(New Member) 3-yr-old cat with diabetes

Hi all,

My 3-yr-old cat Dodger was diagnosed with diabetes just over a week ago. The way I found out is that he suddenly stopped eating his dry food, got constipated, and started crouching and squinting his eyes. I took him to the vet and she suspected pancreatitis, but the lipase test came back negative. His glucose was high so she sent out for a fructosamine test. That confirmed diabetes. Then they ran a UA and there were ketones in the urine. I was in shock over all this. I've only had Dodger 4 months. He was a stray that I trapped under my deck. He was always skinny and hungry, but I thought it was from being a stray.

The vet suggested I leave him with the emergency vet for the weekend. It would've been outrageously expensive, so I opted to just care for him at home. They gave me a crash course in insulin injections and prescribed Lantus 1 unit every 12 hrs. The next day, after only 2 insulin injections, he became lethargic and I saw him stagger, so I ended up taking him to the emergency vet anyway. That vet said he was hypoglycemic and to stop the insulin for the weekend. He didn't think the keto was as serious as my regular vet said. Thankfully I didn't have to leave him there.

On Monday morning I took him back to my regular vet for another UA. The ketones were gone and she said to cut the insulin to 0.5 unit every 12 hrs. My vet feels there's another component going on such as pancreatitis or IBD. (Isn't IBD also unusual for a cat this young?) She wanted to put him on a steroid that day, but I said let's give us both time to adjust to the diabetes first, eh? I mean, this poor cat has been through the wringer.

The rest of the week Dodger has gotten better and better. His energy is back and he's back to being a little stinker again. He doesn't look like he's in pain anymore. And his appetite is back and he's pooping better. Yay!

I'm still lurking and learning, but I just have a few questions for now.

-Has anyone had a cat this young with diabetes? Is this pretty unusual? My vet said this is the youngest cat she's seen with diabetes. Is there a good chance of reversal?

-I am only supposed to feed him every 12 hrs with the insulin injection. But he's hungry for more food. He even got into my bowl of pretzels tonight. Would it be okay to give him small amounts of food in between injections?

 

Hi and welcome to you and Dodger to the forum. Can you tell us what country you live in please…it will make a difference as to what we tell you about food and buying things.
You have come to the best possible place to get help and support. I am very glad that Dodger seems to be improving and he is eating well.
I was very concerned when I read that the vet said to stop insulin for the weekend after ketones were found in the urine.
Stopping insulin when there are ketones present is risky.
I would not put Dodger on a steroid. Even, if it is IBD or pancreatitis…at this stage it is better to find out definitely before taking the serious step to giving steroids.I would try lots of other things before I gave a steroid.
With ketones in the picture….I know that there were none when you went back to the vet, but Dodger is obviously prone to them so it is necessary to take steps to ensure they don’t reappear.

• To prevent Ketones reappearing it is necessary to feed him more food than he is used to eating. So I would offer him 1 and a 1/2 times as many calories as he normally eats. Feed him a good meal before each dose of insulin and then offer several snacks of food during both the am and the pm cycle. A cycle is the time inbetween each dose of insulin.
• Don’t miss any doses of insulin. The things that will help stop ketones coming back are insulin and food.
• Offer plenty of fluids. You can put a teaspoon of warm water into all his snacks.
• Test daily for ketones. To do this you will need a bottle of Ketostix from Walmart or a pharmacy. You then collect a urine sample and test the urine with a test strip. Read the result exactly 15 seconds later against the colours on the side of the bottle. There should be no ketones.
• I would strongly recommend you think about hometesting the blood glucose. We can help you with getting set up.
  
• Are you using U100, 3/10ml, 30 or 31 gauge, 6 or 8 mm insulin syringes with 1/2 unit marking?

HELP IS HELP YOU has useful Information for you. If you decide you will hometest, which I hope you do, you will need to set up a spreadsheet to add the data. It is the best way to keep Dodger safe and to get him regulated. We can help you with setting it up if you have trouble.
We sometimes get young kitties here who have diabetes. Most are older though. We can’t guarantee remission but if you are hometesting and following one of our dosing methods you will be giving him the best possible chance of doing so. You will need to buy a glucose meter to test the blood glucose…I would recommend a human meter as the pet meters at pre too expensive to run.
What type of food are you feeding him. The best food is a low carb diet of 10% carbs or under….and a wet diet…no dry food which is high carb.
FOOD CHART this food chart is for the US. If you are not in the US we can still help you with food choices …we have charts for other countries.
Let us know if we can help you further. Keep asking questions.
Bron

 

Welcome to FDMB!

Several years ago we actually had a 2yo kitten that was diagnosed with diabetes. It is unusual in cats that are that are as young as Dodger but it's certainly possible.

Pancreatitis may have been a factor. However, a lipase test is not definitive in cats. You want a test that is called either a Spec fPLI or a Snap fPLI. They are the same test except one is sent out to a lab and the other can be done in the vet's office. (The Snap test looks much like a home pregnancy test in that you get a "+" or "-" result.) If Dodger is feeling better, it may not be necessary to get more tests!

The presence of ketones will always get our attention! They can be very dangerous so it's great that they are not persisting. I would, however, encourage you to follow Bron's suggestion and test for them at home. It is a great preventative measure and truly a way to avoid an expensive hospital stay. If you see a level higher than trace, you want to talk to your vet, make sure your kitty is eating, and add water to your cat's food.

Lantus has a great record for getting newly diagnosed cats into remission. Just be aware that remission means that your cat's diabetes is controlled by diet. In other words, you want to start feeding Dodger a low carbohydrate, canned food diet now and forever more. The food chart that Bron linked has a wealth of foods that are low in carbs. As she mentioned, we consider low carb as less than 10% -- although most members feed their cats food that is in the 5% range. There are only a scant few dry foods that are low in carbs (and none of them are the "diabetic" dry foods.)

It is not necessary to feed your cat only twice a day. This is particularly the case with Lantus as it has a more gentle onset than many of the shorter acting insulins. Most newly diagnosed cats are ravenous! Feed your cat!! Most of the members here will divide up their cat's food into several small meals and spread out the meals over several hours. The only time you don't want to provide food is 2 hours before shot time.

Please let us know how we can help!

 

Thanks Bron and Sheba and Sienne and Gabby! Reading your comments has been so incredibly helpful. I am making notes and will do everything suggested. The CatSite recommended this site to me and said how knowledgeable and helpful you all were. They weren't exaggerating! To address your questions & comments:

-I live in the US (Michigan)

-Regarding the stopping of insulin last weekend - I had reservations. The emerg vet poo-pooed the Keto (even though I showed him the results) and even questioned if he had "real" diabetes. (Not a fan of this emergency vet clinic.) I was so confused, overwhelmed & frustrated last weekend. When I took him back to my regular vet on Monday, I told them I felt like we were all throwing spaghetti at the wall to Dodger's detriment and urged them to confer and figure this out.

-I should note that before the diabetes diagnosis, they put him on Cerenia, gabapentin and metronizadazole treating for possible pancreatitis. The pilling was hard and I stopped giving it to him after the diagnosis.

-OK, more history I didn't include before because I didn't want to type a novel: Prior to this, when I first adopted Dodger, he had a totally hairless belly and then started getting bald patches on his legs. The vet thought it was a flea allergy from being in the wild and put him on Prednisone. That's when his appetite got really ravenous. His hair did grow back, and his belly is hairy again. A month after the pred was over was when he stopped eating dry food, only wet.

-On the lipase test, I generalized in error. The name of the test was SNAP Pro and the reading was iPL Normal. The vet said we may have tested on the tail end of it, hence the normal reading.

-Relieved to read he should NOT go on steroids. This didn't hit me right and I didn't want to barrage him with so much at once. I wanted to work on the diabetes/ketones part first. So far, so good. To me, a stress component seems more likely than IBD because of the issues with my other male cat who hasn't accepted him. This is a much longer story. In a nutshell, the cats are separated and have been since day 1. Dodger has the upstairs to himself and only supervised visits downstairs. I've been working on this and my other cat is slowly coming around. Dodger does look more relaxed around him now. Hoping we turned a corner there.

-Food: He's only eating the Fancy Feast Classics pate foods - no gravies, etc. Currently the turkey and giblets, which was the only one I could get him to eat last weekend. He's still gobbling it up and I didn't want to rock the boat. I will look into the low-carb wet foods list and give him more snacks as suggested.

-Water: I've never seen this cat drink very much, but he does urinate quite a bit. I've been putting the bowl in front of him and swishing the water, and this sometimes works to entice him to drink. Going to get a cat fountain because he seems to like drinking from moving water. (And also the toilet, but I digress.)

-The syringes are U-100 30 gauge with 1/2 unit markings.

-My vet did not talk about home testing yet, but I will definitely look into it. I feel like I'm shooting in the dark not knowing where his glucose is. I will get the Ketostix too.


Whew! Sorry for the long-windedness. Dodger has had quite the history in the 4 months I've had him. If I left anything out, ask away. I greatly appreciate the help!

 

Dodger is a lucky boy to have found you.
You are doing an excellent job looking after him. It is very good he is eating well.
Great you have the correct syringes, are feeding low carb pate and going to test for ketones…that’s very important as ketones, if caught early can be managed.
If Dodger does not drink much, try putting a teaspoon of warm water into each snack.
A lot of vets are not in favour of hometesting the blood glucose for some strange reason, so don’t be out off if they say it is not necessary. We have proved time and time again it saves kitties lives. And it is the best way to know if you have the right dose of insulin.
You can buy a ReliOn premier meter from Walmart for $9 amd a box of test strips for $17.88.
You will also need a box of 100 lancets size 26 or 28 gauge and some cotton rounds to hold behind the ear when testing.
Don’t let the vet sell you a pet meter such as an alphatrak meter as they are too expensive to run…the test strips are $1 each! the ReliOn human meter is fine.

Do you have a hypo kit set up?if not I would suggest getting one set up asap case it is neeeded.
HOW TO TREAT HYPOS
You will need honey or Karo, some high (over 17% carbs) medium carb food 11-16% carbs), ER phone number, a large syringe with no needle. Mark the top of the cans with the number of carbs so you can grab one quickly and know what you are giving.
Link to hometesting HOMETESTING HINTS AND LINKS

 

The FF classic pates are perfect and are low carb The Turkey and Giblets is 2% carbs, excellent choice.

 

Cats have a very limited thirst drive. In the wild, they get most of the moisture they need by eating the prey that they kill. I add water to my cats' food. Water is very good for their kidneys and in the case of a diabetic cat, diabetes is hard on the kidneys so adding water (low sodium broth, etc.) to Dodger's food is a good idea.

It sounds like your vet did all of the right stuff with testing for pancreatitis. He was correct that the main issue with testing for pancreatitis is that if you're too early or too late in the process, the tests may not provide an accurate result.

You've also been making all the right decisions! The only word of caution I would offer is that despite the diabetes diagnosis, if your cat needs a steroid, it will raise blood glucose levels but you can always work an insulin dose around the steroid to keep your cat in healthy numbers. We have cats here with medical conditions where a steroid is indicated.

 

Hi and welcome to the FDMB! You have heard from some of the most knowledgeable people on the planet when it comes to treating and caring for a diabetic feline. This group saved my boy (oh crap, tears welling up again where's that tissue box dammit)

*deep breath*

So anyway....I just wanted to chime in and say welcome to the group, such a young diabetic feline! I think you are taking a great approach so far. I love the pic of Dodger what a cutie. Home testing of the BG by using a lancet and getting a droplet of blood from kitty's ear sounds tough but if I can do it, so can you. Took us a few weeks to get the hang of it but eventually we did.

@Sienne and Gabby (GA) or @Bron and Sheba (GA) do you think Dodger's FD could have been induced by the pred? I know we see that from time to time here. But it sounds like the course of steroids was done with a month before the FD dx. If I understand the timeline.

 

A steroid-induced diabetes is certainly possible. Even with a month between the course of steroids and the diagnosis, it's possible. Most of us only know that our cat is diabetic once the vet makes the diagnosis. There's no way to know exactly when the numbers started to go up. It would be helpful to know what the blood glucose numbers currently look like.

 

I'm reading and taking notes and will get the testing supplies very soon. Daunted by the pricking of the ear, but I suppose it gets easier in time? Just ordered a drinking fountain. Hoping this will get him to drink more. He's doing great! Playful and back to his old self. VERY hungry in the morning and literally in my face until I get up and feed him. There's no way he'll let me miss a dosage. LOL