? Does my cat need insulin?

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CleoParker

Member Since 2024
Hi everyone I hope someone can offer some advice because I'm losing my mind with worry.

My cat is nearly 14 years old.
It all started last year when I noticed my cat was peeing and drinking a lot more. She was hungry all the time too. There was an odd smell in the litter tray so I bought some test strips online to do some tests. I assumed it might be a urine infection.

To my surprise it picked up sugar in the pee. I brought a urine sample to my vet who wasn't concerned and told me it wasn't diabetes and she didn't have an infection so we left it.

Two months later she stopped eating and drinking and became lethargic. We rushed her to the vet who put her on a drip and ran tests.
They determined it was pancreatitis. Her fructosamine was 330 so in the normal range? But her Glucose was around 21 so they put her on prozinc insulin shots of 1.5 units a day. I know my cat was very stressed so I wondered if it could be stress hyperglycaemia?

While in the hospital she had a hypo and needed the antidote because her sugar got too low. (This was while on short acting insulin)

After she was discharged we continued the insulin shots of prozinc 1.5 units roughly once a day and the next fructosamine was 195 and the next one after was 185 but her sugar was always around 11 in the vets office. I was testing her pee at home and there was always sugar in it too.

They recommended stopping the insulin and this really scared me because I didn't want my cat to get pancreatitis again. I had noticed that while on insulin her drinking and peeing had got much better and she wasn't harassing me for food all the time.

I'd asked for a test on her liver and kidneys and it came back perfectly normal.

Around this time we had a falling out with the vets so we left the vets with a prescription for insulin and basically just kept giving her a small dose of insulin every day. Her symptoms had almost disappeared apart from occasional diarrhoea. I was giving her dry diabetic food because that's what the vet recommended but I was supplementing with normal wet food sachets because I've read dry food was bad and the wet diabetic food looked so unhealthy.

just before Christmas we took our cat to a new vets because she seemed to have an infection and we weighed her. She was the same weight she was 4 months before (6kg) After Christmas we took her in to buy a new bottle of insulin because ours had been open 4 months at this point and it didn't seem to be working anymore. Her blood sugar was 23 and she had sugar in her pee.

I was hoping this would be enough to convince the new vet to give us more insulin so we could go on our merry way for the next few months but he wanted to do a fructosamine test. He said because we've been giving her insulin up until recently we'd need to stop it completely for a week so we could do a fructosamine to see if she really had diabetes and to be extra cautious (I had asked why her initial fructosamine could have been really low?)

Now this has been a really scary time for me because I've not taken her off insulin since she was diagnosed. I've read about the dangers of ketoacidosis. She's been drinking excessively and peeing outside the litter tray very diluted pee. One of her canine teeth fell out this week too but I don't know if that is related (can't see any gingivitis or gum disease)

I'm taking her in Friday for her fructosamine but I have a feeling it will come back normal or low again and I'm scared he won't give us the insulin. If she's not diabetic then why is she drinking and peeing so much?

I read about what can lower fructosamine and it keeps pointing to hyperthyroidism which she has never been tested for although I believe hyperthyroidism can have some of the same symptoms as diabetes?

Is it worth asking for a hyperthyroidism test even though she's not lost any weight?

Is it possible that the diabetes was misdiagnosed?

If I stop giving the insulin from now on what is the likelihood she will get into trouble? I've been testing her pee for ketones this week and it's been negative. She's still full of energy and doesn't seem to have lost any weight.

Many thanks.
 
CleoParker said:
They determined it was pancreatitis
Click to expand...
How did they determine it was pancreatitis? Do you know which test they performed? Was it a test that had to be sent away to the lab (spec fPl)?


CleoParker said:
Her fructosamine was 330 so in the normal range?
Click to expand...
No, this is too high. The fructosamine will tell you the average blood glucose over the course of about 2-3 weeks. So it’s too high. Actual blood glucose (BG) would have had to have been both higher and lower than that at times.
CleoParker said:
I had noticed that while on insulin her drinking and peeing had got much better and she wasn't harassing me for food all the time.
Click to expand...
This indicates to me that she was benefiting from the insulin. Your instincts are good.
CleoParker said:
I was giving her dry diabetic food because that's what the vet recommended
Click to expand...
These foods are generally way too high in carbs for a diabetic cat and will cause elevated glucose. Are you still feeding this?
 
So we need to get you up and running with testing her BG at home. This is the only way to make absolutely sure that she is safe on a dose of insulin. A fructosamine only gives an average over time, as I said, so you need to know how low (nadir) a dose is taking her (probably in the middle of a cycle.). More to come.
 
Hi there,

Thankyou for replying

Yes it was an FPI test because I've requested a copy of her medical records and it says it on there.

I'm feeding purina DM dry food and 1 packet of felix in jelly a day because I'm really confused about what to feed so I just give both.
 
CleoParker said:
One of her canine teeth fell out this week too but I don't know if that is related (can't see any gingivitis or gum disease)
Click to expand...
This definitely could be a cause for higher blood glucose. Not necessarily the only cause, but it can contribute to higher BG. This is another confirmation that you need to test her BG at home and keep track of it to make sure she is safe with the insulin. We need to see what her numbers are to see how much, if any, insulin is needed.
 
CleoParker said:
Hi there,

Thankyou for replying

Yes it was an FPI test because I've requested a copy of her medical records and it says it on there.

I'm feeding purina DM dry food and 1 packet of felix in jelly a day because I'm really confused about what to feed so I just give both.
Click to expand...
Can you copy and paste her bloodwork into this thread.
 
I’m glad you are testing for ketones. That is important. I’m not at all convinced that she isn’t diabetic. If you could test her at home using a human’s BG meter, we could see what her blood glucose is throughout the day.
 
CleoParker said:
Hi there,

Thankyou for replying

Yes it was an FPI test because I've requested a copy of her medical records and it says it on there.

I'm feeding purina DM dry food and 1 packet of felix in jelly a day because I'm really confused about what to feed so I just give both.
Click to expand...
@Diane Tyler's Mom can you help with how many carbs are in these foods?

A diabetic cat needs to be on a low carb (less than ten percent carbs) diet.
 
Diane Tyler's Mom said:
The Purina DM Dry food is about 18% carbs too high
Click to expand...
Yes. This is a high carb food. That percentage of carbs is one we would use in a hypo situation where we need to raise BG very quickly (although we would preferably use a wet food with high carbs in that situation.). So that food isn’t helping his BG. I would request, however, that you would NOT change anything about his diet until you begin home testing and we get you set up with a spreadsheet to track his BG. The reason is because changing from high carb to low carb food cam dramatically lower BG and we want to make sure that any such changes are made slowly and under close supervision so that we will prevent hypoglycemia. Okay? You have told us a lot, and we have also asked you a lot of questions and related a lot of information — so ask us questions and seek clarification if you need it. There’s so much information to take in at the beginning.
 
330 is above the normal range for fructosamine, which tops out at 286: Reference Ranges for Fructosamine Test 21 (378) for blood glucose is really high for vet stress. Was that from the lab test or a blood test done by a meter at the vet clinic? Having both high fructosamine and high BG looks like diabetes, especially if also sugar in the pee.

In the chart Diane linked above, you want foods that are under 10% carbs for a diabetic. The Felix products are all what we consider low carb.
CleoParker said:
Is it worth asking for a hyperthyroidism test even though she's not lost any weight?
Click to expand...
Definitely. If nothing else, cats that are hyperthyroid can be harder to regulate if diabetic too.

The following link has suggestions for blood sugar test kits: UK Diabetic Cat Food Info (includes some supplies). Doing some home testing will tell you whether she's diabetic if you stop giving insulin.

Stopping insulin will not cause pancreatitis, but if there is an infection or inflammation, she's not eating enough and no insulin then DKA can be a concern. Do the urine test strips you have also test for ketones?
 
History - urine shows high spec gravity with no blood , glucose +/-2.5 mmol so
dibetes unlikely but could do blood glu or fructosamine to check.owner says
urinating more often and not always in tray suggest could be cystitis and suggest
appointment with vet needed.

05/05/2023 12:05 Weight updated from 5.300(Kg) to 6.220(Kg)
05/05/2023 12:15 Document Created - GA Consent Form.docx
05/05/2023 12:39 IDEXX InterLink Request made for Catalyst DX
05/05/2023 13:45 Metacam Inj For Cats 2mg/ml David Cockburn 0.62
05/05/2023 13:47 Synulox Injection Rtu 1ml 0.30
05/05/2023 13:54 Consultation 1.00
lab chem 15, lyte4, haem and sdma 1.00
lab Fructosamine 1.00
05/05/2023 14:06 History - Since march has continued to drink more but last 24hours lethargy and
off food
Katie Gilbert
Examination - t40 and dehydrated body score 8 and poor coat condition blood
showed elevated whte cells 19.5 and glu 21.5 fructosamine in normal range 330 ,
alt elevated alkp normal borderline diabetic with secondary infection try to reduce
temp and if imp will try strict diet and retest glu and fructosamine ,
05/05/2023 14:11 No Follow Up requested
05/05/2023 18:30 History - later - urine 25 glucose so decide to start insulin 1.5 units bid David Cockburn
05/05/2023 18:32 Drip Administration 1.00
hospitalisation cat Level 2 1.00
AQUPHARM 11 HARTMANS SOLUTION 250ML 1.00
05/05/2023 18:33 prozinc insulin for cats 1 vial (1.5 units twice dailyinject under the skin twice a day
-- MUST BE KEPT IN THE FRIDGE)
1.00
05/05/2023 18:34 PROZINC 0.3ML INSULIN SYRINGES (Use with prozinc insulin for cats) 10.00
05/05/2023 18:49 STRONGHOLD PLUS >5-10gk CAT 1ML 3 PIP (Apply one pipette to back of neck
every four weeks -- FOR EXTERNAL USE ONLY)
1.00
No Follow Up requested dcockburn
05/05/2023 18:57 Insurance Claim (owner has paid) Administation Fee Libby Yarnal 1.00
06/05/2023 10:05 History - O reports perked up and ate when home last night, but since then hasn't
eaten and not drank very much
Was a bit brighter when got home, otherwise just been very quiet and lethargic
Lucy Blount
Examination - BAR, mmp&m
Delayed skin tent, still dehydrated
HR 204, chest ausc clear, RR WNLs
Abdo palp very limited but NAD
T 40.3
06/05/2023 10:14 No Follow Up requested l.blount
06/05/2023 10:17 Estimate Created:- 19187, Sedate to scan abdo, IVFT By: l.blount
06/05/2023 10:18 Document Created - GA Consent Form.docx Lucy Blount
06/05/2023 10:28 Plan - Admit for further IVFT, sedate to scan abdo
Consultation Follow Up 1.00
06/05/2023 10:55 Examination - O thinking of claiming for tx - May hold off for a while and will
contact Pet plan. Payment taken for admin fee, but please refund if O decides to
put claim through themselves
Libby Yarnal
06/05/2023 11:00 History - Sent to Operation list
06/05/2023 13:24 Drip Administration Suzanne Muirhead 1.00
hospitalisation cat Level 2 1.00
AQUPHARM 11 HARTMANS SOLUTION 250ML 1.00
sedation cat <30 mins 1.00
DORBENE INJ 0.10
ALZANE 10ML
Description Site Vet Qty
CLINADRY MULTI EYE LUBRICANT (used during General aneasthetic) 1.00
Torbugesic Injection 10ml , 0.10
Alfaxan /ml 2.00
06/05/2023 13:25 Ultrasound examination < 15 mins 1.00
Snap Spec Fpl 1.00
Cerenia Solution 0.60
06/05/2023 13:50 Synulox Injection Rtu 1ml 0.30
06/05/2023 14:16 Ultrasound - scan Chloe Newton
06/05/2023 14:28 History - sedated to be able to start on ivft and then scan abdomen
u/s abdomen - no gall bladder sludging; no masses seen in liver or spleen;
stomach empty, normal layering of walls, look quite prominent but not thickened
when measuring; small intestine 0.295mm wall thickness; kidneys and bladder
wnl's; no enlarged ln's seen; uncomfortable when scanning in area of pancreas
despite sedation, 1.5cm hyperechoic area cranial to spleen with multiple < 1mm
diameter hypoechoic circular areas within - pancreatic tissue?; no free fluid seen
BG today 17 mmol/l, with a normal range fructosamine not convinced diabetic
think more likely stress induced hyperglycaemia
Suzanne Muirhead
06/05/2023 14:54 History - Called O. Suspect a pancreatitis/poss triaditis given further blood results
(fpl abnormal) and scan today
Adv best course of action would be continued supportive care and medication at
vetsnow
O agrees
Cerenia and synulox injection given
Has been on 4ml/kg IVFT
Lucy Blount
06/05/2023 16:37 History - slide aglutination negative Suzanne Muirhead
09/05/2023 09:36 Imported Document - Vets Now Hx Libby Yarnal
09/05/2023 09:41 Imported Document - Vets Now additional details and hx
09/05/2023 11:24 History - has been at VN over the weekend
started on Acrapid insulin on Sat evening and BG dropped as a results to
2.9mmol/l on Sunday morning
started on 1.5IU Pro-xinc Sun evening-8pm which has provided a more stable BG
readings ( 19.7 Mon morning) Given again 1.5IU prozinc on Mon evening at 8pm
and BG=11.7 during the night after.
has eaten well applause this morning at VN.
Svidna Boyd
09/05/2023 11:35 Estimate Created:- 19200, hosp, supportive Tx By: SBoyd
09/05/2023 11:36 Consultation Follow Up Svidna Boyd 1.00
No Follow Up requested SBoyd
09/05/2023 11:37 History - admitted for cont ivft and supportive Tx, BG, electrolytes check
she is very grumpy so taken sraight in teh back for bloods and TPR as I don't want
to stress more by taking in and out of her basket.
Svidna Boyd
09/05/2023 11:38 Document Created - GA Consent Form.docx
09/05/2023 12:04 IDEXX InterLink Request made for Catalyst DX
09/05/2023 16:57 History - BG =14.97 this morning, better controlled than in ten last two days
electrolytes - K is at the lower end of ref range so left the fluids with added K.
settled in kennel, tempted with fresh cooked chicken but wasn't interetsed.
a lot less grumpy today
Svidna Boyd
Consultation Follow Up 1.00
Buprecare Multi Dose0.3mg/ml 0.41
Buprecare Multi Dose0.3mg/ml 0.41
Cerenia Solution 0.60
Drip Administration

hospitalisation cat Level 2 1.00
Lab Glu 2.00
Lab Electrolytes (lyte 4 clip) 1.00
Sampling Fee 1.00
09/05/2023 17:03 Lypex Caps (Give 1 capsule per day split between all meals. Sprincle on top --
exp date:)
14.00
09/05/2023 17:56 IDEXX InterLink Request made for Catalyst DX
09/05/2023 18:39 History - BG=17.58 at 6pm
given 2IU 18:45hrs
has passed urine today, well hydrated, hasn't eaten
also not grumpy anymore, would let you do anything.
had a chat with Os about guarded prognosis and how long they feel they should
keep her going.
adv my hope is she will start eating at home as here she might be too stressed.
plan: take home, try to tempt with food, RC tomorrow morning
RC BG and lytes tomorrow morning.
Svidna Boyd
10/05/2023 08:34 History - O reports since got home last night has been eating and drinking fine
Has been playing
Used litter tray - has been passing urine and faeces
Lucy Blount
10/05/2023 08:37 No Follow Up requested
10/05/2023 08:51 IDEXX InterLink Request made for Catalyst DX
10/05/2023 08:56 Examination - BAR, mmp&m
HR 160
Abdo palp limited but NAD
T 38.2
Lucy Blount
Plan - Check BG and electrolytes - BG 14.6 and electrolytes WNLs
Tgh with insulin 1 IU BID and rvn to show how to inject, recheck tomorrow
morning and if all okay in 7 days
O asked re freestyle libre, can disc in 7 days
10/05/2023 08:59 Sampling Fee 1.00
10/05/2023 09:00 Lab Glu 1.00
Lab Electrolytes (lyte 4 clip) 1.00
10/05/2023 09:13 Synulox 50mg (Give 2 tablets twice daily for 4 days, starting Thursday morning --
10/05/2023 09:16 Consultation Follow Up 1.00
Synulox Injection Rtu 1ml 0.30
10/05/2023 10:04 History - messaged Jo to do claim Vicky Holder
10/05/2023 15:13 History - ***claim sent via VetXml for investigate polydipsia and lethargy £1,403.24 Joanne Collins
11/05/2023 10:54 History - called o for update - doing well. much happier now home. eating,drinking
well.
12/05/2023 15:36 History - O unable to catch Cleo for today's appt - will call to rebook Avril Wiley
12/05/2023 16:36 IDEXX InterLink Request made for Catalyst DX
12/05/2023 16:37 Lab Glu Charlotte Pratt 1.00
Sampling Fee 1.00
13/05/2023 16:42 Plan - tried to ring owner no answer as had message to ring owner Sarah Banning
15/05/2023 14:53 History - BG 12.12, called O to report results and had long disc about monitoring
options
Seeing Cleo Wed and will look at diabetic diets and at home glu curve vs freestyle
libre between now and then
Lucy Blount
15/05/2023 16:22 History - ***claim sent to VetXml for investigate polydipsia and lethargy £30.40 Joanne Collins
17/05/2023 08:48 RC VHN FEL DIABETIC 1.5KG Jo King 1.00
17/05/2023 08:49 History - doing well cancelled appoin today

Document Created - Urinalysis Results.docx Lucy Blount
13/06/2023 17:29 Weight updated from 6.220(Kg) to 6.160(Kg)
13/06/2023 17:36 No Follow Up requested l.blount
13/06/2023 17:52 Sampling Fee Lucy Blount 1.00
13/06/2023 17:53 Examination - BAR, mm p&m, CRT< 2secs
Eyes, ears, nose NAD
LNs WNLs
HR 164, matching pulse, chest ausc clear, RR WNLs
Abdo palp limited but NAD
BCS 8/9 - small amount of wgt loss
Plan - Disc poss of going into remission
Check gluc and fructosamine today, plus urinalysis
Will call O with results later this week, will disc whether we give SID/BID dosing
etc and whether to taper her dose down and trial her with no insulin
Urine Sample In House (Vetscan + SG) 1.00
Lab Glu 1.00
lab Fructosamine 1.00
Consultation Follow Up
History - message to Jo c-request add charges since 15.05.23 on to ongoing claim Jo Hodgkiss
14/06/2023 17:23 History - Fructosamine 197 and glucose 11.8 (mild hyperglycaemia)
However 2+ glucose in urine
?going into remission
Plan: O to give 0.5 units BID, O has urine dipsticks at home so they can test the
urine and if they have 3 successive days of no glucose present that is a positive
sign and we can try and taper down her insulin even more
In meantime O to keep working on wgt loss with diabetic diet
Recheck with phone consult in 2 weeks and in-person check up in 4 weeks
Lucy Blount
16/06/2023 18:20 History - **claim sent to Petplan via VetXml for diabetes £156.02 Joanne Collins
27/06/2023 05:47 prozinc insulin for cats 1 vial - Prescription (inject under the skin twice a day --
MUST BE KEPT IN THE FRIDGE)
Jane Whitaker 1.00
Prescription - VET_PRESCRIPTION_29695_DOCUMENT_1687841250566.doc
Written Prescription Charge (1 prescripion, one drug) 1.00
30/06/2023 05:42 PROZINC 0.3ML INSULIN SYRINGES (Use with prozinc insulin for cats) 10.00
30/06/2023 05:43 prozinc insulin for cats 1 vial (inject 0.5ML under the skin twice a day -- MUST BE
KEPT IN THE FRIDGE)
1.00
30/06/2023 15:52 History - messaged Jo to do claim
meds collected
Vicky Holder
30/06/2023 16:47 History - Telephone consult: Called and disc options after chatting to vet from
boeringer given Cleo likely in remission
1) Trial Cleo off the insulin, closely monitoring her clinical signs
2) Place a freestyle libre and monitor her blood glucose for a few days before
taking her off insulin, again monitoring clinical signs closely

BAR, mm-P+M, crt< 2s
sup Ln nad
eyes/nose/ears nad
HR 176, rge/irreg, no murmur
chest is clear
abd soft and comf
BCS 8/9
t=38.1
adv check BG and fructosamine, no signs of pancreatitis so no cPli
BG=17.4
plan: O to cont to check urine, will ring Idexx on Monday when the fructosamine
resukts will be ready too
No Follow Up requested SBoyd
14/07/2023 17:48 IDEXX InterLink Request made for Catalyst DX
14/07/2023 17:56 Consultation Svidna Boyd 1.00
Lab Glu 1.00
lab Fructosamine 1.00
Sampling Fee 1.00
14/07/2023 19:42 History - ***claim sent through VetXml for diabetes £134.22 Joanne Collins
15/07/2023 14:22 IDEXX InterLink Request made for Catalyst DX
15/07/2023 18:44 History - routine biochem requested by owner, all completely normal. Low glucose
prob due to sample being stored overnight.
Pippa Adams
17/07/2023 13:33 Plan - spoken to o, he will bring in urine sample.
please test and put a message for me to call on Thurs/Fri
lab chem 15, lyte4 and sdma 1.00
Urine Sample In House (Vetscan + SG
 
Diane Tyler's Mom said:
@Suzanne & Darcy
Sounds like @CleoParker might be from the UK because she said she's feeding
1 packet of felix in jelly a day .
I see it on the UK food chart but there are notes about it in red which I don't understand
It looks like some of the Lily's Kitchen lines are lower in carbs

https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml
Click to expand...

I've studied the list and I think you're right. Lily's kitchen looks the best. I can easily buy that in pets at home and it's not too expensive. I've fed her gourmet and felix in the past but they all contain added sugars but lily's kitchen is no added sugar. She's been on the dry food from the beginning because they told me not to change her diet while taking insulin so I was scared to stop it incase it caused a hypo. Now she's been off the insulin for a week would it be worth switching to lily's kitchen and then having another fructosamine in a few weeks to see if her blood sugar has come down? Maybe getting a freestyle libre and monitoring her at home? Really think she'd benefit from cutting out the dry food completely.
 
You don't need the vet's permission to feed something other than dry DM. Just go ahead and feed whatever low carb food you feel is best for your cat. The lower carb food will improve blood glucose levels so a fructosamine results in another week or two should be much better. I don't know what webbox sticks are but the best low carb treats for cats are freeze dried 100% meat ones, such as these on Zooplus UK https://www.zooplus.co.uk/shop/cats/cat_treats_catnip/cosma_cat_snacks/xxl/365593

If you question your vet, feel free to take your cat to another vet for a second opinion. Bring copies of your cat's medical records with you.
 
Wendy&Neko said:
330 is above the normal range for fructosamine, which tops out at 286: Reference Ranges for Fructosamine Test 21 (378) for blood glucose is really high for vet stress. Was that from the lab test or a blood test done by a meter at the vet clinic? Having both high fructosamine and high BG looks like diabetes, especially if also sugar in the pee.

In the chart Diane linked above, you want foods that are under 10% carbs for a diabetic. The Felix products are all what we consider low carb.
Definitely. If nothing else, cats that are hyperthyroid can be harder to regulate if diabetic too.

The following link has suggestions for blood sugar test kits: UK Diabetic Cat Food Info (includes some supplies). Doing some home testing will tell you whether she's diabetic if you stop giving insulin.

Stopping insulin will not cause pancreatitis, but if there is an infection or inflammation, she's not eating enough and no insulin then DKA can be a concern. Do the urine test strips you have also test for ketones?
Click to expand...
The blood tests are from a vein and I assume lab tests.

Yes the urine strips test for ketones. They have been negative so far. She is on antibiotics at the moment though. She had a convenia 14 day injection. I'm not happy about it because I've read the horror stories of convenia. You can't stop my vet he just gives her convenia before you can say anything. I'm considering leaving this vet as well because of the convenia injections. If it turns out she's diabetic and he won't give us the insulin then I might have to consider finding another vet but my partner thinks I'm crazy for changing vets all the time and thinks I'm just being difficult.
 
:bighug: Sometimes it takes switching around until you find a vet who you are comfortable working with. That's the most important thing. A good vet is one who listens to the client's concerns seriously and works with the client to come up with the best treatment plan. I switched vets way way back with Squishy. The first vet was ok but we didn't really "click". With a recommendation from a FDMB member at that time, we got a new vet who was awesome and pretty much let me take control of how I wanted Squishy's diabetes managed. I used the same vet when I got Leroy and civie Emma as kittens and he's still our vet today :D He knows I'm pretty well versed in basic veterinary medicine because of my job so he's comfortable letting me doing things he usually won't let other clients do. He once said his job was to just adjust medicine dosing and do bloodwork / diagnostics and he'll leave me to monitor the cats at home the way I want and to keep him updated.
 
CleoParker said:
I've studied the list and I think you're right. Lily's kitchen looks the best. I can easily buy that in pets at home and it's not too expensive. I've fed her gourmet and felix in the past but they all contain added sugars but lily's kitchen is no added sugar. She's been on the dry food from the beginning because they told me not to change her diet while taking insulin so I was scared to stop it incase it caused a hypo. Now she's been off the insulin for a week would it be worth switching to lily's kitchen and then having another fructosamine in a few weeks to see if her blood sugar has come down? Maybe getting a freestyle libre and monitoring her at home? Really think she'd benefit from cutting out the dry food completely.
Click to expand...
Tagging Suzanne
@Suzanne & Darcy
 
CleoParker said:
I often give her webbox sticks? Do you know if these are OK? I believe they have 85% protein.
Click to expand...
I'm not familiar with these but I did a search on our site and found this posted by a UK member about treats
LOW CARB CAT TREATS/REWARDS
Many of the most popular commercial cat treats are laden with carbohydrates. Avoid if possible. :stop:
Try to stick with treats that are entirely made from meat or fish. These are the lowest in carbohydrate.
Popular freeze dried treats include; Thrive, Pet Munchies, HiLife 100% meat, Wilko freeze dried treats, Orijen freeze dried treats, Iams 'naturally' pure meat treats. Also from Zooplus; Zoolove 'cat snacks', Cosma snackies (avoid the Cosma ‘Thai’ treats as these contain rice.), Wild Freedom lamb lung or chicken hearts (chicken hearts are a great source of taurine too!), Purizon cat snacks.

Another option is the semi-moist treats, often in stick form. These tend to be a bit higher in carbohydrate but should still be below 10% cals from carbs (often below 5%). Nature's Menu 95% meat treats, Waitrose 7 deli snack sticks, Tesco cat sticks, Asda tiger '6 Stix', Webbox 'tasty sticks'. And from Zooplus, Feringa meat/fish cat sticks, Feringa fish snacks, Tigeria cat sticks, Catessy cat sticks, Sanabelle tasty treats.

Little pieces of plainly cooked or raw meat, or cooked fish, also make good treats. And some cats like a tiny piece of cheese or a lick of plain unsweetened yoghurt.









 
CleoParker said:
The blood tests are from a vein and I assume lab tests.

Yes the urine strips test for ketones. They have been negative so far. She is on antibiotics at the moment though. She had a convenia 14 day injection. I'm not happy about it because I've read the horror stories of convenia. You can't stop my vet he just gives her convenia before you can say anything. I'm considering leaving this vet as well because of the convenia injections. If it turns out she's diabetic and he won't give us the insulin then I might have to consider finding another vet but my partner thinks I'm crazy for changing vets all the time and thinks I'm just being difficult.
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I have also left vets who just gave Convenia injections without telling me what they were doing! That is outrageous. This was a very old school vet who jist did things without asking or telling you what he was doing. It was a vet I used for foster kittens and cats, but no more.
 
CleoParker said:
Snap Spec Fpl
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Looks like they did what is called the Snap fPL test. It would be more accurate to get the Spec. fPL test which will be sent out to a laboratory and would take a few days to het results. However, I would not worry about this right now.
CleoParker said:
Now she's been off the insulin for a week would it be worth switching to lily's kitchen and then having another fructosamine in a few weeks to see if her blood sugar has come down? Maybe getting a freestyle libre and monitoring her at home? Really think she'd benefit from cutting out the dry food completely.
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You are right about benefitting from cutting out the dry food. If she’s not currently on insulin, you could do a transition to low carb wet food while monitoring her BG at home with a handheld monitor or a Libre. Keep the numbers in the spreadsheet. We can help you get one set up, if needed. Get a test in the morning before food and again in the evening before food. Also get a few tests during the day and evening if possible (it could take a while to get up to speed with testing at first— again, we can help with that.). This information will help us all to see if she needs insulin and what a safe starting dose would be.
 
@Larry and Kitties From the post on fructosamine levels that I linked:
PLEASE NOTE: IDEXX changed the reagents used in their fructosamine test in 2019. The above numbers are the old ranges. The new, reference range for non-diabetic cats is 137 - 286. They company indicates that you can subtract 40 from the old values to make the conversion.
Here is the page from Idexx: https://www.idexx.fi/fi/veterinary/...-and-feline-fructosamine-reference-intervals/

@CleoParker Larry was referencing the old ranges. Not all the websites have caught up. On the new Idexx ranges, your kitty's fructosamine was above the normal range.
 
Now that your kitty is not on insulin, it's a perfect time to try to switch her to an all low carb wet food diet and see if that makes the difference.
 
Diane Tyler's Mom said:
I'm not familiar with these but I did a search on our site and found this posted by a UK member about treats
LOW CARB CAT TREATS/REWARDS
Many of the most popular commercial cat treats are laden with carbohydrates. Avoid if possible. :stop:
Try to stick with treats that are entirely made from meat or fish. These are the lowest in carbohydrate.
Popular freeze dried treats include; Thrive, Pet Munchies, HiLife 100% meat, Wilko freeze dried treats, Orijen freeze dried treats, Iams 'naturally' pure meat treats. Also from Zooplus; Zoolove 'cat snacks', Cosma snackies (avoid the Cosma ‘Thai’ treats as these contain rice.), Wild Freedom lamb lung or chicken hearts (chicken hearts are a great source of taurine too!), Purizon cat snacks.

Another option is the semi-moist treats, often in stick form. These tend to be a bit higher in carbohydrate but should still be below 10% cals from carbs (often below 5%). Nature's Menu 95% meat treats, Waitrose 7 deli snack sticks, Tesco cat sticks, Asda tiger '6 Stix', Webbox 'tasty sticks'. And from Zooplus, Feringa meat/fish cat sticks, Feringa fish snacks, Tigeria cat sticks, Catessy cat sticks, Sanabelle tasty treats.

Little pieces of plainly cooked or raw meat, or cooked fish, also make good treats. And some cats like a tiny piece of cheese or a lick of plain unsweetened yoghurt.
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Yes thankyou, I found this too. She will be very happy she can still have her meaty webbox sticks she loves them.
 
*** UPDATE ***

So I saw my vet today. We were supposed to be doing a fructosamine test but he didn't do it and I'm really upset about it because I was finally going to get an idea on how she was doing off the insulin. He said it was useless doing it today and I need to wait another two weeks. Does this sound OK?

He weighed her and said she had lost 100g in the last week. Is that good?

He just did a glucose test with a hand held monitor. He said the glucose was 16 this time but 23 last time. I think you can have variation during the day so that doesn't tell me anything?

He said I had to keep her on the Purina DM but I've gone out and bought the low carb wet food that I think is better. She hasn't had any dry food yesterday or today. That might be why her sugar was down today.

He said he wants to keep her off the insulin to get her weight down because if we give her a chance to lose weight he thinks she might not need insulin. Does that sound right?

I'm worried he could be starving her body of what it needs though?

He said she's not insulin dependant.

He didn't ask about her symptoms just asked if she'd been sick? So I said no.

He says to bring her in if she stops eating. He was talking about ketoacidosis I think....surely it's life threatening by the time it gets to that?

Feeling very worried and stressed out and don't know if I should go along with what he says.

On the plus side her drinking and peeing does seem better recently.

I found out that a cats renal threshold is 16 (I think) so most vets like to keep the blood sugar under 16 to stop the excessive peeing. I'm assuming if she gets her blood sugar under 16 he won't prescribe insulin.

He mentioned they had another cat recently that they put on insulin that had a blood glucose of 14 but that cat was really skinny. I hope he's not going to wait until my cat is skin and bones before he gives her the insulin if she needs it.

Also he takes the blood out of her arm? Is that normal ?
 
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Tell the vet that she won't eat the DM (which she won't if you don't put it out for her). Plus many cats grow tired of the taste. You should be able to get your money back on unused product.
CleoParker said:
He said he wants to keep her off the insulin to get her weight down because if we give her a chance to lose weight he thinks she might not need insulin. Does that sound right?
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No. You don't keep a diabetic cat off of insulin so they'll lose some weight. That is just too risky in regards of DKA or ketoacidosis. You absolutely do not want to wait until close to DKA. That will cost you many thousands of dollars to treat and will put your girl at risk. If you do decide to do this, please test her daily for ketones. Ketones can go from trace to large really quickly, at which point they are life threatening.

You can put her on a diet to lose weight, but you want to do it safely.

Any chance you could find another vet to go to?
CleoParker said:
I found out that a cats renal threshold is 16 (I think) so most vets like to keep the blood sugar under 16 to stop the excessive peeing. I'm assuming if she gets her blood sugar under 16 he won't prescribe insulin.
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16 (288) was that measured on a pet meter or a human meter? We would tell anyone with a cat whose blood sugar is that high that they need to be on insulin. Normal blood sugar range is much lower.
 
CleoParker said:
He said he wants to keep her off the insulin to get her weight down because if we give her a chance to lose weight he thinks she might not need insulin. Does that sound right?
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I’m a bit horrified by this suggestion, although I guess I shouldn’t be completely surprised.

The risk of DKA would concern me, as does the fact that the cat won’t be able to properly metabolize food — so not exactly a healthy way to lose weight. Would a human doctor tell on overweight patient to hold off starting insulin injections so the diabetes has time to suck some weight off of them?? Yeesh. Also, the connection between weight and diabetes in cats might not be as strong as it is in humans (at least per my IM vets). Finally, it’s generally accepted that the best chance of remission in cats occurs when you diagnose and begin treatment quickly. The longer you wait, the more potential damage to the pancreas and less likelihood of remission.
 
My first instinct was to change vets because I was slightly horrified as well. I just wanted to see what people thought on here first. I got her to the vets last week to do a blood test and urine test to get more insulin because I felt she needed it. She's very stressed going to the vets and it's very stressful for me but I put her through it because I thought she was going to get the treatment she needed. He didn't give us insulin even though her sugar was 23 and sugar in the urine. He wanted to see us again after a week with her off the insulin and a fructosamine test. I thought, fair enough just to be extra cautious. I reluctantly agreed because I thought it would get things sorted. Now he's not done a fructosamine like he said he would and I have to anxiously wait another 2 weeks. Between this and the convenia injections I've practically had enough.

I've got another vets in mind I could go to but I'd have to start all over again. Is it possible to get a vet to diagnose diabetes in one visit and what do you need to do? I've shown she has high blood sugar, showed sugar in the urine and explained that she's drinking all the time and peeing all the time. I've asked for a fructosamine and not been given one. Not sure what else I can do.

I could anxiously wait another 2 weeks and hope and pray I get the promised fructosamine and insulin before she gets seriously ill? Or do I go to a new vets?
 
CleoParker said:
My first instinct was to change vets because I was slightly horrified as well. I just wanted to see what people thought on here first. I got her to the vets last week to do a blood test and urine test to get more insulin because I felt she needed it. She's very stressed going to the vets and it's very stressful for me but I put her through it because I thought she was going to get the treatment she needed. He didn't give us insulin even though her sugar was 23 and sugar in the urine. He wanted to see us again after a week with her off the insulin and a fructosamine test. I thought, fair enough just to be extra cautious. I reluctantly agreed because I thought it would get things sorted. Now he's not done a fructosamine like he said he would and I have to anxiously wait another 2 weeks. Between this and the convenia injections I've practically had enough.

I've got another vets in mind I could go to but I'd have to start all over again. Is it possible to get a vet to diagnose diabetes in one visit and what do you need to do? I've shown she has high blood sugar, showed sugar in the urine and explained that she's drinking all the time and peeing all the time. I've asked for a fructosamine and not been given one. Not sure what else I can do.

I could anxiously wait another 2 weeks and hope and pray I get the promised fructosamine and insulin before she gets seriously ill? Or do I go to a new vets?
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I think it’s dangerous to wait two weeks. That’s risky. Her BG is elevated. You should already have, or be able to obtain, all of the bet records from this current vet and take them with you to a new vet. Those records, including all bloodwork and test results, belong to you. You paid for them. So the bottom line is he won’t give you a prescription for insulin? This is all wrong.
 
Suzanne & Darcy said:
I think it’s dangerous to wait two weeks. That’s risky. Her BG is elevated. You should already have, or be able to obtain, all of the bet records from this current vet and take them with you to a new vet. Those records, including all bloodwork and test results, belong to you. You paid for them. So the bottom line is he won’t give you a prescription for insulin? This is all wrong.
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He must know it's dangerous because he said "make sure she eats plenty of food" and "if she's sick bring her in straight away" so he knows there's a risk of ketoacidosis. Surely the decision weather to take risks with my cats health should be my decision not his? I wanted the insulin a week ago. I've just had the worst week of my life worrying about it and now I have to worry for another two weeks? I can sort of see where he's coming from though. A fructosamine test looks at the average blood glucose over 2 to 3 weeks and she's only been off the insulin a week. A fructosamine probably wouldn't give an accurate reading if it's counting the week she was on insulin. I think he just wants to be absolutely sure before he prescribes anything. (Although his idea that most cats can be managed on diet alone sounds wrong to me)

(Last year she got pancreatitis, stopped eating and drinking and was hospitalised for 4 days and cost us £4000 so obviously I don't want to go through that again)

He didn't flat out say no to insulin I think he might prescribe it next time.

I think my plan is to just leave it a few days and let my cat recover from the stress and see how she does on her new food (she's on a wet food now, low carb).

If we go in next time and he still refuses to do a fructosamine test and doesn't prescribe the insulin I'll make an appointment with a new vet.
 
If you decide on taking your cat to a new vet, request all copies of your cat's medical records including bloodwork results. If possible, send the copies to the new vet ahead of the appointment to review. Based on what information is in the records, the new vet may or may not want to repeat bloodwork or other diagnostics. Some vets just aren't very good when it comes to certain health issues. You don't necessarily need a cat only vet or a specialist, just a vet who is willing to work with you and listens to you.

Blood can be taken from anywhere on the body really. Vets typically use a leg because that's easiest for them and their staff. For home blood glucose monitoring, it's easiest to use the edge of an ear. A few people may do paw pricks.
 
CleoParker said:
He must know it's dangerous because he said "make sure she eats plenty of food" and "if she's sick bring her in straight away" so he knows there's a risk of ketoacidosis. Surely the decision weather to take risks with my cats health should be my decision not his? I wanted the insulin a week ago. I've just had the worst week of my life worrying about it and now I have to worry for another two weeks? I can sort of see where he's coming from though. A fructosamine test looks at the average blood glucose over 2 to 3 weeks and she's only been off the insulin a week. A fructosamine probably wouldn't give an accurate reading if it's counting the week she was on insulin. I think he just wants to be absolutely sure before he prescribes anything. (Although his idea that most cats can be managed on diet alone sounds wrong to me)

(Last year she got pancreatitis, stopped eating and drinking and was hospitalised for 4 days and cost us £4000 so obviously I don't want to go through that again)

He didn't flat out say no to insulin I think he might prescribe it next time.

I think my plan is to just leave it a few days and let my cat recover from the stress and see how she does on her new food (she's on a wet food now, low carb).

If we go in next time and he still refuses to do a fructosamine test and doesn't prescribe the insulin I'll make an appointment with a new vet.
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True. But if you tested blood glucose at home with a meter (or have a Libre continuous glucose monitor put on) it would be very easy to see within a day or two whether insulin is necessary.
 
Suzanne & Darcy said:
True. But if you tested blood glucose at home with a meter (or have a Libre continuous glucose monitor put on) it would be very easy to see within a day or two whether insulin is necessary.
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Yes I agree. My current vet said he's never fitted a freestyle libre and would have to refer us to a very expensive specialist. I think I'll have to shop around for that one.

I do have an Alphatrak 2 I bought last year but getting a blood sample from her ear has been impossible.
 
CleoParker said:
Yes I agree. My current vet said he's never fitted a freestyle libre and would have to refer us to a very expensive specialist. I think I'll have to shop around for that one.

I do have an Alphatrak 2 I bought last year but getting a blood sample from her ear has been impossible.
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Impossible because she won’t let you?
 
Are you warming the ear before pricking? Warming the ear helps improve the blood flow. There are various ways to do this. The most popular method is by using a "rice sock": take a small old sock, fill with uncooked rice (uncooked dried peas or beans would work too), tie the sock closed, toss into the microwave and heat until comfortably warm for you to hold in your hand for a minute. Wrap the warm sock around the cat's ear for at least 30 seconds. If the cat flinches, the sock is probably too hot for comfort so remove the sock and try to prick. And make note to microwave the sock for less time so it's not so hot.

Are you using a lancet device? Have you adjusted the setting to find the one that works for your cat?
 
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