Hospitalized Diabtetic Cat!!! HELP!!!

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UPDATE: Sorry I have not been on here in while to let you all know how my little Princess is doing (been so stressed and confused) She came home from the hospital Thursday. She was definitely feeling much better. She was sent home on 1 unit of Lantus twice a day and 1/2 can of Pro Plan DM 2 times/day. The problem is she was also diagnosed with chronic pancreatitis :( I should also mention that, I may not have communicated her condition properly. When she was in the hospital they were having a hard time bring ger BG levels down. I guess that wouldn't be considered "bouncing" or trying to "regulate" her. They were trying to figure out WHY her levels were not coming down. With poor communication on their end, I am not sure just how "high" her levels were but they did say one testing was at 500 then one morning at 5am she was at 118. I took her to a new vet yesterday who I will be working with on all this and PRAY she is good. She gave a gal that comes to her clinic my phone number because she told me this woman has a diabetic cat and is very knowledgeable and keeps her kitty well regulated on her own. After talking to her Thursday and then the vet Saturday I am getting conflicting information. The gal Kathy told me I could use Relion to monitor her BG, the vet said NO this is NOT accurate for cats and to use the AlphaTrak2. I am also now confused (because now I am not only treating a diabetic cat but one with chronic pancreatitis) what is best to feed her. Since I noticed her starting to get sick (about 1 1/2 mths ago) I put her on a great probiotic/enzyme supplement in her food which, after researching looks like I was doing the right thing ( I am BIG into holistic healing) I see that cats with pancreatitis need moderate levels of fat and protein which confuses me because diabetic cats need high protein? Should I keep her on the DM? I am definitely going to start monitoring her at home. Last night after she gobbled up her food and got her shot she came and layed on my lap and seemed "passed out" I was SO worried that her BG may have gone LOW and had no way to test her. The vet is looking Monday as she said she believes the AlphaTrak is running a special on a free monitor. I sure hope I am giving her these shot correctly as the vet tech at the hospital showed me how on a darn stuffed animal dog even though I asked them to show me ON Princess. Also, I expressed concern with the $272.00 cost of Lantus with the vet and she suggested after the vial is gone we can switch her to Vetsulin. My head has been spinning for the last 7 days with all of this. Any suggestions/comments are much appreciated!!!
 
Kris & Teasel said:
Many people in the US order in from a Canadian pharmacy based in Vancouver called Marks Marine Pharmacy. The cost is almost half and they ship to the US. You just need a vet's prescription.
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I looked into that and they seem to be in the $150.00 range. Between insulin/needles/vet prescribed food/and the high cost of the test strips for the lphaTrax etc PLUS an over 4,000 hospital bill, I am trying hard to keep my cost LOW and still help my precious Princess. The vet said the Vetsulin would cost about 58.00 which helps alot!
 
I bought my insulin from Canada. Their customer service is great and I never had a problem. Max had chronic pancreatitis too. I got him very tightly controlled although he never went OTJ. I used a Relion meter. I bought my test strips on eBay. I often bought large amounts on auction. My vet had never used a Relion meter but after seeing my results told me that I managed Max’s diabetes better than any client in his 35+ years of practice. You don’t need to use the expensive AT. Max never had sugar in his urine once I got him regulated.

The only curve my vet ever did was after his first shot. He never even suggested I bring him in for one as if you test at home it’s more accurate.
 
Oh, wow, that's so stressful!

On costs: the big testing costs come with the test strips, which for the AlphaTrak are quite pricey. There are a couple ways people have managed this with a vet who insists on the AT. First, I think there's a cheaper strip (the FreeStyle?) that can be used in the AT. Second, what many people do is have a human meter for day-to-day use, and an AT for an occasional day-long glucose curve to be reported to the vet. This means having to interpret two kinds of readings (your vet is right that they are not comparable), but helps on costs so that the first priority when you are testing is just whether you need to do a test to keep Princess safe, not whether you can afford to go through yet another expensive strip. In terms of the difference in numbers, the main important thing is the "too low" number for each meter type which you need to know to keep her safe. Other than that, the absolute "true" BG isn't as important as the changing patterns day-to-day.

For insulin: while Vetsulin is cheap and some cat owners have used it to successfully treat diabetes, in Princess' case I'd very strongly urge going with Lantus and ordering from Canada with the vet's prescription to cut costs. You can also sometimes get a pharmacy to sell you a single "pen" of Lantus for about $90 or so (the $150 from Mark's is for 5 pens, so obviously this is more per unit, but less out-of-pocket). The reason I'd recommend the lantus even with the higher cost is that Vetsulin is a rather "harsh" insulin-- it's very good at bringing numbers down, but it acts fast and is hard to counteract once it gets a head of steam going. With Princess being so underweight I'd be very afraid of overshooting and getting into hypo territory using Vetsulin.

Pancreatitis: ugh. It's so common in FD cats! Here is a "primer" on pancreatitis. Note that food recommendations are very unclear for cats-- so I'd stick with the FD recommendation to start. As tiffmaxee says, pancreatitis can be managed symptomatically.

Finally, now that I've gone through all that: I'm glad to hear that Princess is feeling better since coming home!
 
Insulin - look on the Supply Closet subforum. Alan Hamman sells insulin for a discount. I did not know him before my first purchase. All purchases have gone smooth, with timely delivery. And he has saved me money. There are other suppliers on the subforum too. I use Levemir pens, and extract with a U100 syringe.

Alphatrak vs Relion. Both work. Search the forum. A common topic. I use AlphaTrak 2 and FreeStyle Lite strips. I get the strips from Ebay. Last batch was $94 for 300 strips = $0.30 each. I use 3 or 4 strips a day.

Food - there is nothing "prescription" in prescription cat foods. Our cats get low carb, high protein Fancy Feast Classic. And I cook chicken tenders once in awhile. The chicken tenders are also known to cats as Cat Heroin! They are addictive and the cats go bonkers for them!:D

Syringes - I get 100 x U100 syringes from Walgreens for $18.00. So $0.18/syringe = $0.36 each day. Do NOT reuse syringes.

Kudos to you for making it this far. As things settle down, this will all become part of the daily routine. Your will spend less time doing it, and you will find the cost effective solutions (food, insulin, testers).
 
Sorry, turns out I have more to say!

If I understand your update post, Princess is now on 1U Lantus 2x/day? That sounds like a high starting dose for such a tiny cat. I'm especially concerned since in the hospital (assuming it was the same dose) it took her from 500 to 118 at least once, and then also you noticed her becoming lethargic after a shot. Since you aren't yet testing her, there's no way to know what's going on, but if I were you, I would make sure I had plenty of high-carb food on-hand just in case. If you suspect her blood glucose is going low, high-carb food can help bring her back up quickly. In the short term, too high is much better than too low-- I don't want to scare you, but too low can kill!

Good high-carb options to have ready: the "gravy" part of Fancy Feast Gravy Lovers varieties is good for a quick boost. If you really need to bring her up fast, karo syrup, honey, or some other syrup can be rubbed on the gums. More details on treating hypos is found here. The best way to prevent them is to be testing, which I know you'll be doing soon, I just want to make sure you have this info for today/tonight before you have a chance to see the new vet.

So sorry to be flooding you with all this info-- I know you've got a lot going on right now!!!
 
Yes, Princess is up to 4 lbs she was around 3 when we took her to the hospital Saturday. She always was a very tiny petite little girl ( I rescued her as a 8 week old barn cat) her usual weight is about 6 lbs. I wanted some of you guys opinion on her original vet. I took her in to get her teeth worked on as I noticed bad breath, back in December 2016. My vet called me about an hour after I dropped her off and said she thinks Princess may have diabetes as she lost a few lbs and she doesn't want to risk the surgery. Her tests came back no ketones and her BG was in the mid 300's. She said we want her in the 200's and we can try adjusting her diet to low carb. When she was rechecked a few mths later she came down to mid 200's and gained some weight. She said because she was in the "200's" insulin was not necessary. I kind of question that because isn't mid to high 200's still high for a cat even on a low carb diet? Do you think she should have been more on top of it? She wanted to test her again in 6 months after that, and we never got around to the bad teeth. That's why I switched vets. I don't think all vets are on the same knowledge level with diabetic cats. Even the ones at the hospital seemed kind of in the dark. They seem to know the basics but what I have read, pancreatitis and diabetes CAN go hand in hand.
 
You're right, 200's is still definitely diabetic! A lot of vets have a very liberal range of acceptable BGs in diabetic cats. I think this is mostly because, sadly, many owners will choose to euthanize rather than treat diabetes, so vets figure a live cat in the 200's is better than that. Along the same lines, not many pet owners are willing to do the home testing that is required to get a cat down into lower numbers safely, so vets will often give a wide safety margin for insulin administration, assuming that the owners aren't testing.

The thing is, if you are testing, you can get and keep a cat in normal BG numbers (especially on a gentle insulin like Lantus), and that's a really good thing! Some cats (not all) are able to heal the damage to the pancreas and stop being insulin-dependent, and the chances of that happening are greatly increased the more time the cat spends in normal BG numbers (decreases stress on the pancreas). But again, most vets, even if they're willing to support a treatment plan with that as the goal, aren't going to start there because they don't want to scare off the owners with such a huge-sounding care assignment.

As for the dental, hard to say, but that was likely a good call by the vet. It's definitely possible for diabetic cats to have dental exams-- in fact, dental problems are a prime cause of increased BG numbers (many diabetic cats who achieve remission lose it when dental issues appear), so Princess's diabetes prospects would be better after a dental. That said, though, anesthesia is risky with all small animals, and particularly underweight ones like Princess. For that reason alone it was probably a good idea to hold off on the dental until she got the diabetes under control enough to put some weight back on. It's something to pencil in for a future date.
 
tamitam1458 said:
@Juliet your spreadsheet scares me. I have NO idea what I am looking at :( You guys are going to have your hands full teaching me this complicated stuff
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Take some deep breaths...it will be ok. I remember how freaked out I felt when Sketch was diagnosed in March. These folks can help out a rookie just like they did with Sketch and me. The testing, shots and spreadsheet will become second nature after a few weeks for both you and Princess. The people on this site have the knowledge and will point you and Princess in the right direction.
For what its worth I agree with many here that say get Princess home and start working to regulate her from there. Often the numbers the vet may be getting on the BG test may be stress driven depending on how she reacts to being at the vet or what else maybe going on around her at the vet...dogs barking or crying or cats yowling (as may have been mentioned BG #s go up with stress so dosing may be difficult to get dialed in if scary stuff is going on around Princess and she is in an unfamiliar environment ).
The first thing my vet suggested was get to the store and buy a meter review some youtube videos on testing and then bring Sketch in and she would review it with me. Well...the youtube video and info here was enough that over the first weekend I was able to test him multiple times. My cat has been difficult to get regulated and bounces (more than likely something else going on but many $$$ and multiple tests have yet to give a definitive reason) The start low go slow (SLGS) is the best method in my opinion since it takes time for your kitty to adjust to the dose of insulin and its scary, but higher is better then lower when it come to BG#s...lower can be fatal. And certainly I would find a vet that is knowledgeable regarding feline diabetes that can explain things to you about Princess in terms you will understand without having to get a medical degree!
Best of luck to you and Princess by the time you read this you may be an old pro and well on the way to managing her diabetic issues!
 
It's a big learning curve. While Princess is a small kitteh, you should prioritize getting her back to a normal weight. I keep a little bit of fat on Leo to get him thru some of the tough diabetic times.
 
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