New bewildered member

Hello! I am Jill, grey cat Merlin’s mama. He is 12. We just relocated from the US to Ireland seven months ago with our three cats. It’s been hard to adjust for all six of us. So different in so many ways here. Two of us have had accidents that caused back injuries, we have all had Covid, and now, just yesterday, our beloved boy has been diagnosed with diabetes. I am beside myself with worry. He is an indoor boy with outdoor enclosure, but he got out one night a month ago and got into a fight with a fox. His tail was bitten and he was treated with antibiotics, but it was so stressful that I believe it brought his health level down. Before that incident he was feeling a little bony by his tail and had begun to drink a lot of water, but since then his whole back has gone bony and he drinks and pees excessively. We took him to the vets on Monday, and they never called back with his blood results, so I called them yesterday (Thursday) to find out he has diabetes. The vet said she would call me back with “pricing,” and I am still waiting for her call. I am starting to feel like maybe this is the wrong vet, but we don’t have many choices here in Cork, and they had pretty good reviews online. The vet also mentioned that they would need to keep Merlin in their clinic for 12 hours to get the insulin levels right. I really don’t like that idea, as it will stress him out so terribly. He is a very easy going cat, and I’m sure he will be compliant with whatever needs doing to him if we are the ones doing it. I am worried about: his health; not ever being able to travel now that we are wanting to explore a new country; the expense; and, again, his health. This is such a long message, sorry everybody. This a a wonderful forum. I was up so late last night getting overwhelmed with facts and figures. Any kind words would “go down a treat,” as they say here. It’s Friday and I will be worried about Merlin all weekend. Will he be ok til Monday??? Thank you for reading all of this. ❤️Jill

 

Hello and welcome to the group. That is not a long intro post, believe me! No worries.

So it sounds like your vet wants to do what it seems every vet wants to do: an in-house curve. This is where they keep the kitty for 12 hours, testing his blood every 2 hours to check the glucose level and see what it does throughout the day. Most vets want to do this 1 week after starting insulin. When I joined this group, my vet wanted to do it and everyone here told me to just do it at home instead: kitty is much happier, blood glucose levels aren't stress elevated from being at the vet, and it saves you a lot of money.

However, at the time I had never tested Hendrick's blood myself so it seemed a near impossible thing to do. As it turns out, it is quite doable after you get the hang of the home testing.

As far as Merlin over the weekend, as long as his appetite is good he should be fine but it would be best if you can check for ketones. Many people use ketostix, and just dip them in the kitty's urine spot or catch urine in a ladle, or by putting plastic wrap down under the litter. Ketones can develop in a newly-diagnosed diabetic cat that is not on insulin yet, and they make kitty nauseous and lethargic - and can cause a deadly condition called DKA if not caught quickly.

My boy Hendrick was diagnosed with diabetes on a Wed and by Saturday was hospitalized for DKA. Vet had told us we would get insulin the next week -- NOT SOON ENOUGH. So it is important that Merlin eat and drink plenty, and get on insulin soon as possible. I am not one of the experts here at all, just a newer member with a similar experience so thought I would welcome you and chime in. The experts here will surely hop on in here soon to offer additional support and guidance.

-Kyle

 

Thank you, Kyle. I watched your super cute video, but it made me cry thinking that I will have to do this. I am scared and emotional today, and I wish this wasn’t happening to Merlin and us. I am feeding him canned supermarket wet food watered down like every four hours. He loves the extra attention but seems oblivious to the fact that he is sick, which is good. The vet still hasn’t called back which makes me want to switch to a different vet already. I feel like a bomb was dropped in us and then we were ignored. It’s gonna be a long weekend.

 

honestly this makes me a bit misty-eyed because it hits home so soundly. I remember when Hendrick first got diagnosed it was, as you say, like a bomb. I felt so depressed, confused, lost. Both me and my wife did. And our vet also was so nonchalant about it "oh yep he has diabetes, we'll make an appt for next week for you to come in and learn how to shoot the insulin ok bye"

and there we were just totally baffled and upset, vet hung up, we were on our own.

finding this group was like a life preserver thrown to a drowning person. Saved me, saved Hendrick.


By the way Merlin is adorable!! What a cat. Love that picture.

 

Hi Jill, it's normal to feel overwhelmed in the beginning, we all were but we are here to help, in no time you will get the hang of everything.
Pricking Merlin's ears will not hurt him,
Sorry the vet hasn't called you back yet, keep calling ,ask them if they did a fructosamine test to diagnose diabetes,
fructosamine test is a blood test to measure the last 2 or 3 weeks blood glucose or did they just prick his ear to get his BG number and what was it
I know you haven't started any insulin yet , you don't want vetsulin/ caninsulin , it's actually prescribed for dogs, try and get lantus or prozinc.
I am going to tag a member from Ireland who can give you some information ahead of times about wet low carb foods. Then after you find out what insulin you will be using she can tell you where to get insulin, and syringes
You couldn't have found a better group to join
Everyone here is very compassionate and experienced
What's the name of the wet food you are feeding now
@Paulina

 

Hi Jill and Merlin,
Merlin is such a ham in that photo!
You poor thing. That's a lot in a short while to be dealing with. to you and your family (human and animal)
I'm new too, just like @Hendrick Cuddleclaw . I envy you for starting here. I wish I would have started here on this message board but I was just emotionally defeated for the first almost two months after Cleo (my kitty) was diagnosed.
Kyle's video is amazing; however, Cleo was not accommodating AT ALL to home testing until I did what was recommended in this thread https://www.felinediabetes.com/FDMB/posts/2922939/ at post #15. It took some time - but Cleo does let me get an ear prick in. (FYI, the rewards/treats are for you too. appropriate treat for kitty and favorite chocolate for you )

I couldn't agree with @Diane Tyler's Mom more! People here are soooo experienced and extremely compassionate. I also owe her a special thanks for the pics of the "sweet spot" for the ear pokes. It helped a lot!
There is a wealth of information here to help

Reach out if you need anything, even if its just a shoulder.

 

@Angela & Cleo

 

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand
I find it better to see where I'm aiming
You can also put a thin layer of vaseline on the ear ,to help the blood bead up
@Merlin’sMama

 

yeah @Angela & Cleo I have reposted that absolutely FIVE STAR post by @Elizabeth and Bertie a few times now, and was going to do so again in this thread. Beat me to it, you did!

 

Thank you! We are feeding all three cats Felix As good as it looks, Felix Doubly Delicious, and Purina Gourmet Perle and Fine Cuts. Dry Food Purina One. We had trouble with transitioning them from American brands when we moved here. They were quite addicted to Fancy Feast, and it was hard to find an equivalent. They don’t really love any of it, but they tolerate it. Since our appointment on Monday where they drew Merlin’s blood, I have switched him to Gourmet Gold pates because it felt gentler and I could add lots of water to it. He has been scoffing it up, a little bit at a time, four times a day. He is so bony right now it scares me.

 

Take a look at this food list
https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml

 

I feel this. It is very disturbing when they have lost all that weight from diabetes, Hendrick felt light as a feather to me and it was frightening.

For Hendrick, he started gaining weight about 2 weeks after being on insulin. We were feeding him about 150-200% of what his calories should be for an ideal weight of 11.5 lbs and he finally gained like 2 tenths of a pound after 2 weeks. It's pretty slow going at first because an unregulated diabetic cat can't utilize the nutrients well.

He started to put weight on much more quickly as his BG numbers came down, so will Merlin!

 

HI JILL AND MERLIN!!
Sorry only saw a message from Diane just now! I can see u got lots of help already from everyone here. I can only add that my cat Frodo is on Lantus and when he was diagnosed the vet put him on pro zinc but he was very bouncy on it so we switched few months ago. Also when We started this adventure I didn’t know this group so as per vets advice we started insulin and vets dry food straight on. Only by accident I saw a post about cats diabetes and someone posted a link to this group and thats when I changed his food but still I didn’t test until months later which was the biggest mistake ever…. But anyways I found out I can get a prescription here from vet for lantus - I got 5 vials and then the syringes too - they are very expensive in the vets like 10in bags for few euros and I got it from pharmacy for 20 something euro and it’s 100 in the box! Also I buy my glucometer strips in Poland as I couldn’t afford them here - I use contour plus glucometer. As per food zooplus.ie is my friend. I’ve never asked if it’s good food- I buy what I can afford so I use smilla. I can post links to the flavours I use if you would like? I also buy Lidl and Aldi food from time to time. Pls let me know if u have any questions and sorry if my post is bit chaotic

 

Thanks so much Paulina I appreciate you helping Jill out

 

Thank you, Paulina! It’s nice to know I’m not alone in Ireland. Are there any Irish support groups for feline diabetes? I joined the UK Facebook group. Maybe I should start an Irish one? I’m sure I’ll have more questions when Merlin’s treatment begins. I’m enjoying the weekend before our lives change forever.

 

Hi Kyle

To add insult to injury, I emailed the vet to ask what to do next and she said she was ordering the insulin and prescription food which won’t arrive til the end of the week and then we will have an appointment. I wrote back that I would prefer Prozinc or Lantus as I had been reading up on feline diabetes, and this was her reply.


“The decision on what insulin to use is more complex than googling different types of insulin and can depend on several factors. His blood glucose was 25 mmol/L.
You can start him on low carbohydrate food if you wish.”

I had also requested to see the blood results.

I find this rather condescending, or am I being oversensitive? She is new to me, as are all things in this country, but I am trying to establish a relationship where I can actually contribute to or at least have a say in Merlin’s care. A friendly or sympathetic conversation might be s good place to start. Or maybe I should get a second opinion?

What do people think?

Thanks
Jill

 

Hi Jill @Merlin’sMama
Everything is strange and confusing at the start but it does get easier and you will soon be into a routine with Merlin.
You need to tell your vet that the prescription food is not required as it's very high in carbs and it will keep Merlins blood glucose high, you honestly don't need it.
A low carb cat food is adequate and there are loads and loads to choose from on the UK food list.
We have to be careful with our cat as he has an intolerance to vegetable protein extract in some foods which make him really ill and flares his pancreas. We just feed him Sheba fine flakes in jelly and he seem happy with that.
As for your vet i can't say whether you need to change or not but if you feel uncomfortable and not at ease with them then that's your answer.
We never took our cat in for the day to do his curve, we just did it at home and showed the vet the results, to be honest our vet never intervenes, we just show her a curve every few months and everybody is happy, plus stress from the vets visit can raise a cats blood glucose levels resulting in false readings on the curve.
I'm posting the link to UK information page created by @Elizabeth and Bertie there is loads of fantastic info there.
Also the low carb food list that @Diane Tyler's Mom has already posted.
UK info page
https://www.felinediabetes.com/FDMB...-vit-b12-and-other-need-to-know-stuff.137376/

UK cat foods low carb
https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml#

Also there is this cat food carb convertor, i always double check food with this because manufacturers can and do change their ingredients.
https://secure.balanceit.com/tools/_gaconverter/index.php?

 

I try to sympathize with medical people like vets, nurse and drs in the age of the internet, I'm sure they are more questioned than ever by people who have done very little research (aka just googled). But at the same time, to assume you are that type of person and just automatically lump you in with that group seems short-sighted.

Also, imo email or text is a terrible way to get a sense of tone and intent, maybe take a deep breath and try to have a phone conversation or face-to-face where you can properly explain your reasoning? Also, many here would say -- this is YOUR cat. You hold the syringe. You have every right to ask for and receive what you want for your kitty.

 

If it were me, I would point out to my Vet clarifying that it wasn't a mere Google search but based on research from reputable organizations like this one https://www.aaha.org/globalassets/0...iabetes-management-guidelines-2022-update.pdf
I know you're overseas but you are originally from the States. Perhaps it might help.
My Vet had a similar stance at the beginning. But the more we engaged and progressed he came around and agreed with the guidelines here regarding feeding schedule, increases/decreases, using a human glucometer...

 

Did she say what insulin she ordered? You don't need prescription food, I see she said you can start him in low carb if you wish. Don't take the prescription food from her
I would get a human meter ,test strips and 26 or 28 gauge lancets and cotton rounds now so you have it , I guess you will need to know what insulin she ordered so you know what syringes to buy
Also the link for the UK will tell you what foods for your hypo kit if needed if you ever have to bring Merlin's BG up
Meters are also listed there

 

The link that @Angela & Cleo posted is a very good resource to print out and hand to the vet -- or email. The bottom line is that often Caninsulin is prescribed in the UK. It is a harsh, shorter acting insulin. The problem is that it can drop numbers fast and it does not last very long (i.e., it has a short duration). As a result, you have high numbers at shot time and the numbers can then drop abruptly so there are wide swings between when the insulin starts working (onset) and the lowest point in the cycle (nadir). This is why insulin such as Caninsulin or Novolin are no longer recommended. Lantus (glargine) and Prozinc are longer acting have have a far more gentle cycle.

I do find her response a bit heavy handed. I can be pushy, as well. Ask her to provide the scientific research to support her decision on which insulin to use. That may give her pause. Frankly, she has no clue whether you're an endocrinologist or a someone who researches insulin/diabetes for a living! And what would she expect you to feed your cat? If she is recommending dry prescription food, you might ask if she would feed her diabetic child cookies. It's about the equivalent. (OK, I'll get off my soapbox. I truly dislike medical and veterinary professionals who don't engage people as partners in managing their own or their cat's health.)

Please let us know how we can help.

 

Here’s a new question… Is it possible that if I get Merlin on a low-carb diet that he wont need insulin? Also, when the vet did the blood work, I wasn’t sure if Merlin had eaten or not. Should we retest at the vets? I know this is probably all about denial, but I am just hopefully wondering. Then again, he pees a lot and drinks a lot and is bony, so there you go.

 

The big difference between cats and humans is that it's possible for a diabetic cat to go into remission. There's no way to predict whether a cat will go into remission, though. And once a cat does reach remission, the cat is a diet controlled diabetic. (In other words, you can't go back to feeding your cat a higher carb diet.) Cats that are in remission can have a new onset of diabetes as well.

Some cats do have a dramatic response to being on a low carb diet. Usually, this is the case if they were on steroids which caused the rise in numbers or there was an infection or some other reason that triggered an elevated blood glucose level. Again, there's no way to know if the diet change will be sufficient.

The best advice I would give is to be hopeful and do what you can to get Merlin's numbers as good as you can get them but don't be disappointed if he doesn't go into remission. I worked very hard with Gabby and she never went into remission.

 

hiya!! I actually never looked i only joined this group and it was life saver. All the help I got here I can thank enough as I’m all alone in this battle with my cat. If u start the Irish group pls invite me Also I didn’t go for holidays yet since my cat diagnosis but I do have a lady who comes to do the injection when we visit someone and we r back later than the shot time, I got her number from my vet (she’s a vet nurse) so it’s worth to ask around too. Once again welcome and a big hug

 

Thanks so much for your kind words and support.

 

Hi @Merlin’sMama Jill,
I woke up thinking about you and Merlin this morning. How are you today?

 

I now feel thoroughly swamped with information and facts. Unfortunately I’m at the stage where they’re just all jumbled up in my head, and I don’t know what to do first. Although, I know I am going to look for an alternative vet today. Being talked down to by the vet from the very start isn’t a good sign. As I homeschooled my child, I will have to hometreat my cat! (Hopefully with he help and cooperation of a professional).

 

FANTASTIC!! I love your reasoning for changing Vets!
You are right there is soooooo much information and all at once is overwhelming. If you don't mind some newbie advice... I wish I would have learned to home test (ear pricks) from the beginning. Getting those blood glucose (BG) numbers throughout the day/night are essential to knowing how your furbaby is really responding to not just insulin but also food, medications, exercise. My Vet discouraged home testing at first but he eventually came around and agreed that it's needed.

 

it still baffles me why so many vets say hometesting is not needed, downplay it or discourage it.

The only thing I can think of, is that they don't want to be responsible for any challenges with home testing, if they say to do it maybe the fear is you'll be constantly asking for help or assistance with it? I don't know.

We at least found that the ER vet we took Hendrick to, offered to have us come into the office and they would show us how to do an ear poke in person. THey didn't really show us how to do it properly, tbh (marginal vein, bah) but it was enough to get us on the right track.

 

If you don’t start insulin straight away and decide to do the low carb food first, I would really recommend you test the urine for ketones daily until you start insulin. Diabetic cats who are not getting insulin can start to form ketones in the urine which can lead to DKA which is a very serious illness in cats.
You will need to buy a bottle of Ketostix or Keto-Diastix from a pharmacy and collect a urine sample and follow the directions on the bottle. There should be no ketones in the urine.

 

Is it ok to start with low carb food and no insulin if I test for ketos? Could this be all he needs? At least for a while? As it is, I am feeding him soupy wet food every three or four hours right now until the vet gets some unspecified insulin in. This also indicates to me that she doesn’t have any other cat diabetics under treatment now, if ever. Should I try just the frequent LC food first?

 

I don't know that you'll find anyone on here willing to tell you it's okay to not give insulin. That is a decision you'll have to make yourself/with a vet if you want to go that route. As skinny and bony as you describe Merlin to be, me personally? I would get insulin in him ASAP. But I am biased because I've seen what wonders insulin did for skinny bony Hendrick.

A senior member responded with this when you ask that question earlier:

 

Oh thank you, Angela! I am feeling more and more distraught as the day goes on, and I keep crying. I don’t know if I can handle this with the current vet. I don’t know any other vet in town and if they are any better. I bought the ketostix just now, and I feel like I have to rush home and will have to forever. How can we have a new life here in a new place now? How can I survive my darling boy suffering for an unknown amount of time? How can I do such a hugely important job? I’m kind of a mess right now. Thanks so much for your concern. XxxJ

 

It’s still me wishfully thinking that this isn’t happening. I just have to find a better vet I think. Thanks

 

To be honest i dont deal my cats Diabetes with my vet if thats any comfort for You! I post here and seek for help from the lady’s that know much more than the vets so don’t worry!! And it does get easier once
U start testing. I use to think I won’t be able to do the insulin and yet I do and then monitoring sugar - Im so mad that I didn’t start that on the beginning and when I tried first time It was a disaster. I cried too a lot!! Like a lot!! We were all the same on the beginning

 

First thing first
You are already ahead of the game. You came here first! You DO NOT need to know everything all at once. Lean on the knowledge here. And ask TONS of questions.
I was a crying wreck for 2 months after Cleo's diagnosis. I get it! I watched my Cleo sleep and checked to make sure she was breathing. I was borderline about to have a nervous breakdown. Then I finally created my profile and another 2 weeks later I posted my first post. IT DOES GET EASIER I PROMISE.
I'm not an expert but what you're feeling...stress anxiety fear etc etc...sounds normal to me.
Merlin has a mom that cares...cares so much she's overwhelmed with information.
Take deep breaths. Set up a spreadsheet and learn how to test with blood samples and urine. For me, it relieved most of my fears and anxiety. When I started doing that, managing Cleo's diabetes AND having a personal life was clearer. It was actually full of colors on a SS. It literally painted a picture.
Heck I used the remarks column as a dear diary. It actually became cathartic.
Switching to a better food is always a good first step!
I will be here if/when you need. I can't give dosing advice-still new PLUS you don't even have insulin yet- but I will listen and share all my neurotic fears etc. Misery loves company.

 

I was exactly where you are, in January. My cat Taz suffered from pancreatitis for 3 months, on top of having to learn how to adjust my life to a sick kitty, do glucose testing, and give insulin. If you have a pretty chill cat, it makes things so much easier. Taz is food motivated, and now follows me or leads me to the kitchen because he has learned that he gets a treat every time he gets poked. He will lay down and often purs while I am waiting for the drop of blood or the meter to be ready, and then as soon as it beeps he jumps up and runs to his feeder. Giving insulin is much the same. He will lay down and pur while I give it to him. He gets a lot of love (petting) during both experiences and he's adjusted pretty well in the last 4 months. We both have! I do still ask tons of questions here because I like to know details and have answers for everything, but I promise it does get easier. In fact, it can become a little addictive to take blood glucose tests so you know your boy is in a safe zone.

As for traveling, the best thing you can do is get an automatic feeder. This will give you freedom to take day trips. I'm getting ready to go to Vegas next weekend (2.5 hours away). We'll leave as soon as we give insulin, spend the day there (about 7 hours), and leave 2.5 hours before he's due again. We went to the zoo three weeks ago and had a wonderful time. Taz is mostly confined to our living room and kitchen area, and I have 2 cameras in my house in those areas so that I can watch him and make sure he's ok when I'm not home. It relieves a lot of anxiety. We haven't done any overnight trips yet, and I'm not sure when we'll feel up to those. I'm not quite ready to have someone else care for him.

 

Not sure which vet are u with but just googled this one
https://m.facebook.com/bluecoastveterinary/?refid=13&__tn__=,g
they say they are dedicated Small Animal Veterinary Clinic and also Boarding Cattery which can be great option if u need to go out of town etc.
and saw their post about diabetes
https://m.facebook.com/photo.php?fb...362&set=a.788539014541723&source=48&__tn__=+=

 

Thanks, Paulina. We live in Cork City, so Youghal would be a bit too far for us. I wish it wasn’t, though! It looks like the perfect place.

 

Ahh that’s a shame (same reason I’m with my current vet - he is the closest) anyways how r u today?and also did they came back with the blood results or is that gonna be
After the weekend??

 

All the vet said was his level on the blood test was 25 mmol/L. I tried to convert that, but I can’t wrap my head around how high or low that is…

 

1 mmol/L equals approximately 18 mg/dL. Therefore, in order to convert from mmol/L to mg/dL, the blood glucose value needs to be multiplied by 18.0182

25 x 18.0182 = 450.455

 

Ok… thanks! So, is that a high number? Where do I find that info? Also, what number doI aim for in carb percentage for low- carb food?

 

Hi Jill,
We tried that method for a month with Duke when he was diagnosed but it never helped him. In my opinion on those high numbers he needs to be on insulin sooner rather than later.
The food we look for to feed our Duke is food lower than 4% carbs but that's us, other go a little higher others opt for zero carb foods.
Duke at the moment is eating Sheba Fine flakes in jelly and that is 2.5% carbs.
I would advise removing the dry food straight away if you can as this is very high in carbs, also (this is a personal thing) i would remove any food that contains vegetable protein extract as this can in certain cats like my Duke raise blood glucose quite a lot. (See the UK food list with foods that contain veg protein extract) Cats are designed to eat animal protein not vegetable protein.
If Merlin is hungry and i suspect he is with those high numbers he will probably eat most things at the moment, try a high calorie low carb food to help him put on a bit of weight, kitten foods are usually higher in calories.
Don't worry Jill about your head spinning it will settle down honestly and everything eventually will become second nature plus the members on this forum will help with every hurdle you come across.
Are you home testing him yet? the reason i ask is if you are not home testing you won't know if the low carb diet is working.

 

yes 450mg/dL is pretty high. A normal, non-diabetic feline would have an mg/dL range of 50-120.

If you're asking where to find the conversion info, I just googled

I can't remember right now what defines low carb, medium or high exactly. Too sick, my brain is so foggy. But I do know that like 5% and lower is low, 10% is medium and 15% and up is high.

that's the percentage of calories from carbs in the food, not the percentage of carbs overall. it can be confusing

 

I got that answer once
low is under 10%, Medium is 11=16%, High is over 16%

 

just wondering if switching food should be gradually or am I wrong? Kinda mixing old with new and then decreasing/increasing day by day to avoid tommy sickness etc ??

 

Hi @Paulina
I think it depends on whether the cat will switch straight away to any new foods, if they do fine. I think the gradual mixing new with old food is to try to get cat to eat special foods that they don't like for instance kidney diets etc but we are just talking normal LC cat food. That's how i look at it.

 

On the chart of Uk foods, it says “percentage of kcals from food”. Is this the line you are talking about? Should I aim for foods with, say, 5 or less in that column?

 

Sorry you are sick. Hope you feel better soon.

 

Ok, so continuing on with my bewilderment, I have a few more questions. You people are so wonderful. Thank you so much.

1) the vet hasn’t gotten the insulin in yet, so I’m stuck in this limbo with Merlin. I have been feeding him more frequently a little bit at a time, thinking this would keep his blood sugar steady because he is so hungry. Am I wrong? Should I be working on getting him on a low-carb twelve hour feeding schedule before the insulin begins?

2) should I just stick with this crabby vet for now until I can find a better one, even if she wants to use Caninsulin? (She won’t tell me what one she ordered)

3) can I let this vet keep him in for twelve hours so that we at least start on solid terms with a proper dosage?

4) if I do that, should I continue the (unspecified) prescription food she wants us to use?

5)if I don’t go with this vet, should I find another vet, have his blood tested again, and start all over, adding to his time without insulin?

6)can I ask for the libre monitor to start with? Does it work for cats?

7)can I use the pen instead of the syringe, if it’s available?

8) once we start the insulin, if we let the vet do a 12 hour curve, how often will we need to test?

9)if we don’t let the vet keep him for 12 hours, how will we know how much to start with?

ok… I think that’s it for now. I must be reinventing the wheel here, but I just need to ask for myself. I hope it won’t be terribly wrong if I choose to let the vet keep him. It seems the most sensible to me right now.

Thank you all, again!

 

Sorry just to be clear are you asking about how many carbs is low carb medium carb and high carb?? Or did i not understand you ?

 

Hiya! Hopefully someone gonna comment on this one as I remember that all I’ve read it was be careful as it can upset their tummy

 

I think I figured out the chart, but I don’t know which percentage I should give to Merlin or how often until he starts on insulin.

 

I’m
Gonna wait for reply from more experienced members but I think all the low carb food from the list is good as long as the cat likes it and as much as he wants to

 

That would be great! I hope that’s true.

 

Hi Jill,
Yes that's the line you should be looking at for the carb content, as i said in a previous post my cat eats Sheba fine flakes in jelly that has 2.5% carbs, also the comments box gives you vital info like added ingredients like vegetable protein, sugars etc that can raise blood sugars.
The last four boxes contain the packet label info that printed on the cat food box or tin etc. This is very useful when it comes to double checking ingredients because manufactures can and do change things, i always double check the numbers on the list to what's on the food packet.
This tool is also brilliant for checking foods that are not on the list or for calculating foods that could have had their ingredients changed, have a go, it's easy to use, i use it all the time, just enter the typical analysis into the boxes and press calculate, it will give you the carb content.
https://secure.balanceit.com/tools/_gaconverter/index.php?

 

Hi Jill, i will try and answer as many as i can but i will tag in a couple of other members just to double check everything or anything else to add.
@FrostD @Bron and Sheba (GA) thanks ladies.
1) I would feed Merlin just as much as he wants at the moment as he's not on insulin yet, but feed him low carb and no dry food.
At the moment his body not producing insulin and this in turn stops any nutrients being absorbed into his body resulting in weight loss and Merlin being ravenous, insulin acts like a key opening the cells in his body so the food can be absorbed.
When he starts insulin feed him his normal breakfast and supper but let him graze throughout the day, say small meals 3,4 and 5 hours after his insulin.
2) You might not have a choice regarding the vet, just keep searching today and have a ring around and yes caninsulin will have to do, but if caninsulin is given you should try and explain that Caninsulin was developed for dogs but used on cats until Prozinc was developed which is specifically for cats.
3) Personally i would prefer to do the curve at home because some cats stress badly at the vets and this can raise their BG at lot higher than usual giving false readings, so i would tell the vet you will do this at home.
4) No, that food is far too high in carbs
5) I can't be too sure about that, some vets will insist on another blood test, maybe if you take the printed out results they might work with that.
6) I haven't used a libre but is you search the forum some have had good results using it but some say that they fall off.
7) A pen if i remember correctly only gives doses in half units so you couldn't give smaller doses inbetween, say a fat or skinny dose or a quarter of a unit. If a cat needs a reduction we nearly always reduce in 1/4 units.
Here is a beginners guide to caninsulin and a piece about pens.
https://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/
And the prozinc board.
https://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/
8) Testing is done every time prior to giving insulin plus well i do Duke at 3,4,5 and 6 hours but some do it less, but i would say at least 3 times during each AM/PM cycle.
9) The normal starting dose i cannot say but certainly not more than 1 unit to start with.

A couple of question from me now Jill
1) Are you home testing Merlin?
2) Has Merlin had a fructosamine test?

 

You can try feeding a low carb diet for a week to see if it lowers the blood glucose levels if you are testing the urine for ketones.
If you just continue to not give insulin and not test for ketones, you are running a very real risk of your kitty getting ketones in the urine, which can quickly lead on it DKA which can be a life threatening and expensive illness to treat in cats.

I would make it a priority to find a vet who will give you some insulin now. It’s just ridiculous that they don’t have any insulin on hand or at least be able to get some quickly. If they prescribed Lantus you could pick it up from a pharmacy the same day with a prescription. It’s a human insulin, very suitable for cats, and I can not imagine that most pharmacies would not have it in stock.

I think the time has come for you to jump up and down to get your kitty started on insulin.
And if you are hometesting, it is not necessary for you to hand over your kitty to the vet for them to do a curve. It is absolutely fine for you to do it at home.
If you are successful in getting the insulin, please check with us first about the dose you have been told to give.

 

Thank you so much for your answers. I finally talked to the vet! She will have the insulin in tomorrow, which means we can get him started Thursday morning. She said that only Caninsulin is available here, so I guess that’s that. She has also ordered the Libre meter. She wants to start with half a ml dose and observe him in the office to see how he responds. I have to say, I am more comfortable with this than with doing his first dosing at home, so I’m going to go for that as the dosage she is starting with is low. She said she has ordered Royal Canin diabetic wet and dry food that I can buy if I want to, or feed him whatever low carb I choose. She is going to show us how to do the injections on Thursday and practice with water…Is that normal? She also said that it’s ok to keep him on the food he has normally been eating for now and then ween him off it later. Luckily he is not picky, so that wont be hard. I have been testing his urine with ketostix and it has been normal every time. Whew. And I don’t know about the fructosamine as she wouldn’t send me a copy of his blood work…

 

yes many vets will have you practice shoot with saline solution

 

Hi Jill
Is Prozinc not available in Ireland? seems strange, i thought it would be available everywhere. I will tag @Paulina to she if she knows any different.
Also are you sure about the half a ml dose, maybe half a unit on a u40 syringe, half a ml is a massive dose, it can't be right and you need to double check on that with the vet before any insulin is given.
Good news about the food.
The fructosamine test is a test to determine the average blood glucose levels for the past two to three weeks, this result is not stress affected so it's more accurate for diagnosis.
You can insist for a copy of his blood work, either via email or printed, after all that is what you paid for, that's ludicrous.

It would help now that Merlin is starting insulin is to set up your spreadsheet and your signature, this will be vital for anybody that helps regarding dosing for Merlin.
This page was set up by @Bron and Sheba (GA) giving loads of info and how to set everything up. If you do struggle to set it up there is always somebody here to help.
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

 

She must have said half a unit. I was so excited to be talking to her I must have written it down wrong.

 

I had a little hunt online, and it seems that, although it’s authorized for use in the EU, Prozinc isn’t available in Ireland.

 

It is as my Frodo was on prozinc. He is on lantus now and Igot it from pharmacy - the vet gave my prescription for it and for the syringes too

 

Also I would request a copy of the blood work first and fructosamine and post it for admins. This way they can see if the starting dose is ok. Not sure if it was mentioned here - he had that fight with fox and although his mama said that he started loosing weight before - I was thinking what kind of medication he got that time? Did he get steroids?

 

He got antibiotics and a single shot of “painkiller.” I’m not sure what it was. I will find out though. And I will not leave until I get a copy of his blood work.

Should I wait to find a vet that will prescribe Lantus? Could Caninsulin do more harm than good?? I was so happy to get him started on something to help him. Is it better to start sooner on Cansulin than later on Lantus? Now I will be up all night worried again.

 

Don’t worry!! U said he has no ketones so one day more or less wouldn’t do any harm. I’m not experienced in types of insulin at all so better if someone else answer but I would ask the vet what’s the story with prozinc and lantus as u can say that ur friend from Galway was using prozinc and now on lantus and u would like some explanation how is that possible that’s not available in ur vets…

 

I will ask her, but she’s the one who wrote me a condescending email about “googling different types of insulin”. I am thinking I might phone around different vets to see if they would prescribe lantus. I did read that if caninsulin doesn’t work, the vet can change, but I don’t want to use Merlin to prove a point that’s already been proven…I just need to know that caninsulin wont hurt and may help at least for a while til I find another vet. I don’t know.

 

I think that’s good idea. I will keep my fingers crossed hopefully some more cooperative vet nearby. In a meantime get some sleep. Sending hugs from me and my gang to u and merlin

 

Hugs from all of us to you. Thank you!❤️

 

Thank you

 

tagging some members who might be able to help with that question.

@FrostD

@Wendy&Neko

@Bron and Sheba (GA)

 

Yes it is Ok to start with caninsulin and then you can relax while trying to get a better insulin.
1/2 U is a good dose to start with. Make sure you feed 1/2 hour before you give the dose.
Are you going to be testing the blood glucose levels?
Please do test for ketones. Your kitty has had an infection and is a diabetic so it’s important you test. Don’t think just becasue he had no ketones at diagnosis that he can’t get them. Hopefully he won’t, but please test.
BEGINNERS GUIDE TO CANINSULIN

 

<3 Bron

 

My girl started on Caninsulin (in Canada). That's what the vet knew. It wasn't until a locum vet came into the office that she got onto Lantus. It will be fine, just not ideal, to be on Caninsulin for a while. It will be much better than not being on insulin at all. In the UK, vets have to prescribe Caninsulin or Prozinc until it's shown one of them doesn't work. I know, Cork is not the UK, but a lovely town I enjoyed visiting.

The Libre is also a good way to start with home testing, but you should also take the time to start learning how to home test. Libre's last a max of two weeks, some cats take them off within days. You'll want to get something like a onesie or surgical suit or something like a sock you can pin around on top of it, to prevent kitty from accessing and removing it. More tips and info here: FreeStyle Libre: video, demonstration, explanations, tips – discussion!

 

Thank you, Wendy. I wrote to our old vet in the US to ask her advice. I will go with the Caninsulin if it’s all we can get, but maybe we can switch, if it doesn’t work. I just hate to start something that is doomed to fail when we could have started off with Lantus had I tried harder. Grrrrrrr.

 

No ketones so far. Vet didn’t call today. I felt reassured that things were happening and we’d be on track when I talked to her yesterday. She said she would call when the Caninsulin came in. I guess it didn’t.

 

Hi everybody. We STILL have not heard back from the vet about initiating Merlin’s treatment! We are changing vets!

 

That's INFURIATING!!!!!!! Good for you for taking back the control. Perhaps the next Vet will get your gorgeous Merlin on a better starting insulin!
Did you start Merlin on a lower carb food yet?
I also had a Libre put on my Cleo and it stayed on the full 14 days+ but the sensor stopped working after 10 days. The readings on the Libre did teach me the immeasurable value of home testing. Have you started a routine of home testing his BG? There are a TON of tips and tricks found on this board. If you're looking for them, you might want to start a new thread.
If you start testing the BG now, it could show how Merlin's BG responds to different % carb food. That information is great to know when he is finally on insulin.

 

The first vet called me and left a message after I sent my husband in to get a copy of the blood work. She said that the monitor will be in tomorrow and we can set up an appointment for Merlin on Monday to place the monitor, and start the insulin, and monitor him for the full day in the office. She said he would need sedation to place the monitor. Is that true? It’s making me all wishy washy about going to a new vet… But, tomorrow I will be talking to the new vet (having sent him the blood work) and I will know what exactly his plan would be. His receptionist hadn’t heard of Lantus, though, so I think that using anything other than Caninsulin is rather hopeless right now. His reviews online are stellar, though, and he doesn’t have a gargoyle for a receptionist like the first vet. She will be super pissed off with me when I tell her we aren't going to go with her. A part of me thinks we still should, because she has all the stuff and is ready, on Monday. Will it take over a week for the new vet to order insulin and a monitor? I don’t know. What do you all think? Meanwhile, Merlin is hanging in there. Still no ketones in his pee. He was eating a lot for two days, but now has tapered off a little. I will get lancets and a monitor tomorrow if I can find them in a pharmacy… I did not realize how small-town “big-city” Cork is.

 

I have a copy of his blood work now. Should I download it somewhere, or will it go into the scary spreadsheet I haven’t looked at yet?

 

Hi Paulina! Could I ask your vet’s name in case the new vet is open to new ideas about different insulin (Lantus)? His receptionist said she’d never heard of that and it probably isn’t approved for veterinarian use blah blah blah…

 

And i thought Galway is small as u Cant buy here what u want only whats available…

 

My vet is Ark Vets in Knocknacarra Galway ( i used to be seen by Aidan but now whoever is available at the day of the appointment which i hate to be honest as I would prefer one vet always)

 

Also remember the Youghal vet and the boarding cattery?? I know u said it’s bit too far but maybe if they can give the prescription is worth to try? Maybe just give them a call to see if they know lantus or prozinc??

 

Ok! Thanks, Paulina. Yes, I get the feeling Ireland is still emerging from being mostly a great big cow farm, but it thinks it’s really continental and hip.

 

And do you pick your insulin up from a pharmacy/chemist, or does the vet supply it?

 

The prozinc I was getting from the vet but lantus I bought in the pharmacy - the vet just had to give me the prescription for it and the for the syringes too.

 

Hi Jill
Regarding the insulin, i don't know if it's the same over there in Ireland but here in the UK vets have to use the cascade system by law.
I don't know if your vet will prescribe Lantus as it's a human insulin and they only prescribe human insulin if the animal insulin is not working, it's called the cascade system.
This means that vets have to use insulin designed for animals but if they don't work then human insulins can be used.
This is the UK version but like i say i don't about Ireland.
https://www.gov.uk/guidance/the-cascade-prescribing-unauthorised-medicines#about-the-cascade

 

It's not that scary Jill, infact it's a life saver and i honestly could not be without it.
Take a look at my Duke's spreadsheet, all his blood glucose readings/Lab results and any remarks are there for which i can revert back to when i want, or for a member to see if i require any help. The most important thing about having a spreadsheet is for when you need help from a member, the member must be able see Merlins spreadsheet so that they can help with any dose changes etc. A member cannot advise without seeing Merlins data otherwise it would be guesswork.
Remember there is always someone here to help you set it up.

 

I have decided to stay with the original vet because she has finally got everything in, and I bet another vet would have to wait just as long to get insulin and the libre device. We are taking Merlin in on Monday to place the libre, (which the vet says he will have to be sedated for), begin the insulin, and do the curve for the day at the vets. I hope the sedation won’t lower his BG, but I don’t think I have a choice about that. Poor old guy, I just want to get him treated as soon as possible, despite my personal preferences for vet personalities. As soon as I have a curve, I will do the spreadsheet. My main concern right now is finding a low carb wet food all three of my picky cats will eat. They sure are hooked on those crunchies!

 

Good idea Jill, you can always switch vets after Monday once Merlin has started his insulin if you are not happy. Those crunchies are a no no, probably very high in carbs, what are they?
As for food it's a case of trial and error, cats are cats. One day my cats love a certain flavour and the next day they won't touch it lol.

 

Same with my cats. It took so long to find a food they would all eat after moving to Ireland. No Fancy Feast here. Usually they just lick the gravy off and leave the meat chunks. Then they load up on crunchies all day and night. I’ve tried taking away the crunchies, but the other two cats eat nothing and vomit water all day rather than eating wet food. Merlin will eat some pates for a few days then get bored. I’m worried my other cats will suffer most when I remove the crunchies. Merlin too, as he also loves them at night. I’m going to try mixing in an all protein crunchy with them to start phasing them out. Their beloved crunchies right now are “Purina One Bifensis Dual Adult,” I think a European brand?

 

I can't say about removing the dry food from the other cats, personally i would, but Merlin really needs to be off the dry food as its massively high in carbs and not doing him any good at all, it just keeping his blood sugars up. It might say the carb content on the packet.
If you do reduce Merlins carbs then you need to be checking his bloods regular because lowering carb content of the diet can reduce blood glucose significantly, and the insulin dose may need to be reduced so as to avoid hypoglycemia.

Foods that contain gravy can also be high in carbs but not all, double check it on the carb calculator to be sure.
Try your cats on wet food in jelly instead to see if they like that, mine do prefer jelly rather than gravy.

Jill could you start a new thread as this is nearing 100 posts and the max is only supposed to be 50.
Just name your new thread New bewildered member continued and include a link to this thread so people can revert back if they wish to catch up.
Also could you please include a link to your new thread here.

 

Hi ladies!! I actually called my vet to ask and they said it basically depends of the vet supplier which insulin they have and also as long as the pet is under the vet care they can prescribe insulin which u can then buy in the pharmacy

 

I answered this on your new thread from today
https://felinediabetes.com/FDMB/threads/new-bewildered-member-continued.262958/