canada most of us do , it's much cheaper , it's Lantus Solostar Pens 5 pack
Lantus Solostar from Canada 5 pens for 164.99
Hit the drop down
https://canshipmeds.com

Just contact them, they are very nice , once you send your script over you do not need another one for refills
You still want to get syringes U-100 with half unit markings so you can increase or decrease by 0.25 units. As I said with the pens you can only do full units
 
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Pharmacies are supposed to be able to fill Lantus prescriptions with Semglee. It runs about $180 for a pack of 5 pens compared to over $300 for Lantus. Depending on your dose that could be enough insulin for 9-12 months or more. Check your pharmacy to see if they have any discount programs. With the one through Walgreens I bought a pack of Semglee pens for $129.
 
Carol Steichen said:
Do the Semglee pens stay viable for 9-12 months in the refrigerator? I was told my Lantus pen was only good for 28 days.
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Yes 5 pens can last up to a year in the fridge, keep them in the middle shelf
A pharmacist will tell you it is good for 28 days because that is all that was submitted to the FDA, for human use
That's only for humans who don't store them in the fridge.
 
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I'd like to correct a few things.

First, do not use the needle tips on any pen. The pens only dispense insulin in 1.0u amounts. You will want to make dose adjustments in much smaller (i.e,, 0.25u) amounts. If you increase in 1.0u amounts, you risk either overdosing your cat or missing what could be a good dose. You need to get a prescription for syringes.
Using syringes with a pen, cartridge, or vial:
  • U-100 3/10cc syringes with half unit markings are the best to use for drawing Lantus, Basaglar, or Levemir from vials, cartridges, and pens.
  • BD Ultra-Fine, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brandsavailable with half unit markings.
  • Syringes come in ½ inch or 5/16 inch needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest)
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Glargine/Lantus or any of the biosimilars (generics) last far longer than 28 days. Barring any problems, you should be able to use a pen until you run out of insulin in the pen. I used a pen for 3 months. (The pharmaceutical company only ran tests for a 28 day period since they were developing the insulin for humans who use much larger doses than our cats.)

As others have suggested, please start insulin. Holding off on starting given where you're kitty's blood glucose (BG) numbers are is risking the development of ketones. Ketones and the resulting diabetic ketoacidosis can be a life threatening condition. The sooner you treat diabetes, the greater the possibility of your cat getting well regulated or into remission.

You will want to add some information in a signature so we don't keep bugging you for the same information. In addition, you'll want to set up a spreadsheet so you can track your kitty's progress and so we can follow along. Instructions for setting up your signature and spreadsheet, along with some additional helpful information is in this post on helping us to help you.

I'm a former Chicago person. If you need a new vet or a second opinion, try Cat Hospital of Chicago.
 
We just checked his blood glc with the Relion human meter and it was 287. He had some food an hour prior (we tried to get it on an empty stomach, but failed poking him a few times and decided to give him a break). He seems better, as in not drinking a lot of water or peeing. I will check his glc throughout the day tomorrow. We are still working on checking his ketones (bought the ketostix, just waiting on catching him after he uses the litter box). Plato and I thank you all!
 
Normal range for BG Is 50 - 120. Plato is still in diabetic numbers and over renal threshold. (Your vet may give you higher numbers as the range he wants your cat in but that's because many people do not home test. The vets don't want the responsibility of a cat becoming hypoglycemic which is not as likely if you are home testing.)
 
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