Cat in the UK just diagnosed with diabetes

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Thanks Critter Mom, I think Squiggles is still peeing slightly more than normal, but she's drinking less, so I'll have to keep an eye on her to make sure she doesn't get dehydrated.

It's difficult to tell how much she drinks, because she won't use her inside water bowl, only the one in the garden & the birds drinking bowl :)

I don't think Squiggles is avoiding us at injection time, she seems unaware of when it's due !
 
It certainly is CM ! I saw my vet today when I went to pick up some more insulin , & she says I should delay Squiggles having her annual boosters, until her glucose levels are better, but she's probably safe to have her worming tablet .
 
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I'm glad you mentioned that, Lynn. Our vet advised me to hang fire on Saoirse's boosters till she was better regulated and I completely forgot to ask him about getting them updated since she went OTJ. Saoirse had a parasite treatment while she was getting insulin. It was a spot-on (Advocate) and she had a rare (but not unprecedented) reaction to it. I think she may have managed to groom some of it off her fur, and it put her completely off her food. Not good when insulin's in the picture. Next wormer she gets is going to be a tablet.
 
I'm glad you mentioned that, Lynn. Our vet advised me to hang fire on Saoirse's boosters till she was better regulated and I completely forgot to ask him about getting them updated since she went OTJ. Saoirse had a parasite treatment while she was getting insulin. It was a spot-on (Advocate) and she had a rare (but not unprecedented) reaction to it. I think she may have managed to groom some of it off her fur, and it put her completely off her food. Not good when insulin's in the picture. Next wormer she gets is going to be a tablet.

I know CM , it's very scary if they manage to lick it isn't it ? One spot treatment Squiggs had on the back of her neck left a temporary bald spot !

Thanks for the link BJM.
 
Our vet advised me to hang fire on Saoirse's boosters till she was better regulated and I completely forgot to ask him about getting them updated since she went OTJ.
Aine, does Saoirse still get vaccination boosters every year? If that's the case, I'm just wondering if they could have triggered some inflammatory response (am thinking particularly about her pancreatitis here...)?

Eliz
 
Hi Eliz,

Good to hear from you. :)

Saoirse was due her boosters in late July and hasn't had them yet. (She's an indoor cat, so thankfully low risk of contracting anything). The only medication that upset her was the Advocate spot-on. I think insulins make her a bit queasy, and like Lisa's cat, Tisha, moving off insulin doesn't help her digestive system either. Relatively abrupt cessation of Caninsulin (on safety grounds) seems to have been the main factor in the inappetence that eventually led to the start of her flare-up (food triggers being the main instigators of the flare-up itself, IMO). She's doing fairly OK now with a food that agrees with her fairly well (Smilla Kitten formula with Chicken). The vet also prescribed Nutramed, an anti-inflammatory herbal nutraceutical-type thang. I still have to be very, very careful about anything to do with her diet (changed her schedule a bit yesterday and the poor girl threw up a few hours later - first vomiting bout in ages but triggered by something relatively basic).
 
Thanks, Lynn. It's better now than in the early days. Thanks to the help I got here, especially from Elise (@tiffmaxee) and Hellen (@ShadowsMom) during the flare-up, I now know what treatments she needs. At the height of the flare-up I didn't know what to do. Saoirse was dreadfully ill. I felt powerless to help her and utterly frantic: it was truly nightmarish. I really was afraid I might lose her. Thankfully we had recently moved to a new veterinary practice - a very FD-friendly one. Our vets have access to Saoirse's spreadsheet and did consults for us over the phone. With their support and the use of BJ's secondary monitoring techniques, I was able to nurse Saoirse at home. Our vets are very hot on this - they believe in minimising stress as much as possible for feline patients in order to speed recovery. I'm very conscientious and conservative about using medications and they now prescribe enough for me to have a squirrel stock at home so that I can address symptoms immediately. We lurve our vetty beans! (Haven't always been this lucky. :( )

Through months of using BJ's secondary monitoring techniques plus close observation and recording of Saoirse's clinical signs and behaviours, I've learned to spot signs of trouble fairly well but even now I get it wrong, hence last night's bout of vomiting. Food changes are so risky for cats with pancreatitis. The food that agrees with Saoirse best (Smilla Kitten Food with Chicken) is a little bit too low in carbs and consequently doesn't stimulate Saoirse's pancreas enough to produce a good supply of basal insulin and she's running in the 6's - a bit higher than I'd like her to be. Both she and I are happier when she's in the high 4's or low 5's. I ran a mini food curve on Saoirse yesterday and she's still getting fasting spikes in BG (7.3mmol/L) due to the lower basal insulin secretion. I tried mixing a bit of her slightly higher carb food (Kattovit Sensitive Chicken) in with her Smilla yesterday evening to see whether a blend of the two foods might help her BG numbers along. It worked a treat for her BG - 5.3 mmol/L 90 minutes after eating - but it really upset her digestive system (even though she got on OK with Kattovit previously). Touch wood, her appetite's OK today and she's not crouching. At the moment she's relaxing on the sofa; always a good sign with her. (She'd be hiding behind it if she was in pain.) I'll be on Poop Watch for the next 48 hours to make sure her system has settled down again. Oh! the joys of motherhood ... ;)

How are you and Squiggles doing today? Please give her some scritches for me. :)
 
Hi. Maybe I'm missing something here but I am wondering if you think your cat has IBD or pancreatitis? I don't see it mentioned in this condo but maybe in a previous one?? If so and if I can help let me know.
 
I'm glad she's a bit better now Critter Mom xx

Hello tiffmaxee I have mentioned pancreatitis to my vet, but she doesn't think Squiggs has got it. Also she hasn't got the runs, but her poos are a bit pale., I'll talk to the vet about it. I'm afraid she might have got some damage to her pancreas, as her diabetes was undiagnosed for 5 months ( all my fault) :(
 
Pale, stinky, often larger than usual, and soft poo may be a sign of exocrine pancreatic insufficiency, where the cells which produce digestive enzymes have been damaged. The treatment consists of pancreatic enzymes to help the food break down.
While they can test, sometimes it may be helpful to go with empirical treatment, where you do a trial of the treatment to see if it helps.
And not every ultrasound, nor fPLI test shows pancreatitis when it is actually present. These tests are not perfect in certain ranges. Is she showing any of the signs of pancreatitis - meat loafing, vomiting, inappetance, etc.?
 
Max has always had a high fPL when I've suspected p'itis. The pale poo could be insufficiency but I notice the color changes with what he eats as well. He almost never has diarrhea with p'itis. I agree that treating the symptoms is a good first step. For us that usually means feeding small meals often which I do always, ondanetron or cerenia for nausea.
 
Pale, stinky, often larger than usual, and soft poo may be a sign of exocrine pancreatic insufficiency, where the cells which produce digestive enzymes have been damaged. The treatment consists of pancreatic enzymes to help the food break down.
While they can test, sometimes it may be helpful to go with empirical treatment, where you do a trial of the treatment to see if it helps.
And not every ultrasound, nor fPLI test shows pancreatitis when it is actually present. These tests are not perfect in certain ranges. Is she showing any of the signs of pancreatitis - meat loafing, vomiting, inappetance, etc.?

BJM she often does her poos in the garden ( which I clear up regularly.) They don't look large or are particularly smelly. She's eating & not being sick & I'm not sure what meat loafing is ?
 
Meat loafing = crouching like the Sphinx, with head down, eyes often squinty because the cat doesm't feel good.
 
Oh right, she's done quite a bit of lying on her side, but I think that's because her back legs are a bit weak at the moment. She's crouched all her life, but from the expression on her face, I don't think she feels unwell .
 
When Saoirse's meatloafing, she looks tense. Sometimes she does a semi-crouch, hunched up around the shoulders, but with her back legs extended.
 
I know someone on here feeds their cat Thrive wet cat food , but I can't remember who. Has anyone got experience whether their cat likes it or not ?
Hiya,
My cats like the Thive food but....it's in teensy weensy tins and hugely expensive per kg..... Why are you thinking of feeding this at this point? Are you finding it hard to find other suitable foods?

Huge hug,

Eliz x
 
Hi Lynn,

That'd be Sarah, Remi's mum. :) Remi's very sensitive to fat content of foods (he also has pancreatitis) and Thrive was one of the better foods Sarah found that was both FD-friendly and with a fat content that Remi could tolerate OK.

I have given the occasional tin of Thrive Complete plain chicken variety to my civvie as a treat (Saoirse couldn't tolerate it). It is a complete food, but personally I don't like the smell of it - its' got a very 'chemical' odour to it (presumably from the added vitamin and mineral supplements?). Sometimes my civvie's stools are slighty looser after a tin of Thrive, but she absolutely lurves the stuff. But then I discovered Porta 21 ...

Porta 21 chicken variety - also available from Zooplus - is a complementary food made from shredded chicken breast. It's a bit like Encore chicken variety but without the rice.. It's FD friendly and doesn't have the 'artificial' smell that Thrive has, but it doesn't have the full range of vitamins and minerals that a cat needs every day. I've fed it to my civvie for a treat and also mixed in a teensy bit of it with Saoirse's food when her appetite was sluggish recently. Both of them go nuts for it, and so far no unpleasant after effects. Indeed, in Saoirse's case it has been a godsend. It helped me to get her through the recent episode of slight inappetence without needing to resort to cyproheptadine. I far prefer to use food as a medicine wherever possible. :)
 
Thanks Elizabeth & Critters Mom. I just thought I'd give it a try for an an occasional treat, ( too pricy otherwise !) though she seems quite happy with Applaws & Nature's Menu.

Has anyone tried the Tuna & Salmon Nature's Menu ? Or is the Chicken one more popular ?

I havn't heard of Porta 21 before .
 
I'm glad to hear Squiggles liked the Nature's Menu food. :)

You can get Nature's Menu pouches in a mixed pack - 4 pouches each of the chicken/turkey, beef/chicken and tuna/salmon varieties - so you could trial Squiggles with all of the flavours to find out which ones she likes and make sure none of them spike her BG, as can happen with some cats. (One of the members here has a cat whose BG goes high when she eats food with beef protein in it, but is fine with other animal protein sources.) From what I've read here, I think the recommendation is to be conservative about feeding fishy foods, partly due to concerns over heavy metal contamination and partly (IIRC) due to phosphorus content (you might want to check that last bit). I trialled my civvie on all the flavours and she got on OK with all them, but I settled for feeding her just the chicken/turkey and beef/chicken varieties because of the concerns over feeding fishy foods. Overall she preferred those two flavours so smiles all round.

Re the Porta, in my quest to find an FD-friendly food that didn't aggravate Saoirse's digestive tract I've done a lot of digging around on zooplus and other sites. I'd never have known about it otherwise.
 
Hi

I use the thrive and remi loves it, it suits him but it is soooo expensive. I get it from zooplus. The only reason I haven't tried anything else is because of remi's pancreatitis. If I do get up the courage to change then it would probably be one of the foods that have been mentioned. The other problem I have is remi's IBD and so I think that he can only really eat chicken and maybe Turkey but definitely no beef, fish,etc.
 
Thank you CM & Phlika, that's very helpful. I've only bought the chicken & turkey Nature's Menu so far, but I think I'll buy a mixed pack, otherwise she'll get fed up with just one flavour !

I understand about Remi's pancreatitis now
 
The Dr's Best methylcobalamin arrived today , so I mixed half the contents of a capsule ( it's a very fine pink powder ) in with a small portion of her favourite food, just to see if she'd eat it, which she did :)
 
Result! Well done, Squiggles. :)

Isn't it always such a relief when we can give them the things they need to help them without making them miserable! :)
 
You're so right CM ! Squiggles woke me up really early today, I had to feed her, as she was hungry. Unfortunately it was 90mins before her next shot was due sso I waited for a while until I got the Other Half out of bed to hold her. ( She's got really wriggly recently ! ) I hope I'm not harming her giving her her injection just over an hour after she's eaten :(
 
It's injecting before feeding that can be dodgy, particularly with a harsh insulins like Caninsulin which tends to drop the BG hard and fast quite early in the cycle. Can you check her numbers during the cycle, Lynn, just to make sure she still has enough food on board to last the full period of Caninsulin peak effect?
 
Yes I'll try CM. I did check her numbers a week ago when she was on 2.5 , hadn't eaten much, had been rather lethargic & was due her next injection, & they were OK . I even rang the vet up to ask if it was ok to give her her next shot.. I'm a bit limited because she struggles too much for me to do her glucose testing by myself, & my OH isn't always very co-operative !

She's due to have another blood glucose curve done at the end of this week, so I'll see what she's like then.
 
I'm sorry Squiggles isn't the most co-operative with the testing, Lynn. :( Saoirse was as good as gold with it from the first, so I was spoilt. :)

Looking forward to seeing Squiggles' curve data later in the week.
 
CM the trouble is, if I don't get it right first time, my OH starts moaning, so I make him use the special needle pen now !

I think Squiggles is becoming more aware when we're about to give her her shot. OH holds her & she jumps a little bit as soon as I put the needle near her skin , despite me doing nothing different ! I always make a fuss of her & give her some treats before & afterwards.
 
Just what you need, Lynn: a critical audience. :(

Saoirse was never fond of injections. She really didn't like the Caninsulin ones, especially when she was on 3IU BID. As I said above, the BG rollercoaster that is Caninsulin really hammered her system and she twigged very quickly that the injections were responsible and made attempts to hide in the most inaccessible spot she could find. I had to block off various hidey holes. She'd grumble sometimes when receiving Lantus injections - it stings - but it was much gentler on her system and she didn't try to hide. Made her mommy feel a little better about having to give it to her.
 
Just what you need, Lynn: a critical audience. :(

Saoirse was never fond of injections. She really didn't like the Caninsulin ones, especially when she was on 3IU BID. As I said above, the BG rollercoaster that is Caninsulin really hammered her system and she twigged very quickly that the injections were responsible and made attempts to hide in the most inaccessible spot she could find. I had to block off various hidey holes. She'd grumble sometimes when receiving Lantus injections - it stings - but it was much gentler on her system and she didn't try to hide. Made her mommy feel a little better about having to give it to her.

CM Other Half is incredibly impatient ! Caninsulin seems to suit Squiggles, I think she'd run a mile of the injection stung.
 
I'm hopeless at things like that CM but I'll have a go ! I've found the spreadsheets Do I fill it in on line ? ( sorry to be dim)
 
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Yep. As soon as you update it, the new data is visible to everyone with the link, hence why we add spreadsheet links to our FDMB signatures. In addition to making BG data available to members here when asking questions, it's really cool to look at all the kitties' spreadsheets to see how they're progressing. Filling in the remarks section is very helpful, since it acts like a journal. Sometimes on the way to regulation/remission a dose might not work as well as expected. Having the record of what has gone before is great because it can help to spot why something did/didn't work.

If you get stuck, start a post on the Feline Health board and there will be plenty of us to help you get going. You need to use the WORLD version of the spreadsheet and record your data on the 'World mmol' tab. The spreadsheet will automatically update the US mg/dL values for you.
 
Be sure you make a copy of the google spreadsheet doc, and don't start entering data into the template. We've had that happen before and had to find out who was doing that and get a copy made for them.

If you have problems following the step by step instructions on setting up your own SS, there are a couple of people that set up spreadsheets. Two that I know of are Sue and Oliver, Marje and Gracie. Send them a conversation (private message) and ask if they'll set up a SS for you. It only takes them a couple of minutes.
 
We've just done Squiggles first blood test of the day ( we're doing a curve.) The result was 7.0 pre food & shot ,but I can't see it on the spread sheet .

I've just checked with the vet that it's alright to give Squiggles 2.5 iu of insulin as normal.
 
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That might be a bit much. (7*18=136 mg/dL).
Wait 30 min without feeding and retest. It may be OK if he is rising and you'll be available to monitor through the day.
We normally suggest folks not shoot below11 mmol/l ( 200 mg/dL) starting out.
 
BJM I rang the vet & she said go ahead , so I was a bit worried but I did. The results are on my spread sheet below my signature. The 2nd reading after 2 hours was 18.7 & the 3rd reading after 4 hours was 10.7 So I'm going to watch her very carefully this afternoon.
 
Interesting that she seems to be going up, not down. I would continue to test and be prepared to give her some higher carb food if she drops below 3. (54 ) Check your conversation. Sorry I forgot to do the World version which will convert from metric to US.
 
Hi Lynn

Glad to hear that you're able to monitor Squiggles closely. I will be interested to see if her numbers go higher over the cycle.

It would be helpful if you could include feeding times and rough amounts of food given in your updates. I'm trying to ascertain why the BG went up so much at +2. Also, what sort of numbers was she getting before?

Keep a close eye on her clinical signs, especially if she starts looking for food or seems sleepy. If she does, grab a BG test. Have you got some higher carb food
 
Also, can you add the meter you're using to your signature please, Lynn. I can't remember which one you use. (NB if Alphatrak, 3.9 is the low end of the normal range for a cat not on insulin - that's when you need to make sure you feed and test more often to make sure BG is rising if using the pet-calibrated meter.)
 
I've just done her latest blood test folks ( 15.00 hours UK time ) & it was 15.2 using the UK version of Alphatrak 2 I've got some honey of I need to rub her gums with it & some of her old cat bics, & old wet food which is high carb. I think if she was going to go any lower, she'd have done so by now, but I'll keep watching her.

I've forgotten how I add things to my signature !
 
Thanks Sue, I thought I had entered the results on the Worldwide version. At the bottom I can click between US & WW, so I clicked on the latter
 
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