New Diagnosis and some questions

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alex miller

Member Since 2020
Hi there! First time posting here. Kind of a long one. Thanks for reading and helping!

I have two cats who are sisters: Kupo & Judy (both 8 years old). Recently Kupo has been diagnosed with diabetes and I’ve been wading through the waters here. Making it extra difficult is the Corona virus scare and all the vets are on lock down so it’s always a drop off and pick up situation and have to talk to the vet on the phone so its hard to get some face to face and have a real good discussion about it. Here is some back story:

Kupo has been losing weight for almost 2 months now and started the drink water very heavily. She would eat a ton of food (both dry and wet) and still be hungry for more. The typical diet would be to feed them each a can of fancy feast twice a day (morning and night) and had dry food out all the time. Kupo will snack on the dry food but Judy has never touched it in her life.

Finally we ended up taking her to the vet, they initially thought this was Hyperthyroid but they did a blood test and it came back negative for that. Next step was to get a blood test done for Diabetes. The blood levels came back very high (I believe in the 400s) and they had found ketones in her urine. The vet was worried she could possibly be going into diabetic ketoacidosis (even though she wasn’t really showing signs of that, maybe a little lethargic but still acting relatively normal) so she recommended I immediately bring her to the emergency room to get another blood test done and make sure she wasn’t DKA.

I brought her to Angell Medical center and they said she is not DKA and gave me the quick and skinny on diabetic injections but said not to change the diet immediately but to follow up with my regular vet in a week for a blood curve test. I received some insulin (Lantus) and some syringes and was told to give 1 unit twice daily every 12 hours.

I started the insulin doses immediately that night for their wet dinner and continued on for the next week until bringing her back to the vet. They did the blood curve test and her levels started out at around 400 and dipped into the 300s as the day went on. They recommended I purchase royal canin glycobalance dry and wet food and I also got some glucosupport m/d wet food. They also recommended I raise the insulin injection to 2U. They said to bring her back in 2 weeks for a mini curve test. I took their recommendations and continued on.

Fast forward to today. I brought Kupo in for her mini blood curve test on Thursday and they said her levels are still in the 400s and didn’t really drop off too much which was concerning. They now recommended I increase the insulin dosage to 3U and come back in 3 weeks for another mini curve, and this is when I have now started going down the rabbit hole of diabetic cat websites such as this one which I admittedly should have done from the start. I’m wondering what people here think of the so far approach by the vet I’m currently seeing and have a few questions for the people here:

I’m reading that dry food should be stopped immediately and not given since it’s so high in carbs, even the glycobalance which the vet recommended. I’d like to do this but I have ALSO have read that any drastic changes in carb reduction will almost immediately require a change in insulin administration otherwise they risk going into a hypoglycemic state. What are my options here? Is it to get a home test before I do any changes to the diet? Should I just monitor her behavior and adjust the insulin down if she seems different?

I'm also reading that the vet diet products are not necessarily needed and some seem to even be high in carbs (!!). I see that the fancy feast classics are a good choice so I'd like to switch over to this, and it will be appropriate for both cats. What is everyone's opinion on the special vet diet productions? I'm thinking my goal is I want to remove the dry food all together and switch to low carb wet food but give it more consistently throughout the day, maybe 3 times morning afternoon and night.

Kupo also still seems to be losing weight while eating anything she can get her paws on and more. Is this normal? Could something else be going on?

Thanks again for reading, this is all so overwhelming and just trying to get a grasp on it and better understanding.
 
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WELCOME TO FDMB! We have many people who can answer all your questions but the first glaring one is...TESTING Home testing is the ONLY way to get your kitties BG in control. It seems hard and frankly Vets for some reason are wired to think that most people cant or wont do home testing. THAT is false. Everyone here hometest and SO WILL YOU! The benefits greatly outweigh the negatives.

The reason Kpos numbers went back up PROBABLY because they added dry food to her diet. This can totally be fixed. Just takes a human gluco meter, test strips, and TREATS. Yes treats a tiny favorite treat to bribe Kupo. ;)

I fed my Trouble Fancy Feast pates and it helped tremendously. Took away his beloved dry and boom his numbers reduced significantly. To do this you HAVE to home test. For some reasons my links arent working but If you click on the "Forums" page there are protocol subjects. Read then come back and get some answers. Theres even a spread sheet page...check it out !

Again welcome to FDMB The best site on the planet to help you help Kupo!:bighug:
 
Definitely skip the prescription food and go with ff classic. Feeding morning noon and evening is a good plan.

We recommend raising doses in 0.25 dose increases because the right dose might get skipped. The only way to know if the dose is good is by home testing. I have a video in my signature showing how I test my cat.

if you go to Lantus section of this board you will see messages at the top with yellow stickies. Read through them about the dosing protocols. Start low go slow or tight protocol.
 
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Welcome to FDMB! Great questions!

To start: no, you should not be increasing the 3 units. Be aware that stress causes BG to rise, and a vet visit will always cause stress. Also be aware that you cat may have been having a "bad day" and you cannot base dose on just one day. That is why we recommend home testing, so we can see what is happening in "real time". :)

And yes, if you are currently on dry food you will want to be home testing before introducing lower carb food because it will definitely lower the needed insulin dose amount. You can do this gradually by mixing the Fancy Feast in with the current food to transition over the course of several days. The special diet foods are lower carb, there is no medicine in them, but they are not as low as they need to be for diabetics (crazy right?).

All the symptoms you mentioned about Kupo are normal, nothing out of the ordinary. She will need LOTS of food because right now she can't process the food correctly due to inadequate insulin dose. At least 3 cans of FF Classics a day, perhaps more. Her hunger will wane after she gets better regulated (this can take weeks/months so don't stress about it not happening quickly). Diabetic cats need several meals a day - during the day and during the night. For example, my own cat gets her breakfast, and then mini meals 2, 4, and 5 hours after her dose. This is to keep sharp drops in blood sugar from happening AND to help the pancreas heal. You're a cat pancreas nurse now! :joyful: I also do the same thing at dinner time, with mini meals at the same time. Obviously you can't be up all night for feedings, so you want to invest in a Petsafe 5 Autofeeder. There are other kinds but these are REALLY good since you can schedule it to go off at literally any time and you can schedule 4 meals. I bought a used one for cheap on Ebay.

alex miller said:
What are my options here? Is it to get a home test before I do any changes to the diet? Should I just monitor her behavior and adjust the insulin down if she seems different?
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Yes, as mentioned above you want to introduce home testing before making a diet change. There's lots of info here on how to do it and what supplies you need - just remember there is a learning curve so don't get frustrated if you can't get any blood at first. ;) We recommend newbies to not give any insulin if the pre-shot test is under 200, until you get enough data to tell you otherwise. You can't rely on behavior changes for adjusting insulin, some cats can go hypo and show no signs whatsoever. My cat has been too low and way too high and I can't tell the difference in her attitude.

Keep asking questions! We're rooting for you two!
 
I am going through the same thing you are. My cat is newly diagnosed. The first 4 days on insulin were great. His numbers were steadily falling. Then, they started rising. His vet had given me very little information. He told me to email his readings to him every day. When my cat's numbers starting rising, the vet didn't respond even when I called the clinic after 3 days of rising numbers.

He emailed me last night and told me to raise his insulin dose by 2 units or wait until Monday when he is back in the office. Also, he is off on Tuesdays as well. The only reason I am sticking with him for now is because my cat has had complicated medical problems this last month.

I had a wonderful vet for 40 years. He retired 2 years ago and sold his clinic. I have yet to find a good vet.

My cat is also eating a lot and drank 2 full bowls of water yesterday. All he wants to eat is beef. He won't eat chicken or anything else right now.

I can't tell you not to worry because I am a nervous wreck myself right now.
 
Jumping doses means you could miss the dose thats right. By slowing climbing its easier on the cat and gives you valuable information. It is frustrating but in the long run better for your kitty.
 
Scdal said:
3 days of rising numbers.

[....]
My cat is also eating a lot and drank 2 full bowls of water yesterday. All he wants to eat is beef. He won't eat chicken or anything else right now.

I can't tell you not to worry because I am a nervous wreck myself right now.
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@Scdal , do you have a thread somewhere where you are discussing your kitty, or could you start one? I don't want to hijack Alex's thread here, but it sounds like Phoenix has something going on.

Edit: whoops, found the thread, see you there! Blood Glucose Rising after Injection
 
Hi there I used to use that pet monitor but the test strips are outrageously priced
About 50.00 for 50 test strips. You will be testing a lot in the beginning until you see how the lantus is working.
My vet always had them in stock, but I don't think many do, I could be wrong

So you would have to make sure you always have enough in case you have to order them on the internet.
I switched to a human meter from Walmart, they carry the Relion Prime, its 9 dollars and for 17.88 you get 100 strips. They also carry the Relion Premier Classic

Most of us here use human meters, they take a little more blood but I have never had a problem
If you don't mind paying that price for the test strips for the pet meter that's fine
Best of luck, you are in the best place ever, everyone here is amazing and in my opinion they know way more than most vets do, my cat wouldn't be doing so good if it wasn't for the members here can be all there knowledge
 
Aside from the cost of strips (keep in mind you could potentially be testing 5-10 times a day, so that's $5-$10 a day), you'd just have to keep in mind that almost all info here is based on human meters which read lower than Alphatrak. You also won't be able to pick up strips at the store if you run out suddenly, they have to be ordered. I had Alphatrak but switched quickly due to cost but either are fine!
 
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