New Member (04/11) - just diagnosed, overwhelmed and with so many questions

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Perezamado23

Member Since 2023
Hi, I am the owner of two sibling cats who are about to turn 16, Remy (male) and Malik (female).
Remy had lost some weight at the end of last year and after blood and urine tests his vet thought he had early renal disease so I switched him to Royal Canin Renal diet, mostly wet food. Over the last couple of months he has continued to lose weight and I noticed he was very wobbly on his hind legs so the vet came over last week and today I was told he has diabetes.
On the other hand, his sister Malik (who has hyperthyroidism) now shows early signs of kidney disease.
I am very scared and confused about the future of my precious cats. Malik will need to stay on the renal diet but I believe renal diet, even if it's wet food, will not be good for Remy. I have a follow up appointment with his vet this Friday so she can show me how to start him on insulin. He has a very healthy appetite and the vet said we could leave them both on the wet Royal Canin renal food and control his diabetes with the insulin.
I have just ordered a glucose meter so I can eventually test Remy's blood sugar levels but I don't even know where to start or what "normal" level should be.
I'm sorry if I sound flustered but I just want to ensure I'm doing the best thing for my cats.
Thank you for reading.
 
hi and welcome to the FDMB! Sorry to hear about Remy and Malik. Yes with the diabetes diagnosis comes a lot to learn, it is very overwhelming and depressing. I was so lost. I wanted my boy to be ok but I didn't know how to help him.

Then, like a life preserver thrown to a drowning person -- I found the FDMB and wonderful people like Diane, Suzanne, Wendy, Bhooma and so many more -- too many to mention.

Testing the blood glucose sounded pretty much impossible to me and I had NO idea what I was doing. But with the help from people here I learned how, and eventually it was downright easy and routine! You will do fine I'm sure, you sound like you have the dedication and resolve and that is all it takes.

There's going to be a ton of information thrown your way just take it slow. The best way to get started is to follow this:

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
 
I know it’s overwhelming but once you start to learn all about how to treat feline diabetes, it becomes less scary because knowledge is power!

did you order a human or pet meter? Normal range is 80-120 so the goal is to try to get your cat within that range with insulin as much as possible. In the beginning the numbers will be higher and it takes time and patience to get your cat regulated. We like to say that feline diabetes is a marathon not a sprint.

what you’re seeing on the hind legs is called neuropathy and it’s a common side effect of unregulated diabetes. The good news is that it’s reversible once your cat is regulated. My cat Minnie had severe neuropathy and recovered 95%. There’s a supplement called zobaline that helps a lot too but not until the diabetes is regulated so that the excess sugar stops “attacking” the nerves on the back legs.

I think the royal canin is too high carbs for a diabetic cat unfortunately. With a diabetic cat you need:

  • A low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs
  • A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
  • We recommend hometesting the blood glucose with a human meter…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.
  • HELP US HELP YOU has information about the spreadsheet, signature and hypo box which you will need to be able to look after your beloved kitty properly
We are happy to help you with setting up the spreadsheet, sorting out what food to buy, how to transition safely to a low carb diet, how to learn to home test and much more.

FOOD CHART have a look on this chart and choose foods that are under 10%.

This is an excellent site for diabetic cats…it has been around for more than 25 years and has very experienced people to help you.

Keep asking lots of questions.
 
I know it’s overwhelming but once you start to learn all about how to treat feline diabetes, it becomes less scary because knowledge is power!

did you order a human or pet meter? Normal range is 80-120 so the goal is to try to get your cat within that range with insulin as much as possible. In the beginning the numbers will be higher and it takes time and patience to get your cat regulated. We like to say that feline diabetes is a marathon not a sprint.

what you’re seeing on the hind legs is called neuropathy and it’s a common side effect of unregulated diabetes. The good news is that it’s reversible once your cat is regulated. My cat Minnie had severe neuropathy and recovered 95%. There’s a supplement called zobaline that helps a lot too but not until the diabetes is regulated so that the excess sugar stops “attacking” the nerves on the back legs.

I think the royal canin is too high carbs for a diabetic cat unfortunately. With a diabetic cat you need:

  • A low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs
  • A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
  • We recommend hometesting the blood glucose with a human meter…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.
  • HELP US HELP YOU has information about the spreadsheet, signature and hypo box which you will need to be able to look after your beloved kitty properly
We are happy to help you with setting up the spreadsheet, sorting out what food to buy, how to transition safely to a low carb diet, how to learn to home test and much more.

FOOD CHART have a look on this chart and choose foods that are under 10%.

This is an excellent site for diabetic cats…it has been around for more than 25 years and has very experienced people to help you.

Keep asking lots of questions.

Thank you!! I just went through the food list and saw the one I was feeding them has 23% carbs!! I went through the list and found one that might work for both, it’s called Pro Plan Urinary Tract Health formula and it only has 3-4% carbs so I’m running to buy some for them right now.
That food list is AMAZING!! I still have to go to the vet and see what insulin she will send him and am doing my research on glucose meters.
I’m sure I will ask a lot!
Thank you!!
 
hi and welcome to the FDMB! Sorry to hear about Remy and Malik. Yes with the diabetes diagnosis comes a lot to learn, it is very overwhelming and depressing. I was so lost. I wanted my boy to be ok but I didn't know how to help him.

Then, like a life preserver thrown to a drowning person -- I found the FDMB and wonderful people like Diane, Suzanne, Wendy, Bhooma and so many more -- too many to mention.

Testing the blood glucose sounded pretty much impossible to me and I had NO idea what I was doing. But with the help from people here I learned how, and eventually it was downright easy and routine! You will do fine I'm sure, you sound like you have the dedication and resolve and that is all it takes.

There's going to be a ton of information thrown your way just take it slow. The best way to get started is to follow this:

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Thank you for all the valuable information and warm welcome!!
 
Happy to hear that! It does get easier I promise. Your vet may try to tell you need a pet meter but you don’t. Most of us used human meters, myself included. Walmart’s ReliOn is a trusted one with the least expensive test strips. That’s where your money will go and pet meter strips are about $1 each!

I do hope your vet prescribes you Lantus or prozync. Those are the best ones for cats and I’ll insist on one of them if I were you. Note that caninsulin, also called Vetsulin, was made for canines and it’s no longer recommended for cats as it doesn’t protect them 24/7.

We also have lots of tips for home testing so we can go into that more once you’ve got the supplies. You’re off to a great start!
 
Hi and welcome to the forum. You have been given some very good information.
I just wanted to mention about Malik and early kidney disease.
You don't need the prescription food that the vet had for early kidney disease. That is low protein and is old thinking and will cause muscle mass wastage in cats.. What you need is low phosphorus foods.
You will find on the food chart that Ale gave you in post three, there is a column for phosphorus. Look down that column for foods that have 250 or 200 mg phosphorus (or less) /100 kcals.
You will also find Weruva have a very good new line of food for cats with kidney issues and they are low phosphorus
See this link https://weruva.com/brand-summary/wx-phos-focused-foods/
 
Hi and welcome to the forum. You have been given some very good information.
I just wanted to mention about Malik and early kidney disease.
You don't need the prescription food that the vet had for early kidney disease. That is low protein and is old thinking and will cause muscle mass wastage in cats.. What you need is low phosphorus foods.
You will find on the food chart that Ale gave you in post three, there is a column for phosphorus. Look down that column for foods that have 250 or 200 mg phosphorus (or less) /100 kcals.
You will also find Weruva have a very good new line of food for cats with kidney issues and they are low phosphorus
See this link https://weruva.com/brand-summary/wx-phos-focused-foods/
Thank you and thank you for the comments on Malik, I will look for a food that is both low carb and lower phosphorus so I can keep them both on the same food (hopefully) which should make things simpler to control.
I also have bought freeze dried chicken to give them as treats as they love their Greenies but those are high on carbs.
Thanks again!
 
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Here are Remy's full results. He doesn't seem to have Ketones in his urine, not sure if that is a good thing or a bad thing.
 

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Yes, having no ketones at diagnosis is good.
His kidney results are towards the upper end of normal so having him on a low phosphorus diet as well as Malik would be a good thing.
I was just wondering about the food transition. I removed his dry food yesterday (he was only grazing on it throughout the day) and stopped feeding him the Royal Canin Renal Support last night and replaced it with one of the foods on the list that has less than 10% carbs.
Will this change in diet impact anything else? Should I slowly be moving him over to the lower carb food? His previous food had 23% carbs. I'm eager to feed him diabetic appropriate food but don't want to go and cause another issue.
Help please!!
 
I’m transitioning Bobo from regular food to raw so I’m doing it overtime to avoid any intestinal issues like diarrhea. But I don’t think you need to do that when you’re going from wet to wet. Let’s see what Bron says. The main thing is if he were already on insulin, you’d want to be testing him daily because going from high carbs to low can drop the bg significantly, by as much as 100 points, so the insulin dose could required tweaking to keep him safe. He’s not on insulin yet, so he’s safe. I’d also make sure you start him on a low dose. We recommend 1/2 or 1 units but not more than that.
 
Welcome to the FDMB, the best place where nobody wants to need but thrilled to find. Changing the diet abruptly can lead to intestinal upset which you want to avoid. On the positive it might lower the glucose a lot since the new food is low carb which means less insulin would be needed and just might lead to becoming diet controlled. I agree with Ale that you would want to start in a low dose of insulin.
 
Thank you all for your replies.

Before starting him on insulin would you recommend I do a few days of the new diet and track his BG to get his new “baseline”? How many days would you recommend? Is there any danger in not starting him on insulin asap?
 
Thank you all for your replies.

Before starting him on insulin would you recommend I do a few days of the new diet and track his BG to get his new “baseline”? How many days would you recommend? Is there any danger in not starting him on insulin asap?
The risk of not starting insulin is that ketones could develop.
As long as Remy is eating well and you test for ketones daily it would be OK to change him over to a low carb diet first.
To test for ketones you need to buy a bottle of Ketostix from Walmart or a pharmacy and test the urine. Compare the result of the test strip against the colours on the side of the bottle exactly 15 seconds later. There should ne no ketones.
 
I did my first BG at home test last night. I should be getting the ketone measuring sticks this weekend.
Remy has been eating very well, using his litterbox and hasn't been very active but that has been how he has been for a few weeks now, plus, we are in a weird heatwave in Toronto and our AC hasn't been turned on yet so our condo is pretty hot! I don't blame him for not wanting to be active :)
How long would you recommend I do the "food change only" option a chance? How often and at what times should I be testing while we are just doing food change?
We are going in to the vet today to get the insulin prescription and more instructions but I think I can hold off on starting if he has no ketones in his urine?

Thanks for all the support! These last few days since his diagnosis have been a whirlwind of emotions but educating myself and learning more and more from this forum has helped me keep my sanity!
 
I would test before you feed him in the morning at at night ( that’s 2 tests ) and I would get a test in 3 hours after you feed in the morning and if you are awake at night, three hours after you feed dinner, I’d test then as well.

I think a week or 10 days is enough to see if the food change is enough, as long as the ketones are negative.
Do you know what insulin the vet is giving you. Make sure it is Lantus or Prozinc. Dont accept Vetsulin or Novolin N.
I would also check here about the dose the vet suggests before you start.
Hope the vet visit goes well
 
I just wanted to pop in to say, hi! I'm in Toronto too and my cat Penelope was just diagnosed at the end of February. I certainly don't have all the awesome knowledge of the exceptional people here, but if you want a local diabetic cat parent pal or information on where to find stuff in the city, I am available for those things.
 
I just wanted to pop in to say, hi! I'm in Toronto too and my cat Penelope was just diagnosed at the end of February. I certainly don't have all the awesome knowledge of the exceptional people here, but if you want a local diabetic cat parent pal or information on where to find stuff in the city, I am available for those things.
Hi Alanna!! Thank you for your post :) I'm still navigating through everything!!
 
I would test before you feed him in the morning at at night ( that’s 2 tests ) and I would get a test in 3 hours after you feed in the morning and if you are awake at night, three hours after you feed dinner, I’d test then as well.

I think a week or 10 days is enough to see if the food change is enough, as long as the ketones are negative.
Do you know what insulin the vet is giving you. Make sure it is Lantus or Prozinc. Dont accept Vetsulin or Novolin N.
I would also check here about the dose the vet suggests before you start.
Hope the vet visit goes well

Hi, we just came back from the vet and they gave us Caninsulin starting at 1 unit every 12 hours. I told the vet I wanted Lantus and she said she would get a second opinion from another one of the vets in the clinic and would call me on Monday. We agreed I wouldn't start insulin until next week.
 
Hi, we just came back from the vet and they gave us Caninsulin starting at 1 unit every 12 hours. I told the vet I wanted Lantus and she said she would get a second opinion from another one of the vets in the clinic and would call me on Monday. We agreed I wouldn't start insulin until next week.
Stick to your guns and say you only want Lantus. Caninsulin is no a good cat insulin. It was made for dogs
 
Thank you!! I just went through the food list and saw the one I was feeding them has 23% carbs!! I went through the list and found one that might work for both, it’s called Pro Plan Urinary Tract Health formula and it only has 3-4% carbs so I’m running to buy some for them right now.
That food list is AMAZING!! I still have to go to the vet and see what insulin she will send him and am doing my research on glucose meters.
I’m sure I will ask a lot!
Thank you!!
Hi Samantha , I feed Tyler the Purina Pro Plan Urinary Tract Health , yes it's low carb and low phosphorus, he loves it. He was blocked once so I switched to this many many months ago
Purino Pro Plan Urinary Tract Health .
I feed the Beef & Chicken flavor and the Chicken Entree in Gravy
That's good that you are feeding it because it's low phosphorus also

Are these the ones you are feeding
The Chicken Entree
https://www.amazon.com/Purina-Pro-Plan-Urinary-Formula/dp/B003R0LM2U


Here's the Beef & Chicken Entree
https://www.amazon.com/Purina-Pro-Plan-Urinary-Formula/dp/B0170YQ822
 
Hi Samantha , I feed Tyler the Purina Pro Plan Urinary Tract Health , yes it's low carb and low phosphorus, he loves it. He was blocked once so I switched to this many many months ago
Purino Pro Plan Urinary Tract Health .
I feed the Beef & Chicken flavor and the Chicken Entree in Gravy
That's good that you are feeding it because it's low phosphorus also

Are these the ones you are feeding
The Chicken Entree
https://www.amazon.com/Purina-Pro-Plan-Urinary-Formula/dp/B003R0LM2U


Here's the Beef & Chicken Entree
https://www.amazon.com/Purina-Pro-Plan-Urinary-Formula/dp/B0170YQ822
Hi, yes, those are the ones that I was thinking about feeding both Remy and Malik but my vet said that because Malik has early renal disease she should stay on her Royal Canin Renal. We are able to give them different foods and have been successful at ensuring they don't eat each other's food. The vet said that the formula is good for urinary tract health in general but not for renal failure (?).
I will give Remy the ones you showed in combination with some other cans I have found that are low in phosphorus and low carb. The vet gave me a few cans of Pro Plan DM pate wet food and I checked and they look ok in terms of carbs (6) but phosphorus is on the high side (297).

Still no progress just with diet change... only thing is stinky soft stool this am :)
 
I would figure the pro plan would be good for kidney issues since it's low phosphorus
Beef and Chicken Entree pate
Carbs are around 4.80
Phosphorus is 1.44 dry matter

Chicken Entree in Gravy which isn't pate it like tiny pieces of chicken like the size of a chicklet piece of gum lol remember them, they are like tiny tiny chunks
Carbs are 4.5
Phosphorus 0.78 dry matter
 
I would figure the pro plan would be good for kidney issues since it's low phosphorus
Beef and Chicken Entree pate
Carbs are around 4.80
Phosphorus is 1.44 dry matter

Chicken Entree in Gravy which isn't pate it like tiny pieces of chicken like the size of a chicklet piece of gum lol remember them, they are like tiny tiny chunks
Carbs are 4.5
Phosphorus 0.78 dry matter
I bought a few of the Pro Plan cans and they have been eating them so far, I got the Chicken Entree (and yes, it does loock like chicklets!!) and a Turkey and Giblets entree which is a pate and they both liked them.
I'm still not on insulin as I'm pending a follow up conversation with his vet regarding Lantus but I have been checking his urine for ketones and it has been negative so far.
I am only testing him once a day before I feed him his dinner at around 6pm and his values are quite high, I hope I can sort the insulin disagreement with his vet soon to get him started.
 
I bought a few of the Pro Plan cans and they have been eating them so far, I got the Chicken Entree (and yes, it does loock like chicklets!!) and a Turkey and Giblets entree which is a pate and they both liked them.
I'm still not on insulin as I'm pending a follow up conversation with his vet regarding Lantus but I have been checking his urine for ketones and it has been negative so far.
I am only testing him once a day before I feed him his dinner at around 6pm and his values are quite high, I hope I can sort the insulin disagreement with his vet soon to get him started.
@Perezamado23
I'm happy they like the pro plan so far, Try and get Lantus, I see you live in Canada from what I have read here you don't need a script for it in Canada ,just tell them it's for a cat , you can even get the generic ones. Check with your local pharmacy's.
I would get the 5 Cartridges ,one would last about 6 months , they are good until the expiration dates ,keep them in the fridge ,middle shelf .
You would just insert the syringe into the rubber stopper and draw out the insulin


There are a couple generic versions, Basaglar, Semglee is another one. They are all considered Insulin Glargine just like Lantus is.
If you do get lantus or the generic you will need U-100 syringes with half unit markings because we adjust the dose by 0.25 units which makes it easier to do
I found this posted by a member about U-100 syringes with half unit markings from Canada
Check out your local pharmacy for the BD Ultrafine II syringes (purple and yellow box). Those are U100 syringes. If you have a Costco near you, check them out. Or Safeway pharmacy
333-320440__1.png
 
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@Perezamado23
I'm happy they like the pro plan so far, Try and get Lantus, I see you live in Canada from what I have read here you don't need a script for it in Canada ,just tell them it's for a cat , you can even get the generic ones. Check with your local pharmacy's.
I would get the 5 Cartridges ,one would last about 6 months , they are good until the expiration dates ,keep them in the fridge ,middle shelf .
You would just insert the syringe into the rubber stopper and draw out the insulin


There are a couple generic versions, Basaglar, Semglee is another one. They are all considered Insulin Glargine just like Lantus is.
If you do get lantus or the generic you will need U-100 syringes with half unit markings because we adjust the dose by 0.25 units which makes it easier to do
I found this posted by a member about U-100 syringes with half unit markings from Canada
Check out your local pharmacy for the BD Ultrafine II syringes (purple and yellow box). Those are U100 syringes. If you have a Costco near you, check them out. Or Safeway pharmacy
333-320440__1.png
Thank you!
After talking to my vet yesterday we settled on Lantus! We will start with 1 unit and do a full curve after 7-10 days.
I will go to Costco today to get everything I need to start him on insulin tomorrow. Turns out my mom’s neighbour who owns 10 cats has a sugar cat and on Saturday when I went to see my mom she showed me the Lantus cartridges that she buys at Costco so that’s my stop after work today.
Remy is still eating really well and urine strip test still shows no ketones. Last night he came and slept on his pillow (my pillow) which he hadn’t done in over a week.
 
Thank you!
After talking to my vet yesterday we settled on Lantus! We will start with 1 unit and do a full curve after 7-10 days.
I will go to Costco today to get everything I need to start him on insulin tomorrow. Turns out my mom’s neighbour who owns 10 cats has a sugar cat and on Saturday when I went to see my mom she showed me the Lantus cartridges that she buys at Costco so that’s my stop after work today.
Remy is still eating really well and urine strip test still shows no ketones. Last night he came and slept on his pillow (my pillow) which he hadn’t done in over a week.
@Perezamado23
That's great, don't forget to get those syringes :cat:
Can you just put DX in front of April 2023 so we know that's when he was diagnosed, he's a very handsome boy
30-unit-insulin-syringe-markings.jpg
 
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@Perezamado23
Hi Samantha I see you are using the Alpha Trak 2 just wanted to let you know
that the AT2 is being discontinued and AT2 test strips will no longer be available for sale as of September this year. There will be an AT3, but why bother, it takes completely different test strips. Details here
Most of us use human meters that's what our numbers are based on

Take a look at these posts about the Alpha Trak 3 from members
https://felinediabetes.com/FDMB/threads/anyone-using-the-new-alpha-trak-3.276538/#post-3064919
https://felinediabetes.com/FDMB/threads/alpha-trak-3-problems.276539/#post-3064589

Found this posted by a member
Strips are expensive in Canada and especially the AlphaTrak (a pet meter). Most people use a human meter. The two measure glucose in slightly different ways.

FreeStyle Lite is a good one. Strips run about $90/100. Shop around for the best price. PC points can be used at Shoppers and PC pharmacies.

There is also the Bravo meter but it has some downsides. It needs a much larger drop of blood and you can only get strips online meaning that if you run out of strips during the middle of a low numbers event, you cannot run out to a pharmacy and buy more. If you go with this meter, you need to have 200-300 strips on hand at all times.
https://diabetesexpress.ca/products/bravo-meter

If your vet says that you need to use a pet meter, tell them you can't afford the strips. Vets used people meters before animal meters were invented. Forum members are very familiar with both types of meters and can help you.
 
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@Perezamado23
Hi Samantha I see you are using the Alpha Trak 2 just wanted to let you know
that the AT2 is being discontinued and AT2 test strips will no longer be available for sale as of September this year. There will be an AT3, but why bother, it takes completely different test strips. Details here
Most of us use human meters that's what our numbers are based on

Take a look at these posts about the Alpha Trak 3 from members
https://felinediabetes.com/FDMB/threads/anyone-using-the-new-alpha-trak-3.276538/#post-3064919
https://felinediabetes.com/FDMB/threads/alpha-trak-3-problems.276539/#post-3064589

Found this posted by a member
Strips are expensive in Canada and especially the AlphaTrak (a pet meter). Most people use a human meter. The two measure glucose in slightly different ways.

FreeStyle Lite is a good one. Strips run about $90/100. Shop around for the best price. PC points can be used at Shoppers and PC pharmacies.

There is also the Bravo meter but it has some downsides. It needs a much larger drop of blood and you can only get strips online meaning that if you run out of strips during the middle of a low numbers event, you cannot run out to a pharmacy and buy more. If you go with this meter, you need to have 200-300 strips on hand at all times.
https://diabetesexpress.ca/products/bravo-meter

If your vet says that you need to use a pet meter, tell them you can't afford the strips. Vets used people meters before animal meters were invented. Forum members are very familiar with both types of meters and can help you.
Thank you, yes, I became aware of the AT2 being discontinued later on this year. I was able to get some AT2 strips on sale through Chewy (my sister lives in the US) so I should be covered for a few months. After that I will look into changing to a human meter to keep up with my testing for Remy :)
 
Thank you, yes, I became aware of the AT2 being discontinued later on this year. I was able to get some AT2 strips on sale through Chewy (my sister lives in the US) so I should be covered for a few months. After that I will look into changing to a human meter to keep up with my testing for Remy :)
That's great , if you do switch to the Freestyle Lite Meter look on EBay for them too, they are a lot cheaper , I just looked and really good prices they also tell you when the expiration date is ,if not ask :cat:
 
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