New and Frustrated

[amilli611]

Hello! My name is Andi and my cat man is Mac. He is 9 and was diagnosed about a month ago. I am frustrated because of his insulin levels and the behavior that isn't changing (thought I know it's not his fault). He is urinating next to and near the litter box, but mostly not in it. I rent my house and because of that, we are close to needing to find him a new home if he continues urinating where he isn't supposed to. In addition, he was put on lantus which start at 1 unit twice a day and now we are up to 4 in the morning and 3 in the evening. The cost is quickly increasing and becoming an issue. We don't want to lose our boy, but we are at a struggling point and don't know what to do. I w as told I should join this message board for advice, so I'm hoping to learn from everyone and find a way to make him feel better.

I have gotten some advice and am struggling because what I am told from my vet seems to be almost exactly opposite almost all of the advice we have gotten. How do I determine what is an isn't right? How do I do the opposite of what my vet tells me?

 

[Kris & Teasel]

Intro forum thread: http://www.felinediabetes.com/FDMB/threads/new-and-frustrated.181212/

 

[Chris & China (GA)]

Hi Andi and Welcome to the FDMB!!

This is Chris....I was talking to you earlier when you contacted DCIN

You might want to read the "Stickies" at the top of the Lantus Forum ...there is a LOT of information about Lantus there to help. I'd suggest reading the one titled "LANTUS & LEVEMIR - TIGHT REGULATION PROTOCOL (TR)".....at the bottom there are links to the only protocol that's been published in a veterinary journal and maybe your vet will be willing to learn along side you!!

We all came here because our cats weren't responding the way we thought they should and started questioning our vets. Getting Mac's glucose under control is the best way you can help with his peeing, as well as making sure there's nothing else going on like a urinary tract infection. All the sugar in the urine is a perfect growing medium for bacteria so UTI's are quite common in diabetic cats.

Now for the dose....As you'll read in the Sticky's, we usually start at .5 to 1U twice a day and then adjust in .25 unit increments because insulin is a very powerful hormone and a little can make a big difference. It looks like your vet has increased Mac too much and too quickly, so starting over at a reasonable dose is probably going to be what's best.

If you're in the US, you can get your insulin a LOT cheaper by buying it from Canada too!! That's where most of us are buying from now!! It's 1/3 the cost compared to the US. Here's a post on Buying insulin from Canada with all the information

I know you're currently feeding a high carb dry food. As with human diabetics, controlling the carbs is key to regulation. You can't eat potato chips all day and expect your glucose numbers to stabilize and it's the same with our kitties!! Getting Mac onto a low carb canned diet will be one of the best things you can do for him. Here's a chart that shows pretty much all foods you can buy and their carb percentages....you want under 10% carbs

Home testing will keep Mac safe as well as tell you how he's responding to treatment. The Relion Confirm or Micro meters are available at WalMart, take the tiniest sample size and the strips are affordable. It's important that you learn to home test BEFORE you reduce the carbs in the diet or you could end up in a hypo crisis.

Here are some videos that people here have made to help you learn to home test.

 

[jayla-n-Drevon]

hang in there !!! try not to get upset--I know easier said and we have all been there
I promise it gets better

 

[Sue484]

If I listened to my vets, my cats would be dead by now. I was following my vet and the specialist vet at the RVC for Frankie to the letter and it was only when they wanted to increase him to 7 units twice daily of Lantus I started asking for advice here and following it. Now Frankie is well regulated on 1 unit twice a day and I never see my vet for anything diabetes related. I did tell them I was changing to a wet food and ditching the dry. After an argument my vet said she would do some research and get back to me. She never did get back to me, so I guess she realised how wrong both her and the RVC were, and that was the last time I spoke to them regarding diabetes, and that was 2 years ago.

 

[Yong & Maury GA]

I have gotten some advice and am struggling because what I am told from my vet seems to be almost exactly opposite almost all of the advice we have gotten. How do I determine what is an isn't right? How do I do the opposite of what my vet tells me?

Hi Andi, again
I actually just typed this up for another member: I know it can be very conflicting when we give different advice than your Vet but please understand we're not trying to say your Vet is wrong but to remember we all live with our own sugar baby 24/7. Our experience easily outweighs the Vet's 5 hour course in Vet school . We always err on the side of safety!

The decision on which advice to follow is still completely left to you and you can always stick to your gut instinct .

 

[Veronica & Babu-chiri]

I have gotten some advice and am struggling because what I am told from my vet seems to be almost exactly opposite almost all of the advice we have gotten. How do I determine what is an isn't right? How do I do the opposite of what my vet tells me?

Hi Andy and welcome, this is really the best place you can be under the circumstances.

Regarding your vet unfortunately is up to you to decide but one thing to take into consideration is that most vets, even though they may be good doctors (mine is an excellent surgeon and I have seen him do wonders with broken bones) do not have much experience with diabetes and on top of that most of their patients with diabetes are dogs, so they start treating out kitties probably old school, that's what they remember and if like mine they have a lot of experience that means school was a few years ago (from what you mentioned about giving a different dose am and pm sounds like your case) , and like dogs, which means treatment is not the best for our kitties, you may try and discuss with him the information and advice you've received and hopefully he will agree to cooperate with you on a different approach than his

 

[JanetNJ]

I'm not a lantus expert, I'll leave dosing advice to the others... but as an owner who had a cat who liked to pee RIGHT NEXT TO THE FREAKIN' BOX I will tell you what saved my sanity was putting puppy training pads down for him to use. He hardly had any accidents other then the pads and box after we came to that compromise.

Now this was not my diabetic cat... his issue was behavioral... for your cat since she has diabetes it could very well be that this is caused by back leg weakness/pain common with diabetics called neuropathy. The way to reverse that is to get the BG levels under control, and give Vitamin B 12 metho. supplements. A common brand to use is Zobaline. You just add it to the food.

Trust the folks on here to help with dosing.... they've helped countless Lantus users achieve regulation and many of also gone into remission! Most vets raise the doses by whole units which is not the best method as you could skip the ideal dose. too much insulin often looks like not enough. Clearly your dr.'s way of doing it is not working.... so you might as well try this way.

 

[Julia & Bandit (GA)]

Hi Andi! Welcome.

Unfortunately, very few vets get all the aspects of successfully treating diabetes in cats right. Vets are general practitioners--they have to know a lot about many different medical issues in many different animals, and typically have incomplete or out of date information when it comes to feline diabetes. Some vets are also hesitant to recommend certain important aspects of treatment because they think their clients will be unwilling to comply with those recommendations. Things like daily home testing, all canned diets, and good insulins like Lantus (because they're so expensive in the US), sometimes scare newly diagnosed owners, but none of these are as bad as they seem with a little support. I've attached an article to this message if you need information to print and bring back to your vet to get them on board with the treatment guidelines we recommend here. The AAHA guidelines for Diabetes are also available online to bring to your vet.

Your vet is definitely not dosing the Lantus correctly. Dose adjustments need to be made in small, .25-.5u increments, and Lantus should always be the same size dose in the AM as the PM. I agree that the dose was raised too much, too quickly. This can keep BG uncontrolled and high just as much as not enough insulin. Cats rarely show signs of hypoglycemia unless it's gotten to the point over time of being life threatening--their livers dump glucose into their bloodstream to counteract the low blood sugar, so low numbers are typically followed by several days of very high numbers. That's why daily testing is so important in determining the right dose--office curves are typically inflated from stress and these rebounds from low blood sugar, leading to chronic overdosing. They don't give you a good picture of how the insulin is actually working in your cat--and it's much cheaper to home test. You don't have to pay for office curves or any other diabetic testing at the vet if you're home testing.

Chris gave you some great information up above--there are three things that are key to getting your cat's diabetes under control: A low carb, canned diet (there's a TON of commercial options--check out that link to the canned food list), dose adjustments via daily home testing (this is NOT as hard as it seems--even the most fractious cats accept it after a week or two of routine and diabetic safe treats), and slow acting insulin like Lantus (which is WAY cheaper if you buy from Canada). The large majority of cats will go into remission when these three things are done.

One important note--many diabetic cats need drastic decreases in their insulin dose or even go into remission completely when you switch the diet from dry to low carb, canned. It's very important to make sure you're home testing and lowering the dose when you change the diet--otherwise your cat could have a dangerous hypoglycemic incident.

This seems overwhelming at first, but once you get on a good treatment path and routine, things really get easier! Bandit's been diabetic for 8 years now, and I actually think he's been healthier in the long run because of it because it made me learn about feline nutrition and make much healthier decisions for him.