Greetings from Romeo and his Spazzy Mommy

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Alpandia

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Hello! My name is Stacy and my 8 year old, Romeo, was just diagnosed with diabetes this past weekend. The vet was awesome about it - when I took Romeo in for what I thought was going to be fixing a bad cut on his leg making him walk weird, the vet knew right away that it would be diabetes before he ordered the blood tests.

Blood work is covered under my insurance (I go to Banfield, and tons of stuff are covered on Romeo's plan), though we did also do x-rays just in case. His glucose was off.... the.... charts.... It was very very high. The vet prescribed him 2cc of Insulin Glargine once a day, and switched him over to their prescription dry food (Royal Canin's Diabetic DS 44). He gets that twice a day (splitting up the food seems to work for him) with wet food at night. I have three cats, and tend to split one can of wet between them as a treat.

He's still got the odd gait to his walk, but the weird smell to his breath has gone away. Yeah, he no longer smells like he gargles with mommy's nailpolish remover.

I am sure I do not have to tell you how completely freaked out this has made me. He's my baby. I'm already stressing from an upcoming Black Belt test, which now I have to coordinate his care while I'm away for the weekend with a friend who I have to train to give the shots I only just figured out how to give. Oy.

I've been reading a back-and-forth on the internets about dry vs. wet. I know there's probably a zillion threads on here with the same discussions, and if someone could point me out to them, that would be great. Also, any recommendations for wet food (I saw a reference to a list, but cannot find it) would really be helpful.

We are going back on Monday to re-test his glucose which hopefully will come down from the near 500 level where it was when he tested on Saturday. The doctor has not spoken to me about testing his blood sugar at home, nor did we discuss feeding vs. not feeding before injection. I've been giving him dry food for breakfast while waiting for the insulin to come to room temperature, and then giving him the shot after he eats. He seems to be okay with this, but I wasn't sure if that was right.

Also, will my baby walk normally again? I think that's part of the whole thing that's freaking me out... it makes me ache to see him not able to walk normally and jump where he wants to get.

Thanks for being here, and for listening to me ramble!
 
Hi Stacy (much nicer name than "spazzy mommy")! and Romeo
Just a couple things -
The odd gait is most likely neuropathy, and as his condidtion improves, so will that.
The "nail polish" smell to his breath. Most likely "ketones". Did the vet say anything about Ketoaciadosis?
The food - click on the link in my signature and it will take you to a page full of nutrition links. On that page you will find links to two "canned food lists" (old and new). Look over both of them. The best diet for sugarcats is an all-wet low-carb canned diet. The column on the charts you want to pay attention to most is the "carbs" percentage. You will want to feed Romeo foods with a carb content of under 10% (under 7% is even better). Many foods you can buy at the grocery store, but others on the list would be found in petsmart or petco for instance.
Definitey consider home-testing strongly. It is the best way to always know what Romeo's BG level is. That matters because his insulin should be based on where he is at BG-wise. Weekly tests at the vet (which would read "higher" than normal due to stress are not a reliable method of determining Romeo's BG.
You should also see if you can pick up some Ketostix (for urine ketone testing) to make sure that Romeo has no ketones.
Lots of others will be along shortly (this is an amazing community!) to advise as well, but I just wanted to give you a couple of things to read and consider while waiting for others to chime in.
Again, welcome to the board. This is the best place you could have found for learning about and treating Feline Diabetes.
Carl and Bob in SC
 
Stacy,
There are a couple other things from your post....
Glargine (or Lantus) is a long-lasting insulin BUT the vet should have told you to dose twice a day, 12 hours apart. Not once a day. If he told you 2 units once a day, it would probably be better to shoot 1 unit twice a day. Please ask you vet about this.
There will be lots of information to absorb, but just take it a day at a time. Learning to home test or shoot inuslin is a pretty short learning curve. It might freak you out the first couple of times, but a couple weeks from now, you'll wonder what exactly it was you were worried about . :smile:
I understand (we ALL do) how you feel right now. We've all been at one time in your shoes. I know I was. That was in May. In July, my Bob got his last insulin shot, and now he's a diet controlled diabetic. Every cat is different, but diabetes doesn't doom Romeo. Even if you have to treat him for the rest of his life, he can still live many years and be happy and healthy other than he might need insulin injections.
The sense of being overwhelmed will pass. In a couple months, it'll be you greeting new members and passing on what you have learned and experienced.
Just take a few deep breaths and realize it is all going to be okay!

Carl in SC
 
Hi Stacy!

Carl gave you some good advice. Dry food, even the prescription stuff, is bad for diabetic cats because of the high carb content. Diabetics need low carb canned diets, or it can be incredibly difficult to regulate them. Some cats even go into remission once the dry food has been removed.

The nail polish remover smell on your cat's breath were most likely ketones. Diabetic Ketoacidosis is a very serious condition that can develop from high blood sugar, and I would urge you to pick up some ketostix at your local pharmacy and test for ketones.

As Carl mentioned, the only safe way to administer insulin to your cat is to home test. Lantus (glargine) particularly needs daily monitoring to make dose adjustments. Another potential roadblock I see is that your vet only prescribed 2u once a day--while this works with dogs, cats need insulin twice a day (every 12 hours) because they have much faster metabolisms than dogs or people.

I'm attaching an article that outlines the proper treatment and dosing for Lantus. I would urge you to print it out and give it to your vet. The major steps to regulation outlined are having your cat on a low carb canned diet and dose adjustments made via home testing. 80+% of cats go into remission when these guidelines are followed.

I hope you keep posting and asking questions! This site is a wonderful source of knowledge for diabetic cat owners.
 
Hi and welcome,

Carl mentioned that your kitty problem had ketones and I think he's right, that smell is how many of us first detect it, that and often high blood sugar numbers. It's very important that you do hometest and I would also encourage you to test the urine for ketones often using the ketostix that he mentioned. You can pick them up at any drugstore.

I would break the dose down to 1 Unit two times per day instead of the 2U once per day. Insulin is measured in units, not cc, so I don't want to confuse you, hopefully what you have are U-100 syringes with the orange cap for insulin injections. Cats metabolize insulin faster than humans, so BID (twice per day) is the recommended way to give insulin.

Others who have more experience with Lantus can explain that better than I can :) I do agree that the neuropathy will probably get better with the insulin, but you can also add MethylB12, that helps as well. For my Misty when I adopted her she had it, we went with just insulin regulation and she did great, but many others do well with the MethylB12 addition.

Glad that you are here and looking forward to learning more about you and Romeo.
 
Just bumping to ask if your kitty is OK. Did the vet talk to you about ketones at all during his appointment, or is this thread the first you are hearing of it? I don't want to be overdramatic, but the way my vet put it when Saima was first diagnosed was that they had to make absolutely sure she didn't have diabetic ketoacidosis, because this is a very serious condition and the cat can do very poorly or even die. I was totally inexperienced with diabetes and had no idea this was a possibility. As others have said, acetone is a ketone and that's what nail polish remover is made of, so it seems likely that this is what you were smelling on his breath.

It may be tricky to get the urine sample (some folks hold out a ladle or something to catch the urine; others put aquarium gravel or something else non-absorbent in the litter box, or cover part of the litter with saran wrap so the urine will pool) but the test strip itself is very easy to use and not all that expensive. At my local CVS you can just pick them up off the shelf where the diabetic supplies are, or at other pharmacies you may have to ask the pharmacist for them, but you don't need a prescription. I hope someone else will correct me if I am wrong, but my understanding is that if you do detect ketones in his urine, this is an emergency situation and he would need to go back in to the vet immediately.
 
Alpandia said:
The vet prescribed him 2cc of Insulin Glargine once a day, and switched him over to their prescription dry food (Royal Canin's Diabetic DS 44).
Click to expand...

Others have pointed out that the prescription dry is not low carb. Another problem is that diabetic cats have hydration problems. They do a lot of drinking and peeing. Wet food adds moisture to the diet; dry does not.

The Royal Canin website gives the following nutrition information for its Royal Canin's Diabetic DS 44:

Metabolizable Energy: Dry
Kcal per kg diet 3756
Grams per 8 oz cup 69
Kcal per cup 258
% ME Protein 48.3
% ME Fat 28.6
% ME Carbohydrate 23.1

Lana
 
saimasmom said:
. I hope someone else will correct me if I am wrong, but my understanding is that if you do detect ketones in his urine, this is an emergency situation and he would need to go back in to the vet immediately.
Click to expand...

No, you're absolutely right. If you get trace ketone readings, don't worry unless you get them two days in a row. Anything higher (or trace twice) is an emergency that needs to be taken care of ASAP.
 
hello! If you have a Wal-Mart nearby, go and grab a Relio Micro meter. The test strips are sold at the pharmacy counter $20 for 50 (meter is like $9). You don't need alot of blood to get a reading, so I have found this tool to be a god-send. My mom works for mcKession and could have gotten me something, but this meter was the most economical for me.

Lantus needs the 2x per day dose. I have Cedric's sheet below in my signature. he was on lantus. The highest he got was 2.5 u twice per day. Note he was eating 1 3oz can of any kind of fancy feast I chose for him plus 1/2 cup of blue Buffalo weight management (which did nothing for his 18 lbs BTW). He ate 2x per day. I switched him to canned grain free, high protein low carb plus the same type of dry (BB Wilderness). the nice folks here finally convinced me to take him off the dry 9after first cutting back) and he had his last dry on 5/19 - note the drop of BG #. Two days later they were normal and he hasn't had insulin since 5/21. he now eats only canned food and gets 4 smaller meals per day. The stray I just rescued will be eating the same food, whihc I hope will improve his coat. Cedric's coat is beautiful.

I work 7 days a week, so I bought the Cat mate C20 autofeeder. It has an ice pack for the bottom of it, and I put 1 refridgerated portion and one frozen portion (it has 2 sections that pop up) and he gets fed at 6am (by me) between 10-11am and 3-4 pm by the feeder, then around 8pm by me. I am hoping to get the stray (his name is Dallas and I should stop calling him "the stray") into the same schedule, when he stops inhaling his food.... :lol:

this is really managable. I have a friend who has 2 cats and probably another one of their 4 that have CRF. If they can take care of their brood (plus my friend has developed dimentia at the age of 58) people like you and me can handle FD. chin up, you are doing great, have found a great site and a great group here!
 
First off, thanks so much everyone for taking the time to respond. I'm not always the best at dealing with BIG news (so it's not even that it's "bad" so much that it's changing - you should've seen me when I found out I got my house - I think I cried for 2 days lol).

Re: Ketones: I didn't realize it was a symptom associated with the diabetes until I started researching feline diabetes, so I didn't mention it to the vet at the time. I really thought he had just had an odd reaction to maybe a cleaner (he seemed fine, but for the breath) or was something to do with my well water causing it. When I called just now to confirm that the dosage they gave me was what I was giving (2units once a day) I asked about the breath, and I will follow-up on Monday with the vet about it again, as the urse on the phone didn't say that, given this information, I should bring him in immediately (which is what I asked.... though again, the breath has gotten to the point where I can smell his cat food and that's it).

Re: Home Testing: This looks so very daunting to me. Romeo doesn't tolerate much in the way of foot touching, which is why I look like a cutter the last few weeks trying to clean off his back paws. And that's the way I've see videos do it for home testing. Is there another way? I can't stand to hurt my kid :( At the very least, I'd need someone standing by to stitch me up.

Re: Ketostix: Do I have to keep them in the urine stream, or can I just scope out the litter box after he goes? With three cats, it's hard to get urine or stool samples and know for sure it's that cat, unless I'm stalking them, which tends to make them not want to pee at all.

Re: Latus Shots: I just called and double-checked with the vet who confirms he prescribed one dose every 24 hours, 2units each time (sorry I said cc's, so new to this and I don't have the script in front of me). I'm guessing that this is at least until Monday when we have our check-up, and redo of the blood draw. Does this really last only 28 days once you start using it? Seems like I'm not going to go through all of this in a month, and this stuff is expensive. But yes, they are the orange capped syringes.

Re: Neuropathy: Is the MethylB12 a pill? Another injection?

Re: Wet vs Dry: Thank you all! I had read the concern for wet is the teeth degrading. I have another cat who is on a special dry-food for her UTI-prone self, but we haven't had an issue since December on her front and that was the first time EVER She had that issue. I would much prefer the wet-to-dry, and I think the cats liked it better, too.

Carl & Bob, thanks so much for the link to foods! I will definitely be using this as a guideline for shopping!

Julia, thanks for the paper on Glargine! I'll be bringing this with me on Monday for our follow-up.

Lana, thank you for looking up the carb levels for the dry food. YIKES!

Again, thank you all. It's really great to know there's so many folks out there who know more about this than me. :) I'm trying to take it one day at a time with the research - there's just so much of it!

And Doombuggy, I love your name. That was the name of my Beetle (may she rest in piece, damned car accident) I even had a license plate that said DoomBuggy from WDW :)
 
Hi & Welcome....this is the best place to be for kitties with Diabetes.

I won't repeat all the info you have received.....but I will answer your comment about hometesting. You don't have to use a paw, in fact, most people don't. I would lose an arm if I tried to test using one of Zoe's paws. Most people poke along the edge of an ear....between the vein and the edge. Simple to do (really!). I have a very fractious cat....who I thought there was no way i would ever be able to home test....she purrs, thru each ear pokie and will run to her testing spot when its time to test. Amazed me....but then I found out this is pretty normal, once the kitty gets adjusted to testing.

Here are a bunch of links to hometesting....it really isn't difficult, I promise!

HomeTesting Links

Love the name Romeo......my kitty before Zoe was Romeo....all black with a few white hairs on his chest.
 
Thanks for the info, Sherry! I'll be talking to the vet about doing home testing for his BG (is that the right acronym?) as well as switching to a more low-carb wet food diet, and how that is going to impact the levels and perhaps need for insulin.

Romeo got his name quite by accident - while waiting in the lobby at the Target or Walmart for my ex to come out with all the cat-gear the day we bought him, he was curled up and loving on me and would take pets from anyone who came by. Some lady commented that he was quite the Romeo with a gaggle of ladies surrounding him giving him pets and the name stuck. He's all black with two white toes on each of his front paws. In fact, all my cats are black (not by conscious decision but by fate). My littlest, Spooky, is all black except for her "SuperGirl" crest on her chest :).
 
Stacy, I have a few answers to some of your newer questions:

Your vet is unfortunately mistaken in prescribing it only once a day. Here is a link to the study that shows it needs to be administered TWICE daily: http://www.sciencedirect.com/science/article/pii/S1098612X08001563. It's also mentioned in the article I provided earlier.

It's a myth that dry food helps cats' teeth. Their teeth are maintained by regular dentals and genetics, just like people. Both of my cats ate dry for most of their lives and they both had to have nearly all of their teeth pulled, before the switch to canned food. Look at it like your own teeth--do you keep them healthy by brushing regularly and visiting the dentist, or do you eat crunchy cookies all day long? It's the same with cats.

And please don't be scared of home testing. It's only hard the first few times you do it, and it doesn't hurt the cat. The large majority of even difficult cats end up tolerating it if you give treats after every test. My Bandit fights me tooth and nail just to brush him (you don't even want to know what baths are like!), and he fought me testing in the beginning, too. I had to wrap him up in a blanket. Today, he comes running to me when he hears the glucometer beep on and lies down patiently and purrs while I test him. Nearly everyone here has a similar story!

It's worth the difficulty in the beginning to keep your cat safe and dose correctly! It's very, very hard to get a cat regulated without testing. On the other hand, most newly diagnosed cats (84%) who are dosed according to the Lantus protocol via home testing go into diet controlled remission (no insulin!). And if that payoff isn't worth it to you, also think about how much money you'll save on vet testing. If you're home testing, the only time he needs to go to the vet is for his regular checkups, or he's sick in some other way. Apart from his initial diagnosis and a needed dental, Bandit never once went to the vet the entire time he was on insulin. He's in remission, now, and is a normal, healthy cat.
 
Regarding the ketones, I totally feel your pain on the difficulty of getting a urine sample. The ladle method would never have worked for Saima, no way no how. I'm thinking that what you might want to do is shut him in a room alone with a tray of some kind of non-absorbent litter (it wouldn't have to be much, or a very large box, depending on how fussy he is about his litter box), and then you can go in after a while and test, and you will know for sure that it's his urine. My vet gave me a kit of special "pellets" to use for this purpose at one point, but I'm pretty sure they were just aquarium gravel.
 
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