Feeling Duped By Vet; Advice Appreciated

Status
Not open for further replies.
S

StormyCat

New Member
Hi, I'm new to registering on the forum but I've been lurking on and off here for a few months.

I'll give a basic backstory on my diabetic cat - Stormy was a stray cat and probably close to death before the stubborn thing finally let humans get close enough to rescue him. After I adopted him, he's basically never been able to be satisfied with his food and has always been a complete glutton. I think that was probably a mostly psychological issue in his mind after being on the streets for so long without much food. Anyhow, I always feared he would become diabetic as he got heavier. I know I should've put him on a better diet before; I feel horrible about this. I've had him close to 5 years ago. Last December, he was very listless and urinating constantly. I took him to the vet and lo and behold, he was diagnosed as diabetic.

From things I've been reading on this site (which is a wealth of information; I'm so grateful this place exists!), it seems like my vet just isn't well informed. He told me my cat could be put on diabetic dry or canned food and that he had been eating the dry while at the vet's, so I purchased a bag of the dry food. Now I know dry food is not good at all for diabetics, which makes complete sense to me. He also put Stormy on the Humulin N insulin, which from reading some posts on here, seems like it's the worst of the insulins! :-x

Stormy did a little bit better after the initial diagnosis (probably just due to being some insulin in his body). However, he started to go downhill again about 2 months ago. He was urinating constantly and drinking oceans of water. He also was developing, IMO, neuropathy because one day I came home from work and he was limping one of his rear legs around. I did some research and found this site that day. That was how I found out that the dry food was not any good for him and I put him on the Hills W/D canned food.
Since then, the drinking and urinating have drastically been reduced; also the neuropathy went away.
What I'm mostly concerned about now is he's still dropping weight. I feel his rib cage and his vertebrae feels very prominent to me.

Having said all of that (whew, that was a mouthful, my apologies!), I basically just feel duped by my vet. It seems like everything he's said or done has been the wrong thing for my cat. I would appreciate any advice about how to get started the right away. Should I buy a blood glucose tester? The vet didn't even mention testing his actual blood. He just gave me some strips to collect his urine..which is near impossible! Should I try out a different brand of insulin?

A couple of things I should mention..my cat is eating 1/2 to 1/3 can twice a day of the Hills W/D canned food. Should I increase this? He acts ravenous all the time, but it doesn't seem to make a difference whether I give him 1/2 a can or only 1/3 of a can. He never used to beg for people food or jump on counters (well probably he was too fat before :lol: ), but he's out of control now. Should I switch to a different food?

He is currently receiving about 4.5 units twice a day. This seems pretty high. Should I try backing it down or keep it there?

Also, there are other cats in the household. However, I'm really good about separating him from the rest of the pack for mealtimes and he doesn't really mind.

One other thing..I have a little bit of experience with feline diabetes..My family had a diabetic cat about 15 years ago. I was pretty young so I didn't know tons about the regulation for food and whatnot, and obviously there's been research since then about the best theories on treating feline diabetes. She was regulated about 5-7 years I think. It seemed like she became unregulated after a family trip and died a few months later. She was pretty old too. This is pretty much how I figured my Storm had diabetes and why I dreaded that diagnosis that I knew was coming.

I'm soo sorry for blabbing away like this! I just wanted to get it all out and make sure I touched on everything pertinent. Any advice would be very much appreciated!!
 
OK, I understand your feeling about feeling duped. Think about it this way. Your vet is a general practitioner, he doesn't specialize in any one area and therefore, has a little bit of knowledge about many different things. Sadly, many vets don't understand diabetes and how food plays an important role in the process. And it is a process.

So, with that being said, here is what I write to newbies that I think you will find useful:


WELCOME, this forum is a great place to gain knowledge and really learn how to manage feline diabetes. By doing just a few things each day (that really won't take up much of your time at all), you won't need to worry about losing your precious cat, not where feline diabetes is concerned.

There are three key factors to managing diabetes: food/nutrition, home testing and insulin

1) Feline Nutrition: Now, as far as diet - definitely dump the dry food (if you are feeding any) and if the vet recommends purchasing prescription food like DM just say "no thank you". ALL cats, and especially those with diabetes, do best on a species appropriate diet that is high in protein and low in carbs. Dry food DOES NOT fit that bill and DM food, even canned, just really isn't that great as far as quality. Most here on FDMB feed low carb/high protein canned, raw bought from a pet store or they make there own.

Here great links, one is to a food chart put together by one of our board members that breaks down the carb % and protein % of most of the commercial brand foods. You want to keep the carb % below 10% and around 7% is great. The other link is to a site by a vet "Dr. Lisa DVM" ... who also posts on this board from time to time ... there is in-depth info. there about many things, including nutrition and how to make raw food.
Nutrition/food info

The good thing with feeding your diabetic cat this way, is that it is ALSO good for any non-diabetic cat too. All your cats can safely eat the same food without worry and it may save you some costs and headaches of having to do separate feedings and keeping track of what they are eating.


2. Home testing: It is impossible to convey the value of testing your cat's BG (blood glucose) level at home. Some vets will "suggest" this, but most won't even mention it. They will send you home with insulin and an amount to shoot and maybe some instructions about hypoglycemia (blood sugar dropping to a dangerously low level).

Well, the thing is, human diabetics don't EVER give themselves insulin without checking there BG to make sure it is safe to do so, so why shouldn't it be the same for our kitties. Here on FDMB it is. You will notice that the vast majority of people here test their cat's BG at least 2x/day (before giving each shot to make sure the level is safe enough) and periodically at other times to see how the cat is responding to the current dose. We use a human glucometer, test strips and lancets - which are all very readily available and easy to use.

Our kitties get lots of love and treats for "putting up" with this and most of them actually come out to be tested on their own 'cause they want those treats . Here is a collection of great links that "Carolyn and Spot" pulled together about hometesting. See what you think ... it truly is the best way to not only keep Your cat safe but also really get a handle on this disease and help him to live a healthy life with FD (feline diabetes).

Home testing Links

3. Insulin: There are several types of insulin available. Many people, myself included use Lantus or Levimer both of which are great insulins. They are gentle insulin and given twice (BID) per day in 12 hour increments. Or you could also choose PZI or the new version called Prozinc.

Please read up on the insulins available, here is a link to the Insulin Support Groups:

Insulin Support Groups

However, one caveat and again this shows how these three things are inter-related:

If you are feeding dry food or even a high carb food, BEFORE removing these foods, please make sure of your insulin dose as it will most likely need to be reduced, so as to avoid a possible hypoglycemic situation due to the removal of the dry/high carb foods that will lower the BG’s and reduce the amount of insulin required. Again, another reason why home testing is important.

I know this all seems like a lot, and that's because it is ... there is a learning curve here. But as long as you are determined and keep at it, you will have it down before you know it and you'll be seeing the results in Your cat' overall health and happiness. Ask all the questions you can think of - that's why we are here!

Also, let us know where you live - city/state as there are probably people in your area who can provide on the ground support and help you to learn home testing, etc.

So, how else can we help you.
 
Good for you to have done your own research! My theory is that vets have to treat everything from lizards to mice, so they can't be experts. All we do are diabetic cats and the protocol here has worked for hundreds of cats.

Hills is expensive and doesn't have particularly good ingredients. Lots of us feed Fancy Feast, Wellness, Friskies and Merrick. Some people feed raw. Whatever you can afford that your cat will eat.

Are you still using Humulin? Some cats have been regulated on it, but it is harsher and harder on the cat and parent. Can you afford other insulin? Would your vet be willing to give you Lantus, Levemir or ProZinc?

Yes, unregulated cats are literally starving, so you could feed a little more. Sometimes spreading out the meals into smaller portions helps. Some cats also like to have some warm water added to make it gravy-like.
 
W/D is the old school formula for diabetic cats and is now used for weight reduction. He isn't going to gain any weight while on W/D. Others have given you the info you need....just wanted to mention about W/D. Glad you posted.
 
Just a couple of things to add, but "HI" first!

Yes, Humulin is not an ideal choice for treating diabetes in cats. It works better on dogs who don't metabolize insulin as fast as cats do. It tends to cause steep and rapid drops in BG and won't usually last 12 hours.

And yes, the 4.5u twice a day is a very high dose! Especially with that insulin. The best thing to do is to get a glucometer, and begin testing his BG at home so that you can tell if the dose is too high for sure. I would think he would need less, but unless you can see his numbers, you won't know for certain.

Carl
 
Thanks for the great links everybody. I will look into purchasing a glucose tester. I desperately want to get my kitty regulated so he can live a long and healthy life.

My cat is strictly on the Hills W/D canned food. I cut the dry out completely; I should have made that clearer.
My other cats eat Fancy Feast Grilled selections.. So it would probably be ok for Storm to eat their food? The Hills food is running me about $36 for 24 cans, so...yeah, I'm shelling out big bucks for this once homeless cat. :lol: I will definitely try increasing his food. He 'looks' fairly normal, but I fear it's because of all the loose skin he has from the excess weight he lost. As I mentioned, I can feel his ribcage and vertebrae prominently and he has that sunken in look on his haunches.

I live in South Florida, so if anyone has any recommendations for any vets specializing in feline diabetes that aren't going to cost me my life's savings, I'd appreciate it ;)
I'm not sure if the vet would give me another prescription for a different brand of insulin. I'd have to talk to him about it. Gotta pump myself up so I don't sound like a know it all and tell him he's doing everything wrong :lol:
 
Where do you live in South Florida? Maybe put a new post that you are searching for a vet in __________, Florida. I was just recommended a good vet in Coral Springs. Let me know if you are near there.

It's best to do the testing of your cat's BG yourself. You can try to get the meter at Walmart, called ReliOn. It's pretty cheap, about $9. Then buy the strips (package of 50) which also need to be ReliOn.

Hope this link comes up on home testing your cat. http://www.sugarcats.net/sites/harry/earprick.html

Try to find a vet that knows about other insulins than the one your cat's on. I know, it's not easy, but maybe if you called around your area and just asked if the vet sees cats with diabetes and if they say yes, ask them what protocol and insulin they work with.
 
Fancy Feast grilled are a little too high in carbs for a diabetic, but you can feed FF Classic flavors which are all below 4-5% carbs instead. Word of caution though. Get the meter and start testing prior to doing a diet change. W/D is also pretty high in carbs (more than 20% I think), so switching to a low carb diet is going to lower the BG, possibly by a significant amount. You want to be able to know what the numbers are when you shoot the dose, and know for sure that it isn't too much if his BG is lowered by the better diet.

Carl
 
If you're looking to "placate" your vet re. food, I would give the wet Purina DM along with Friskies, Fancy Feast, etc. That's what I did, so that I wouldn't feel too rebellious against my vet, lol. But, pretty soon Lily got tired of the DM, and now she's solely on Friskies. And she's doing really well!
 
Hopefully someone in Florida can recommend a good vet for you. A cats only vet would be best if you can find one as they would also be more familiar with feline medicine generally. The increased appetite/weight loss could be a symptom of high blood hlucose levels but it could also be a symptom of hyperthyroidism which is common in older cats. Once you find a good vet I'd recommend getting a set of labs that includes the thyroid level.
 
One important thing to note is that even some canned foods are not good for diabetic cats. Diabetic cats need less than 10% carbs in their diet. The ONLY prescription food sold that is good for a diabetic cat (3% carbs) is Purina DM canned. Hills W/D canned is 26% carbs, which is still way too high for a diabetic. There are also foods that diabetic cats should avoid, just like human diabetics need to avoid sugars. These are Corn, Rice, Wheat, and Soy. If you look at the first two ingredients in W/D canned, it's Brewer's Rice and Corn Gluten Meal. These are not appropriate ingredients for any cat food.

There are many, many commercial foods that are less than 10% carbs and a good diet for a diabetic cat. There are options in different price ranges, so you want to pick the best food you can afford. Check out the cat food nutrition charts and just pick something with a low amount of carbs: http://felinediabetes.com/diabetic-cat-diets.htm.

One very popular mid-grade food with diabetic cat owners are the grain-free, diabetic safe flavors of Fancy Feast: http://felinediabetes.com/glutenfree.htm.

However, it's very important to remember that switching to a low carb diet can lower blood glucose levels by 100-300 points, so make sure you are lowering the amount of insulin as you change the diet. Most cats on a low carb, canned diet do not need much more than 1u of insulin.

I agree wholeheartedly with the others that home testing and switching insulins asap is your best bet. And your cat can still recover fully! A friend of mine got in touch with me in November because her vet had her on the same treatment your does--5u of Humulin-N, no home testing, and a high carb, diet for 4+ months. Sydney (her cat) had neuropathy so bad he couldn't walk more than 5 steps and had to pee on a puppy pad in the middle of her floor. I taught her how to home test, had her switch him to Lantus and a low carb, canned diet (she feeds Grreat Choice low carb flavors from Petsmart and Fancy Feast), and she started him on Methyl-B12 supplements. Today, Sydney has regained near full mobility, runs around her house like a kitten (and is back to only using his litterbox), and is now on day 4 of his off-insulin trial! It's never too late to start the right treatment.
 
SAFETY NOTE

To reiterate what Carl said - Do not make food changes until you are testing

Changing to low carb canned food may drop the glucose levels 100 points. It you are not testing, you will not know if it is safe to give insulin.

You mentioned attempting urine testing. Please see the Secondary Monitoring Tools link in my signature for some ideas to help test for ketones. High levels of ketones can occur in diabetic ketoacidosis, which is extremely expensive to treat (I've seen values from $2,000 -$4,000 due to hospitalization) and potentially fatal.
 
Welcome!

Please know that you can take any prescription (junk!) food back to the vet for a refund. The vet will get a full refund from Purina or (more likely, as I've seen written here, feed it to the other hospitalized pets). Just say that your cat absolutely refuses to eat it.

I accept no excuses for a vet's lack of knowledge. I don't know if vets have some sort of oath of doing no harm, but if they excuse the harm they do by the scope of knowledge they need, they need to specialize or hit the books, veterinary journals, continuing education, etc. Sign me "a crotchety 70-year-old."

:-D :-D :-D The smiles stand for my 3 kitties who are much healthier due to this forum and not the vet they've been seeing for some 10 years. My sweet Pudge is off insulin all due to this forum. My vet's recommendation of 4 units of ProZinc 2X a day and no mention of testing except see you in a week for a curve, then see you in two weeks, would probably have killed him. I simply find no excuses for such practice of veterinary medicine. I'm not going to say anything about my own ignorance, as I find it even harder to tolerate. I totally empathize with your situation.

Welcome again and sending healing vibes to your Stormy,

Sophie
 
Welcome, I know that the process of learning all the diabetic info is challenging at first. I found out my Little Bear was diabetic because he dropped half his body weight, ruined an entire room of carpet because the neruopathy in his hind legs wouldn't allow him to get into the litterbox, and because he would go through liters of water a day.

We have been through a few insulin's. I've found that sometimes it takes trying different ones. The first thing we did was start home testing. The vet I had wasn't very supportive but I found that (as others have said) he didn't have an expansive knowledge about feline diabetes. He is after all the general practitioner. Once I was doing home testing it became evident that the insulin we had him on wasn't working. Just tell the vet that and ask for a different insulin. You can request by name. I found that the more I learned about feline diabetes the more relieved my vet seemed to get because he didn't "need" to do the research. I've started using a new vet now who works with me and knows a little more about diabetes.

Once I was home testing and using an insulin that Little Bear reacted to I switched to making my own food. I feed him raw. Because we have two cats we made it easy on ourselves and put them both on a raw diet and twice a day feedings. It was just easier this way and it means that there is no issue if Little Bear gets "into" the other ones food.

Just a few things we did that we found really helpful.
 
Status
Not open for further replies.
Back
Top