New diabetic cat mom

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Nolan'sMom

Member Since 2014
Hi, my cat Nolan was recently diagnosed with diabetes. I took him in to the vet because he had lost some weight, the vet did a blood test and determined that he is diabetic. This was around the end of March. She started him on insulin and after a couple of weeks of dosages and in office test she decided that 5 units of pro zinc insulin was his dosage. She told me to continue feeding him the dry Purina cat food I had been for years. The vet told me two give him 2 shots of 5 units once in the AM and once 12 hours later in the PM. I thought Nolan was all set, he seemed happy and eating fine but I began to notice him walking down on hocks of his feet, I did some research online and found out that this is called feline neuropathy and is a sign of poorly regulated blood sugar. I made an appoint ment right away (this was last week) Rhe vet tested Nolan's blood sugar and it was in the high 300's, she upped his dose from 5 units of pro zinc twice a day to 8 units ( this seems high and I'm not sure if it is, but Nolan is about 18 lbs, not obese though, just a large cat) Anyway I took him in again last Friday and he tested at about 348 so now the vet prescribed the purina dm canned food. It is very costly and Nolan would need a lot of it, I bought him a case but I see that it has almost the exact same ingredients of some of the canned foods available right at walmart. Would it be fine to feed him that? The vet also recommended that he only eat the wet food, which I'm fine with but I'm worried that changing his diet and not adjusting his insulin dosage lower could be dangerous to him? I expressed this concern to the vet but she didn't seem to think the food would make that big of a difference... I also mentioned that I had read about at home testing, but she wants me to keep him at 8 units twice a day for about two weeks and keep him on the canned food diet, she said that we will test him again Aug. 4th at his appointment and talk about at home testing then. I'm just really nervous about everything, and waiting two weeks without knowing Homs levels is driving me crazy. Not to mention the fact that my poor baby is walking so poorly, he is in good spirits and eating good, but he lays down a lot and won't walk very far :( anyway that is Nolan and my journey so far, I am so greatf to have people to talk to who are going through the same struggles, any suggestions would be appreciated as I am here waiting and feeling heless until the next vet appointment.
 
Welcome to you and your sweet Nolan,

I am concerned about your vet's advice. Very few cats here use that much insulin unless they have a high dose condition. And increasing from 5 to 8 units is, in my humble opinion, dangerous. We suggest increasing by half units at the most. And to think that the diet won't make much of a difference! Our Oliver switched from dry to wet and went down 100 points with his next preshot. If we hadn't been testing, and given our usual dose, he would have hypoed.

If he were mine, I would run out and buy a ReliOn meter, strips and lancets. I would start testing him at home. (you don't need your vet's permission - Nolan is your cat and you are trying to keep him safe.). We have taught hundreds of people how to test and would love to teach you. Once you know what his numbers are, without the stress of being at the vet's office, then you can safely see what the dose is doing. I would not change to wet low carb food until you are testing, so you can see exactly how low the dose is taking him.

And yes, you are right. There is nothing "prescription" about Purina, other than the price. Most of us feed Fancy Feast or Friskies. Purina will accept returns if you want, take it back to the vet and tell him Nolan won't eat it.

I know it's difficult to hear advice different from that of your vet (especially from people on the internet) but the people on this site have been dealing with and helping cats for over 15 years. Everyone who replies to your thread is paying it forward for help they received. Read some of the other threads on this page and see how others are dealing with their diabetic cats.
 
Whoa! I think your vet may be going too fast on the insulin dosing.

Glucose levels at the vet may be from 100 to 180 mg/dL higher due to vet stress. Home testing with an inexpensive human glucometer such as the WalMart ReliOn Confirm or Prime gives you real time data to help you ensure your cat is safe and stays safe. And its your cat, so its your decision, not the vet's, as to whether or not you home test. Consider this - would you give a child insulin without making sure it would be safe to do so?

Diet - a low carb, over the counter, canned food may drop the glucose level 100 mg/dL and could reduce the insulin dose by up to 2 units. Friskies pates are suitable and relatively inexpensive. Fancy Feast Classic Pates also are low carb (<10% calories from carbohydrate.)

Insulin - if the dose is too high, the glucose level may bounce up due to the effect of compensatory hormones releasing stored glycogen which converts to glucose. Your vet may have started and/or gone too high with the dose. This can be dangerous. Once the stores of glycogen are exhausted, your cat could hypo.
 
Thank you so much for the advice. My veterinarian seems to be a very nice person but since I've been doing this research on Feline diabetes some of the things she is doing and prescribing just doesn't seem to be matching up with everything I'm discovering on-line. I am picking up a gloucometer as soon as the pharmacy opens, I've watched some YouTube videos that demonstrated testing, and I think Nolan will do okay with it. I certainly don't want to give him that much insulin if he doesn't need it, but I also don't feel comfortable adjusting his dose on my own. Also it's Sunday so I can't even call the vets office for further advice on his dosage. It really frustrates me that I specifically asked about lowering his dose when changing his diet and she said to leave it at 8 units. I'm so regretful that I took my vets advice blindly in the beginning with out looking into this more on my own... I think I may need to look into switching veterinarians because as nice as she is, it seems now that a lot of mistakes have been made.
 
Nolan'sMom said:
I am picking up a gloucometer as soon as the pharmacy opens, I've watched some YouTube videos that demonstrated testing, and I think Nolan will do okay with it. I certainly don't want to give him that much insulin if he doesn't need it, but I also don't feel comfortable adjusting his dose on my own.
Click to expand...

We can help you with the dosing. Most cats only need between 1-2 units unless there are other medical issues going on. It is much better to give too little insulin than to much. An 8 units is way too much. At that dose, you have a high risk of Nolan becoming hypoglycemic and that could be dangerous or even deadly.

It would be better if you start back over at a low dose, such as 1 unit twice a day. You should also wait at least one week before increasing the dose and if one is needed, only increase by 1/2 unit at a time. Wait at least another week before you determine if another increase is needed.

We can help you set up a spreadsheet and determine if you need to adjust the dose. Also, if you tell us where you are located (city, state and country only), we may have members in your area that can recommend a good vet near you.
 
Since it's Sunday and your vet is unavailable anyway, I'd get the testing supplies and see what his levels are.

Here is a shopping list:

A human glucometer. Any one that sips and takes a tiny sample is fine. Some members stay away from any meter with True in the name and the Freestyle meters. Some people think they are unreliable and read lower than other meters. The meters are often free at drug stores; it’s the strips that are expensive. You can, however, buy them on ebay at less than half the price of stores. Lots of people here also like the ReliOn from Walmart. It is an inexpensive meter and its strips are the cheapest around. Try the meter out on yourself or someone else before you try it on your cat. You want to be familiar with it before you poke the cat.

Lancets and a lancet device. Usually, until the ears “learn” to bleed, a 26-28 gauge is good. Any brand will work as long as the lancets match your device.

Ketone strips. (Ketostix) Just like human diabetics use. You will sometimes need to test urine if the numbers are high.

Rice sack. Make this out of thinnish sock, filled with raw rice or oatmeal and then knotted. You heat this in the microwave until very warm but not hot. Then heat the ears before poking. You can also use a prescription bottle filled with very warm water. It provides a good surface to poke against.

Also nice to have. Flashlight: so you can look at the ears and find the little capillaries that come off the vein running down the ear. Vaseline: Put a tiny smear where you want to poke. It will help the blood bead up.

And some lo carb treats to give your kitty, successful test or not Lo carb treats

BE SURE to pick up ketone strips, If we are going to suggest lowering the dose, you want to stay on top of possible ketone issues.
 
Many vets are just not up to date on feline diabetes. Most often they get a workshop on it in vet school with a nutrition class given by Purina foods (!). Unless they see a lot of felines with diabetes and take classes, they just don't know the current protocol.

This site sees about ten new diabetics a day and our protocol is very successful; many vets do now support home testing, a wet low carb diet and one of the three milder, longer lasting insulins. (your vet did get that right). If your vet will be willing to learn about wet low carb (we have a vet written website on the benefits) and hometesting (there are also some vet studies on the value of it) maybe you can help other kitties and bring her up to date. If you want to change, post your city and state and maybe someone knows an FD friendly vet in your town.

Here is the protocol for ProZinc we put together


http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=109077
 
Thank you all so much for the quick responses and great advice. I'm heading out to pick up the supplies now to start home testing. I'm also going to grab some low carb cat food. I'm hopeful that things are going to get on track and get better for Nolan and I from here. You all seem to have a lot of knowledge and I so appreciate the help! I have been seriously losing my mind these last few weeks! I am still pretty uncomfortable with the approach my vet has taken and if anyone can advise me on a good vet in the central Maine area I would really appreciate it. My concern now is that Nolan has been receiving 8 units of pro zinc twice a day, and this number seems outrageous as I read about others only giving 1 and 2 units! I don't know what I should be doing at this point. I am going to get the supplies to home test, but then what? Change his dose on my own? In addition I've been reading others posts and it seems like my vet skipped some steps in the beginning of Nolan's diagnosis because he never was kept for the day and tested every few hours. I took him in because if weight loss. She said it was probably diabetes or it could maybe be kidney complications. She tested his BG it was in the 400's I believe, so she said he was diabetic and started him out in his Prozinc insulin. I made 8-10 day appointments and he got tested again and his dose was adjusted until she decided that 5 units was working well. So he was in 5 units twice a day for about two months, until a couple weeks ago when I took him in because he started walking on his hocks. she adjusted his dose to 8, which I slowly worked up to in 1 unit increments over a few days, but then as I said before, I took him in last Friday he still tested I. The high 300's so now she mentioned changing his diet! It seems like this should have been done long ago, but when I asked her about it previously she said to leave him on the purina dry food I had been giving him! I was operating under the assumption that she was the professional and knew best, but honestly Nolan's walking has gotten worse and I need to figure out how to get him on the right track. I'm sure I'll have lots of questions in the future as I beging his new diet and home testing, in so greatful to all of you for being available and offering up all this support!
 
Methylcobalamin, a specific for of Vitamin B-12, plus good glucose control, is helpful in resolving diabetic neuropathy. Check out Vitacost brand as 1 option - no added sugar or sweeteners.

Many of us do adjust the insulin dose based on a specific protocol - there are Tight Regulation for Lantus and Levemir, Start Low Go Slow which may be applied to most insulins, we have a draft of a protocol for ProZinc/PZi type insulins, and there are some older protocols for using Humulin/Norolin N and for Caninsulin/Vetsulin. In the case where someone cannot test - ex. disability of human - there is a much older protocol using water drunk, eating, urine volume, and urine ketone testing. It may not be optimal, but is better than nothing.

The use of these protocols requires the human to test the cat's blood glucose before each shot, as well as checking the nadir period, when the glucose is likely to be lowest. The nadir is often between +5 to +7 hours after the shot, although cats can and do vary.

If you do decide to reduce the dose, I strongly urge urine ketone testing. Ketones form as a by-product of fat breakdown for calories. Too many may indicate diabetic ketoacidosis, and expensive to treat, potentially fatal complication of diabetes.
 
I am glad you want to test at home. That is really the best way to manage Nolan's diabetes. A diet change to a low carb canned food will help also. However, please do not change his diet until you are hometesting and lower his insulin dose. Changing to a low carb diet can easily drop the BG levels over 100 points. If you do not decrease your insulin, you are at a great risk of hypoglycemia. That can be very dangerous.

As I suggested earlier, you should start over with your insulin dose at a low dose, especially with the diet change. With hometesting you will be able to determine how well the dose is working and if you need to increase it. You want to increase it slowly (over a period of weeks) until you find the optimal dose that works best to keep Nolan's BG levels under control. Don't worry, we can help you with that. The important thing is that by starting over with a much lower dose with a diet change, you reduce the risk of hypoglycemia.

The Methyl B12 will help with the neuropathy. Vitamin B12 comes in two types. The one you usually see at your pharmacy has the ingredient cyanocobalamin. That type will not work with neuropathy. The one you want is the type that contains methylcobalamin. You can find it online or many health food stores carry it. But you want to make sure that it has no sugar or sweeteners it.

It will take some time to see improvement in the neuropathy, so be patient. Most cats significantly improve over a few weeks. My cat Spot had very severe neuropathy when I adopted her, she could barely walk. Within a few weeks of the proper treatment, she was starting to run and jump. After a few months, you would have never guessed that she at one time could barely walk.

I know everything may seem very overwhelming and we may be throwing a lot of information at you. But we can help you learn all of it. There is a lot of experience on this board so please ask any questions that you may have. Also, if you can tell us where you are located, we may have a member near you that can recommend a vet that is experienced with FD.
 
Okay, so I went to the store and picked up a relion meter, test strips and lancets. I read up on testing and watched some videos on how to test from his ear. I gave Nolan his vet recommended dose of 8 units this morning ( but based on everything I've read and hear on here, I think that May be the last time he has a dose that high. I also picked u a bunch of low carb wet food to get him started on. I tested him at 1:00 and it was 65, this made me nervous so I tested him at 2:00 and it had gone up to 99. I give him his doses at 6:30 am and pm so I just tested him again and it read 289 on the meter. There was enough blood on his ear so I decided to test the accuracy of my meter and tried testing him twice more the second time the meter read 316 and the third time it read 3221. Why would it fluctuate like this? And also now I don't know how much to dose him? I wish I could call my vet but it's Sunday night, and she's the one who told me to put him at 8 doses, which seems like a bad idea at this point.. Any ideas what I should give him for insulin? Is it safe to drop his dose on my own?
 
Okay, so 12 hours after this am shot, he is in this range (289, 316, 321) Those are all within that 20% variance that every meter has, but they are still in the same range (around 300) Since we don't know where he was this morning, and the 8 units took him down pretty low (we consider below 50 to be a range to watch out for), I'd vote for conservative. You can test him from now on so If a lower dose doesn't take him down enough, it is easy enough to raise. Do you want to try the wet food tonight? If so, I would try 2 units and feed him wet instead of dry. If you want to phase the wet in slowly, then maybe 4 units and plan to monitor? I am sorry I can't be more definite but we are guessing at this point, what the food will do, what the dose will do, etc. I definitely think I would not give 8 units as that was a pretty low midcycle number and you won't be able to monitor as well overnight.

What are you thinking?
 
Just for reference, we suggest new diabetics not receive insulin if they are under 200, but wait 20 minutes without eating and retest. If the number goes up near 200 or over, we'd think to shoot but maybe reduce the dose a little. (because the previous dose gave you a pre shot too low to shoot) We consider a cat regulated if they are in the mid 200s at preshot and in double digits at nadir, but above 40-50 which is near hypo range. If a cat is in the 40s, we suggest intervening with food and possibly higher carb food and then syrup so they don't drop in the 30s which is too low. A cat is in remission if they range from 40 -120 OFF INSULIN, with the majority of the time in double digits, for 2 weeks.
 
Greetings!

I am a newbie myself, so can't give dosing advice, but I believe the meters can have a variance of +/- 20%....but that is ok, you aren't necessarily looking for the EXACT number, but the TREND of the numbers. By doing the spreadsheet and inputting the numbers, it makes it much easier to see the trends that Nolan is having which will help the more experienced people here help you with the dosing.

Take a look at Skooter's spreadsheet....he started at 1u and was increased by the vet weekly to 5u....due to his IBD, we didn't think we could give him wet food and thought we were stuck with the dry food and a higher dose.

Thanks to the amazing family of FDMB, Skooter is now on an all wet diet and is DOWN to 2u of Lantus twice a day. There also really hasn't been a flare up of his IBD either (knocking on wood).

As for the testing, one of the best tips I got was to get neosporian with pain relief and to out that on my cat's ear for about 5 minutes before testing. When it is time to test, wipe the ear off and not only does the pain medication make Skooter chill while I am doing the test, the neosporian helps the blood bead up and makes it easier to get a sample.

Happy testing! I said I would never ever home test, it scared me too much, and now.....TESTING FREAK!
 
Two other things - doesn't it feel good knowing exactly where he is instead of guessing and worrying? (BTW, congrats on the test. Welcome to the Vampire Club!) And we need to get you a spreadsheet so you and we can see what is going on when you need advice. I am sending you a private message and will help you set it up if you want. Look at the top of the page "1 new message"
 
FWIW: When I switched spitzer to low carb, he went from 3 units to 1 unit of Lantus.
 
Thank you all so much, I defiantly plan to make out a spread sheet soon. It does feel great to see where he's at and not have to feel panicked every time I dose him. Now I just need to decide how much to give him tonight. Since he's been getting 8 units and today I switched him to wet food, how much lower should I go? He scored 289, 316, 321 when I just tested him (I took multiple readings)
 
Okay thanks again, I'll try 2 units. I'm going to dose him now, and I'll take a couple tests tonight to see how he does with that. I truly appreciate all the help you all are amazing :)
 
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