Welcome to FDMB.
I'm so sorry you're going through this. I truly wish I could say your vet is an outlier but we do hear about many vets who are not well trained when it comes to managing feline diabetes. I'm linking the
diabetes treatment guidelines from the American Animal Hospital Assn for you and please feel free to discuss the information with your vet.
The AAHA points out that Vetsulin is not a good insulin for managing feline diabetes. It was developed to treat dogs. (Its name outside of the US is Caninsulin.) As a result, it is too short acting given a cat's fast metabolism. Since 2018, the AAHA has recommended either Prozinc or glargine (Lantus) for the treatment of feline diabetes. These are gentler, longer acting types of insulin. Unfortunately, if your vet is not familiar with using Vetsulin, it's likely that the vet won't be familiar with either Prozinc or Lantus.
I am concerned about the vet raising your cat's dose to 4u of Vetsulin. That's a large dose especially if you are not home testing. Vetsulin can drop numbers hard and fast. I suspect that you've not had issues with your cat developing hypoglycemia because what you're feeding your kitty is a high carbohydrate food. Also, I suspect your vet did not tell you that you need to feed your cat 30 min prior to giving a shot. You need to have food on board prior to giving a dose of Vetsulin. Just so you have more information, this a link to our
beginner's guide to Vetsulin.
The high numbers you've been seeing are likely the result of the DM food. It sounds like you are feeding your cat the DM kibble. It's ridiculously high in carbohydrates (and has no business being a "diabetic" food). In essence, using DM is like feeding your diabetic child a diet of cookies, candy, and ice cream. Hopefully, the variety of Fancy Feast you've selected is lower in carbs. We consider low carb as under 10% and many cats here are fed a diet that is around 5% carb. This is a link to a
food chart that was compiled by a vet who is knowledgeable about
feline nutrition. Most dry food is high in carbs and fundamentally isn't a species appropriate diet for cats. Cats are obligate carnivores and can't adequately metabolize carbohydrates. A canned food diet is better for their health. The chart lists most of canned foods available in the US along with information on the carb percents. You have lots of choices! Just take your time transitioning your kitty to a canned food diet.
It is typical of a diabetic to be hungry all of the time. Until the diabetes is better controlled, your cat will be ravenous. The reason is that insulin helps to transport glucose from the blood stream into the cells. With diabetes, your cat's pancreas isn't manufacturing enough insulin to get the glucose where it needs to go. As a result, it's still floating around in the blood and when you test, you get high blood glucose numbers. If the end product of metabolism (i.e., glucose) isn't getting into the cells, your cat will be hungry and likely will be losing weight. For now and until you're seeing better numbers, feed your cat!
I've never heard of a cat needing to be sedated to have a Libre installed. Unless your cat gets aggressive at the vet's office, that's an unreasonable suggestion. Even for the members here who use a Libre, we strongly suggest that you learn how to home test. The Libre is not foolproof (i.e., the sensor stops working, your cat removes it, it tends to read inaccurately at lower numbers) so having a backup is important. Many of the members here use the Walmart Relion glucometer but any human meter is fine. People like the Relion because the strips are the least expensive around. We can provide you with resources on home testing.
If you're not comfortable with your vet's management of your cat's diabetes, you may want to consider looking for a new vet especially if you discuss your cat's treatment with your current vet and you get push back. Some vets are willing to learn vs taking the "my way or the highway" approach. There may be a "cat only" clinic in your area. There is a professional veterinary association for cat friendly practices. We have information on interviewing vets. When I moved to a new city, I scheduled an appointment to meet with a new vet -- without bringing my cat -- to discuss her philosophy for treating diabetes and how she would work with me. I wanted to see the clinic -- make sure it was calm and clean -- and I definitely wanted to meet the vet before entrusting my cat to her care.
and many you can’t. But we kept at it and slowly but surely our skill set has improved. Do I have anxiety still that I don’t have a clue and my cat will suffer from it—yes, but the advice and support here has made a huge difference. you are not alone.