Junior is newly Diagnosed Diabetic Kitty

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kay&junior

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Hello, very new at this, already lost my first posting....Junior is 9 yo, 8 weeks a Diabetic, started on 1 unit Glargine twice daily, and increased to 2 units twice daily after 4 weeks of slight improvement, big problem, his ears don't bleed, anyone ever tested a pad on the foot? dip stick testing his urine shows +++
and his back legs are very weak, he does walk flat, and is not happy about it. my vet is on vacation, she does not want to do anything about his legs til his Diabetes is regulated, is this correct, or can I start something sooner? food is 1/4 cup twice daily, Hill's d/m, urine output has been ok, better than before the insulin anyways. any suggestions for the ears, have tried just about everything...any help would be so appreciated.
 
Hi and welcome! It sounds like Junior has a bit of diabetic neuropathy. Some kitties improve once the diabetes is more regulated, some need help with supplements. I think B12 is one of them, but I know that people with more experience with neuropathy will chime in soon! Is the D/M wet or dry? Either way, it's not an ideal food for a diabetic kitty. Junior should be on a low-carb wet food, with less than 10% carbs. Here is a list of cat foods and their carb content http://binkyspage.tripod.com/CanFoodNew.html, http://binkyspage.tripod.com/CanFoodOld.html. popular choices are friskies pates and fancy feast classics. I use 9-lives pates because my Charlie eats A LOT and they are inexpensive. Most people agree that you should feed an unregulated diabetic cat as much as they want. They aren't properly processing their food while they are unregulated, so they are basically starving all the time. You can worry about cutting back once the diabetes is more regulated. Free feeding also works well for most kitties. I can't truly free feed, cuz Charlie would eat the house if he could :shock: (he's what we call a hoover), but I mimic it to the best of my ability by feeding him 5 small meals through the day.

For getting his ears to bleed... do you warm them up with a rice sock that you microwave for a few seconds? That usually helps. Have you tried a few different areas along the outside edge of the ear? Some kitties bleed better lower, some higher up on the ear. I know that it is possible to test paw pads, but I've never heard of anyone who does it. Maybe someone will stop by with some tips for that. If you're going to try that, I would make sure to use neosporin on it to help protect it from infection in the litterbox. that would be my only concern. I hope that helps a little bit. Welcome to the group!
 
Regarding getting blood:
- Make sure that you are firmly backing up the ear. when you poke the ear.
- Post your general location. Maybe some one is nearby to give you pointers in person.
 
What gauge Lancets are you using? It can be hard to get blood from the ears at first, but warming them and using a larger Lancet (26-28g) helps. The small lancets (30-31g) are very hard to get blood with.

Home testing is the first step to getting Junior regulated. It's nearly impossible to do it any other way.

I'm a little concerned about the dosing. Lantus (glargine) should not be increased in whole units--when you raise the dose too fast you risk missing the cat's correct dose. This does not show up in vet numbers because too much insulin looks exactly like too little insulin unless you're home testing daily. Here's a link to the dosing protocol that we use for Lantus: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581. Often the problem is just that a lot of vets haven't heard about it yet. I had to bring a copy to my vet and tell her that this was how I wanted to dose Bandit. Once she read the article and the protocol, she was on board! Here's a copy of the protocol for you to print out and give to your vet: http://felinediabetes.com/Roomp_Rand_2008 dosing_testing protocol.pdf, as well as the citation to the article the shows the high remission rate and safety using this protocol for cats: http://www.ncbi.nlm.nih.gov/pubmed/19592286.

Diet has already been mentioned, but I did want to point out that switching from dry to wet food can lower your cats blood sugar levels by 100-200 points overnight--so you want to make sure you're hometesting when you switch the diet. Most cats do not need much more than 1u once the dry food has been removed.

Welcome!
 
Thanks so much for answering so quick, we live in the Mountains of New Hampshire, very remote, 45 minutes to vet office. I have tried to warm the ear, tried different spots on his ears, and will now try a larger Lancet. Will also check into switching his food, I have printed out the diet pages, Thanks to Charliemeow. we will work on that, he has been a dry food cat his whole life. he does have a litter mate brother who lives with us, he is fine, a little overwieght, but on a diet since finding out about Junior. will also print out pages about Lantus for my vet, thanks again! I am not sure about testing his pad, think i'll wait on that, and keep trying his ears...will let you know more as soon as i know more!

another thing, he was diagnosed on my mom's birthday, June 16th, she is in hospice and wants to see him well again. thanks everyone.
 
Welcome Kay & Junior,
I wanted to quickly add that my Sugar Bean has a problem with the right ear, however, I can get the left to deliver! I rub the same amount of time and even over do the right and still have no luck!
Keep trying - hoping someone lives close by and can lend a hand!
 
Hello again, have been trying the right ear because it was easier for me, now it is time to try the left ear, which might work better for Junior! thanks!
 
For some reason I can only get blood from Bandit's left ear, too. My boyfriend insists he has no problem getting it from the right ear, but I cannot get his right ear to bleed for the life of me.
 
Just wanted to stop by and say hello. Love your cat's name, but then again I'm a little biased. LOL!

Sounds like you're getting some great advice on the board!
 
Hi, and thanks for the welcome!
Junior got his name because he was the runt of the litter, his big brother is twice his size!
Tonight is the night, I have all my supplies ready to try again, glucose testing, got the larger lancet, 26 g., will try the left ear as suggested, wil warm the ear first, and pray it all works! i just want a number, is that to much to ask? and I am slowly transitioning him to wet food the last 36 hours, taking out a few dried pieces and mixing in a 1/2 teaspoon of wet food from the fabulous list of low carb wet foods! he loves it, I never thought he would. I will be very aware, as someone had mentioned his glucose could drop quickly going from dry to wet food. Still watching his water intake, and urine output, which are ok at this time. His vet answered me last night and said to increase him to 2 units, already done, and she is still insisting on b-12 shots, not Methyl b-12, waiting to speak in person with her. she also said she would rather he stay on the Hill's dry. d/m., maybe because she sells it? one more question, has anyone ever changed their vet because they won't work with you? I only have 2 other choices in my area, and they are even further away, or stick it out and be more forceful about my kitty's care?

thanks again for any help offered, this is the best place for help!
 
Tonight is the night, I have all my supplies ready to try again, glucose testing, got the larger lancet, 26 g., will try the left ear as suggested, wil warm the ear first, and pray it all works! i just want a number, is that to much to ask?

Sounds good! Sometimes it is easy, sometimes takes time and practice

and I am slowly transitioning him to wet food the last 36 hours, taking out a few dried pieces and mixing in a 1/2 teaspoon of wet food from the fabulous list of low carb wet foods! he loves it, I never thought he would. I will be very aware, as someone had mentioned his glucose could drop quickly going from dry to wet food. Still watching his water intake, and urine output, which are ok at this time. His vet answered me last night and said to increase him to 2 units, already done,

only problem with increasing his dose AND changing his food as it may work TOO well

and she is still insisting on b-12 shots, not Methyl b-12, waiting to speak in person with her.

No, it is methyl b-12. See http://www.laurieulrich.com/jasper/


she also said she would rather he stay on the Hill's dry. d/m., maybe because she sells it?

There is nothing about the HILLS MD (Purina is DM). Take a look at the ingredients. It is lowish in carbs for a dry food, but the protein sources are not great at all. Why not have a healthy protein source??? And dry food is dehydrating. See Dr Lisa www.catinfo.org

one more question, has anyone ever changed their vet because they won't work with you? I only have 2 other choices in my area, and they are even further away, or stick it out and be more forceful about my kitty's care?

Its up to you and depends on your options. My vet and I disagreed about hometesting but I proved her wrong and we're still together

Jen
 
Well on the vet question, it really depends on how well you like this vet for the routine stuff and non-diabetic stuff. If you like here and she is willing to work with you on the everyday cat stuff then you can just do like I did for awhile, until I retrained my vets...just smile and nod when they suggest this or that and then go home and do what is right by your kitty. I did originally change vets with my first sugarcat because they were completely unwilling to listen to me or work in partnership with me, but unfortunatly by the time I made the switch it was too late for my original girl.

Now with Maxwell and Musette, my vet has seen Maxwell exactly once, and then he wasn't a patient he was helping me give them a demo on home testing. But wit Maxwell he was perfectly health except for being diabetic, and had been recently vetted before I adopted him. Musette on the other hand, was being treated for a UTI when I adopted her, and since she was a little touchier about getting regulated than Maxwell, they did get to see her as a patience but that was to make sure she didn't have any other health issues complicating her getting regulated such as a bad tooth or still having the UTI.

Otherwise, with both of my current diabetics I do all their care at home, with the resources from the folks on this board and my own research. My vet is there for the same stuff they are there for all of my cats, vacinations, wellness exams, bloodwork etc.

Mel, Maxwell, Musette & The Fur Gang
 
Regarding Junior's vet, she is very nice, that being said, I was stuck when he started getting sick, and she is a Mobile Vet, who was able to come to my house after work to see my boy. She has not had lots of sugar kitties in her practice, I asked, she was more concerned that we have the money to take care of him, and the time, which I said we would be able to handle, even with illness in Mass. ( my mom ) I think we will stick with her for right now, get the glucose testing going tonight, I hope, and nod yes to her, and then go home and do my thing! being very careful to watch my little guy for any signs or symptoms.

as always, thanks!
 
Kay,
On the vet and food issue. You can only get Hill md from a vet. They buy it from a salesperson who's trying to making a living selling it. It costs a fortune, and I'm sure a good part of that cost is mark-up by the clinic. As far as food for a diabetic cat, it's garbage, dry or wet.
When I first sa Binky's canned list, I could not believe I was being told to feed Bob something that was 14% carbs, and paying over a buck a can for it, when there are so many grocery-store-available options that cost half that or less, and are actually BETTER for sugarcats! Next visit to the vet, I printed out Binky's list and told her flat out "I am buying these to try, and I am feeding him nothing but canned with less than 10% carbs. I showed her the big 14 on the MD, and she was actually surprised (either that it was that high, or cheaper foods were so much lower). They took back the case of cans I had bought a few days earlier. Bob pigged out on it for 2 days, then he wouldn't touch it.
So yeah, they make money on it, but also, I doubt if they really have all that much spare time to listen to some sales rep talk about how great their product is, and they probably say "OK yeah whatver, I 'll try it, talk to you later". Many vets don't specialize in nutrition. Very few specialize in diabetes. I'm sure they have a more or less generic plan of attack whenever they do run across something they see so infrequently as they see feline diabetes - "yeah, we'll prescribe Hill MD dry and canned, 1u Lantus BID for one week then bring him back in and we'll run a curve on him." Cha-ching....next please.

Now on the other hand, I love my vet. I didn't agree with everything she suggested, but I have always been able to talk freely with her and have been able to drag her along for the ride. She didn't suggest a diet change, I told her what I was doing. She did periodically tell me to raise the dose of insulin. I followed her instructions. She showed me how to home test, I home tested. She taught me how to give sub-q fluids, I did that too. But after reading and posting here for a while, I'm the one who decided to lower the doses, and I decided to adjust them based on Bobs numbers each day. I'm the one who decided to stop giving Bob insulin to see what would happen. She didn't know I'd stopped the insulin until I brought Bob in for a scheduled visit and I gave her a copy of his BG test results for the past week (all numbers lower than 100) and told her that it was her copy to frame. Then I told her, "Bob hasn't had any insulin for seven days". Rather than being upset that I'd gone "rogue" on her, she looked at me all teary eyed, looked down at the paper, and emphatically said "YES! This is the way it's SUPPOSED to happen!" She was absolutely thrilled with everything I'd done. And I'll keep using her and I still have her cell number that she told me I could call anytime, 24/7 if I had any questions, problems or just wanted to chat about how Bob was doing. Awesome vet, awesome vet techs and great facility. My real hope, and I've told her this would be okay, is that she share my phone number with the next people who come to see her with a sugarcat so I can help them out like I've been helped by the great people here.

If you have anywhere near that sort of relationship with your vet, then my advice would be to try to keep a good thing going. But this is your fight, not theirs. And your kitty, not theirs. I would do everything you can to try to bring them around to your way of thinking. If that is not possible, then do it your way, and after it works, tell them and show them how you did it. The best result would be for them to actually learn something from your experience. They'd benefit, but more importantly, the next diabetic kitty and the next sugarcat's mom or dad will have a much easier and more successful dance than the cases that preceeded yours. You'll be blazing that trail for them.

And that's all I have to say about that... I need an editer!

Carl in SC
 
Kay,

Like Carl, I was blessed with an awesome vet that I work hand in hand with. We don't always see eye to eye on everything, but when I was in one day with one of my non-diabetics he asked about Maxwell, at this point they knew Maxwell existed they had copies of his spreadsheets and bloodwork from when I adopted him, but had never seen him. When I told them oh he is in remission now and has been since November. My vet looked at me and said "How did you do THAT?" "Can you bring me a copy of the protocol you used?" my response was "Sure, no problem" So I came on here, I printed out all the stickies for Lantus, Levermir, and Prozinc, I made them copies of all 3 of Binky's lists, yes, even the dry food one. Then I made a fourth list where I pared down the lists to just those foods that were under 10%carbs, and brands that I knew were available in my area. I took them a contact list that included, this board, Diabetic Cat Care, Diabetic Cats in Need, and finally my phone number and email address. They called me back a week later and asked if Maxwell and I would come in and give them a demo on home testing, which we did. Then I get a call from my vet asking if I would come back and train his staff on home testing. Again I did, and since that time I have gotten calls to come back and help with curves at the clinic, to come in and talk to new sugarcat moms and dads about the importance of diet and home testing.

Just because your vet doesn't have a great deal of knowledge in this particular disease doesn't mean they can't learn as you do, and that you can't be the teacher. Because when you boil it all down, you are the one that serves the food, and you are the one that holds the syringe and meter. Junior is your cat, your baby, and it is his life you hold in your hands. As my vet told me once, I can only make suggestions, but I can't make you do anything. I can give you the meds, I can't make you give them. And then he paid me the ultimate compliment..." I only wish every cat I see would have as informed owner as you, I would see far less critical ill cats, and my job would be easier and a whole lot more fun." :-D He's a great guy, he has a great staff and he openly admits he knows a lot about a lot of animals, but he doesn't know everything about every animal. And that he will never know an animal as well as their owner. He sees them for a few minutes once in awhile, the owner lives with them day in and day out.

Now my last vet it was his way or the highway, so I chose the highway. And in doing so I found a couple of gems that works with me as a partner in caring for my furry family, because in the same practice I quickly learned that when it is a dog problem I ask for Dr. Rick, if it is a cat problem, it is either Dr. Rick or Dr. Adrian. Dr. Adrian is a great guy as well, but dogs especially large dogs, which I have, just aren't his thing, they scare him. But he is super with even the biggest freaked out cat. Cats are his thing, he is just more a cat guy than a large dog guy.

Mel, Maxwell, Musette & The Fur Gang
 
That was an awesome reply! no editing needed.
I will work with my vet as long as she works with me, and I will be her teacher too, as long as I am learning, she will learn!
and your right, I see him much more than she does, so it is up to me to take care of my little guy!
as far as last night, no success once again on the glucose test, no blood, freaked out cat, mommy had wine!
I did get a urine glucose, 450. waiting for the vet to call me back. he is doing good with water, urine, and loving the transition, very slow transition from dry to wet, hoping this helps as he really likes it! will try for the blood again tonight.
and all will be well.
k.
 
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