Confused Newbie....LONG!

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MayBTheresHope

MayBTheresHope

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Hello Everyone,

My 8.5 year old male kitty, Max, was diagnosed with DM about 1.5 weeks ago. We have 3 other cats, as well, all seemingly healthy. At first, my hubby and I noticed that a lot of water was disappearing from the water bowl (and a lot of urine was clogging up the litterboxes). We couldn't find litter that wouldn't sludge up the bottom of the boxes, making it nearly impossible to get out (cleaning the litterboxes daily, even). Then I noticed that Max had slimmed down some and he was starting to beg for human food (which he HATES). So off to the vet we went and all tests indicated that he is diabetic.

My vet admits that he is not that experienced with diabetes, but mostly everything that I have read here, he is in agreement with. The only thing that he does not agree about is the Purina DM. He thinks it is the gold standard for diabetic cats, though he does not stock it normally and I paid an arm and a leg for the stuff. He was put on 1 unit/ 2x a day of ProZinc and I received my AlphaTrax monitor yesterday after the vet watched him for the day to do an initial glucose curve. The numbers fell between 318 and 386 throughout the day. The vet decided to increase the insulin to 2 units /2 x a day. I, however, am hesitant to go up that high and am thinking of increasing the dose to 1.5 units / 2x a day, instead. I gave him just 1 unit this morning, as I wanted to consult you guys first.

I tested his BG last night and let me tell you, those little ear veins are a booger to find. I don't know who was more traumatized, me or Max! I sure hope that home testing gets easier. I can handle giving the shots okay, but trying to prick a cats flicking ear is for the birds! I'm going to try the rice sock idea tonight. I am also going to pursue the Fancy Feast Classics and Friskies Pate b/c A. Reading here, there are better options, B. My cats don't really like the DM (although Max does eat it pretty well) and C. the DM costs wayyyyyy too much. I'm still not sure how I'm going to handle feeding them all. To make things even more fun, my husband HATES (and I mean HATES!!!!) the smell of wet canned cat food. He doesn't want me to feed Max in the house, but it is too hard to monitor his eating in the garage. He will just have to get over it!

Sigh. On top of it all, we own our own business, I work 40 hours a week and we have a 3 year old daughter that is potty training and does her best to make me late for work every morning. Needless to say, I didn't need any added responsibility in the mornings. Can you tell that I am a bit stressed out?!

Now for my confusion...how much to feed Max. He is 14 lbs, so slightly overweight, and not very active. The vet wants me to feed him 2 cans of the DM per day, but that seems like an awful lot to me. Since I want to switch him to the Fancy Feast Classics or the Friskies, what do you all suggest would be a serving size for him? I'm confused by the Binky charts b/c I'm not sure if the percentages are based on the can size or just 100grams, and if it is based on 100grams, is the % cumulative? Am I an idiot? I'm just used to cal per gram method and am probably just confusing myself.

According to my calculations, at 20 cal per pound of body weight, Max needs approximately 280 cal per day.

  • 8 to 9 cal per lb of body weight needs to be from protein (so 112-126 calories or 32-36 grams).
  • Then at least 7 cal per lb of body weight needs to be from fat (so 98 cal or 11.5 grams).
  • Then less than 12% of the calories needs to come from carbs (so 33.6 calories or 9.6 grams).

All of this adds up to 244-258 calories. Do I make the rest up in fat calories, protein calories or both? Am I on the right track? How do I translate this to the can amounts? Am I making it to complicated? And do I or do I not need to add anything else, like egg and Vitamin E? This is the part that is stressing me out the most right now.

Finally, is there any advantage to the ProZinc over Lantis or vice versa? How possible is it to get him off the juice with Prozinc and Fancy Feast?

Sorry for all of the questions. I just can't seem to get it straight in my head and I don't want to make a mistake and end up making my cat sicker. Boy, you guys are really going to hate me when I move on to the charting....
 
Okay Breathe!!!

You are making this far more complicated than it needs to be. :-D

First off you are right to change his diet to either Friskies pate or Fancy Feast Classics.

As of this coming saturday there will be 14 cats in my house, 3 of which are diabetics. At 14lbs Max will need about 1 to 1 1/2 cans of Friskies pate although in the beginning he may eat more until he is regulated. Everyone here eats exactly what my diabetics eat which is that same Friskies Pate. Even my big 17 pounder only eats 2 cans so it really isn't hard to feed canned food. And here is a trick to help you out with the hubby..put the canned food in the fridge before opening it, when cold it has nearly no smell. Then right before you serve it add a little hot water to warm it up to make it smell nice for Max.

Yep making those little ears bleed is a challenge in the beginning but it gets easier and in a week or two you will be able to do it in your sleep. You really don't need that expensive Alphatrak meter any human meter will do just fine but since you have it already might as well use it but might want to get a human one as a back up, since you can only get the strips for the Alphatrac at the vet's or online and they are pricey.

To make the process even easier, make up that rice sock and use it to back the ear and hold on to that ear against the rice sock when you do the poking, that way he can't flick it all over the place. And if you have problems just let us know and I will bet someone here has figured out a way around the problem. :-D

I will leave the dosing advice to those with experience with your particular insulin as mine are on Lantus and Levemir, and I know next to nothing about ProZinc

But trust me it gets much easier so easy in fact that not only to I have 11 non-diabetic kitties I adopted my two current diabetics as diabetics and this Saturday we will be welcoming home our third diabetic that we are adopting..And I can still get all the critters (11 non-diabetics, 3 diabetics, 1 large dog) and a husband, fed, tested and insulin give in under 30 minutes every morning, it is just adding another step to the morning and evening routine.

Mel, Maxwell, Musette & The Fur Gang
 
Hi, and welcome to FDMB!
My 8.5 year old male kitty, Max, was diagnosed with DM about 1.5 weeks ago. We have 3 other cats, as well, all seemingly healthy. At first, my hubby and I noticed that a lot of water was disappearing from the water bowl (and a lot of urine was clogging up the litterboxes). We couldn't find litter that wouldn't sludge up the bottom of the boxes, making it nearly impossible to get out (cleaning the litterboxes daily, even). Then I noticed that Max had slimmed down some and he was starting to beg for human food (which he HATES). So off to the vet we went and all tests indicated that he is diabetic.
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Wow, I could have written that last May when I found out Bob had diabetes. I had no idea feline diabetes even existed, and I've had kitties for 30+ years. We actually tried every brand of litter on the market, wondering why they had all changed their formula because it sure as heck seemed to have stopped working right! It wasn't until we noticed Bob's paws totally encrusted with litter that we figured out it was him with the apparent problem. And big time weight loss, which we were sort of happy to see since he'd once been up to 22lbs. And eating and drinking like he thought it was his last meal/drink. Poor guy was in really bad shape before I brought him to the vet.
The vet decided to increase the insulin to 2 units /2 x a day. I, however, am hesitant to go up that high and am thinking of increasing the dose to 1.5 units / 2x a day, instead. I gave him just 1 unit this morning, as I wanted to consult you guys first.
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Great instinct on your part. You are right, going from 1u to 2u based on one glucose curve is "too much too soon". First off, his numbers being stuck at the vet clinic all day are not representative of "normal". He's in a strange place with strange people poking him all day, strange noises and smells....that can all cause stress, and stress can elevate BG. You have seen how tiny 1u looks in a syringe right? So 2u doesn't look like all that much more.... but it's a 100% increase in dose, and that's just not good. Your .5 increase is better, but we usually advise going up in .25 increments at first. The safest way to know for sure is to be home testing, and now that you have a meter, you're well on your way.
Now you just have to perfect the technique, which takes practice. Here's a good pic that will show you the best place to try to poke for blood. You don't want to hit the vein directly, just hit between the vein and the edge of the ear. At first, it might seem like there's no blood in there, but it gets easier. The size of the lancet matters. Do you know what gauge lancet you have? Most meters come with the smallest gauge (33g), but you can get bigger ones (they come in 26, 28 and 30g as well.) I used "all of the above", starting with 26g, and over time, I was able to get good enough to use the 33g tiny ones. The higher the number, the smaller the poker.

According to my calculations, at 20 cal per pound of body weight, Max needs approximately 280 cal per day.

8 to 9 cal per lb of body weight needs to be from protein (so 112-126 calories or 32-36 grams).
Then at least 7 cal per lb of body weight needs to be from fat (so 98 cal or 11.5 grams).
Then less than 12% of the calories needs to come from carbs (so 33.6 calories or 9.6 grams).

All of this adds up to 244-258 calories. Do I make the rest up in fat calories, protein calories or both? Am I on the right track? How do I translate this to the can amounts? Am I making it to complicated? And do I or do I not need to add anything else, like egg and Vitamin E? This is the part that is stressing me out the most right now.
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Like Mel said, you're making it a little too complicated. On Binky's charts, the math is already done for you. You see the three columns that give you the "%kcal from" data? That's per can, per spoonful, per ton, per whatever. You just want something that says 7% or less in the carbs column. All the way to the right on the charts, it tells you how many calories are in a can, whether it's a 3oz can of FF or a 5.5oz can of Friskees, that's what you get out of the can itself. So if you are trying to feed 280 calories a day, just add the total calories per can up until you get to 280 (which would be 2-3 cans of FF or 1-2 cans of Friskees per day. I used to look at the charts and write the calories info on the cans, then stack them in daily portions so I'd know Bob was getting the right amount.
One note - that "20 cal, per pound, per day" formula is based on "ideal body weight", not necessarily his current weight. Also keep in mind that a diabetic will most likely require more calories per day until the numbers are better regulated, because they can't process the food "normally" due to the diabetes. And activity level factors into the equation also. An active cat will require more calories per day than say a sloth like my Bob tends to be. :smile:
You probably don't need to add to the food, unless the vet has found that Max is lacking (from blood panel test results) something like potassium for instance.

You will see this on a daily basis, but one of our "tenets" is that ECID....every cat is different. Prozinc and Lantus are definitely different, and they work differently. And they work differently on every cat. There is a study that shows that 84% of the cats in the study, following a tight regulation protocol, (and being treated early after diagnosis, and not having been on a different insulin previously) using Lantus went into remission in a matter of a few months. My cat, Bob, was on PZI for ten weeks, ate FF classics and Friskees pates, and became diet contolled (hasn't had insulin since last July). "The best insulin is the insulin that works best for your cat", is what I've been told and have read here often. Lantus, Levimir, and Prozinc are all good choices for cats.

Boy, you guys are really going to hate me when I move on to the charting....
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I wouldn't worry too much about that! We love spreadsheets, charting and data of all kinds!

Carl

edit to add "sweet spot" pic...ooops!
 

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Hey welcome!
I love long posts, mostly due to my own inability to post short ones.

I admit I have not yet read your whole post yet, but wanted to start my response with info about DM.... it's crap and many cats won't even eat it! My own cats try to cover it up like a litter box deposit!
Here is the link with info on the ingredients.... ask the vet what's good about byproducts, and see what kind of response you get. Seriously, poultry and meat byproducts? Yummy and oh so healthy!
http://www.petfooddirect.com/product/58 ... d-Cat-Food
Ingredients
Liver, poultry by-products, meat by-products, water sufficient for processing, chicken, salmon, oat fiber, salmon meal, guar gum, potassium chloride, carrageenan, salt, Vitamin E supplement, calcium phosphate, taurine, thiamine mononitrate, zinc sulfate, ferrous sulfate, niacin, calcium pantothenate, copper sulfate, Vitamin A supplement, manganese sulfate, menadione sodium bisulfite complex (source of Vitamin K activity), pyridoxine hydrochloride, riboflavin supplement, Vitamin B-12 supplement, biotin, folic acid, Vitamin D-3 supplement, potassium iodide.

About the quantity of foods.... until Max is regulated, at a good dose for him and in some decent numbers closer to 100 - 200, he is going to need more food as his body is incapable of extracting the needed nutrients from the food he's getting. My 2 cats were eating close to 24oz and 30oz before they were regulated and then they dropped down to more like 8 to 12oz a day.... big difference once they are feeling better and the insulin is working well for them.

there is absolutely nothing wrong with fancy feast pates and friskies pates; they are low carb and their ingredients are not worse than the DM.... maybe compare the ingredients with your vet and ask for the vet to point out the good stuff in the list of DM ingredients. As well, DM is way too expensive for what you get. If you want to spend the money, there are plenty of better foods like EVO which is real decent ingredients and no byproducts

Poultry by-product meal (PBM) is a high-protein commodity used as a major component in some pet foods. It is made from grinding clean, rendered parts of poultry carcasses and can contain bones, offal and undeveloped eggs, but only contains feathers that are unavoidable in the processing of the poultry parts. Poultry by-product meal quality and composition can change from one batch to another.
Chicken by-product meal, like poultry by-product, is made of "dry, ground, rendered clean parts of the chicken carcass" according to AAFCO and may contain the same ingredients as poultry-by product. Chicken by-product can vary in quality from batch to batch. Chicken by-product costs less than chicken muscle meat and lacks the digestibility of chicken muscle meat.

from another site:
Definition: Chicken by-product meal consists of the ground, rendered, clean parts of the carcass of slaughtered chicken, such as necks, feet, undeveloped eggs and intestines, exclusive of feathers, except in such amounts as might occur unavoidable in good processing practice.
Examples:
Chicken by-product meal is considered an inferior source of protein for cats. Although cats may eat a certain amount of by-products "in the wild," the most nutritious commercial cat foods will show a named meat, such as "chicken" as the first ingredient, rather than "chicken by-product meal."

I say just let him eat and since your husband can't stand the smell of the DM, tell the vet nope, can't feed that.

The ears 'learn' to bleed. I never aimed for a vein, just poked near the edge/tip of the ears. yes, I know there is a fancy diagram and some people say to aim for the vein but why? You will end up with a big gusher and a huge scab on the ear..... I just poked in the general vicinity and we did just fine. As for the meter you are using, I know only that the strips are much more expensive and you have to purchase them from the vet, so be sure you have a good stock of them and don't run out.... I wonder if you may want to get a meter for humans from the pharmacy to have as a backup, just in case. I love the Bayer contour meters and also the OneTouch meters, just don't get any of the Freestyle meters as they give false readings.

For the insulin you are giving, I never used it so you may have better support by posting in the PZI forum and they can help you more with dosing , etc.
I prefer Levemir, and have used Caninsulin and Lantus before. Lantus and Levemir are human insulins that are longer lasting and have some overlap which give you some flexibility, but PZI can be good as well, just no overlap so when it's used up, you have to give more.

For now, just let Max eat the amount he wants and worry about calories later; he will eat more now but will drop down alot later. Binky's has a wide choice of some great low carb foods with good ingredients.

As for hating you? Nope. That won't happen. We are all here for our cats and any way we can help you, we will, so you can help Max.
 
I am also an overwhelmed newbie :cry: I have the 18 year old kitty, who's not hefty, and is basically healthy, not appearing her age. I don't know yet what insulin we will be advised to use. As out of town overnight we will see vet again next week and go there.
I have done testing and insulin on humans but not any kitties. Overwhelmed as to testing. I think isn't it lantus that has pen with U-100 insulin? Think adjustable by 1/2 unit?

I am very glad to hear some Fancy Feast, natures variety instinct, freeze dried raw can be used.

If switching between flavors within a brand, or brand to brand does that make regulation difficult? We have started her on Hills M/D dry and canned and she seems to be ok with it, better then I am yuck by products!

Again apologies didn't mean to hijack thread just seemed we are both on same base as start, I just learned Missy was diabetic a few days ago!
 
So far you have received some great advice so I am not going to repeat it.

As for the amount to feed right now, feed him more than what you think is necessary. Until you get his glucose levels stabalized (which you will be able to tell by testing), he is most likely going to be very hungry. The reason why is right now his body does not process food the way it is supposed to. So if you do not feed him extra food, he probably will lose weight. As his glucose levels become under control, so will his appetite.
 
We are newbies too at this and getting your cat's blood does get easier.

Here is a good link on pricking your cat's ear: http://www.sugarcats.net/sites/harry/ea ... chor144779

Try 26 - 28 lancets. We use them without a pen and feel like there's better control.

You don't have to use a warm washcloth, a sock of rice (we microwave for 17 seconds) is fine. My cat actually enjoys this ear warming process. We use a little Neosporin with Pain Relief on his ear.

Remember when you finally do get blood, to let it "sip" into the strip -- don't try to shove the strip to the blood.

We still have to do it several times sometimes. :roll: After all, we're only humans, not cats.

Jennifer
 
Cheryl A'Purrson said:
I am also an overwhelmed newbie :cry: I have the 18 year old kitty, who's not hefty, and is basically healthy, not appearing her age. I don't know yet what insulin we will be advised to use. As out of town overnight we will see vet again next week and go there.
I have done testing and insulin on humans but not any kitties. Overwhelmed as to testing. I think isn't it lantus that has pen with U-100 insulin? Think adjustable by 1/2 unit?

I am very glad to hear some Fancy Feast, natures variety instinct, freeze dried raw can be used.

If switching between flavors within a brand, or brand to brand does that make regulation difficult? We have started her on Hills M/D dry and canned and she seems to be ok with it, better then I am yuck by products!

Again apologies didn't mean to hijack thread just seemed we are both on same base as start, I just learned Missy was diabetic a few days ago!
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Just quickly, ....
get rid of the dry food, all of it, as it will make regulation pretty much impossible ... it's high carb and not what you would feed a diabetic cat if at all possible. For that matter, the vet's rx food is not worth the price as you will find that fancy feast pates are perfectly fine and more economical. You can get some very decent low carb wet food with no byproducts and much better than the vet foods.

Lantus is a great insulin and so is Levemir, so that would be my recommendation. You can get them in pens or even just cartridges, but the pens are just fine.... you will not be using the pen needles for the pens; you will extract the dose you need using U100 syringes to draw via the stopper on the pen.
Pens will not give you the entire dose as dialed and you don't want to be worrying about the pen's mechanism not functioning properly. Best to draw what you need with a syringe.
 
ammonzon said:
We are newbies too at this and getting your cat's blood does get easier.

Here is a good link on pricking your cat's ear: http://www.sugarcats.net/sites/harry/ea ... chor144779

Try 26 - 28 lancets. We use them without a pen and feel like there's better control.

You don't have to use a warm washcloth, a sock of rice (we microwave for 17 seconds) is fine. My cat actually enjoys this ear warming process. We use a little Neosporin with Pain Relief on his ear.

Remember when you finally do get blood, to let it "sip" into the strip -- don't try to shove the strip to the blood.

We still have to do it several times sometimes. :roll: After all, we're only humans, not cats.

Jennifer
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Jennifer asking about the pen I meant one of the new insulin pens. I am trying to learn all options angels before start insulin talk with vet next week.
 
We still don't use the needles that screw onto the pens because the pens can only give full units at a time, and we raise or lower doses in .25u increments at a time, so while most of us that use either Lantus or Levemir buy the pens but still use syringes to draw the dose we need.


Mel, Maxwell, Musette & The Fur Gang
 
MommaOfMuse said:
We still don't use the needles that screw onto the pens because the pens can only give full units at a time, and we raise or lower doses in .25u increments at a time, so while most of us that use either Lantus or Levemir buy the pens but still use syringes to draw the dose we need.


Mel, Maxwell, Musette & The Fur Gang
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Gothcha thank you ;-)
 
I can't add to anything that's already been said, but just to encourage you--it DOES get easier. It really does. The beginning is crazy, and super expensive, but once you get into a rhythm, it just becomes a part of daily life and the cost also goes down.
 
Thank you all for the good advice, especially the ear pricking advice. I was going for the vein.

The vet mentioned lantis, and if there is a bit more overlap with the dosing times I might want to look into it further. We have very hectic schedules right now so if it buys us some time if we can't get home right on time for dosing that would be better. Am I understanding this correctly?

Also thanks SO much for simplifying the feeding charts for me. I feel much better. FF classics and/or Friskies pâté it is! One question, though...since I have 4 cats, and they will all be eating canned food, does that mean I will have to fed them all 1.5 cans each per day (assuming the Friskies sized can)? At 6 cans a day, we will be in the poor house before long!

I will look into a back up meter. His bg levels were 346 tonight. I am going to go with the 1/2 unit increase for now, as well.
 
Better to give them all canned food, Fancy Feast classics or the Friskies, rather than buy dry and pay for it big time when they get sick later. Look for sales--I just bought cans of FF 2 for $1 at CVS --I stocked up! Go low carbs, high protein. It's called the the "Catkins" diet!
 
Try looking around for sales on Fancy Feast or if you have a big box store like BJ's or Costco they sell by the case at a pretty reasonable rate. I feel like we go thru a case a week per cat around here but by buying a lot when we find a sale (usually at BJ's) it's not that expensive. Dump the dry food - taking Robbie off dry food our first time around helped get him OTJ in about 2-3 months AND reduced his insulin from an all time high of 8U's to .50 in no time at all. Plus his skin and fur improved amazingly so your other cats will benefit from this change too. Forget that prescription junk - seriously everyone here is steering you in the right direction.
It will get easier - hang in there - as for the ear pricking my boy seems to have uncooperative ears. First time around his left ear was the "ear of choice" it always produced a droplet of blood - but the right ear was a pain in the neck - NOW almost 2 years later the RIGHT ear is the "ear of choice" :roll: go figure. So experiment. I also find "milking" the ear sometimes helps if your kitty will tolerate it - Robbie is pretty good about it cause he knows he'll get a "treat" afterwards.
 
I know for humans using warm water to warm fingers, and milking finger a bit before the stick greatly helps. At least with inside kitty do not have to think about fighting blood out of calloused fingers. ;-)
 
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