Hello all & Unsure what's happening

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kmc

Member Since 2023
Hi all,

We have found this website and forum to be very useful with great information, thankyou.

Hoping we can get some advice with others who may have had the same or similar experiences as our vets seem to be getting a bit confused and going to specialists.

Basically up until March we didn't have any concerns.
Then in April she started to pee outside the litter tray and we bought some test strips that suggested high glucose so took a urine sample in to the vets and they suggested stress which we put down to another cat coming in the garden.
Early May she didn't eat all day or drink and seemed to be unwell so we took her in. They did a blood panel and told us she had diabetes and gave us Prozinc etc. They said it was odd as her blood glucose was high but her fructosamine was perfectly normal so thought it had just started to come on (she's just turned 13).
The next day she still didn't seem right so took her back. They did an ultrasound this time and found inflammation. She went on a drip and was hospitalized for 4 days on an IV etc. For Triaditis.
After that we focussed on the insulin and suggested 1 unit up from the half initially. We had trouble at the start, days were missed etc as she was difficult with the injections but has got better now. We were given dry diabetic food and have supplemented it with high protein wet food and Webbox sticks as a treat instead of dreamies.
The fructosamine in May was around 300. Then in June it was 197 and now it's 186. The blood glucose was 17 today but last time in June it was 12.
We thought she was going into remission so aiming to reduce and stop the insulin but when we took her off she seemed to be more hungry and thirsty.
Also confusing is her weight in May was about 6.5kg and has stayed above 6kg since but has dropped to some extent after she was ill.
What concerned us in the last few weeks was an advent of diarrhoea. Well it was more softer stools but then once or twice it was more squirty and liquid but then it seemed to go back to normal. The vet suggested checking for pancreatitis again but thought it seems ok as she's normal again. We were given Lypex after she was ill in May but she didn't really take it and she had normal faeces at that time. To thicken up her droppings we tried pumpkin and the Lypex again but she seems to have settled. She also had Stronghold Plus to treat any possible parasites too. The vets also suggested possible tapeworms.
We had difficulty with lancing using an Alpha Trak we purchased (which our vet suggested isn't even accurate) and the vet has been suggesting a Freestyle Libre instead.
We have been using urine test strips and the sugar has been high on those too the last week or two. She's on 1 unit in the morning and half a unit in the evening at the moment. She seems normal, bright eyed, enjoys going out in the garden etc and jumping up on the settee etc. She was never one for running around and playing but does show interest in things.
We're confused as to how much insulin to give and the vets are consulting a specialist. I'd be really interested for any advice as we don't know what's going on and the vet says she's a complex cat.
 
Welcome. Waving from Canada.Urine test strips do not give a good indication of glucose. The Alpha Trak is a good meter but strips are expensive. The Libre is hard to keep on the cat. Human meters also work just fine. Bumping your post up to the top.
 
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Welcome and a few things to note, as Red said the urine test strips don’t tell you much. It’s really recommended that you home test. You don’t have to use the alphatrack, most of use use Walmarts ReliOn. Also, the dry food is too high carb for a diabetic cat. Unfortunately most vets do not know a lot about feline diabetes….they have many animals to look after and they all have different diseases and treatments. Vets also get their information about nutrition from the big cat food manufacturers so they are biased in what they recommend. A dry high carb diet is not good for any cat, especially a diabetic cat. That’s like feeding your diabetic child a diet of chips, ice cream and sweets.

With a diabetic cat you need:
  • A low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs
  • A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
  • We recommend hometesting the blood glucose with a human meter…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.
  • HELP US HELP YOU has information about the spreadsheet, signature and hypo box which you will need to be able to look after your beloved kitty properly
A word of warning though…don’t change the food you are feeding at the moment over to the low carb food until you are testing the blood glucose because a change over can drop the BGs by up to 100 points and we don’t want you to have a hypo on your hands.

We are happy to help you with setting up the spreadsheet, sorting out what food to buy, how to transition safely to a low carb diet, how to learn to home test and much more.

FOOD CHART have a look on this chart and choose foods that are under 10%. You will also need some higher carb foods for that hypo box..information in the help us help you link.

This is an excellent site for diabetic cats…it has been around for more than 25 years and has very experienced people to help you.

Keep asking lots of questions and in the meantime tagging a few folks to see what they think about the other symptoms @Sienne and Gabby (GA) @Bron and Sheba (GA)
 
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Excellent, thanks both. Very useful information.

What we're unsure of at the moment is why the fructosamine seems low or normal when the blood glucose is quite high. Apparently our vets don't do glucose curves for cats.

Is 186 on the fructosamine too low?

We'll do some further checks on the food situation.
 
Fructosamine is a 3-week average so the daily being higher doesn’t surprise me. For a newly diagnosed cat, I think 186 is pretty good, but I’d worry she’s dipping too low often and that’s why the average is on the low side. I’d really encourage you to start home testing to see how low the dose is taking her in a 12-hour cycle. You would also then be able to do the curves every 2 weeks at home. It’s much better for your cat since there’s no stress involved and you’re getting the true bg number. I’m not familiar with pet meter numbers but when you say the bg was 17 today, what do mean? At what time was that taken? We recommend you test at least before each insulin shot to see if it’s safe to give insulin and then twice more, once more per 12-hour cycle. Take a look at either one of my cat’s spreadsheets I have linked in my signature and you’ll see how much bg fluctuation there is in just one day. We dose by the lowest they go in a cycle not the preshot values like most vets do. We also do dose adjustments by 1/4 or 1/2 unit depending. If you can set up your signature and spreadsheet with the numbers you do already have, it would be helpful for members to see.
 
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@Ale & Bobo & Minnie (GA) - 186 on a fructosamine test is normal for a nondiabetic cat. The ranges for a fructosamine test are not calibrated like blood glucose. See this link on fructosamine reference ranges.

The change in your cat's fructosamine from May to June is a big change. These numbers typically do not change quite as drastically as your cat's numbers have shifted. It makes me wonder if it was a bad test. Blood samples and labs can, on a rare occasion, make mistakes or there can be an issue with the sample.

I would rely more on a blood glucose test you do at home. I have no idea why your vet would tell you that the Alpha Track is unreliable. It's good meter. The only downside is, as Ale mentioned, the strips are quite pricey. Any human meter is fine. Many people here use the Walmart Relion brand meter because the strips are inexpensive.

It would help to be able to see your cat's blood glucose numbers over the course of a few days. I would not rely on urine glucose testing. It is not a reliable means of testing for diabetes. Blood glucose is the accepted means of testing.
 
Thanks both, I'll discuss it with my other half who does the injections and manages it. I think there has been trouble with lancing her ear so we might need to get a new lancing device. Apparently the cat gives a look of "why are you doing this to me?" That makes the ear lancing difficult. They have it easy at the vets as she just flumps on the table and doesn't move, different when trying to get hold of her at home I think that's something we'll need to work on now we have got the insulin injection routine sorted. She doesn't seem to show any signs of hypo or anything. Will see if we can sort the testing.

Sorry I think being in the UK some of the values for blood glucose and fructosamine may be measured differently possibly causing confusion. I believe it's 17 in mmol?
 
I didn’t know that, thank you @Sienne and Gabby (GA) but now that I’m doing the math in my head ir seems obvious :banghead: what do you think about him transitioning away from the dry food? Btw @kmc can you please tell us what brand dry food you’re feeding her?

Just want to add that Minnie had IBD, diabetes, asthma and cardiomyopathy so don’t let your vet shrug it off as in she’s a complex cat. Yes, there are cats that have multiple illnesses and react differently to treatments, but a specialist would know how to treat them, if they don’t know much about diabetes. Both my cats see IMs now because I have yet to find a general vet who I trust or feel is truly competent so maybe see if there are any animal internal medicine vets near you.
 
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O
kmc said:
Thanks both, I'll discuss it with my other half who does the injections and manages it. I think there has been trouble with lancing her ear so we might need to get a new lancing device. Apparently the cat gives a look of "why are you doing this to me?" That makes the ear lancing difficult. They have it easy at the vets as she just flumps on the table and doesn't move, different when trying to get hold of her at home I think that's something we'll need to work on now we have got the insulin injection routine sorted. She doesn't seem to show any signs of hypo or anything. Will see if we can sort the testing.

Sorry I think being in the UK some of the values for blood glucose and fructosamine may be measured differently possibly causing confusion. I believe it's 17 in mmol?
Click to expand...
Ah you’re in the UK. Gotcha. So you may not find most of the foods listed on the chart there. I’ll try to tag some other UK members here for ya!

about testing, most of us free hand because the lancet device can be startling to cats. When you use just the lancet, you also have more control over the pressure you’re applying to prick the ear. A few tips, always give a treat immediately after the test, whether you fail or succeed to build positive reinforcement. I’d always have the treats right there visible so they knew it was coming. Always warm up the ear first so you can get a decent size droplet. Most of us use a sock filled with rice that we nuke for 20-30 seconds then hold it up against the ear til it’s warm to the touch. I used to sing a lullaby to clan us down, including me. Lastly, always aim for the sweet spot:
upload_2023-7-15_11-41-31.jpeg
 

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Excellent thank you, we tried a needle for the ear prick and she went to bite so may try the methods suggested. We give her food at the same time as her insulin which she has now recognised as a positive time.

The food we give her supplied by the vets is Royal Canin Diabetic Veterinary.

Sorry to hear Minnie has multiple complications. We were upset by one surgeon at our practice who actually said that our cat is likely to have problems going forward and if it was her cat she would probably put her to sleep as she "had lost the will to live". She said if she got home and ate and drank then come in the next day and they'd show us how to do the insulin but if she didn't then...

We got her home and she was fine, it was on the medical reports that she was a "grumpy cat" and not happy being there. She was a bit miserable and withdrawn for a few days after the days of hospitalization but she started eating and drinking and not long after she was back to her normal self, roaming around, affectionate, bright eyed and loving life lounging around in the garden as she did before. We have heard of other cases where vets seem too ready to end an animals life unnecessarily and the animals have lived happy lives after.

We have considered going elsewhere as it isn't a "cat friendly clinic" and they seem to have been a bit brutal with the treatment of our cat we feel. It's always a bit sad when they have to shave the fur on her neck to do the fructosamine test.
 
One note about food, cats do better eating several small meals throughout the day. It’s easier on their pancreas and it helps avoid big sugar spikes. Most of us feed the 2 larger meals around shot times and 3-4 snacks or smaller meals throughout the day. Most also leave out a snack overnight. I use a timed feeder for that. Low fat snacks can be any freeze dried snacks or even regular chicken.

when you say needle do you mean a lancet not an actual needle right? You use the lancet to prick the ear. You want to build positive association with testing and getting a reward. It can be food or anything she truly loves like chin scratches or belly rubs
 
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Thanks, we have an automatic feeder that dispenses dry food several times a day and we give her little snacks (meat sticks).
We give her the wet food when doing the insulin.

Sorry yes, the Lancet that came with the Alpha Track.
 
Got it. Try the tips I mentioned then. Eventually you want to transition her to wet food only. I’m thinking those meat sticks are high carb too. The ones here in the US are. I’d look into freeze dried and see how she likes them. Here in the us there are 2 low car dry foods Dr. Eslseys and Young Again Zero Carb but not sure about there @Elizabeth and Bertie ?
 
Royal Canin dry food, even the ostensibly diabetic diet, is very high in carbohydrates. Neither of the low carb dry foods available in the US are available in the UK. This is a list of canned foods that are available in the UK. However, it may not be entirely up to date.

If you set up the spreadsheet that we use here, there is a World template. Using that spreadsheet will automatically convert the mmol/L to the format used in the US. If you need help with the spreadsheet, I've tagged Bhooma (@Bandit's Mom) who can give you a hand. The information on setting up your signature and spreadsheet are in this link -- helping us to help you.

As for the fructosamine numbers, I routinely ask my vet to give me a copy of my cats' lab reports. There should be reference ranges for all of the tests. The spreadsheet also has a page to enter lab values in case you want us to be able to lend a hand with the interpretation.
 
Hi @kmc , welcome to FDMB :-)

Let me know if you need help with setting up your spreadsheet and signature. I can do it for you very quickly.

Also, the UK low carb food list shared by Sienne has a list of dry food options at the end. However, canned food is much better for cats than dry food since it provides much needed hydration.
 
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