Just diagnosed - need help!

[Marlowe]

I returned from a trip in the US on Friday night and visited my Mother, only to find that one of her cats (10 y/o male) looking lethargic & obviously thinner. He was an 18LB bull of a cat and now looked pathetic. She couldn't tell me when he last ate since she just leaves dry food out for him & Charlie (Blue Wilderness Indoor - grain free). This must have been gradual, even I noticed last week he didn't look his energetic self. Yesterday he appeared generally normal otherwise and after just paying more attention to him on Saturday and noticing that he started hiding in the basement, I decided early Sunday to take him to the nearby emergency clinic in Scarborough (Toronto).

The vet called me later this morning to tell me that Marlowe has diabetes, and after adjusting her initial estimate ($2400 -$3000) upwards to $3500-$5500, asked me if I wished to pursue treatment. He would be kept in the clinic until he was stabilized. She seemed to be suggesting putting Mar down because of the trouble involved. I was told twice daily injections for life. I needed to discuss with my mother first , who seemed intimidated by the thought of the needles since Marlowe has a history of being a bad patient at the vets (read: towels, rubber gloves, muzzle, and extra hands..).

I found this forum this morning while waiting for the call from the vet and the panic has subsided, doesn't seem the impossible task I first thought. Does anyone have any recommendations for my elderly Mother with regards to her ability to handle the testing/injections? I travel a lot & can't be here for her every day even though I live within 10 miles, but she seems resigned to the easy solution. I would like to keep Marlowe going as long as possible.

Also, what are "curves"? If my mother missed one or two of the injections for whatever reason would it be fatal? I have many more questions but I'm sure most are covered in the topics on this forum.

Thanks!

 

[Sue and Oliver (GA)]

As you have probably read, diabetes is not a life time sentence. Cats can and do go into remission. We suggest starting with one of the longer lasting milder insulins like Lantus, Levemir or ProZinc. Two shots twice daily are necessary. Testing before each shot is very important - to see how the insulin is working and to be sure the dose you plan to give is safe.

i would get him on wet low carb food and test to see where his levels are, without vet stress. If insulin is needed, get one of those above.

I wonder if you could get your Mom started with the shots. You do the testing at first, teaching her and showing her it is not impossible. Worth a try?

 

[Deb & Wink]

Did the vet mention DKA? Diabetic ketoacidosis is a life threatening complication of diabetes and does require in clinic monitoring. It is expensive to treat and can not be treated at home.

What was the ketone levels at the vets?

What was the BG (blood glucose) levels at the vets?

Were other tests done to confirm the diabetes?

 

[Carl & Polly & Bob (GA)]

I was told twice daily injections for life. I needed to discuss with my mother first , who seemed intimidated by the thought of the needles since Marlowe has a history of being a bad patient at the vets (read: towels, rubber gloves, muzzle, and extra hands..).

Diabetes, if treated, is not a death sentence, nor is it necessarily a life-time of two shots per day. Cats can go into remission. My cat got two shots a day for ten weeks, and he's been off of insulin for nearly two years.

How is Marlowe at home, with Mom? Lots of cats are bad patients at the vet, but are not that way at home. I'd never tested blood at home, and the only shots Bob ever got before diabetes were vaccinations at the vet. But at home, the shots didn't bother him at all. My other cat, Mullet, requires two vet techs holding him down while a third clips his nails. When he goes to the vet, the techs all find something else to do, and at least one of them ends up bleeding. But I'm confident I could give him a shot at home without assistance if I had to.

Just as an aside, I don't know what exactly your vet did to give you a bill that high, or what they plan on doing, but that cost seems criminal to me.

Marlowe doesn't need to stay at the vet to get "stabilized" if all that's wrong is a simple diabetes diagnosis. If he's currently in diabetic ketoacisdosis status, then yes, he'd need to stay at the vet until they can get THAT issue under control. And the cost for that seems to run upwards of $1000 a day. But if all they are going to do is give him insulin and monitor his numbers, he doesn't need to have that done at their clinic.

Do you know the details of the diagnosis and what their treatment will consist of?

Do you think your Mom would be able to get BG tests daily? Maybe 3 or 4 of them? Giving the shots is easy once someone shows you how to do it, and we have lots of videos that show how to test and how to give the shots. It's the testing that seem to be the big hurdle at first, but once you have that down, this isn't a major thing to deal with.

Curves are when you check the BG values several times during a cycle of 12 hours between shots. They aren't something you need to do every day by any means. Most people test every two hours from the AM shot till the PM shot when they do a "curve". They can give you a really good idea of how the insulin works over the course of one insulin cycle. But they aren't required every day.

The "big things" we find are
A proper low carb diet which is usually just canned food that is low in carbs. Food you can buy in a grocery store, nothing "prescription" needed.
Home testing - it enable you to treat this illness at home rather than have to bring the cat to the vet for tests.
A good insulin for cats - Lantus, Levemir and Prozinc are three "good ones". Vetsulin, Caninsulin, Novalin N, not good choices.

I had no idea that cats could even become diabetic when I heard "Your cat has diabetes", and if freaked me out! But after the initial crisis, which in Bob's case did involve DKA and ER treatment, once I got him home and started to test, shoot and feed him appropriately, it was really not that big a deal. I was extrememly fortunate in that he went into remission (and rather quickly), but the same possiblity exists for every cat.

 

[Marlowe]

Thanks for all the quick replies! Yes, DKA was mentioned as a complication, so, not good, but survivable. And I'm assuming that is what the added cost will be.
You're right, I'll have to get my Mother used to injections, but she couldn't handle giving him pills when he needed them for some infection 5 years ago. That was a busy week for me!

I think I read another post somewhere that their cat didn't seem to mind injections/testing at home either, even though the same cat went wild at the vets when there for vaccinations. Hope this is the case for Mar.

I had to leave the cat at the clinic alone for today, so I will find out more about his treatment when I get to the clinic tomorrow.

I now have to wonder if my food choices for the cat has led to this..... seems to be high carbs in most of the dry food (which they prefer).

 

[Carl & Polly & Bob (GA)]

One thing that seems to help when you have to leave kitty at the vet...
Try taking a sweater, shirt, pillow case, etc... something that smells like "Mom" to the clinic and have them put it in the cage with Marlowe. It might make him feel more secure.

Don't go down the "if only I'd fed him differently...." road! I fed every cat (a couple dozen) I've ever had dry food because it was the easiest thing to do. Bob is the only one who ever developed diabetes. Yes, it might contribute, but if it was a certainty, there'd be like 2 out of every 3 cats (or an even higher percentage) getting diabetes. And who knew, before the diagnosis, that dry food was high in carbs and that carbs were a no-no??? Not too many people, I would guess.

My basic thinking with this, (and with life in general) is "Live for today, look forward to tomorrow, and screw yesterday, it's over." Knowing now that dry food isn't a good choice for diabetics, or for any cat for that matter, every cat you come across in the future, and everyone you know who has a cat will benefit from that knowledge.

 

[Blue]

Thanks for all the quick replies! Yes, DKA was mentioned as a complication, so, not good, but survivable. And I'm assuming that is what the added cost will be.
You're right, I'll have to get my Mother used to injections, but she couldn't handle giving him pills when he needed them for some infection 5 years ago. That was a busy week for me!

I think I read another post somewhere that their cat didn't seem to mind injections/testing at home either, even though the same cat went wild at the vets when there for vaccinations. Hope this is the case for Mar.

I had to leave the cat at the clinic alone for today, so I will find out more about his treatment when I get to the clinic tomorrow.

I now have to wonder if my food choices for the cat has led to this..... seems to be high carbs in most of the dry food (which they prefer).

I have a few questions... why is the bill so high, or is that just an estimate?
If that's a bill, I would want a DETAILED AND ITEMIZED list of ALL treatment that added up to those amounts.

DKA. Was it mentioned or did the vet say that's what your cat has NOW?
Why does the cat have to stay at the vet office? If it's to regulate the diabetes, forget about that. No cat is regulated in a few days at a strange vet place. You don't know how long the cat's been diabetic, so nobody has a clue how long it will take to regulate the cat. For all you know, it's just a lousy diet and once you switch over to a low carb wet diet, Marlowe may not even need insulin.

So, the first few things you need to do is the switch the diet to a low carb wet food, like fancy feast or friskies pates, or just check Dr. Lisa's list for foods under 10% carbs
catinfo.org/docs/FoodChartPublic9-22-12.pdf

The next thing you need to do is pick up a blood glucose meter, test strips, and lancets at Walmart or someplace. You can do your own home testing and forget about curves at the vet place..... that vet seems like a crook with those prices, and talking like putting the cat down? Really? Why?
Most people here home test their cats.... just a poke on the tip of the ear, then sip the drop of blood on a test strip in your meter. If you test every 2 hours for 12hrs, that's a full curve. You and your mother can do that easy and safe yourself a big bill, plus no stress for your cat.

Many cats are fine with their owners, but very nervous and stressed at the vet place, so the numbers the vet gets will likely be very high but the numbers you get at home will be lower.

So start testing, change the diet, and then after a week, decide if you need to give insulin.
All of this is provided the cat's not DKA and needing to be at the vet, so ask exactly what's wrong with the cat and if it's just diabetes, bring Marlowe home.

Gayle

 

[Wendy&Tiggy(GA)]

Hi there!

I live in Oshawa and my vet is in Whitby. When my Tiggy was diagnosed, my vet told me that taking him in to do a curve was inaccurate and expensive and recommended home testing to me. I was reluctant at first but soon realized how much safer it was to test at home, how much more valuable information I was getting, and within a few months Tiggy went into remission.

My sister in law's vet is in Oakville. Her vet did a curve and kept the cat in for 2 days to "regulate" his diabetes. Cost her over $1000. One week after bringing him home, Nikko had a hypo and died. No home testing.

These cases arent unique. I know you trust your vet but I have realized the painful way that more than a few vets are out of date with the latest diabetes research and are giving out of date advice.

So that being said, we can certainly help you out - the more you do correct from the start, the better chance Marlow has of remission (40% of cats) and the less work or stress for your mother. So here are a few pointers

1. Giving an insulin shot is so so much easier than giving a pill. The needle is short and the cat doesnt feel it - especially if you do it when eating.
2. Testing - since you are in Canada (and unless you want regular trips to the US), you dont have access to the cheap US walmart brands. So I would recommend the Bayer Contour - you can get a free one from here (http://felinediabetes.com/FDMB/viewtopic.php?f=15&t=98448)
3. Food - dry food unfortunately is likely the culprit. The fancy feast classic pates (currently 56c at petsmart) are a great cheap low carb option. But you want to be home testing if you change to wet food and start insulin at the same time.
4. Insulin - Lantus and levemir and prozinc are the best choices for remission and regulation. You can get a vial of Lantus at Shoppers for $75 ( and points!) and it will last you up to six months


Wendy