New and worried

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TinalovesArwen72

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Hello. My name is Tina and just learned last week that my 13 year old cat Arwen is diabetic. She had been acting fine, but was drinking a lot and had urinated in the living room, so I took her in for an exam thinking she had UTI. I started her on Humulin N as per my vet on Sunday while we await the PVI I think it is to be ordered. She had 4 units Sunday and was raised to 6 on Monday. She had 6 again yesterday and was raised to 8 today. He has me testing her urine and her urine sugar has remained at 1000 snce we started testing. I am worried because there has been no change yet and today it seems as though she is drinking even more than she was before. She has urinated more than I have ever seen, she filled the bottom of her litterbox and soaked 3 weewee pads (I put these in a few spots she had peed on because I could not fit a litterbox there), all between 5 and 11 am. Is my vet raising her doses too quickly? I am at work worrying I will get home to find she has had a seizure or something. I am new to having a cat with any kind of health problem and also lost another cat to a brain tumor without warning in February, so I hope I am not overreacting. I dont know anyone else with a diabetic cat. Thanks in advance for any advice
 
Hi Tina and Arwen,
Diabetes is a fairly easy disease to manage after the first bit of the learning curve.

There are 3 components to managing diabetes, and you are already on most of them.

First is diet. Low carb, wet (canned) food is the way to go. I'll get you the link to the food lists - choose something less than 10%. If Arwen is eating dry food now, you would need to watch her blood glucose levels carefully as you introduce the wet food.

Second is insulin. If our vet hasn't already ordered the PZI (guessing - thinking that PVI was a typo), you might want to ask about either Lantus of Levemir. Both are longer acting, more gentle insulins. I should add that some cats do well on PZI - you can look in the insulin support groups for each insulin to see how the insulin works and various people's experience with their cats.

Third is testing. Glad to see that you are urine testing. I'm wondering if your test sticks are also testing for ketones. Others can tell you that ketones are not something that you want to see. The really essential testing is done by taking a tiny drop of blood from the cats ear. We use human glucometres and they are available at any pharmacy. Poking Arwen's ear probably sounds brutal, but its not - especially if fav treats are liberally handed out after the poke. Sometimes another board membe can help you - having someone show you how really speeds up the learning curve. If you want to post your general location, someone might be able to help if you want.

Each one of these points involves some detail and reading. Post lots of questions. Lots of people are willing to help you help Arwen.
 
Welcome extra sweet Arwen and Tina!

The first thing..........breathe.......

Now let's talk about Arwen. You're in the right place to get help. Before this, no, you didn't know anyone with a diabetic kitty but NOW, you've got a whole 'FAMILY' of them. Our 'extra sweet' cats are our special Angels.

Humulin N - altho' it's the cheapest insulin, it's definitely not one that works well with cats. When the 'animal' insulin was discontinued, the vets were told to move to Humulin N as the company's reason for discontinuing was there was no measurable difference between what they made for animals and human insulin. My vet even put a note to himself on his drug cabinet door which he pointed to during our initial diagnosis visit.

I THINK I understand vets reasoning for raising it so much so fast but I'm not sure I agree. I AM TOO NEW TO GIVE DOSING ADVICE SO THIS IS MY OPINION ONLY. I think he's trying to get Arwen's BG numbers down quickly and keeps throwing more and more at it. Humulin is also a short acting insulin - it's effects wear off after a few hours. That's why we've changed KT to Lantus.

There's definitely a continuing problem with her still filling the litterbox but it's one of the things associated with her high BG levels...

Now..............breathe again........someone else will be along shortly to give more!

HUGS!
 
Hi Tina,

Absolutely your vet is not dosing correctly, and dosing incredibly dangerously at that. Humulin is a very harsh insulin with steep drops, and raising your cat up to 8 units in the course of 3 days is super, super dangerous! Please do not shoot that much insulin tonight!

I have a few questions--did your vet mention if he tested Arwen for ketones, and if they were present? This can sometimes lead to slighting higher dosing (i.e. starting with 2u of insulin instead of 1u), but never 8u in 3 days. And you never raise the dose that quickly. Even if he didn't you should test for ketones regularly as uncontrolled diabetics are at risk for diabetic ketoacidosis, a serious and potentially deadly complication from diabetes. You can pick the urine test strips up at any drug store--they're called ketostix. If you get ketodiastix it tests for both ketones and glucose at the same time.

However, I would highly recommend you pick up a glucose meter and start blood testing the ear instead. Urine testing will not tell you if Arwen's blood sugar is going too low, and it's very important if you think there is a potential hypoglycemic situation to be able to see if her blood sugar is low so that you can treat it before it gets too bad. You can use any human meter and test strips. The Walmart Relion Micro is a good meter with really inexpensive test strips, but you can use any meter you prefer. Home blood testing before each shot is the only way to make sure it is safe to shoot insulin. You'll also need some lancets--26-28g work best. There are tons of tips and tricks here to help you get started if you need help! Home testing seems scary at first, but the large, large majority of cats do not mind it all within a week or two once they get used to it.

Humulin N is also not the recommended insulin for cats. It works well with dogs, but cats have faster metabolisms and need a long lasting insulin like Lantus or Levemir. I would urge you to get a prescription for one of these instead of the Humulin. Lantus and Levemir has a 84% remission rate in newly diagnosed cats. I'd be happy to provide the study to print and give to your vet so that he'll be on board with you changing insulins. Or you could switch vets to one a bit more knowledgeable about feline diabetes and start fresh.

What are you feeding Arwen? It's very important diabetic cats are feed low carb, canned diets. Dry food, even the prescription dry food, is high in carbs and will keep Arwen's blood sugar high. There are many commercial canned foods that are inexpensive and good to feed diabetics (for example, all the of the Fancy Feast "classic" flavors are diabetic safe). Many people are concerned about switching because they want to have food available when they are at work--but you can freeze portions of canned food to leave out or just leave some out with water added to it so it doesn't dry out. However, I would not recommend changing the diet until you change insulins, as Humulin is very harsh and prone to causing hypoglycemic incidents.

Please ask lots of questions! Diabetes is very treatable with the right plan, and my cat is healthier today than before he was diagnosed! It's overwhelming at first, but once you start blood testing and get her on a better insulin, a lot of this stress will subside.
 
Thanks to all of you. I do have ketostix as well as urine sugar test sticks, I had inadvertently purchased them and did not know I could use them as well. I will also talk to my vet about the insulin. He had me get the Humulin because the PZI had to be ordered and would take a week to come in. To be honest, I would MUCH rather use a glucometer for testing. Arwen is extremely laid back and I am not at all concerned about poking her, I am just wondering about my vet's justification for that right now. One of you cautioned me against giving her the 8 units, but I had already done it earlier today. I took a break and ran home to check on her and she is fine. I have to call the vet in the am and will let him know my concerns. I do live in a small town in a relatively rural area in Western NY. The only other vet in the area is a 30 minute drive away and Arwen is TERRIBLE in the car, I don't think I could get her out there without getting into an accident, so I am kind of limited in choice. I am very grateful for the information on this site and will ask lots of questions now that I know a little more about all of this. Thanks also for telling me to breathe. This little gal means the world to me...
 
Hi there

Glad you came back :)

Chiming in here..your vet's dosing is insane. Period. Please, no matter what your vet says, consider cutting that dose in half at the very least. You haven't said what you are feeding, but for now, I hope it is dry food filled with carbs so that your girlie doesn't crash.

Humulin N is old school. Yes, using it is better than waiting a week but overdosing with it is just wrong. A cat's body takes time to adjust to insulin, and insulin is typically started at 1-2 units twice a day (max) and raised by 0.5 units at a time after waiting a few days for each change to settle.

Jen
 
Just a thought - since you aren't testing her bg with a glucometre, and are considering cutting back her insulin, be sure to get out those ketostix and make sure that she isn't passing ketones.
 
I know you're overwhelmed and you've gotten some excellent advice so I won't repeat what was said I just want to point out that if for some reason you can't get blood from her ear or she hates it you can always try her paw. I test Raja's back paws and it works wonderful for us and if you look down at my signature there are two youtube links of me testing Raja's blood sugar by pricking her paw.

Now on to the vet. Remember just like a human doctor not all vets know everything or are as up to date on things as we would like. If your doctor told you to do something you considered dangerous would you do it simply because he told you to or would you think twice about his advice? It's the same with Arwen (love the name BTW) If your vet tells you to do something that you feel will harm Arwen you do have the right to say no.

I know you said the other vet is a good 30 minutes away but it might be helpful to call them and get a second opinion over the phone, you may not need to bring Arwen to them and once you get her BG under control you wont be trekking to the vet often so although if you had an emergency you probably wouldn't be able to get to them they might work as a primary vet
 
Hi Tina! I've been to Olean before, so I understand your predicament. I grew up in very rural northern NY, and the situation with vets there was very similar. I currently live about 2 hours away from you, in Ithaca, but Jamestown is pretty close to you, isn't it? I know there will be some vets there that will be able to recommend the right treatment. Apart from an initial visit, if you're home testing you won't need to bring Arwen back again. You just need a vet that will give you prescriptions for the right insulin and will be able to work with you getting Arwen's diabetes safely under control. Phone consultations are also possible!

If your vet is not current with feline diabetes (and he really is giving you potentially deadly dosing advice, so I'm going to say that he's not), you can also take control of Arwen's diabetes yourself. Many people here have had similar situations with vets, and they basically use their vets for the prescription for Insulin and Syringes and get advice and support dosing here instead. There is a ton of highly educated, knowledgeable people here 24 hours a day that can help you out with dosing.

You don't need your vets permission to home test. You can run to Walmart and pick up a glucose meter and start right away. That way you know Arwen is safe.

I've attached an article that you can print out and bring to your vet. I would have him read it and ask for a prescription for Lantus. If he's unwilling, perhaps another vet further away will write you the prescription for it if you bring Arwen in for a single trip. PZI isn't bad (much better than Humulin N!), but Lantus has a higher remission rate. Plus, it's the most popular insulin here so many have experience with it. If you're willing to put in the work educating yourself, you can successfully and safely treat Arwen yourself. There is a ton of information on this site that will give you everything you need to know to help Arwen get better.

Please post back and let us know how we can help!
 

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Good afternoon! Just wanted to chime in and reassure you that, with the information you can get here, you can definitely take control of Arwen's diabetes treatment and bring him back to good health! I know that many people have excellent results with PZI and, knowing little about it, I'm in no position to debate the merits of it vs. lantus/levemir. One thing that might be helpful for you, though, is that Lantus and Levemir are human insulins that you get from your local pharmacy. If you are concerned that your vet lacks knowledge or wants to be extremely hands on in dosing decisions and you don't trust him/her (and, with that 8u Humulin N dose, I can't say that I would!), with a Lantus or Lev Rx with some refills (which, fyi, the pens tend to be more cost effective), you wouldn't have to worry as much about keeping the vet happy to ensure that you keep getting your insulin on time.
 
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