New Dx. Prescribed insulin, but can I start with diet change FIRST?

[Jessica & Henry]

Hi friends,

First post here - just received my cat's diagnosis Thursday evening - and I could really use advice/perspective.

I had suspected diabetes, but was not emotionally prepared for the diagnosis or the decisions I needed to make! I asked to take Henry home for the night to think it all over (which due to unexpected events Friday that prevented a return to the vet, I now have the weekend to keep thinking/researching).

Henry's BG was around 500, but no ketones in urine. He's lost 3 lbs since his last vet visit a year ago (the weight loss has happened since July/August of this year). Vet wanted to deliver an IV of fluids and an antibiotic (for possible UTI), then start 1/2 unit of Vetsulin 2x/day, along with diet change to dry Purina DM 2x/day. A glucose curve in 7 days, then another glucose curve 4 weeks after that. She understood that budget is an issue and said that if the 2nd curve looked good, we could push the next one out 3-6 months.

I'm really reluctant to start an expensive regulation period for my cat, and due to my busy lifestyle (I'm single, no kids, travel often), I'm worried about my cat needed 2x daily insulin, even with generous friends that can help out occasionally.

My question - is it acceptable to try diet changes FIRST and see if I can lower his BG levels before starting insulin? I want to make a full switch to low-carb wet food regardless, and I'm concerned about starting an insulin dose now (when he's historically eaten dry) and then sending him into hypoglycemia because I'm also switching to 100% wet high protein/LC.

My tentative plan is to immediately switch to 100% wet (Fancy Feast Naturals, 68-75% protein, 23-32% fat, 0% carb) for a few weeks with home BG monitoring (using a Relion glucometer) and see if that makes a difference. Then the BG levels are still really high, start insulin. Does that seem like an acceptable plan?

THANK YOU!!

P.S. I'm really surprised that DRY diabetic food even exists! My vet stated that Purina claims 40% of cats on their diet go into remission, but if I can cut this (unneeded?) expense, I would love to.

 

[Judy and Freckles]

Hi Jessica,
I'm new to this feline diabetes thing as well, but have been receiving lots of support and suggestions. There are a lot of people on here that have years of experience that will be able to offer you great advice. The stickies in each forum(go to the Forum tab at the top of the screen and click in each forum. Advice that was given to me was to not try and read everything in there all at once) are packed full of information. It was a bit overwhelming and still is, to know where to post and how to post questions. There is a forum for cats that are taking Vetsulin. From the Forum tab at the top of the page, scroll down and you will see the Insulin Support Group forum and there is one for Vetsulin. People in that forum also give their cat Vetsulin and can offer some great advice. If you have a question about dosing, the Vetsulin Insulin Support Group is the place to post (put a ? at the start of your thread title).

Since I'm new, I'm definitely not going to be offering answers to your questions but I will be following it to see what other more experienced people will say. If you don't get responses, try putting the ? in the subject line.

Here is a link that may answer more questions that you may have. http://binkyspage.tripod.com/faq.html

And a cat food database that I have found to be extremely helpful - looks like you have information on the food already but you may find it handy.
https://catinfo.org/chart/index.php

Oh, and when shopping for a glucometer, there are lots who offer a free meter if you buy the strips (I didn't know this initially and spent $ on one).

 

[Sienne and Gabby (GA)]

Many people do try a diet change first. Were you feeding the DM dry or canned? The canned, while not wonderful ingredients, is low in carbohydrates. The dry food, on the other hand, is not low carb!

There is an excellent site on feline nutrition that is authored by Lisa Pierson, DVM. This is the link to her food chart that has the carb count for most of the canned cat foods available in the US. The Fancy Feast you mentioned should be fine.

I would not wait more than a week or two at the very most with a food trial. If your cat is still in very high numbers, the sooner you start insulin, the greater the likelihood of remission.

While Vetsulin may be among the least expensive insulin, it is not a good insulin for a cat. (It's also called Caninsulin -- it was developed for dogs.) It is harsh, it can drop numbers very quickly, and does not have the duration that is necessary given a cat's metabolism. The two types of insulin that are recommended by the American Animal Hospital Assn are either Lantus (glargine) or ProZinc. The latter was developed specifically for cats and is available through your vet. Lantus is a human insulin and available at any pharmacy. Most people here buy Lantus through a Canadian outlet, Marks Marine Pharmacy, given that the cost is far less if you buy in Canada.

I'm single, work full time and did so throughout the 6.5 years that Gabby was diabetic. I won't lie -- you make sacrifices but, your true friends will understand. I also found an exceptional cat sitter. There is a link to Gabby's legacy in my signature. See the #7 post. It may provide some perspective on this journey.

 

[FurBabiesMama]

You can definitely try a food change first. It's great, by the way, that you have researched enough to know low-carb wet food is the way to go and that home monitoring is important. I would not wait weeks though. You should be able to tell pretty quickly what impact the diet change will have. I would say you will have a pretty good idea after 1 week. IF you are seeing much improvement, you could go maybe another week before determining if insulin is needed. I would not go longer. The longer your cat has high glucose, the more damage can be done, and it can reduce the likelihood of remission.

If you do end up needing insulin, it's great that your vet says to start with 1/2 unit. Many vets start out way too high. You may want to talk to your vet about a different insulin though. If I was starting out now, I would start with Levemir (detemir) or Lantus/Basglar (detemir). ProZinc is another good option, and is what we started out on, but I would go for one of the others right out of the gate, if you can.

If your cat has a urinary tract infection (which is common for cat's whose glucose is so high that it is in the urine... bacteria loves sugar), you will need to start antibiotics as soon as possible. You do not want to let the infection get worse, and it won't go away on it's own.

UPDATE: I forgot to say...if you are going to be testing at home, you should not have to go to the vet for curves. That will save your cat stress and save you money. Your vet should be willing to have you do the curve and provide the results.

 

[Jessica & Henry]

Thanks everyone. Yes, I actually found this forum through Lisa Pierson’s website, and I’ve gone through her entire database of cat food to find what might work for Henry (AND be affordable). I’m glad that it’s jot unreasonable to try a week of diet change first. I plan to keep plenty of data to share with my vet. And thanks for the heads up about Vetsulin, I know she talked about other options, but I was overwhelmed at the time with all the information.