Does anybody NOT use insulin?

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The Highwayman (cat)

Member Since 2013
Oh man, I am ready to get torn apart here - but I could use some advice. My story:

I adopted my cat, HighwayMan, about 8 years ago. He was one and a half years old and at a shelter. He was the next to be euthanized, so I said "That's the one for me". Since then, he is just the coolest most incredible dude. I think he's about 9 and a half.

He's 20 pounds, strong as hell, and goes in and out as he pleases. He was always a bit feral, so keeping him inside was just cruel (believe me, I tried). Anyway, he does well as indoor outdoor. He comes home and sleeps with me every night with a big ol smile on his face.

Four months ago he was diagnosed with Lymphoma. It was real bad. His lymph nodes had swollen so large that they were closing off his throat and preventing him from breathing properly. It was horrible to watch. Everyone in my life instructed me to put him down. I was very very close to doing it. Paying $4500 for radical removal of his lymph nodes - which wouldn't cure the cancer, only prolong his life a bit - was going to financially destroy me. I did it anyway. The surgeon removed 80% of his throat muscles and had to reattach his tongue etc. Basically reconstructing his entire throat. They said he had another month or two, that his meow would never come back etc. Well, he pushed through it and he's meowing. He's also bouncing around and playing in the bushes etc.

The only drug he's been on is prednisone. I refused chemotherapy due to the nature of the lymphoma and that I didn't want to put him through it. He hates vet trips, it ruins him (he's still feral about carriers - literally poops on himself every time and howls). Also, what a horrible way to spend your last year on earth... radiation, syringes, vet trips etc. I figured, time to let him play in the sun until it gets too bad.

Well it wasn't getting too bad. He recovered wonderfully. The prednisone seemed to be working great! And he's back to his old self for who knows how long? That was until about two weeks ago. Then the lethargy set in. He started drinking a ton, peeing almost nonstop (once on my brother). What was going on with him, was the cancer back with a vengeance? A vet trip (another $350 in tests) taught me that the prednisone had given him diabetes. Oh God. I had no idea that this was a side effect.

How do I make him feel better immediately? I asked the vet. Well, the problem is, I take him off prednisone and the cancer comes rapidly back. I keep him on the prednisone and diabetes makes him feel horrible. Two insulin shots a day, trips to the vet for readings and blood tests etc... this is not what the HighwayMan needs for his last year. And I can't spend more than $5,000 on my little buddy that has incurable lymphoma (my parents politely declined loaning me more money for diabetes treatment as they think it is time to let him go).

So, I got to work on the internet. I researched everything. Now he's on a mix of Blue Wilderness Tuna and Before Grain Chicken (96%). He gets ZERO dry food and no treats. I've got him on 25% of the amount of prednisone that he was on before and guess what? He's doing great! He's bouncing around again, going outside, jumping up on my bed and purring... I really think the food is helping.

Is this all a dream? Or can I continue with the wet/no carb food and just ween out the prednisone? I know that his cancer might come back faster, but that's better than being an untreated diabetic, right? If he appears to be feeling this well, do you think that means his insulin has balanced out? I just can't go back to the vet anymore for more tests. Neither one of us can. We just can't. The last round of $350 provided nothing for him.

He's doing great on this diet. I don't know for how long, but can anyone offer advice? Does anyone else regulate their cat's glucose levels with food only? Successes?
 
hi and welcome!

I just want to say that yes, in some cases diet change is all that's needed.

One way to know if it is working, without having to go to the vet again, is to get your own glucose meter and test kitty yourself. Did you know you can do that? If not, you definitely can :-) you want more info on how to do that? we'd be glad to teach you how. just give the word :-)
 
What a journey you two have had! Some cats do go into remission with just a diet change. If he were mine, I would get a meter and test his blood sugar levels at home. You can immediately see if he is in normal levels or not. Lots of members use the ReliOn meter from Walmart. It is a cheap, good meter with cheap strips. We have taught hundreds of people how to test and would love to help you and HighwayMan.

You can't look at the symptoms (feeling better, drinking less etc.) and be sure he is no longer in diabetic numbers. Once you know, even if he is higher than remission numbers, it could just take a little course of insulin to get him into remission. It could be that he will be a long term diabetic, but that doesn't mean he can't be happy and healthy. Treating a diabetic cat is peanuts compared to what the two of you have been through!

Lots of people here have diabetic cats on steroids; they just balance the two. They'll be along to help.
 
My goodness, you do have a lot of decisions to make, don't you?! What was the glucose level, by the way?

Don't feel bad about trying to control the diabetes with diet. In fact, that's where all of us start. After a month, if the low carb diet didn't do the trick, then we had to get on the stick and do the insulin.

Many people here have cats that went into "remission" only after one to two months on insulin. Then they just needed to control the diet. However, everyone tests their kitties every so often to make sure the blood sugars are still under control, and some cats do fine off the insulin for years.

There is a relatively inexpensive, non-vet involved way you can keep an eye on things for the next month to see how your boy is doing (of course, the best thing to do would be to home test with a meter, but I suspect that is not what you were hoping to hear).

If you somehow can do a urine clean catch from your boy, you can use dip sticks to see if he is passing any ketones and/or glucose in his urine. If you are interested, I'll pass along some product recommendations for you (very inexpensive). If your boy is indeed passing ketones, you will need to deal with it immediately. If he is passing only glucose, depending on the severity, you will need to deal with it sooner than later. Also keep in mind that excess glucose running through the urinary tract creates a bacteria breeding ground, causing UTI’s.

If the low carb diet doesn’t work, and you don't do the insulin, most likely he will start to lose weight and begin to not feel very well. I understand your quandary regarding the prednisone – it’s nasty stuff, but necessary for your boy to survive.

It sounds like your recent reduction in prednisone dosage is working for now, though, and I think you are aware that you cannot just stop a steroid without tapering it off over time.

So, please do take a deep breath. Wanting your boy’s time left on this earth to be as enjoyable as possible is not something any of us should beat you up over. He is lucky to have you.

DZ and Sarah
 
As others have already posted, please get a meter and test his blood glucose at home. That alone will save you vet bills. Also, cancer trumps diabetes, so I would not cut out the pred which it seems is really working well for him. If he needs insulin, you can just test and work up to the correct dose of insulin he will need. You have done an amazing job of giving Highwayman the best care........diabetes is just another step to learn in continuing his care. If he does need insulin and you do not give it, the diabetes might kill him long before the cancer. Wishing you and Highwayman a lot more time together and whatever help you may need you will find it on this board.
 
Greetings to you and HighwayMan!

First let me just give you a hug for taking such great care of your buddy. I think you're very wise to focus on his quality of life and I also totally appreciate the balancing act you are dealing with.

I will tell you that when my two cats, Owen and Mac, were first diagnosed maybe 6 years ago, we were able to manage them really well on diet alone. They had been eating dry food (because I traveled a lot and thought it was better for them... I didn't know any better.) Less than two weeks after we got them off carbs and onto canned food, their BG values were normal and they've stayed there for years. So YES, it is absolutely possible. You can easily test his blood sugar at home using a human meter - there are tons of resources here on this site to show you how that works. It's easy and inexpensive.

I think it's also important (and OK) to be realistic about the financial aspect of things. Very few of us have unlimited resources. My guy Owen developed a kidney problem and wound up in the kitty ER this past weekend... thankfully he is improving and we hope he will be able to come home tomorrow, because I am running out of $$$... As of today we are at $4K and tomorrow will be another grand or so.

Wishing you and HighwayMan lots of sunny days ahead :)
 
Greetings Highwayman and your person.

Well even if you do have to put your buddy on insulin that doesn't mean that you have to keep dragging the elderly gentleman to the vet's all the time...in fact back in March I adopted a lovely tortie girl that was a diabetic, the only trip she has made to the vet's thus far is to get her shaved because she is long haired and her other person had let her go so long sick with diabetes she couldn't groom herself and her fur had become a living straight jacket. That's it, that is the only time she has been to the vet's period. I started her on insulin as I already had her adopted diabetic brother Maxwell, so I knew the drill. I test them both at home and do all the adjusting of her doses by the numbers she gives me at home. While I don't know her true age, I do know she is more than likely closer to 20 than she is to 10. ( A lady never reveals her age..lol).

Just get a meter and start testing Highwayman at home, if you have to put him on insulin we can teach you how to manage that was well at home. But yes, some go off insulin with just a diet change, some do it on diet change alone and others are lifelong insulin taking diabetics but they all are living healthy happy lives...just like human diabetics.

Mel, Maxwell, Autumn & The Fur Gang
 
Hi all,

Wow, thanks so much for the fast responses. What a cool message board!

I think buying a home glucose meter is a fantastic idea. I will look into the walmart one. I certainly think it's important to know where he's at.

His level was around 360.

I should explain: I work search and rescue in National Parks. I've been working, seasonally, in Yosemite Park and can't have a cat there (he'd get eaten by bears). So he's been living with my parents this last year. They love each other, he sleeps with them now. I came home in November and discovered the lumps in his throat (they never noticed). Since then, I've been taking care of him, paying for treatment etc. Unfortunately, as I've spent my savings, and it's time to go back to work - I have to head to the Grand Tetons for the next two months. My Mother, who's great, isn't willing to give him two insulin shots every day. Not because she's heartless, but because she's watched me spend my savings on him. And she cares about me. She thinks that he's great, and she's willing to feed him this diet I have for him (I've bought two months supply of no carb wet food) and to take care of him while I'm gone. But, I can't expect her to pay for insulin and make two injections a day.... She would do this if he was just diabetc. But after the cancer, all of the surgeries, all of the money... she just thinks I need to let him go.

Also, when he first got diagnosed - the vet said we needed to come in twice a week for glucose readings. The breakdown for everything - including insulin - came to around $900 a month. This is where my Mother gave me the look of "Son, we need to know where to draw the line...".

Anyway, so I am trying to make it easy on her. I think I can get her to use a glucose meter. I leave on Friday, but I can read/check his levels before then. I'm just hoping that the diet will regulate him while I'm gone. I'd love to see him again in two months. But, I'm prepared for the other outcome too. But he's relatively young, strong and a fighter. I really have a feeling we just needed to get him off dry food and prednisone. This guy has been all over the country with me - We've lived in a tiny studio in NYC, in Brooklyn, college in LA, SF and now at my parents house in Seattle. I think about him every night I go to bed on a mountain without him.

He's really doing great right now. He was on three 5mg pred tablets every day, now I have him down to one (half twice daily). I'd love to hear more about how people balance cancer and diabetes...
 
I cannot imagine needing to go to the vet so often! I have been testing my cats at home for 6+ years and they have only ever gone to the vet for routine stuff... glucose is quite easy to check at home. My guys have done fine on diet alone but I have looked into the insulin routine since it's always been a possibility that they would need it at some point. Truly not a huge deal.

I do think diet is huge, FWIW. My cats were both fairly high (400-500) when they were first diagnosed. Once we switched them to the canned food (we use Fancy Feast) they dropped to below 100 really quickly, and have stayed there. Owen, my grey shadow, has spiked some since he had the kidney issue. We are not sure what caused it, and he's had a lot of therapy the last few days, but even with all of that going on, he hasn't needed a ton of insulin. He will probably need it for a while at least, when he gets home. I've seen him get the shots at the clinic and he really doesn't care. So if that turns out to be an issue, maybe Mom could watch a shot and realize it's NBD?

In any case, it sounds like HighwayMan is a very lucky cat, and you're doing great with him.
 
Important reality check here and it may be a bummer to read:

At a minimum, he needs to be monitored for ketones, a by-product of fat breakdown.
High levels may evolve into diabetic ketoacidosis (DKA), a very expensive to treat complication of diabetes that can be fatal. This may be done with inexpensive urine test strips. If he develops DKA, you need to be prepared to make an unpleasant decision.

Untreated diabetes is like starving to death in the midst of plenty. You eat and eat, but are always hungry because there isn't enough insulin to allow the body to use what you've eaten. I'd recommend you find someone who can come test him and give insulin if needed while you are gone because of this; you don't want him to suffer for 2 months while you are gone.
 
Can you Mom come on and post to this board for help with hometesting, shooting insulin, etc.? Must be so hard for you to know you have to leave him again.
 
Mom's a busy woman that I was trying to make this process SUPER simple for. Ugh, this isn't what I wanted to hear. I don't even know what a "keytone" is or how to monitor it. Looks like I have some more researching to do. The last thing I want is for him to suffer.

The only thing that's brought me peace throughout this is that cats have no way of knowing their own mortality. In a way, we keep sick cats alive for ourselves. Which is very beautiful. But when they get sick from radiation and don't know why they feel so bad, or sick from diabetes or cancer... we prick them and regulate them etc. I just think it depends on the cat how much this is okay.

My HighwayMan is named this because he is a HighwayMan. Do you remember the song by Willie Nelson? It's about dying and coming back as a drop of rain, or a blade of grass etc. About remaining. He never has been a cat. He is a dog the way he runs along behind you when you're jogging, or comes when you call or fetches a bottle cap. He is a human the way he wanders at night, but find his way home to bed... watches TV and stares at you with a wink or glimmer like he knows what you're thinking. But he is also a cat, how he can always look more comfortable then I have ever felt in my entire life. But he is also a HighwayMan.

I battled with philosophies when paying so much money to keep the highwayman alive when, clearly, it was his time to return to another form. But, I felt selfish. I wasn't ready to give him up yet. I just don't know if the highwayman is going to want a lot of vet trips and blood drawing and needles etc. Especially, as his cancer is supposed to get worse any day now. Also, I adopted him because he was the next cat to be put to sleep... and now so many other cats that don't have cancer are being euthanized every day. And I'm spending $5,000 on a cat that is going to die soon of cancer anyway. Isn't that irresponsible? Shouldn't I have donated that to keep healthy cats alive? Shouldn't I have saved more?

But I love my highwayman. I'll look into what all of these things are... I just hate this.

Edit: By the way, we have a ton of liquid buprenorphine (for the cancer) if he ever seems like he's in pain. The stuff just sends him off into space for 12 hours. I hate it, because I miss him for those 12 hours, but it beats the alternative.
 
There is no easy answers for you or Highwayman, but diabetes alone should never be a death sentence...Cancer just plain sucks. So here is a question..Is Highwayman ready to give up the fight? Have you asked him? Yeah I know it sounds crazy but after just losing two cats this year I knew in my heart when it was time to let them escape their fur. Onyx I lost to cancer and like you I was willing to spend whatever it took to keep him with me, until the day came that he clearly without question told me he had had enough. He was tired of the meds, his was lung cancer and he told me loud and clear that enough was enough, he didn't want to struggle to breathe anymore, he didn't want the fluid drained out of his chest anymore, he was just plain done.

Then there is my Autumn and Maxwell my diabetics, both of who shouldn't be here with what they went through before I adopted them as diabetics, but here they are, one in remission and off insulin now for 2 years and sleeping on my feet at the moment and the other still taking insulin but working towards remission and purring at my side.

I also have 12 other cats, one large dog and a house and husband to take care of, testing and giving insulin to Autumn adds less than 5 minutes to both my morning and evening routine. It has become so routine that it is like brushing my teeth or making the bed in the mornings. But I also know from Autumn what happens to a cat that needs insulin and doesn't get it, you see before she became my cat she was allowed to go 10+ months with no treatment whatsoever. When she came to me, she was less than 6 pounds (her ideal weight is 14). She was so dehydrated that her little ears didn't even feel like kitty ears they felt like thin pieces of leather, and was so matted that she was living in a straight jacket of her own fur, and she was walking on her back hocks and on 1.5u of insulin. Now fast forward 8 months. Autumn is 14lbs, well hydrated, leaping to the top of my rolltop desk, window sills etc. Her insulin dose is down to .3u twice a day and she is back to loving life again. And she has been to the vet's once in that entire time and that was she first arrived to be shaved out of her matted fur. Everything else relating to her diabetes I do here at home with the help of what I learned from the folks here.

If we can be any help to you or your mom should you decide to try treating Highwayman's diabetes we will be here with bells on. In fact, we might even have a member close to you that could pop by and show you and your mom how to test and shoot so she can see it really is no big deal.

Mel, Maxwell, Autumn & The Fur Gang
 
As far as costs and keytone monitoring go...
Going back and forth to your vet like that isn't necessary if you learn how to monitor his blood glucose yourself. It's pretty awkward at first, and then in about a week or two, it's easy as pie and you could teach your Mom after you've got the hang of it. I never thought I'd be able to do it for Molly (she was very feral)
but oddly as she got to feeling better, she became much more cooperative.....there are sections of the ear that she doesn't mind at all being tested on and other sections where I would see her wince as though the poke smarted.....you learn this as you go along...also, as you go along for some reason the spot gets
easier to get a sample from.
Lantus insulin is the best one...it costs a bit (around 100.00) , but a bottle lasts for 4 months refrigerated and the syringes are about 15.00 for a box of 100....not over the top expensive.
The keytone monitoring is just like those pregnancy tests...you hold a strip under their urine flow to check every once in a while....a bottle of 100 strips is about 15.00 as well.
There are people on the Lantus tight regulation board day and night to help with dosage recommendations after you read the basic info posted in the top stickies. The start low go slow approach sticky and what to do in case of hypoglycemia (too low blood sugar after insulin) are the most important.

The thing that will cost you a fortune is if the ketoacidosis starts up (keytones in urine).....letting BG soar untreated usually leads to that. Requires hospitalization, fluids and all sorts of treatments as their blood pH levels go wonky and it can shut everything down.....

If you find your kitty is hanging around 200 or lower BG wise now that you've switched Highway man's diet (without insulin)....he'll probably be ok without the insulin, if he's higher...it's much more risky as far as developing ketoacidosis.
There are lots of food charts available on this site (if you haven't found them already) of the best low carb canned foods to feed and which ones to avoid.
Lots of brands etc listed.

Wishing you and highwayman the best :smile:
 
Ketone (no 'y') testing is pretty easy. See my signature link on Secondary Monitoring Tools for how it may be done, as well as some other methods for assessing your kitty.

How soon are you leaving? If you can't convince your folks, you might check around for vet techs wanting to earn a bit part-time, or local students with an interest in veterinary med who could do the testing, shooting, etc.
 
Have you looked into using turmeric (or it's active ingredient 'curcumin') for your cat? I read just the other day that some folks whose cats had cancer were using it for it's remedial/palliative properties. Turmeric is thought to be a powerful natural anti-flammatory but also seems to have anti-cancer properties. I take it regularly as an anti-inflammatory (and really notice if I've forgotten to take it for a while), and was looking online the other day trying to find out if I could also use it for my arthritic cat. That's when I came across the info that people were using it for cats who had cancer. I didn't keep a link to any one particular article, but there is quite a lot on the web about this.... Oh, and apparently cats actually like the taste too...
 
Re: Does anybody NOT use insulin? Tumeric

I was a bit intrigued by the thought of Tumeric. Here is a good article. http://www.umm.edu/altmed/articles/turmeric-000277.htm

Unfortunately, my kitty also has kidney disease which already causes increased stomach acid, so I won't be trying it. However, it is a fascinating thought.

Also, here are the links for the strips to use for testing if there are ketones and/or glucose in the urine (there are various options on the page - just make sure you read the reviews before deciding):

http://www.amazon.com/s/?tag=felinediabetesfdmb-20

DZ and Sarah
 
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