New Arrival- Terrell

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felinefosterfollies

Member Since 2013
Hey folks! My name is Clara. I do medical fostering for a local rescue group and have just gotten my first diabetic foster. I'm thrilled to find such amazing resources here!

The new foster is Terrell. He's 8 years old and was recently returned to our rescue group in pretty rough shape. He was diagnosed as diabetic, and we are still in the initial stages of figuring out just what he has going on. He spent a few weeks with one of our vets, now it's my turn to help get him better, stable, and off to a good forever home. As of today, the vet has him off insulin for the weekend and we are going to test him Monday and see what he has going on. I've got one vet trying to keep him on insulin, and one trying to get him off insulin.

I'm kind of thinking that not being on insulin is the better option, and please correct me if I'm wrong. It would seem that it's a better situation if I can get a diet in place that a new adopter could follow with ease that would keep him in the land of stable blood glucose sans meds.

I look forward to learning more and I'm incredibly grateful for those of you who have gone before me and left all this wonderful information in your wake. Thank you from Terrell and me. :)
 
If he's off insulin right now and not yet on a low carb canned or raw diet, that'd be the 1st step I'd recommend.

Cat Info has a good explanation of how feline nutrition works optimally. From experiences here, the blood glucose levels may drop over 100 points by switching to low carb foods, preferably canned or raw due to the moisture content.

If he is on insulin, I would focus on blood glucose testing to ensure it was safe to give insulin before shooting, and to check around the nadir for the amount dropped, with adjustment as necessary for going too low or not going low enough.
 
No insulin for Terrell may not be the best option. You need to know what his BG (blood glucose) numbers are running.

It is easy to learn to home test. Would you like some tips?
 
BJM said:
If he's off insulin right now and not yet on a low carb canned or raw diet, that'd be the 1st step I'd recommend.
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Thank you! I'm doing food research as we speak. Thankfully my general "sick cat" foods are actually good for diabetic cats. The joys of feeding a grain free diet. :)
 
Welcome, Clara! :YMHUG: What an amazing job you're doing with medical fostering!

I would also suggest you pass along the AAHA Guidelines for Diabetes for the vet who seems to want to keep Terrell on insulin. It is great information on the best way to care for diabetic felines. The three main things it covers that lead to the highest chances of regulation and/or remission:
  • Use the right insulin: PZI/ProZinc (bovine) and Glargine (Lantus) are recommended. Since this was written, a new insulin came out called Detemir (Levemir) that works similarly to Lantus and it's also a good insulin for use in cats. Porcine Zinc (Caninsulin, Vetsulin) and Lente (Humulin, Novolin/NPH) may work great for dogs but are NOT recommended for felines as these cause too steep and too harsh a drop due to a cat's faster metabolism.
  • Ultra-low carb diet: feeding foods at ~5 to 10% carbs (most "prescription" foods are waaay too high in carbs for diabetic cats, much less normal cats).
  • Home-testing: here's a link to some testing tips

Please let us know if you have any questions or need any specific advice. :-D

ETA: Cross-post with Deb. :lol: She's got you covered on the ear-testing. ;-)
 
Ok, you asked for it.

This first link is to a document that talks about the how to's of home testing. Warming the ear first is key.

https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

Second link is how to make your cat more comfortable with the process, written by member Kpassa.

https://sites.google.com/site/michelangeloprofilefdmb/feline-diabetes/ear-testing-psychology

Third is a list of supplies you should have, what we call a new member shopping list:
https://docs.google.com/document/d/...aQmg3s18XJdhldhDKIjCsw/edit?usp=sharing&pli=1

Fourth is a document on how to transition a dry food addict from dry to wet food. Not sure if you need this one or not.
http://www.catinfo.org/docs/TipsForTransitioning1-14-11.pdf

p.s. I'm fostering a diabetic cat for my local animal shelter also. I was very lucky and with some insulin and a switch from dry to low carb wet food, got him OTJ (off the juice, doesn't need insulin anymore, diet controlled).
 
You said he was in rough shape.. Was there any mention of ketones or Diabetic ketoacidosis? Depending on how high his blood sugar is you will also want to test his urine for ketones, especially if he is high and not on insulin.

Home testing is key no matter what,

Also what food are you feeding him exactly? Wet? Brand/type?

Wendy
 
So the Terrell update-

He had a fabulous weekend in terms of behavior. After some researching of the food charts, I stuck him on fixed feedings of Fancy Feast classic 3x daily. He had no signs of lethargy and also didn't drink the water dish dry. The vet wanted him off insulin this weekend after his curve on Wednesday. He's being curved at the clinic today, so please keep good thoughts going for Terrell.

He's got a rack of health issues that are compounding the challenge. He's FIV+, has probable stomatitis (horrible gum infections), and a heart murmur. After getting to watch him this weekend, it's obvious that the teeth are causing major issues. If he approaches the dish wrong he catches his mouth and yelps. :(

I've asked for past BG numbers for Terrell and should get them after today. He's staying overnight to get an ultrasound as well. So we should have a good bit of information to work with going forward.
 
One- if Terrell is a diabetic and does not receive insulin he will eventually starve to death while eating everything he can. Without enough insulin the body cannot pull the nutrients from the food he eats to survive. A few days, that can't be helped- but long-term that is a death sentence.

Two- the mouth infection can be what is raising the BG level. So since Terrell is diabetic, has an infection, and there is no insulin being given keeping a watchful eye on the ketone level will help indicate the presence of DKA quicker than his symptoms will. If his heart can take it getting the teeth fixed should be #1 priority and his BG levels should lower once done- maybe even become a diet controlled kitty. Although you will need to caution the new owner- no dry food or Terrell would become diabetic again really soon- once a sugar cat ALWAYS a sugar cat- even if they are off the juice.

I would get a human meter and test him at home. The Relion Prime at Walmart is $17 and has the lowest strips around- $9 for 50. You can't beat that since the alpha track meter is $150-200 and the strips are over $2 each. You want 3 tests each day at the least, more if you can manage it.
 
Urine ketone testing tips in my signature link Secondary Monitoring Tools.

Ketones are a by-product of fat breakdown. Too many may indicate diabetic ketoacidosis (DKA), a potentially fatal, expensive to treat (hospitaliztion required), complication of diabetes. Most likely to occur in settings of high glucose, infection, and low eating.
 
So I got an email from one of the techs. Terrell's curve was between 30-70 all day with no insulin since Friday. This is similar to his curve last Thursday and why the vet took him off the insulin. For being on the low end, he's acting perfectly fine and not like he feels poorly. Tomorrow he's got an ultrasound to see if there's anything obvious going on elsewhere.

I bought a home meter/strips today so I'll be able to test at home. Crazy cat. :)
 
Crazy cat indeed.

Maybe he was just temporarily fd? That does happen and with a food change it goes back to normal.
 
Yep, definitely sounds like a transient diabetic (or a misdiagnosis?). Maybe it was simply stress and infection causing the hyperglycemia and now that he's getting better and has a wonderful caretaker, he no longer has high sugars. :thumbup That being said, "once a diabetic, always a diabetic" and he should remain on low carb for the rest of his life to help prevent a relapse and a need to go back on the juice. :-D
 
And get his teeth/mouth done so the infection doesn't raise his BG #'s just to spite us all. After all, he's still a cat. :lol:
 
Ultrasound was good, so we should "fingers crossed" be doing his dental next week. His mouth hurts like a son of a gun. New meter is here, so tonight I'll start testing and tracking to see if my numbers match what they are getting at the clinic. I will freely confess to being a bit nervous about turning him into a kitty pincushion, but I know it's important to not assume things are find. I need to make sure I've got some good data.

In other amusing news, last night T jumped into the bathtub with me. He was fairly non fussed about it. I wasn't so thrilled. Goofball. :)
 
felinefosterfollies said:
I will freely confess to being a bit nervous about turning him into a kitty pincushion, but I know it's important to not assume things are find. I need to make sure I've got some good data.

In other amusing news, last night T jumped into the bathtub with me. He was fairly non fussed about it. I wasn't so thrilled. Goofball. :)
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You might be thinking you're turning him into a pincushion, but he's soon going to be thinking he's fooled you into doling out treats just for sitting still. :lol: cat_pet_icon

And was there water in the tub? :o :lol:
 
KPassa said:
felinefosterfollies said:
I will freely confess to being a bit nervous about turning him into a kitty pincushion, but I know it's important to not assume things are find. I need to make sure I've got some good data.

In other amusing news, last night T jumped into the bathtub with me. He was fairly non fussed about it. I wasn't so thrilled. Goofball. :)
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You might be thinking you're turning him into a pincushion, but he's soon going to be thinking he's fooled you into doling out treats just for sitting still. :lol: cat_pet_icon

And was there water in the tub? :o :lol:
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There was indeed water in the tub. *sigh* Cats. Whatcha gonna do? :)

On a serious note, will pain medication have an impact on his readings? He's taking buprenix for his mouth pain 2x daily.
 
Second question/issue- what do you do when your cat is missing the sweet spot on the ear?

He's a former street cat, so his ears are ratty. One is all crinkled up, the other is missing chunks. He was patient whilst I poked, but we had no luck on getting blood.
 
Not sure on the pain meds since Mikey has never needed them. For the poking, when first starting out and having difficulty getting blood, the suggested method is "3 pokes then a treat" even if no blood is given. If your cat tolerates additional pokes and more treats, then keep trying if you feel up to it. If not, let him go and try again in a few minutes or wait till the next test time. Try to look at testing as a necessity that is really only "necessary" for pre-shots and when he's running low; the rest of the tests are practice and if you get a successful test in, then that's just gravy. :cool: Once you two get the hang of testing, then you can focus on getting in as many tests as you two want. Yes, both of you. Michelangelo started surprising me around the 3rd or 4th week of testing and started seeking me out for tests when he wanted to be fed or given treats.

As for the "sweet spot," ECID and some cats have ears that bleed better than their other ear, some cats have other areas in their ears that bleed better as well. Mikey's "sweet spot" is closer to the tip on his ears and his right ear bleeds better and more consistently than his left. The key is to aim between the Marginal Ear Vein and the outside edge of the ear, anywhere from above that little double-fold on the outside (can't remember the name of it for the life of me) and around the rim toward the inside of the head. Hopefully, that'll give you quite a bit of space to play with, even with his street-fightin' battle scars. ;-)

You can also try the frontside rim of the ear instead of the backside and see if that works better.
 
Have you tried shining a small flashlight up from the inside of the ear? This can really help you see that marginal vein and find an area that isn't too ratty to poke. The flashlight is also hard enough to use as a surface to poke against.
 
Deb & Wink said:
Have you tried shining a small flashlight up from the inside of the ear? This can really help you see that marginal vein and find an area that isn't too ratty to poke. The flashlight is also hard enough to use as a surface to poke against.
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Brilliant! Thank you. (Terrell might thank you but he's annoyed that he got poked). Got the blood drop and had a successful first test.

(70 for those interested). I've got the spreadsheet and will start logging. Again for those just catching this, he's not on insulin because he keeps getting some really odd curves at the vet clinic. I'm seeing if numbers I get at home parallel what the vet is getting.

Terrell was thrilled with his treat, not thrilled that it hurt his mouth to eat it. :( Poor guy. I hope that I can get a clear picture through the weekend so I can schedule his dental.
 
He certainly sounds like he is having normal BG levels (40-130). I would love to see that spreadsheet once you have it live.
 
Once you get some data in our standard format spreadsheet, you can link it into your signature in your user control panel, profile, edit signature section.

Here are the directions:http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207 from over in the Tech Support forum. When you do it this way, anyone that is interested can view only the spreadsheet by clicking on the link in your signature. It really helps us to see what is going on and advise you better.

You can even add the numbers the vet is getting for Terrell.
 
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