New Diabetes diagnosis WITH Stomatis steroids

[TheCalicoHouse]

Hi everyone!

I'm new to this site and am just a little stressed. We received a steroid-induced diabetes diagnosis from our vet for our 14-year-old girl yesterday afternoon... So far, she has received three insulin shots and goes back Monday for Glucose testing (we plan on getting our testing kit if she's responding okay)... My main concern is that the vet thinks she needs to be on both Depo and Insulin, but told us that it could make Diabetes treatment not work at all...

Pixel was diagnosed with Stomatitis last year as a 13-year-old. We did a partial mouth extraction and she has done pretty well this past year with her Depo shot and hasn't had any flare-ups... The vet said that while Depo can make it impossible to treat diabetes, she feels like her quality of life would not be there without it... I was just wondering if anyone had any experience or advice on dealing with a cat with both Stomatitis (or other steroidal-required illness) and diabetes? I know the monthly steroid is probably the cause of her diabetes, but I feel lost at what to do...

I love this cat so much, but I want to do what is best for her, and I was trying to see if anyone had dealt with something similar... She is scheduled to return for her next Depo shot on the 12th. I'm trying to be hopeful, but she's lost so much weight in just a week (her last Depo was last Monday, and between Monday and yesterday she lost 2 lbs...). She is still eating, drinking, and acting okay, but just wasn't quite herself which is what made us go in (on top of the weight loss of course).

Thank you in advance...

 

[Bron and Sheba (GA)]

Hi and welcome to you and Pixel to the forum.
We do have cats here who also need to be on a steroid for whatever reason. We just have to work around the steroid and sometimes the cat needs a bit more insulin, so I would definitely not give up hope of getting Pixel managed with diabetes. We can certainly help you with dosing once you are hometesting and have set up a spreadsheet.

I would transition her over to a low carb wet diet starting now.
Have a look at this FOOD CHART and look for food that is 10% carbs or under. Transition over about a week.

I would go out and buy a human glucose meter...if you are in the US you can buy one form Walmart called ReliOn Premier for $9 and a box of 100 test strips for $17.78. You will also need a box of lancets...look for size 26 or 28. And some cotton rounds to hold behind the eat when testing.
Don't let the vet talk you into getting a pet glucose meter. It is not necessary and is much more expensive to run than a human meter. Most of us here use human meters and our dosing methods are based on the human meter glucose numbers.

HELP US HELP YOU has information about setting up a spreadsheet and the signature and also setting up a hypo box.

HOMETESTING HINTS AND LINKS LOOK HERE FOR HOW TO DO HOMETESTING

What type of insulin has the vet given you and what is the dose?
Are you giving it every 12 hours?
How often are you feeding Pixel?
There is no reason why Pixel cannot be treated successfully with insulin...hopefully the vet has given you a good insulin for cats.
Do not be discouraged if Qixel 's blood glucose levels have not come down after 3 days of insulin. Most cats will take much longer than that because insulin is a hormone...not a medication like an antibiotic that works straight away. Hormones take time for the body to get used to them.

She is most likely losing weight because she cant absorb all the nutrients in the food at the moment...this is normal in untreated diabetic cats. Once she is on insulin, she will start to gain weight over time. Dont just feed twice a day...that is old thinking for old insulins.

I am going to tag @Suzanne & Darcy to see if she has anything to add.
Keep asking questions

 

[Suzanne & Darcy]

Well, Bron is correct that cats on steroids can be managed with insulin. The steroid can make the cat more resistant to insulin, but it’s not impossible. Can she be managed on an oral steroid instead of monthly Depo Medrol injections?

 

[Suzanne & Darcy]

What kind and how much insulin are you giving her? I would run out to Walmart and buy the ReliOn meter asap and start seeing how she’s doing on the insulin. What was her fructosamine number at diagnosis?. That number would tell you a kind of average of her blood glucose levels over the previous couple of weeks so it’s an important test and much much better than a one-time glucose test to diagnose feline diabetes.

 

[Suzanne & Darcy]

Atopica is a non-steroidal drug that is used in cats now to treat stomatitis.

 

[TheCalicoHouse]

Hi and welcome to you and Pixel to the forum.
We do have cats here who also need to be on a steroid for whatever reason. We just have to work around the steroid and sometimes the cat needs a bit more insulin, so I would definitely not give up hope of getting Pixel managed with diabetes. .
Keep asking questions

Atopica is a non-steroidal drug that is used in cats now to treat stomatitis.

Thank you both for your advice! We are going back to the vet today and will also be stopping at Walmart to grab a Glucose monitor.

At diagnosis, her number was about 550. She's super hungry all of the time lately, but the vet said to only feed twice a day. I'm trying to follow that advice, but since she has lost a considerable amount of weight (she was never overweight) I feel a little nervous about that.

She is on Vestulin. Is that a good brand?
I will look into Atopica as well. I will try and talk to the vet about it when we go today.

The vet had us buy an expensive dry food, and at the moment I think we just bought it because that was the direction we were getting... I will start trying to find a good wet food diet for her. She's slightly picky on her wet food, but has been getting a lot better after her diagnosis with Stomatitis. I would prefer her to be on wet food anyway...

I'll be doing some research and filling out the spreadsheet. I'm a little scared about doing the glyco tests at home but I know we will be able to do it. Thank you so much!

 

[Suzanne & Darcy]

but the vet said to only feed twice a day. I'm trying to follow that advice,

This is very bad advice for a diabetic cat. It is very old thinking and can be dangerous (especially with Vetsulin). Diabetic cats do much better when fed multiple small meals throughout the day -- it helps to prevent steep drops and helps to stabilize their blood sugar. Your cat is not regulated in normal numbers right now -- she cannot get enough nutrition from her food and therefore is losing weight. Please let her eat more food.

 

[Suzanne & Darcy]

She is on Vestulin. Is that a good brand?

No, this is not a good insulin for cats. It is not recommended for use in cats anymore as a matter of fact (not recommended by the American Animal Hospital Association or the American Association of Feline Practitioners.) It is quite harsh in cats and tends to drop them too low, too quickly, and it doesn't last very long in cats. ProZinc or Lantus (or generic glargine insulin which is the same thing only cheaper) are much better choices. It sounds like your vet may be more accustomed to dealing with diabetic dose instead of diabetic cats. Cats are quite different.

 

[Suzanne & Darcy]

The vet had us buy an expensive dry food

Ugh! Could he/she possibly do anything else wrong. Sorry, I get so frustrated with these vets. It's probably the DM, isn't it. I would look for low carb wet food options. You can just start with either Fancy Feast Classic pates or the Friskies Pates (no gravy types) and then can go from there to find any food that you want to.

But, please, if your cat is used to eating high carb food, you must be testing during the transition to lower carb food and the transition must be made slowly because switching from high carb to lower carb food really will lower her blood sugars and you don't want a hypo.

 

[Suzanne & Darcy]

I'm a little scared about doing the glyco tests at home but I know we will be able to do it.

I cried a lot at first because I couldn't seem to get any blood from my boy's ear. But we have a lot of tips on how to do it and you will eventually be able to. I believe Bron mentioned to start with the larger lancets -- later you can move to the tinier ones. I also recommend not using the lancing device because it makes a noise that a lot of cats don't like. I would just use my hand holding the lancet to do it.

 

[Suzanne & Darcy]

I hope that you will find that her stomatitis improves a lot with greater blood glucose control I have been helping another member on the ProZinc forum whose cat has/had stomatitis and as her cat's blood glucose has improved, the stomatitis has gotten MUCH better. Sugar is very inflammatory and uncontrolled blood glucose definitely contributes to the stomatitis. We are so happy that you are here and we are all hoping to help you and Pixel.

 

[tiffmaxee]

I think Suzanne meant to say Vetsulin is used effectively in dogs but not for cats.

 

[Suzanne & Darcy]

I think Suzanne meant to say Vetsulin is used effectively in dogs but not for cats.

Yes. Did I get mixed up and say it wasn’t good for dogs too? I believe people use it effectively for their dogs, yes. But I have no experience with dog diabetes except knowing one person with a diabetic dog and from what I have read. But definitely ProZinc or glargine would be a better way to start out your diabetic journey with Pixel.

 

[TheCalicoHouse]

This is very bad advice for a diabetic cat. It is very old thinking and can be dangerous (especially with Vetsulin). Diabetic cats do much better when fed multiple small meals throughout the day -- it helps to prevent steep drops and helps to stabilize their blood sugar. Your cat is not regulated in normal numbers right now -- she cannot get enough nutrition from her food and therefore is losing weight. Please let her eat more food.

This makes me feel better because I did end up giving her more food over the weekend...

Oh wow, I didn't realize that about Vetsulin... I'll look into different Insulins then! I don't want her to crash.

The food she "prescribed" is a Purina diabetic food. I don't have anything against Purina, but it was extremely pricy. I have some Fancy Feast Pates already on hand that I've been giving her a little of throughout the weekend. I will scour the wet food list and make a run or order some more. One of my other girls is extremely resistant to wet food, so I hope to find something she will like too. Pixel usually likes most, but only fish varieties.

I'm trying to be hopeful about her Stomatitis since she hasn't had a bad flare-up in awhile... The partial extraction helped a lot. I would love if we could do non-steroidal treatment, so I'll be looking into that with a lot of interest. It will probably help her joints to not have as much sugar too.

 

[Suzanne & Darcy]

This makes me feel better because I did end up giving her more food over the weekend...

Oh wow, I didn't realize that about Vetsulin... I'll look into different Insulins then! I don't want her to crash.

The food she "prescribed" is a Purina diabetic food. I don't have anything against Purina, but it was extremely pricy. I have some Fancy Feast Pates already on hand that I've been giving her a little of throughout the weekend. I will scour the wet food list and make a run or order some more. One of my other girls is extremely resistant to wet food, so I hope to find something she will like too. Pixel usually likes most, but only fish varieties.

I'm trying to be hopeful about her Stomatitis since she hasn't had a bad flare-up in awhile... The partial extraction helped a lot. I would love if we could do non-steroidal treatment, so I'll be looking into that with a lot of interest. It will probably help her joints to not have as much sugar too.

That’s a very good point about her joints. Even my daughter notices some soreness when she eats lot of sugar and she’s young, but I suppose sensitive to it.