Just found out today that he's diabetic

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violetdoll

Member Since 2013
Hi, glad I found this board. My kitty is about 7 years old, male. He is the sweetest thing in the world, so popular with everyone. And now he's diabetic. Figures it always happens to the really good ones (not that they all aren't good, he's just exceptional). I just found out today. He's been losing weight for a few years but he was a little overweight when we started out. He was looking really good for awhile, nice and lean and he was getting really active. But then a few days ago I started getting worried because he seemed so bony. He was thin before but you couldn't feel his spine and hip bones. So I took him in the the vet where i (thankfully) work part time as a receptionist (I get a really good discount). They sent blood out and sure enough, his glucose was 421. She wants to start him on Lantus, 2 units 2 times a day. I haven't been able to pick it up yet since I was working when she called (at my full time job, which is not a the clinic) and didn't get home until later.

So, I'm obviously freaking out a little. He seems so young to have diabetes. She hadn't mentioned anything to me about doing any testing at home. She did say to feed him wet food when I gave the injection. So I'm reading a lot about the low carb diets on here, they seem pretty popular. One of the vets where I work says he always uses WD for diabetics because it's high fiber, balanced protein and fat. He's a little weird if I'm being honest and I wouldn't take my cat to him if I had a choice but he seems to think that he gets cats into remission a lot. The female doctor I do see hasn't really mentioned any total re-haul of the diet. He's on dry food now. I also have 4 other cats and we just feed them a few times a day and they all eat together. We don't have a really ideal place to isolate him if we have to give him a totally new diet. Is the low carb diet ok for non-diabetic cats as well?

She also mentioned that the pharmacist would probably tell me that I had to throw the vial away after 28 days but that wasn't really true. Any thoughts about that? Also, do you guys know where I can get that the cheapest? I wandered into CVS because it's next to the clinic to price check it and it was over $200 for a vial of Lantus. Does Wal-Mart have it any cheaper? How long does it stay good for? If the vials are 10 mLs and I have to give 4 units a day, that's enough for SEVERAL months. I'm assuming the dosage will probably change though. How do you guys deal with the feeding situation when you have a bunch of other cats? How much leeway do you have for injections? Does it have to be given at the exact same time everyday? My boyfriend and I work different schedules so we are trying to figure out when the best time to start injections would be. Any advice on getting his weight back up without compromising his blood sugar? Any words of encouragement? I'm going to take him in tomorrow after I pick up the insulin so the techs can show us how to do everything but it's good to have some other viewpoints as well. I love that guy and I want him to be healthy again.
 
Welcome Violet. You have found a fabulous group here. I know some of the experience will drop in shortly. The monitor pretty well here :)

I'm a still new. Izzy was diagnosed at the end of June and we started on Lantus on 7/1. I was totally freaked out about the Lantus having to be tossed at 28 days and rest assured that is not true. I do treat her vial as if it is a combination of Gold and Nitro Glycerine :) No shaking or jostling, always put it back in the box to minimize exposure to light, always put the box in the back of the fridge where it stays nice and cold and not subject to temperature changes from opening and closing the door. I am still using the same vial I opened on 7/1.

My next batch I have swited to the Lantus pen. I was not one of the lucky people who could find a Pharmacy willing to open the box and dispense a single pen. Many others here have had luck at various pharmacies doing this. A single pen is 3ml of Lantus. Since I had to pay for full box it was almost $300 BUT..this box will last me over a year AND since each little pen vial is 3ml I won't be wasting as much as with the big 10ml vial. So there is something to ponder. I would call around for prices. My local Shopko beat WalMart and Costco pricing.

Have you started home testing? If not, you need to. You can use a human glucometer. I personally own both a Relion Micro and ReLion Confirm. I felt I should have a back up. Murphy's Laws adores me and I figured if I was not prepared...Izzy would hypo on a holiday or weekend after hours, I'd break the glucometer and wouldn't have time to get another. So I have one I used and 1 in a drawer lol :-D
 
No, I haven't even started giving the insulin yet. I just got the diagnosis today and didn't have time to go the pharmacy after work. My doc didn't mention doing at home testing but I think it would definitely make me feel better. I work at the vet clinic and I'm going to be going there tomorrow to have them demonstrate injecting. From reading the forum, I'm a little worried about changing the diet and starting the insulin at the same time, as it seems like the diet change itself can cause a pretty drastic change. Although she also didn't mention changing the diet. I only talked to her on the phone for a few minutes though. She wants me to do the injections for two weeks then retest the glucose. I will be asking a lot of questions tomorrow it seems. For now, I'd be happy if Sinatra gained some weight and started being more active. He's a little lethargic lately.
 
Mostly here I see them recommending you start on a lower dose than 2 units 2x day. If you update your subject line with dosing question nex to the your current title and hit the question mark radio button on the right...it will flag your post for the more knowledeable to drop in.

yes diet change can have an effect. I didn't have to work through that so much because Izzy was already on wet food (FF pate, friskie pate, sheba pate) before her diagnosis so I didn't have that worry on top of starting insulin.
 
Hi Nicole and sugarkitty Sinatra and welcome!

We highly recommend a food change first, before a cat starts on insulin. Changing to a low carb food like the Fancy Feast classics, Friskies pate or Wellness can drop a cat's BG (blood glucose) levels 100 points or more. It's a great first step and safe to do if you are not yet home testing AND have not started the insulin.

One of the vets where I work says he always uses WD for diabetics because it's high fiber, balanced protein and fat.
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And it's extremely high in carbs, 37% for the dry food. :o :shock: :o It's what the vet recommended to the shelter and one of the things that kept Wink unregulated for months at the cat shelter. As soon as I got him to eat the low carb wet food, his BG (blood glucose) levels plummeted and he went OTJ pretty quickly. He's been in remission for 6+ months now, eating Fancy Feast classic pate style and Friskies pate. I would never feed any of my cats high carb junk food like that W/d that your vet is recommending. Doesn't sound to me like he is up to date, with the latest AAHA recommendations for treating diabetes, vet journal published in June 2010, which recommend the lowest carb food a cat will eat and canned food preferred over dry.

Cat's don't need fiber. They need low carb, especially diabetic cats. It's more like their natural diet, that of a carnivore. Their bodies don't need the carbs. They can take the protein and fat in the low carb food and get all the nutrition they need.
 
Glucose numbers at the vet may be 100-180 mg/dL higher than normal levels.
Changing to a low carb diet may reduce glucose levels 100 mg/dL give or take.
So home testing and going low carb may bring the observed levels much lower.

I'd really encourage you to switch food before starting insulin, unless the vet mentioned ketones were present (those are dangerous and you can test for ketones in the urine - see my signature link Secondary Monitoring Tools). One line of inexpensive, low carb, canned food is Friskies pates and I'm feeding all 14 cat under my roof with the poultry versions. For more great info on feline nutrition, written by vet Dr Pierson, go Cat Info. To avoid GI upsets from sudden food changes, shift to the new food slowly, aboout 20-25% more new food and less old food per day.

If you start insulin before diet change, focus on learning to home test the glucose before you make any food changes due to the potential drop of 100 mg/dL. This is for safety. And start with a low dose of about 0.5 to 1.0 units; vets seem to over-estimate the starting dose frequently.
 
Went to the doc's today for diabetic discharge. Got to see one of the good doctors (I'll call him Dr J). I work at the clinic so I know which ones I like and trust. I asked him about the low carb diet (he called it Catkins, :lol: ) and he recommended not changing the diet at first or just adding some wet food to his normal diet of Meow Mix and starting the insulin and retesting the glucose in 2 weeks to see how that was working. He said definitely feed first before giving the shot and if he doesn't eat to skip the dose. I did get a glucometer, testing strips, lancets, ketone strips, and I have Karo syrup in the house so I am prepared to do home testing if only to give myself peace of mind. He did say that if I test him before every shot, I'm just going to make the cat mad. I asked him about the dosage and he said 2 units is a pretty standard starting point. Sinatra is currently 10 lbs, which is a little underweight for him actually, he's a pretty big cat. I don't think I'm comfortable going against their advice and just changing the diet without starting insulin. I do trust his opinion and the other vet I saw on Thursday (Dr A) who diagnosed him, they are the doctors that the technicians use for their pets most often. The doctor (Dr F) that talked about the W/D is a pretty old school doc and I honestly wouldn't go to him, but he has his fans for sure among the clients. I'm trying to take all opinions into consideration. Dr J gave me his cell phone number in case I need to ask him any questions. He told me that they worry about hypoglycemia in very small dogs more than cats and that I shouldn't worry too much about that happening. He told me to watch for changes in drinking and urinating to determine if the insulin was working. Sinatra is currently drinking and peeing buckets. So I think for now I will start out easy and give the insulin tomorrow morning, see how he looks, maybe try to test him before the evening dose just to see what I get and just add a little wet food for now. I'm not ready to jump right in with the very frequent testing and I don't want to traumatize him more than I have to right now. I feel like I need to take all this change a little slowly, he's a kind of sensitive cat and doesn't like being giving medicine. I'm sorry if this is jumbled, I have a million thoughts running through my head right now.
 
Your vet is not up to date. Here is a link to the 2010 AAHA Guidelines. Have a read and please, share them with your vet.

Most of us will vehemently disagree with keeping the cat on bad food - it results in increased insulin needs ($$$) and poor nutrition for the cat. (Meow Mix is cr*p, sorry!). When I put Spitzer on low carb food, he dropped from 3 units to 1 unit ... and I spent one night staying up and testing him because of how low he went before the dose was reduced.

You could do the food change over 5 days and shoot 0.5 to 1.0 units while doing it, to be safe.

No, for the majority of cats, home testing neither hurts them nor upsets them - Spitzer would come into the bathroom to be tested because he always got a small, low carb treat. If I had a diabetic child, I would never give insulin without testing to be sure it was safe to give it. For new folk, we suggest no shot below 200 mg/dL; that number is gradually lowered once you have test data around the expected nadir (5-7 hours after Lantus) to show it is safe.

Furthermore, if you home test, you can do a curve at home and not stress your cat taking him into the vet and getting stress-influenced numbers form 100-180 mg/dL higher than at home.
 
You might want to print out a copy of this post on how to treat a hypo, which lists the hypo symptoms. Most cats show absolutely no symptoms though. At least you have the testing supplies in case of emergency, you can test to check his BG level.

He told me that they worry about hypoglycemia in very small dogs more than cats and that I shouldn't worry too much about that happening.
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I don't understand why your vet thinks it is only small dogs that can hypo. Cats can too.

I'm not ready to jump right in with the very frequent testing and I don't want to traumatize him more than I have to right now.
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Understood. Some cats are easier than others to start the home testing with. Start out slow, rubbing and touching his ears to get him used to that. Then add the warmed rice sock to get the blood flowing and having that touching his ears. If you are going to use the lancing pen, click that by his ears to get him used to the sound. Do this frequently, without even poking his ear yet. Give him a treat like a piece of cooked chicken or a freeze dried piece of chicken like Pure Bites or Halo Liv-a-littles. Always reward him for every session. Three tries and stop, reward with treat and try again later with the various steps.

So I think for now I will start out easy and give the insulin tomorrow morning, see how he looks, maybe try to test him before the evening dose just to see what I get
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Not sure if you had seen this document. It has a lot of greattips and tricks on the home testing.
Something for you to review before you try for that test this evening you mentioned.
 
He didn't say they CAN'T be hypo, just that if it was a very small dog, only a few pounds, then it would be something to definitely watch for because they are more prone to it, more so than a fairly large cat. I'm getting pretty stressed out about all the conflicting information. I do trust and personally know both veterinarians who are telling me to give the insulin. I've worked with them for almost five years now, as in I work at the clinic not just have taken my pets there for that long. I'm not comfortable ignoring their recommendations and just trying the diet change first, or giving a lower dose than prescribed. So it's making me anxious that everyone here seems to think they are totally wrong. nailbite_smile

I do have the testing supplies and I don't think it can hurt to test him, so I probably will do that just to calm my fear. But I know that Lantus can take five days or so before it's the most effective, so I'm not sure if testing him will give an accurate picture of how he's doing. I am planning on taking the guidelines into work on Monday and asking them about it, and to explain why they decided to start insulin right away instead of diet change and why they wanted to start him on 2 units instead of 1, etc. When you do a pre-shot test, do you feed first then test, or test before feeding? How long does it take after eating to affect the blood sugar? I think I need to stop reading about this, I'm getting overwhelmed.
 
Welcome Nicole and extra sweet Sinatra!

Testing....I can't even unzip my sugarboyz meter cases without them coming running for a test/treat! I forgot to change the lancets earlier so unzipped their cases to replace them. Looked around...had 2 previously sleeping sugarboyz sitting at my feet. When I only need to test one of them, the other one is SO confused...Mama! Dat's da meter...why did u not pokie ME? I iz here. Sometimes they insist that I test before they'll leave...they keep patting my leg and laying down in their testing positions.

BIG HUGS!
 
Hello and welcome to the board!

I think its a great idea to test as soon as possible - shooting insulin without testing is like driving with a bag over your head. I usually recommend 4 tests a day:

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

Now I do say I agree with the others, I would change food first, then try the insulin. I think many vets and doctors grab for the drugs too fast. Food usually makes a huge difference .... so much that they never need the insulin at all in some cases ... or if they do - its a reduced dose.

Also 2 units is a high starting dose. I would play it safe and go with 1 unit and work up slowly.

Wendy

PS testing doesnt bother my boys at all - Bailey wants his treats and gets excited.. and Tiggy barely opens his eyes if snoozing.
 
You hold the syringe and its your cat. You might tell the vet you want to switch to low carb food first, before starting insulin, and home testing to get non-stressed numbers. They might appreciate a pro-active owner who is willing to commit; many won't.
 
I have only been testing Izzy since July 1. I don't know why your vet says it will just make them mad. When it's breakfast and dinner time all I have to say to her is..."it's pokey time princess" and she goes to her spot and lays down, purrs and lets me poke her ear. Once we are done, she begins demanding her food (which of course is not ready).

Quite frankly she is much better about her insulin shots than she is her SubQs.
 
violetdoll said:
He didn't say they CAN'T be hypo, just that if it was a very small dog, only a few pounds, then it would be something to definitely watch for because they are more prone to it, more so than a fairly large cat. I'm getting pretty stressed out about all the conflicting information. I do trust and personally know both veterinarians who are telling me to give the insulin. I've worked with them for almost five years now, as in I work at the clinic not just have taken my pets there for that long. I'm not comfortable ignoring their recommendations and just trying the diet change first, or giving a lower dose than prescribed. So it's making me anxious that everyone here seems to think they are totally wrong. nailbite_smile
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They're not "totally" wrong; we just deal with diabetes on a daily basis and see close to a hundred newly diagnosed cats in a month. They maybe see about that many in a lifetime. We have the time to sit and obsess about the daily management and read up on all the new studies and treatments. They maybe have time for a refresher course every few years (if at all). Most of us here have also "trained up" our vets, so that helps them as well. They're not expected to know everything about every disease across every species, so it's not that they're untrustworthy or bad; just uninformed. ;-)

violetdoll said:
I do have the testing supplies and I don't think it can hurt to test him, so I probably will do that just to calm my fear. But I know that Lantus can take five days or so before it's the most effective, so I'm not sure if testing him will give an accurate picture of how he's doing. I am planning on taking the guidelines into work on Monday and asking them about it, and to explain why they decided to start insulin right away instead of diet change and why they wanted to start him on 2 units instead of 1, etc. When you do a pre-shot test, do you feed first then test, or test before feeding? How long does it take after eating to affect the blood sugar? I think I need to stop reading about this, I'm getting overwhelmed.
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Testing him before the Lantus "takes effect" will help you both get more comfortable and more familiar with the testing process when first starting out. You're probably not going to be very successful the first few times or even the first few days, so it's better to get the "practice testing" out of the way so when the insulin starts taking effect, you can immediately get the real data of what's going on. Some cats also don't read the Feline Diabetes Rule Book and will drop far and fast just off the first dose. ohmygod_smile

When first starting out, it's recommended to take all food up 2 hours before the pre-shot test to make sure the BGs are not influenced by food. You also don't want to feed them before you test in case they give you a low number (for new members, this number is 200 on a human meter). If the number is under 200, we recommend you hold off on giving the shot, hold off on food, post here for advice, and test again in a half hour to see if the number is "rising" and if it's safe to give a shot. If you feed them, then that test in a half hour will be food-influenced.
 
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