? Introduction and question

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Diana & Martin

Diana & Martin

Member Since 2022
Hi everyone, this is my first time posting here but I've been lurking the forum for a while. I'll try to be as detailed as possible with background and my question!

My 13 year old Martin was diagnosed with diabetes a month ago. He's always had fantastic health and it is the sweetest baby ever. The DM diagnosis came after we took him to the vet back in February/March because I noticed that he was dry heaving (I then figured he was coughing) a lot without throwing up, especially after using his litter box. Long story short he was diagnosed with a bad-ish case of bronchitis triggered by the new litter that we had started using a few months prior. We of course changed the litter and the vet gave them a steroid shot and a second one three weeks later after the cough hadn't subsided.

Fast forward to last month, I noticed that he was extremely thirsty all the time and peeing a bunch. I also believed that maybe there was blood in his urine which is what prompted us to take him to the vet again. The urine analysis came back negative for blood but his glucose levels were through the roof. A few tests later and he was diagnosed with diabetes (most likely steroid induced, but who knows). The vet prescribed two shots a day starting with 1'1 IU (I'm not sure if I'm writing that correctly, but it was the first two lines of the 0.5 40 IU syringe). We took him again two weeks later for his blood fructosamine analysis appointment and while we had seen him somewhat improve (his coat was looking a little better, he had less dandruff, was not as thirsty, and was a bit more active) his fructosamine levels were even higher than before. After this appointment the vet increases the dose to 3.5 lines in the syringe (again, sorry for not remembering the actual dose!). He also told me that his clinical signs were more important than fructosamine levels because those take longer to go down, so he wasn't too worried about the increase.

It's been a little over a week since that appointment and now I'm a little concerned because Martin has thrown up twice in the past two days. He threw up yesterday afternoon some 5 or 6 hours after his morning shot. Worried about hypoglycemia I hand fed him some of his food and he happily took it (he's a spoiled baby who loves to be hand fed) and after nibbling a little from my hand he kept on eating from his dish a little more. At night, we gave him his regular shot but I decided to give him a lower dose (two lines instead of three), just in case.

I'm worried because he just threw up again today -- both times making a heart-wrenching sound that he only does when (I think) he's in pain before vomiting. Yesterday he threw up on the floor, but today for the first time ever in his life he went into his litter box to puke. Yesterdays vomit was mostly water with a bit of food and todays was significantly thicker (maybe because he had just eaten). Today he threw up an hour and a half after his shot.

Other important things to mention:

- we live in Barcelona, Spain. Our vet here didn't recommend or mention a glucose monitor so we don't have one of those
- what he did tell us to do was to test his urine every two days with urine testing strip and to specifically keep an eye out for ketone bodies. He said that if he ever tested positive for that to take him right away because of ketoacidosis
- I test him every day and there are no ketone bodies. His glucose always shows up extremely high, but the vet told me that glucose is not the best indicator in cats, so he likes to rely more on fructosamine
- being summer in Spain, the vet is on vacation. I just sent him an email but I'm sure I won't be hearing back any time soon
- we have an appointment for his next check up September 2nd
- the insulin I give him is called Caninsulin

so my question is, should I be worried about the vomiting? Should I take him to another vet right now while ours is on vacation? And, should I give him his regular shot tonight?

I appreciate your answers and useful information!!

Ps - I forgot to mention that he had gained a little weight on his second appointment, which was great news because we has losing weight a bit fast
 
Hi and Welcome!

Is this a true emergency situation with your kitty? Doesn't sound quite that serious, so if not please remove the 911 from your post, that is for emergencies only (click in the top right, thread tools, drop-down menu will open and select edit title)
 
Hendrick Cuddleclaw said:
Hi and Welcome!

Is this a true emergency situation with your kitty? Doesn't sound quite that serious, so if not please remove the 911 from your post, that is for emergencies only (click in the top right, thread tools, drop-down menu will open and select edit title)
Click to expand...


Thanks for pointing that out! Still new to the site. Just fixed it!
 
Ty! Martin is adorable I love the photo.

vomiting can be a concern with diabetic felines because of the possibility of pancreatitis. Pancreatitis makes kitty nauseous. A lot of members use anti-nausea meds like Cerenia do you happen to have any on hand?
 
Hendrick Cuddleclaw said:
Ty! Martin is adorable I love the photo.

vomiting can be a concern with diabetic felines because of the possibility of pancreatitis. Pancreatitis makes kitty nauseous. A lot of members use anti-nausea meds like Cerenia do you happen to have any on hand?
Click to expand...

Thanks! I don't have any anti-nausea meds at home, but I can buy some if that's going to make him feel better. Is there a specific kind for cats or would human meds do? And do you think it'd be wise to give him his regular shot tonight? I was worried about hypoglycemia at first, but I kind of think that the vomiting (or the potential pancreatitis) might have more to do with super high blood sugar levels instead of low? He threw up about 2 pm and his shots are at 12 am and 12 pm
 
Cerenia is what most members here find works well

I'm not comfortable advising you on whether or not to shoot. Not an expert, just a layperson who the experts here helped and I try to pay it forward by chipping in here and there with what I do know.
 
Hendrick Cuddleclaw said:
Cerenia is what most members here find works well

I'm not comfortable advising you on whether or not to shoot. Not an expert, just a layperson who the experts here helped and I try to pay it forward by chipping in here and there with what I do know.
Click to expand...

I totally understand! Thanks so much :)
 
The other option is ondansetron which is a human med but you’d need to figure out the right dose for him and it’s usually a vet that will tell you that. Also not sure if you can get it in Spain. What’s his weight? Pancreatitis is a possibility as well as IBD. The only way to try to diagnose it is an ultra sound and I’d suggest you make an appointment for it asap. It’s important that your cat has food when taking insulin so his bg doesn’t drop too low. It’s especially important on a harsh insulin like Vetsulin or canisulin. Can you tell us what insulin he’s on? Would you be able to start home testing him?
 
He's on Caninsulin and weights about 11.4 pounds (5.2 kgs). I googled Cerenia and it doesn't seem to be available here. There's something called Prevomax which is also maropitant, but it is an injectable. Is cerenia injectable as well? Yes I'd be able to start home testing, but I don't know anything about it, since our vet didn't even mention it!
 
Thank you so much for all the helpful resources! I just ordered a glucometer and will start testing as soon as it arrives tomorrow. I'm a little scared and the thought of pricking him on his ear kind of makes me want to cry a little but I've been reading all the advice here and I'm sure we'll be fine (fingers crossed!). I read somewhere that steroid-induced diabetes has a higher chance of remission in cats, so hopefully we can get to that point eventually?? He's always had fantastic health and before the steroid shots and the DM diagnosis, the vet said he was "como una rosa" (like a rose) because all his tests were perfect especially for his age :(
 
If you can set up what we call our signature , information we need about Martin
To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information can you also add to you signature From Spain.
One other thing you need to withhold food 2 hours before testing theBG so it's not food influenced. After feeding you need to wait 30 minutes then feed with caninsulin
If you are not happy with caninsulin ask your vet for prozinc


  • Add info we need to help you:
    • Caregiver & kitty's name
    • DX: Date
    • Name of Insulin (do not include dose or frequency)
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

Once you get your meter and stsrt testing we have a spreadsheet we use to track our cats BG numbers to see how the insulin is working and how low it's dropping
Here is the link , but if you need help setting it up just ask, we have a member that would be happy to set it up for you
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
 
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This was posted by Gill & George about meters also she's from Spain

I use a freestyle freedom lite, and an SD code free (european thing)
The nice thing with the freestyle freedom lite is it requires a tiny sample so really handy if kitty is not a big bleeder, it's my back up meter, (strips for this are pricey here in spain), when I leave George with the petsitter she uses the freestyle, she finds it much easier, because although George is really good when I test him, he plays up when she does, with the small drop required she finds she can usually grab a BG at the first go.(my other meter requires a larger sample and she finds this trickier)
 
Dianasmp said:
He's on Caninsulin and weights about 11.4 pounds (5.2 kgs). I googled Cerenia and it doesn't seem to be available here. There's something called Prevomax which is also maropitant, but it is an injectable. Is cerenia injectable as well? Yes I'd be able to start home testing, but I don't know anything about it, since our vet didn't even mention it!
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I found this
Is Prevomax the same as Cerenia?
Prevomax is a 'generic medicine'. This means that Prevomax contains the same active substance and works in the same way as a 'reference medicine' already authorised in the EU called Cerenia. How is Prevomax used? The medicine can only be obtained with a prescription and is available as a solution for injection.

Also found this don't know if it's available in Spain but read about it
https://vcahospitals.com/know-your-pet/maropitant-citrate
Maropitant citrate(brand name: Cerenia®) is an antiemetic used to treat vomiting and motion sickness in dogs and cats. It also may act as a mild pain control medication.
 
Thanks so much! If I'm being honest I'm feeling a little overwhelmed! A month ago when we got the diagnosis I convinced myself that he was going to start improving immediately and now that's he's thrown up two days in a row I feel like it's going to be a bit more complicated than that. I'm very grateful this forum exists and everyone's so helpful!!
 
With vetsulin/ caninsulin , it is really an insulin made for dogs and is not recommended for cats as there are much more suitable insulins for cats such as Lantus or Prozinc.
Once you start testing and get your spreadsheet set up and your signature the members here will be able to give you some advice.
Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up
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6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, youcan get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
Take a look at the lancets ,you will see one side points up, that's the side you want to poke with
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming
You can also put a thin layer of vaseline on the ear ,to help the blood bead up
Click here to watch Hendrick Test his cat Pokey
 
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Do you have a hypo kit set up with medium and high carb food in case you need he drops to low and you need to bring his BG up to save numbers
anything from 11-16% is medium carb and 16%+ is high carb.
MAKE A HYPO KIT. Hypo may never happen to your kitty, but it's wise to be prepared in case you need to raise blood glucose in a hurry. You'll need some liquid glucose, syrup, or honey. And it would be good to have some high carb food in gravy. Get a few little tins of Gourmet Gold 'in gravy' food. High carb palatable treats are good too, such as Webbox 'Lick-e-licious' salmon cat treats. Always have some honey on hand

a couple of cans of Gourmet Gold: 'Chicken & Liver in gravy', 'Salmon & Chicken chunks in gravy', or 'Beef chunks in gravy'.
These foods contain cereals, and, according to the carb calculation based on the label info ('typical analysis' percentages) have around 25% calories from carbs. (But don't rely on the label info alone. What really matters is the effect of the food on your cat; and 'Every Cat Is Different'.)

When trying to raise low numbers, it is the gravy that is particularly useful. A couple of teaspoonfuls at a time can help to raise blood glucose without filling up the cat's tummy too much (just in case you need to feed more later.)
 
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And Diane is right. Not the best insulin for cats who have a higher metabolism, so it wears off faster, in less than 12 hours and your cat is not protected a full 24 hours. As opposed to a longer lasting insulin like Lantus or prozync that lasts a full day. But we do hear a lot from folks in Europe that Vetsulin is the insulin most prescribed there. Most vets are not current on feline diabetes treatment, not just there but here too. I hope you can get him to switch insulina for you!
 
Home testing can seem and feel overwhelming until both you and your cat get the hang of it, but then once you do it’s just part of the routine like feeding them. Just post any questions or issues you’re having here because most of us have probably encountered them too and have devised tips or workarounds to help!
 
Thanks, all. Martin vomited again yesterday at the same time (about 4 hours after his first shot of the day) but other than that he seems to be doing fine, has an appetite and looks like his normal happy self. Our vet is on vacation but he got back to me via email and recommended to take him to another vet to rule out gastritis? We're taking him this afternoon. In the case of gastritis, could it be the Caninsulin that's too harsh on his system?

We also got our glucometer yesterday and weren't successful getting a reading because we got overwhelmed almost immediately after seeing the tiny puncture on his adorable baby pink ear and gave up. But after a couple of tries we were successful this morning and Martin didn't even flinch! Unfortunately, though, his BG was very high (531) with the monitor flashing the words HYPER and KETONE? (with a question mark). But we also haven't given him his insulin shot since yesterday morning because the lady from the vet clinic told me not to until they see him. Is there anything specific you recommend I should ask this new vet?
 
Diana & Martin said:
Thanks, all. Martin vomited again yesterday at the same time (about 4 hours after his first shot of the day) but other than that he seems to be doing fine, has an appetite and looks like his normal happy self. Our vet is on vacation but he got back to me via email and recommended to take him to another vet to rule out gastritis? We're taking him this afternoon. In the case of gastritis, could it be the Caninsulin that's too harsh on his system?

We also got our glucometer yesterday and weren't successful getting a reading because we got overwhelmed almost immediately after seeing the tiny puncture on his adorable baby pink ear and gave up. But after a couple of tries we were successful this morning and Martin didn't even flinch! Unfortunately, though, his BG was very high (531) with the monitor flashing the words HYPER and KETONE? (with a question mark). But we also haven't given him his insulin shot since yesterday morning because the lady from the vet clinic told me not to until they see him. Is there anything specific you recommend I should ask this new vet?
Click to expand...

yes, I would ask for a script for Lantus or Prozinc. Most likely his BG was so high because Canisulin is a harsh, fast-acting insulin that doesn't have much duration.
 
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