JJ dIagnosed with diabetes today

[Steffi]

My cat JJ was diagnosed with diabetes today (over the phone). I am dedicated about treating my boy and doing whatever I need to do to keep him healthy. I told my vet that I have no problem testing his blood sugar, testing his urine & giving insulin injections. I would need a little bit of training on that. My vet insists that I bring JJ in tomorrow and leave him for 5 to 7 days so he can regulate the insulin . I told my vet that I am willing and able to test blood sugars- I have a glucometer already and just need test strips, and that I'm dedicated to treating my cat at home . My vet is insisting that unless I leave my cat with him for a week it means that I don't trust him. I do trust him and value his care of my fur babies, but I am 100% committed to caring for my boy at home with my vets guidance of course. The cost of keeping my cat at the vet is astronomical. He's a happy love bug and I am willing and able to give insulin injections as well once Dr. gets a dose in place. Am I being unreasonable about not wanting to leave my cat at the vet for 5 to 7 days? My aunts cat was recently diagnosed with diabetes and she wanted to leave her cat at the vet, but they told her no it was better if she took the cat home and did all the testing there and injections . Of course she does take her cat in periodically for testing.

 

[MrWorfMen's Mom]

Welcome to FDMB. There is an incredible amount of information on this site and a lot of people with an immense amount of hands on experience. We can help you learn to do the necessary testing and shots as well as providing you guidance about diet and how to keep JJ safe as you work toward getting him regulated.

You are NOT being unreasonable at all. Sorry for my negativity and bluntness, but it seems to me that your vet, like so many others, either doesn't have a lot of experience treating diabetic cats, is trying to pad his pockets or has a over inflated ego. It is a documented fact that most cats experience an increased glucose level while under stress and most cats are very stressed out at the vets. Unfortunately, we have all too often witnessed cats being so called "regulated" at the vets, only to come home and suddenly having their glucose levels drop dramatically (100 points in the US measure, 5-6 points elsewhere) because they actually need far less insulin than the vet prescribed all because the stress elevation was not accounted for. This not only stresses out the cat and caregiver, it's downright dangerous.

If you start your cat off at a safe dose of 0.5u twice daily or at most 1u (depends on the glucose readings and size of the cat), you can then monitor at home and raise the dose according to the readings you take at home or lower it if his numbers improve. We always test our cats before each insulin shot and get some mid cycle (each 12 hours post shot) tests in to see how low the cat's glucose goes. We have a spreadsheet already set up for keeping track of our readings. We store those spreadsheets online so if we need help with dosing, others here can see our data and offer their incites. You can also share the link to the spreadsheet with your vet so he can see how JJ is doing. And you can run glucose curves (testing glucose level every 2-3 hours for a 12 to 18 hours period) at home instead of taking JJ to the vet, again saving you money and both of you a lot of stress. Unfortunately it sounds like your vet may not be impressed with all this.

Did your vet discuss diet with you? Many vets try to push their prescription foods such as Purina DM or Hills M/D. While the canned prescription foods are not horrible, the dry foods are definitely too high in carbohydrates. The prescription diets are also unnecessarily expensive and many folks here are feeding their cats retail diets such as Friskies or Fancy Feast pates with great success. If you are feeding dry food at the moment, you should transition JJ to a canned diet. If you do have to transition him, take it slow to avoid any GI upsets and if you could get him transitioned before starting insulin, it would be ideal as changing to a low carb wet diet can also have a substantial lowering effect on kitty's glucose readings.

For what it's worth, I think it's vitally important that you trust your vet AND that your vet trusts you and is willing to work with you rather than wanting to take full control in this situation. You are ultimately going to be the one giving JJ his shots and providing his daily care. You want to keep him safe and the best way to do that is to be as hands on as possible. If you cannot convince your vet to let you get JJ started on his treatment at home, you may want to consider finding a new vet.

Please keep us posted on how your appt. with the vet goes and if you convince him to let you start treatment at home, we can provide you with all the info and support you need.

 

[Kot]

I am positive, positive, positive that unless there is an emergency (like DKA) it is better to treat your cat at home and not leave JJ at the hospital. It is stressful for cats to be taken to a vet to start with and if you add here that they do not understand that you leave him/her at the hospital for their own good... all they know is that you left them. Diabetes is manageable at home and if the human as dedicated as you are to do all the testing, adjusting, being prepared for a hypo episode at home then I do not see a reason for the vet to object. You are your cat's best advocate and even a vet should not be of more importance than you are in deciding how to treat your cat.

 

[Olive & Paula]

Home is best. Will they give you a script if you don't leave him there so you can purchase insulin?

 

[Julia & Bandit (GA)]

You are not being unreasonable at all. Cats are best regulated at home, unless there's some serious complication in addition to the diabetes that requires hospitalization, such as diabetic ketoacidosis. Since JJ is safely home with you right now, I'm assuming that's not the case!

Here's a link to the current AAHA recommendations for the treatment of diabetic dogs and cats. Under "Initiating Insulin Therapy", it very clearly says that while it is up to the vet whether they wish to monitor the cat on the first day of insulin (since JJ was already sent home I don't see why it would be necessary), initial treatment should be on an outpatient basis. Cats have inflated Blood Glucose levels at the vet, so it's pretty much impossible to regulate them until they're home and relaxed. Trying to determine the correct dose at the vet's office is dangerous, because the inflated BG numbers lead to overdosing by the vet. Also, it typically takes several weeks or even months to regulate a cat--it's not something your vet will be able to do in a single week.

Apart from annual or semi-annual bloodwork to watch out for other issues, there's no reason to bring your cat to the vet for diabetic testing if you are testing frequently enough at home. Bandit's been diabetic for almost 7 years, and I've never once payed for a blood glucose curve at the vet or a fructosamine.

Did your vet tell you what insulin he wanted to use? Lantus (glargine) and Levemir (detemir) are the recommended insulin for cats, but Prozinc is also a suitable choice if more flexibility is needed in the schedule. Vetsulin and Novolin (Humulin N) are NOT recommended for cats and should not be used. If Lantus is prescribed, I would ask your vet for a script for the Solostar pens, and order online from a Canadian pharmacy, as it's more than half the price of ordering in the US. A single pack of 5 pens (about $170 after shipping) will last you a year or more. If that is too much to invest in at once, you can also order a single pen for about $75 after shipping. It does usually take a week for the insulin to arrive, but you can use that time to change the diet and learn to home test, if needed. The pens are more economical than the vials because they are smaller--doses for cats are very small and you don't typically get to use all of a vial before it goes bad, and you draw insulin out with syringes just like you do with a vial, so you'll need a script for those as well (and you can get those at any pharmacy--Walmart is usually the cheapest). If money isn't a huge roadblock for treatment for you, you could also get your first vial from a local pharmacy to get you started right away, if that's preferred. You will save yourself several hundred dollars not leaving your cat at the vet to be "regulated", so keep that in mind.

 

[Steffi]

Thank you everyone for your great information, ideas and support! JJ and I are making progress and getting there. He did stay at my vet for three days and got great treatment and lots of love there. Brought him home but his glucose levels were so high doctor had me bring him back and leave them for two more days at no charge which was very nice. Where the vet used huge needles to poke JJ's paws , I use the ReliOn lancet device to poke the sweet pink fold of his ear...lots of ear massaging and kisses before and after the poke. Such a good boy We're on 3units of Prozinc morning and night. A few extra glucose checks in between. I call my readings morning and night to my dr, and he checked in with me over the weekend as well. I've been scribbling all of my glucose readings of their dates and times on a notepad. Can you please recommend the best log book or online logbook that I can download and enter the readings? I'm going to keep reading all of your posts, conversations and suggesting. You are all a wealth of information. You truly are special. Thank you, Stephanie and JJ

 

[BJM]

When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback.

Editing your Signature

In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

Click on your ID.

On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback. You are limited to 2hard returns, so separate pieces by | or -.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as your name | cat's name | date of Dx (diagnosis) | insulin | meter general location (city and state/province) any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.

Click the Save Changes button at the bottom.

Always click the Save Changes button at the bottom when you have changed anything.

 

[MrWorfMen's Mom]

Hi Stephanie and JJ.

Glad to hear things are going well and it now sounds like your vet is looking after you both very well.

Here is a link to the instruction for the spreadsheet we all use to log our readings. It's on Goggle docs so you can give the vet access to the file and he can look anytime he chooses or you can send a .pdf file to him of the spreadsheet...whatever works for you.

The spreadsheet is set up to with AM and PM sections. The pre-shot test goes in the column labeled AMPS. Each hour between shots is labelled +1, +2, +3 etc. That way if you need help here, since we are all over the planet, everyone understands where in the cycle you are and can give you the best advice according to your situation.

If you have any difficulties or questions about the spreadsheet, just ask and we'll help you get it set up.

BJM provided info re: setting up your signature. We keep a link to the spreadsheet in our signatures so that anyone here can access it to provide advice or guidance should the need arise.