Hi everyone,
Sorry this is going to be a LONG post
My cat Xeno was diagnosed with diabetes in September. I found this website shortly after and have been using the advice I've read to guide Xeno's treatment. I've learned a lot and done A LOT of my own research as well, but now I need some advice/opinions on insulin dosage and diet.
ABOUT XENO:
9 years old, 13.5 lbs
INSULIN:
The vet prescribed vetsulin starting at 2U twice a day, and said to keep Xeno on the Hill's urinary food. I found this website soon after and was so angry that my vet failed to go over other insulins, food options, home testing, etc. Since diagnosis he's proven to be very uninformed and unhelpful + horrible bedside manner. I have an appointment with a new vet next week, but have been waiting to switch vets until Xeno is somewhat stabilized (our current vet is able to see him very frequently).
After increasing up to 4U of vetsulin twice a day, Xeno's numbers were still in the 300-400s range. After doing research I learned that Lantus (glargine) is a better option because it's longer acting and research shows it has a higher chance of leading to remission. I ended up accidentally dropping and breaking the vile of vetsulin I was using after Xeno had only been on it for a week, so I used that opportunity to ask the vet for a Lantus prescription instead. He said he's never prescribed Lantus before and always uses vetsulin, but I basically demanded we use Lantus after the research I had done.
Xeno started on 2U of Lantus twice a day, and has now been on 3U twice a day for a couple of weeks. After doing a blood glucose curve, my vet got a lowest reading of 195 mg/dL around 7 hours after injection (later than expected). However, that was the LOWEST and the rest of the day his glucose was in the 200s-400s.
HOME TESTING:
My schedule doesn't allow me to do constant readings but I've been trying to do at least one a day at different times of the day. I am now using the Alphatrak 3 for home testing. I initially was using the ReliOn like most people on this website recommend, only to be lectured by my vet that that would not be accurate because it's not calibrated to cats. I've done a lot of research on this and people have differing opinions. However, I have noticed that my Alphatrak 3 consistently provides higher values than the ReliOn (I've tried using them both together to compare). The ReliOn seems to give a reading about 30-40mg/dL lower, so I'm thinking that the Alphatrak IS more accurate.
The lowest reading I've gotten was 178mg/dL, around 8 hours after injection. My other readings tend to be in the 300s still.
FOOD:
Please hear me when I say that I have read all of the advice about diet and have done tons of my own research. I know now that dry food isn't good for cats and that diabetic cats should have a diet low in carbs and high in protein.
Here's where my problem lies: Xeno's diet still needs to prevent calcium oxalate stones from forming, as I literally cannot afford another $6000 hospital visit. In terms of preventing bladder stones, I've read that the food should be low in phosphorus, magnesium, sodium, and calcium. For diabetes, his food should be low carb high protein. Both diets recommend wet food. I've read that many people whose cats have urinary issues+diabetes simply feed a wet food with low phosphorus and low carbs. HOWEVER, I've since learned this is only effective for cats with STRUVITE STONES. I read that for CALCIUM OXALATE stones, their diet needs to be low in calcium and low protein, because high protein diet actually causes more oxalate in the bladder. Additionally, added potassium citrate can help control the amount of calcium in the bladder. So while a diabetic diet is supposed to be high protein, a diet to prevent oxalate stones should be low/medium protein.
The ONLY food I can find that prevents both calcium oxalate stones and is not INSANELY high in carbohydrates is the Hill's Science Diet Glucosupport and the Purina DM. I know many people are against prescription foods, for good reason, as the urinary food Xeno was on turns out to be 40% carbohydrates. However, the Hill's Glucosupport is lower, at 15% carbs (still not ideal) but has the St/Ox Shield to prevent calcium oxalate stones. I have just started Xeno on the Glucosupport dry food and am going to introduce the wet food asap. He has always eaten dry food and hated wet food so it will be a process of trying to transition him.
QUESTION:
Do you think I should increase Xeno's Lantus dosage (to 4U twice a day), and do you have any recommendations for food to control diabetes+ prevent calcium oxalate stones? My vet does not want to increase the dose. I've read that 3U is already a somewhat high glargine dose, but some people go higher if it's not effective enough. Xeno is still drinking and peeing too much, and his glucose only drops below 200 for a couple hours a day. He has glucose present in his urine but no ketones. Despite all of this, he still seems happy and is acting normal.
I'm 24 and practically broke because of this whole situation; I never expected all of this to happen so quickly and am very overwhelmed. I'm doing my best and will do anything for Xeno.
Thank you so much if you took the time to read all of this!! Your input is greatly appreciated!
-Mariah
Sorry this is going to be a LONG post
My cat Xeno was diagnosed with diabetes in September. I found this website shortly after and have been using the advice I've read to guide Xeno's treatment. I've learned a lot and done A LOT of my own research as well, but now I need some advice/opinions on insulin dosage and diet.
ABOUT XENO:
9 years old, 13.5 lbs
- Up until October 2023, Xeno had few health issues except for dental disease (he's had over half his teeth pulled at this point).
- Last October, he had a urinary blockage and I took him to the emergency hospital. They inserted a catheter and did an ultrasound, found that he had 4 bladder stones but that the blockage was caused by inflammation. The vets prescribed Hill's Science Diet Urinary Care + Stress, hoping this might dissolve the stones.
- Two weeks later, he was blocked again and we returned to the emergency room. This time, it was the stones causing the blockage and he had to undergo surgery to have them removed. The stones turned out to be calcium oxalate stones, which cannot be dissolved once they're formed. The vet stressed keeping him on the urinary diet for the rest of his life to prevent stone formation.
- Fast forward to this September, and I notice Xeno is drinking a ton of water and peeing a lot. I took him into the vet and he was diagnosed with diabetes; his glucose level was at 420 mg/dL.
INSULIN:
The vet prescribed vetsulin starting at 2U twice a day, and said to keep Xeno on the Hill's urinary food. I found this website soon after and was so angry that my vet failed to go over other insulins, food options, home testing, etc. Since diagnosis he's proven to be very uninformed and unhelpful + horrible bedside manner. I have an appointment with a new vet next week, but have been waiting to switch vets until Xeno is somewhat stabilized (our current vet is able to see him very frequently).
After increasing up to 4U of vetsulin twice a day, Xeno's numbers were still in the 300-400s range. After doing research I learned that Lantus (glargine) is a better option because it's longer acting and research shows it has a higher chance of leading to remission. I ended up accidentally dropping and breaking the vile of vetsulin I was using after Xeno had only been on it for a week, so I used that opportunity to ask the vet for a Lantus prescription instead. He said he's never prescribed Lantus before and always uses vetsulin, but I basically demanded we use Lantus after the research I had done.
Xeno started on 2U of Lantus twice a day, and has now been on 3U twice a day for a couple of weeks. After doing a blood glucose curve, my vet got a lowest reading of 195 mg/dL around 7 hours after injection (later than expected). However, that was the LOWEST and the rest of the day his glucose was in the 200s-400s.
HOME TESTING:
My schedule doesn't allow me to do constant readings but I've been trying to do at least one a day at different times of the day. I am now using the Alphatrak 3 for home testing. I initially was using the ReliOn like most people on this website recommend, only to be lectured by my vet that that would not be accurate because it's not calibrated to cats. I've done a lot of research on this and people have differing opinions. However, I have noticed that my Alphatrak 3 consistently provides higher values than the ReliOn (I've tried using them both together to compare). The ReliOn seems to give a reading about 30-40mg/dL lower, so I'm thinking that the Alphatrak IS more accurate.
The lowest reading I've gotten was 178mg/dL, around 8 hours after injection. My other readings tend to be in the 300s still.
FOOD:
Please hear me when I say that I have read all of the advice about diet and have done tons of my own research. I know now that dry food isn't good for cats and that diabetic cats should have a diet low in carbs and high in protein.
Here's where my problem lies: Xeno's diet still needs to prevent calcium oxalate stones from forming, as I literally cannot afford another $6000 hospital visit. In terms of preventing bladder stones, I've read that the food should be low in phosphorus, magnesium, sodium, and calcium. For diabetes, his food should be low carb high protein. Both diets recommend wet food. I've read that many people whose cats have urinary issues+diabetes simply feed a wet food with low phosphorus and low carbs. HOWEVER, I've since learned this is only effective for cats with STRUVITE STONES. I read that for CALCIUM OXALATE stones, their diet needs to be low in calcium and low protein, because high protein diet actually causes more oxalate in the bladder. Additionally, added potassium citrate can help control the amount of calcium in the bladder. So while a diabetic diet is supposed to be high protein, a diet to prevent oxalate stones should be low/medium protein.
The ONLY food I can find that prevents both calcium oxalate stones and is not INSANELY high in carbohydrates is the Hill's Science Diet Glucosupport and the Purina DM. I know many people are against prescription foods, for good reason, as the urinary food Xeno was on turns out to be 40% carbohydrates. However, the Hill's Glucosupport is lower, at 15% carbs (still not ideal) but has the St/Ox Shield to prevent calcium oxalate stones. I have just started Xeno on the Glucosupport dry food and am going to introduce the wet food asap. He has always eaten dry food and hated wet food so it will be a process of trying to transition him.
QUESTION:
Do you think I should increase Xeno's Lantus dosage (to 4U twice a day), and do you have any recommendations for food to control diabetes+ prevent calcium oxalate stones? My vet does not want to increase the dose. I've read that 3U is already a somewhat high glargine dose, but some people go higher if it's not effective enough. Xeno is still drinking and peeing too much, and his glucose only drops below 200 for a couple hours a day. He has glucose present in his urine but no ketones. Despite all of this, he still seems happy and is acting normal.
I'm 24 and practically broke because of this whole situation; I never expected all of this to happen so quickly and am very overwhelmed. I'm doing my best and will do anything for Xeno.
Thank you so much if you took the time to read all of this!! Your input is greatly appreciated!
-Mariah
Last edited:
