Need To Be Prepared For Next Vet Visit

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WenDawg

WenDawg

Member Since 2014
I'm new to all of this and feel that after my last vet visit, I need to be more prepared when I return...To make a long story shortish, I took my 14yo male indoor only cat into the vet because I had noticed weight loss, increased thirst, etc. From just the physical examination, besides being a little dehydrated, the vet had me convinced that he was in late stage renal failure and also had hyperthyroidism (diabetes was never mentioned). I waited 2 agonizing days for all of the lab results and everything turned out to be "normal" except for his blood glucose which was 421. After a discussion with the vet where he told me "a change in diet would make little difference" but if I was to change it, I should "use one of the prescription diets that was high fiber, low fat, etc". I chose to go against his advice and went out and purchased low carb canned food and threw out all of the dry kibble. This transition has gone pretty smoothly over the past 2 days. He also received some sub q fluids while at the vet visit. The vet also didn't suggest home testing/monitoring, so I decided to do that on my own too. In addition, the vet also said that he didn't think stress would cause such a high blood glucose number and that I need to bring him back immediately to get started on insulin, etc. I have no problem with starting my cat on insulin, but since the vet was closed today and my vet is off tomorrow, I decided I would home test my cat's blood glucose just to see what type of results I get.

So far today (I've not set up a google doc spreadsheet yet), I've tested (with a human monitor) and received the following results:
Prior to breakfast (fasting) = 249
1 hour after eating = 268
3 hours after eating = 262
5 hours after eating = 233
7 hours after eating = 252
9 hours after eating = 258
11 hours after eating = 253

So my questions are...how much longer would you give the change in diet to take effect (he's been on the low carb diet for 2 days)? Should I monitor for a few more days before returning to the vet as I know my cat will be super stressed and won't eat while there which will throw off his numbers? Which insulin would be best to start off with given the numbers above? Any other information that I need to be armed with upon my return?

Thanks in advance!! I feel like I've got to be an advocate for my cat since he can't speak up for himself, so I am open to any advice that you send my way. :smile:
 
Welcome to FDMB!

My name is Shelly, and my cat's name is Jersey. I just want to commend you on the research you've done so far, and the changes you've made. I, unfortunately, blindly followed my vet's advice for several months before making the necessary changes. Fortunately, the people here were still able to help me get Jersey into remission.

A brief version of my story - Jersey was diagnosed in November, and the vet put her on Hill's w/d dry with no insulin. In January, the diet change hadn't worked, so he prescribed Humulin-N for her. It was only then that I started doing my research. I found out the dry prescription food was loaded with carbs and the Humulin was not the best one for cats. I ended up going to a different vet, who prescribed Lantus. From what I've learned here, Lantus, Levemir, and Prozinc are some of the best insulins for cats.

We started Lantus in February and went OTJ (off the juice) in April. Our vets weren't very knowledgeable about feline diabetes, and we ended up getting all of our dosing advice here at FDMB. We followed the Tight Regulation protocol, which sounds scarier than it is. ;-)

From what I've learned here, you should be able to see the effects of a food change within a few days. Also, research shows that cats have the best chance of going into remission if they're started on insulin as soon as possible. If you don't see a big change in numbers soon, it might be a good idea to consider starting insulin. That's just my two cents' worth, so take it for what it's worth.

I'm sure others will be along soon to offer their opinions. Again, great job on the steps you've taken so far. Keep asking questions; we have really knowledgeable people here who would be thrilled to help you and your kitty. (By the way, what's your cat's name?)

Shelly
 
Thanks Shelly for your reply and I appreciate the information. I'm happy to hear about your positive outcome of getting OTJ and I can only hope for the same results at some point. My cat's name is Abernathy. He's not been sick once in 14 years which is why all of this has come as a shock :shock:

I just want to be stocked with as much information as possible when I return to the vet so that I can make informed decisions.
 
Hey!

I just read your post re food and wanted to chime in. I am newish to the board, but have read around on many of the topics and there is so much knowledge here.

If you can, work the food for a couple of days and see how it does go. I know many really experienced members say its much better to change your cats diet to wet food and see how that pans out for a week or so before starting insulin if you can. Mid 200's thus far aren't too bad for a cat controlled only by food (never having had insulin!) And it definitely shows that a stressed kitty has a higher BG :)

Remember through this whole thing - you know your cat best. And, your vet doesn't have to support all your ideas - its up to you to decide what's best for pus, and act upon it. The people here will help you become a weapon of knowledge so you can gently guide your vet along the path you want to take. If you vet doesn't want to walk with you, there are plenty that will!

Good on you for doing everything you can and have so far! Your kitty is a lucky dude :)
 
Great job making the transition to low carb wet food and getting going on the home testing. :thumbup I'd test for a couple more days and if you aren't seeing any changes in the numbers, it may be time to start insulin. Some cats only need a little insulin support and go into remission. The best insulins for cats are Lantus, Levemir, or Prozinc, PZI.
 
Thank you for the information and support. It's so nice to be able to go to a board full of such knowledgeable people. It makes this new chapter of my life a little bit easier :smile:
 
My cat's name is Abernathy. He's not been sick once in 14 years which is why all of this has come as a shock
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I hear ya on that one; Jersey hadn't ever been sick until her diagnosis, either.

I'm so glad that you're asking questions - please keep asking them. I'm also really glad Wendy (Wendy and Neko) chimed in, too. She's one of the many experienced users here who helped Jersey and I get into remission.
 
WenDawg said:
So my questions are...how much longer would you give the change in diet to take effect (he's been on the low carb diet for 2 days)? Should I monitor for a few more days before returning to the vet as I know my cat will be super stressed and won't eat while there which will throw off his numbers? Which insulin would be best to start off with given the numbers above? Any other information that I need to be armed with upon my return?
Click to expand...

I had the best results when I switched to a no carb diet. Low carb didn't work for me. It took about 2 weeks before I was able to completely stop giving him insulin, but you should notice something within the first few days.
 
zzyzzx said:
WenDawg said:
So my questions are...how much longer would you give the change in diet to take effect (he's been on the low carb diet for 2 days)? Should I monitor for a few more days before returning to the vet as I know my cat will be super stressed and won't eat while there which will throw off his numbers? Which insulin would be best to start off with given the numbers above? Any other information that I need to be armed with upon my return?
Click to expand...

I had the best results when I switched to a no carb diet. Low carb didn't work for me. It took about 2 weeks before I was able to completely stop giving him insulin, but you should notice something within the first few days.
Click to expand...

What what specific "no carb diet" are you feeding?
 
If you are referring to Young Again 0 Carb, it is actually about 5% calories from carbohydrate.
 
I feel where you're coming from - you get that diagnosis and it's like slam bam! It's true that blood glucose can be higher from stress but it is generally supposed to be a small percentage, like less than 10%. There is a variability in meters and that you have more accuracy from a blood draw. I have use 2 meters side by side and seen a 20-40 mg/dL difference. My cat had a blood sugar of >400 at the vet but when I checked it at home it was 180 that night. Clearly that doesn't make sense but he was spilling glucose in his urine and definitely symptomatic so we needed to treat. Hopefully your vet did other tests to determine that your cat needs insulin, like a urinalysis and possibly a fructosamine, which can measure his average glucose over that past few weeks.

You definitely did the right thing by choosing a low-carb diet. :) Your vet may be a bit old school with the low fiber, low fat recommendation but it's now obsolete. The low fat doesn't work because you gotta get the rest of the calories from either protein or carb and guess which is cheaper? And since cats are carnivores, they can only tolerate so much fiber, which provides them with no real nutritive value so it's not surprising that was a fail diet. Low carb (sorry if I digress, but in case anyone is interested) basically just means it's high in protein and fat. The body will digest all 3 of these and convert them into glucose in the liver after a meal, it just does it a lot slower for protein and fat than it does for carbohydrates, like 3-5 times slower. That makes it a little easier on the pancreas and the reason for the benefit of longer-acting insulins. Lantus (glargine) is the type of insulin recommended by my vets. While it's the most expensive, it's also the slowest acting insulin which also makes it the safest for preventing low blood sugars. It works over 24 hours. Humalin-N works over about 12 hours. Any of the fast/rapid acting are much, much shorter. They also have curves of activity - the shorter acting the insulin the more the dose varies as it works. This works great for humans - not so much for cats - because they can't tell us, "I feel like I'm gonna pass out, mom"

If you want to monitor his blood sugar in the future, you can actually check him fewer times in the day even if he's on insulin. You can check him before breakfast and then 4 hours after breakfast (& insulin), and again 4 hours later (8 hours after breakfast). That should be enough information for your vet to use and make any decisions or changes needed.

I hope Jersey is doing well & would love to hear updates! I am hoping my sweet boy 007 will be able to go into remission soon. There's lots of hope out there for our kitties :)
 
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