New Diagnosis and New Member

[neonwooj]

Hello!

To preface this, I live in Australia!

My 8.5-year-old indoor female cat (Zali) was diagnosed with diabetes literally JUST this morning, and I’ve fallen down the Google rabbit hole and psyched myself out a bit. I’m also somewhat sceptical of the vet clinic we’ve been using, so I’d really appreciate some reassurance/advice.

Sorry for the incoming long post.

For the past few months, she’s been drinking quite a lot of water, although we didn’t think too much of it because she’s always been a little obsessed with water. Yesterday (27 Aug) around 1:30pm, she suddenly peed on the floor while loafing. She has never had an accident before, so this was super unusual.

At around 5:30pm, she started leaking blood from her back end. We weren’t sure whether it was urine, stool-related, or something else? However, it continued fairly heavily, so we rushed her to the only non-24/7 emergency vet open after 6pm. This happened to be a vet we had used in the past when our other rescue cat when she had gotten very ill (not diabetes).

Honestly, based off some of the past advice/procedures/interactions with this vet, if has made me a little more hesitant to trust them 100%/completely without question.

Anyway, they recommended admitting her overnight for bloodwork, urine testing and possibly an X-ray. However, Zali handles unfamiliar places and strangers extremely poorly, so they allowed us to monitor/treat her at home.

They did the bloodwork, gave us a urine sample test container, laxative (possible constipation) and gabapentin, and then we went home.

By around 8pm, the actual bleeding stopped, but she started urinating reddish/pink urine. This continued into today (28 Aug), including periods where she tries to frequently pee but can’t. She still occasionally does pee, so she isn’t completely incapable.

This morning, the vet said her bloodwork showed high glucose and ketones, and that there wasn’t anything in her urine (just blood). We were asked to come in ASAP.

They diagnosed her with diabetes and recommended 24–48+ hours of hospitalisation for supportive care. However, after discussing how badly stress could affect her, they agreed we could monitor and treat her at home. They believe the bloody urine is cystitis??

We’ve been sent home with Buprelieve (for cystitis), more gabapentin and an insulin pen (3mL), and told to monitor her very closely. We haven’t been told to change her diet yet, and she is currently eats Royal Canin hypoallergenic dry biscuits plus cans of plain tuna/salmon, which is what our other cat also eats. (It is not perfect, I know , but this is what the same vets previously recommended after our other cat was ill—feel free to offer affordable advice).

My other cat had severe pancreatitis and bowel disease (?) about 4-6 years ago, which she recovered from, and because it is impossible to feed them separate food, Zali is (was?) also eating it.

Anyway, for diabetes, we’ve been told to give 2 IU of insulin twice daily, until her follow-up in two weeks (10 Sept). We were told that we DON’T need to monitor glucose levels at home—just watch her behaviour/symptoms and return ASAP if she deteriorates???

When I got home, I researched everything to make sure I understood it all completely, and that’s where I freaked myself out ://

I’d really like to use the insulin pen because I struggle with perceiving touch/pressure (I’m autistic), and the pen clicking mechanism seems much easier for me. However, I’ve also read that pens may be less accurate for cats??? It’s also around $58 AUD for a new pen every 75 days or so. Additionally, it costs $16 - $22 AUD for new needle caps every 50 days—which isn’t too bad, but on top of the new pen every time, it annoyingly adds up quick.

So, I’d really appreciate some advice:

- Is 2 IU twice daily with no home glucose monitoring for two weeks a reasonable starting plan?
- Should we be monitoring her blood glucose/ketones at home during the two weeks before the appointment?
- If so, how? Do we go back and ask them for something?
- Is an insulin pen appropriate/accurate enough for a cat, or would syringes be preferable? Also what is most cost effective?
- Should we change her diet now, or wait until the insulin is established and the cystitis settles?
- Does the overall plan we’ve been given sound reasonable?
- Does the cystitis affect anything regarding the diabetes? Also, when should we be concerned if the blood isn’t clearing up? (The pee really did not look good at all)
- If we change to a diabetic diet, is it possible for our other cat to eat the same food too?


I’m mainly looking for some reassurance that we are doing the right thing for the next fortnight, and so I can stop overthinking every single thing.

EDIT (20:55 27/8): She has been prescribed Optisulin Solostar (Insulin Glargine Pen 3ml Each (3ml)). Thank you for reminding me to add this information, and I will respond to everyone individually in the morning!

 

[Liz & Crowley]

Hi!! That sounds really scary and overwhelming, but I'm glad your baby is okay!! I'm still pretty new, so I'll let more experienced members tackle some of the more complicated qs, but for some of the basics:

- They're going to ask what kind of insulin she's on! There are a lot of different kinds and you'll get dosing tips from there.
- You can monitor at home & you definitely should! I just got done testing my boy's glucose. I use a monitor I got for cheap at Walmart, but you can use any human meter. I sent a picture of my kit for Crowley to my diabetic friend (human) and it was like... the exact same as what she'd have. Except for the freeze dried treats. She does not have freeze dried chicken in her diabetes kit.
- You can monitor ketones at home with strips too! You have to figure out how to catch his urine (there is a link for that too). Personally I used the foil spoon.
- You can def switch both cats to a diabetic friendly diet. My civvie cat was very happy because they both get wet food now. You don't need a fancy diabetic diet (although, I won't lie, I don't know if the cystitis impacts anything diet wise), but what I did was go to this link and find something low in carbs, since a low carb wet food is what we want for a diabetic cat. I settled on FF pates because they're affordable here, but idk if that's different where you live.

With testing at home, you should also set up a spreadsheet and link it your signature. It's both a great way to track your cat's data and if you ever need advice/help lets the ppl review your info quickly and efficiently.

People here are very friendly and knowledgeable!! I was really nervous and overwhelmed when I found out about Crowley's diagnosis but we're working it out now and I can see improvement thanks to help I've found here!! Hell, I can see improvement in things I wouldn't have even known were caused by the diabetes without this forum.

 

[Connie & Parker & Moonie]

Hi! Welcome!

I’m too new to be answering most of your questions but I can answer a couple

I use a Lantus pen. Here in the U.S., the pen costs me $35 with a manufacturer’s coupon and it lasts me months (Moonie is on 3.25u) so it’s not a huge cost for us in the grand scheme of things. I don’t think there is a real difference between pens and vials. To ensure accurate dosing (especially since I adjust Moonie’s dosing in 0.25u increments), I use a digital caliper and syringes marked with half units.

Info - Dosing with calipers updated w/videos

When Moonie got diagnosed, I got the same advice that home monitoring was not necessary. I think that’s in part because many vets are uninformed about the disease and in part because vets are worried about making diabetes management sound difficult in case owners decide to euthanize instead .

But you would never ever give your diabetic child an insulin shot without checking their blood glucose and it’s no different with our fur babies.

Blood glucose testing seems really daunting at first, but it’s now a simple part of my routine together with Moonie. I test before I give her the insulin shot and 2 hours after to ensure that the insulin isn’t dropping her too far (and occasionally test more than that, especially at the beginning to understand her curve).

Info - TESTING AND SHOOTING TIPS

Finally, you can absolutely feed your non-diabetic cat a “diabetic diet” - all a diabetic diet is a low carb one. Many of the members here feed Fancy Feast pate, though that may not be a good choice if your other cat has higher kidney values. Here’s a food chart I like to use (though it may be more US centric) - you just need to pick a food with carbs below 10 percent.

https://www.bizave.com/foodlists/Combined_Food_Lists_Feeding_Guide.pdf

 

[Tim & Pookey]

Hi and welcome! You got some great information there from Connie/Parker and Liz.

- Is 2 IU twice daily with no home glucose monitoring for two weeks a reasonable starting plan?
- Should we change her diet now, or wait until the insulin is established and the cystitis settles?
- If we change to a diabetic diet, is it possible for our other cat to eat the same food too?

2 units is a bigger starting dose. I had that same advice when I got home from the vet the first night and I'm glad the folks here educated me.

From the Lantus dosing methods:

Starting Dose:

• 1u BID if kitty is not on a wet/canned low carb diet
• 0.5u BID if kitty has been switched to a wet/canned low carb diet
• If the cat was previously on another insulin, the starting dose should be increased or decreased by taking prior data into consideration
• Generally, shots are to be given 12 hours apart.

The important bit in bold about how you're considering a diet change (which is good). You might find the diet makes a big impact on her blood glucose numbers. And we don't want her going too low with too much insulin and no data yet.

 

[CORKY]

Welcome to FDMB
We all have become overwhelmed knowing that our fur baby is diagnosed with diabetes, but it gets better, and we are here to help you in any concern you may have including dosing advice. First If you are not please and have concerns over your vet, follow your instincts, all the suggestions given by the other members are extremely valuable and important, and yes, home testing is a must, testing before each shot and at least 3-4 times during the day is important to see how the insulin is working in Zali's system, Concerning the diet, there's no such thing as diabetic food or diet, humans do not eat special diabetic food, as well as a cat,
a low carb diet, of wet can food between 0-10% is ideal for any cat, especially a diabetic cat, I have two cats grew up on kibbles free feeding and when Corky was diagnosed, I switch them both to wet can food between 0-10%, we are looking for Dry Matter carbs, also a feeding schedule is important, at least 3-4 small meals or snack during the day, and the two main meals before shot, to keeps the insulin in check, the PROTOCOL IS TEST-FEED-SHOOT if you are not home during the day, a wet food feeder is a good idea, some have cameras and chips, so you can program them. below is a Drs approved food list for Australia, and a food calculator, you will the nutrients on the label,
like Tim explained, the transition from high carbs to low carb diet has to be a slow transition not to upset Zali's stomach and testing during the transition is also important since the change in carbs will alter the glucose level low, a non-diabetic cats' glucose level should is between 50-120 Please continue to post, also read the sticky note on our Main 1forum they contain much valuable information

Info - Updated Australian Cat Food List suitable for FD cats
Carb Calculator - Felinediabetes.com

 

[Wendy&Neko]

Hello and welcome. A post that might be of interest to you:

• Information for Aussie Feline Diabetic Caregivers

I have some answers to your questions, not necessarily in order as you did.

• Yes, you absolutely have to test for ketones. Details in the first post I linked, plus this post here: Tips to catch and test a urine sample Ketones above trace are a concern that should be discussed with the vet and untreated, especially with inflammation in place, you do have to try to prevent DKA. How is her appetite now? Any lethargy or reduced appetite is a concern.
• In support of both her cystitis diagnosis, her diabetes, and trying to flush out ketones, she should be getting as much water as possible. Dry food is not the best answer for those conditions. For cystitis, a lower phosphorus food would also be a benefit.
• The two units insulin dose is a little high, but with ketones present, I would be hesitant to reduce the dose, especially if she is eating high carb food. I would get on home testing blood sugars as soon as you can.

Does your other kitty have any specific food allergies? Obviously not fish which was my IBD kitty's trigger. If your other cat has a food allergy, then moving to a novel protein (new to them) might be an answer. Something like lamb or kangaroo? My Neko loved kangaroo.

 

[Tim & Pookey]

Thanks Wendy for pointing out the ketones, I didn’t consider that in my previous reply!