New Member 4-6-24 Just looking for advice

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Emily Kittinson

Emily Kittinson

Member Since 2024
Hey y'all. Like many of you, I'm looking for help after a somewhat recent diagnosis. I have a cat, Emily, who was put on insulin for the first time in December after flirting with diabetes for a few years. She was pretty healthy (other than some plastic acne) for most of her life (she is around eighteen now), then was diagnosed with leukemia in 2019. She also had some serious skin and GI issues around then, which led to her being put on a low dose of steroids. Which is probably triggering the diabetes, but she has not handled going off them. She also was diagnosed with hyperthyroidism a couple of years ago, but didn't handle the pills (see: GI issues) so now she gets the fancy ear rub.

We tried the Hills prescription diet food in the past, but she hated the wet food and seemed to be fine on the dry food until they changed the recipe (and added gluten, which I'm allergic to and she really didn't like). I was trying different foods that seemed low carb, but the diabetes got worse so now I'm trying the Purina DM wet and dry food.

I was feeding her Tiki Cat dry food and BFF wet food. She is super picky with wet food (will only eat chicken, turkey, and beef pate) and tends to only eat dry when she's not feeling well. I've also been feeding her the Stella and Chewy chicken and turkey freeze dried foods which she loves and it helps her eat the wet food. She was eating about a can of wet and a 1/2c of Stella and Chewy a day until I switched her to the dry. If the prescription food isn't helping, I would really like to go back to a food with better ingredients because I feel like all the prescription foods have crap ingredients (such as gluten and soy). My main issue is that I need her to eat and stop losing weight.

Anyways, I found this site when I was trying to find glucose monitors. Emily hasn't been enough that much in the last few days and has been peeing next to her litter box and just laying around all day (and normally she follows me around and wants attention). I got the Relion this afternoon (of course this is happening on a Saturday I have to work) and have tested her twice as she's been high. So I'm guessing the problem is that she's just been high for the last few days.

She's been on Vetsulin for the last few months at two units a day. They did check her a month ago and said that her levels have still been on the higher end. I also started feeding her the dry food a few weeks ago to see if I could get her to eat more. They also gave me HUGE syringes (40 units) the last time I picked them up, so I'm also worried I'm not able to be precise (I did point that out and the vet said it should be fine).

I still need to figure out how to set up the spreadsheet and I'm going to try and figure out a new food to try. If anyone has any recommendations for pate chicken food, I would love to hear them. I've looked before and it's hard because I think the pate tends to have higher carbs, but it is the only thing she will eat.

Thanks for read. Sorry it's long. I tried to cover what I could.
 
I have been feeding her Stella & Chewy, so that's the closest I've gotten to raw so far. After reading stuff on the forum, I'm thinking I might take her off the Purina DM food and go back to a low ingredient wet food. It looks like Nulo might be the cheapest option right now (and is 4% carbs), though I've fed her BFF, Fancy Feast, and Pure Bites (as more of a supplement). I bought a bunch of the similar minimal ingredients chicken puree wet foods over the summer when she was eating more and she liked them all. I'll take a look at that chart and see what all the options are. (I wish the carb count was just on the websites).
 
I just put in a return for the Purina DM dry food, so I'm going to stop feeding her that. I think I'll go grab some Fancy Feast tomorrow, since I should be be able to find that around town. We don't really have any big pet stores in town, but it does look like the smaller ones will be open. I might just start with Fancy Feast and see if she likes some of those flavors.
 
Emily Kittinson said:
I have been feeding her Stella & Chewy, so that's the closest I've gotten to raw so far. After reading stuff on the forum, I'm thinking I might take her off the Purina DM food and go back to a low ingredient wet food. It looks like Nulo might be the cheapest option right now (and is 4% carbs), though I've fed her BFF, Fancy Feast, and Pure Bites (as more of a supplement). I bought a bunch of the similar minimal ingredients chicken puree wet foods over the summer when she was eating more and she liked them all. I'll take a look at that chart and see what all the options are. (I wish the carb count was just on the websites).
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Weruva has all their carb counts on their website. There are a number of great options for low carb and low phosphorus foods there. The BFF pate lovers foods are very good.
 
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Oh, and if she will only eat dry food at this time, you low carb options are Dr. Elsey’s Clean Protein or Young Again Zero Mature.
 
Emily Kittinson said:
They also gave me HUGE syringes (40 units) the last time I picked them up, so I'm also worried I'm not able to be precise (I did point that out and the vet said it should be fine).
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40 units? Insulin syringes are 30 unit, 50 unit, or 100 unit.

For a U40 insulin such as Vetsulin, you want to use U40 insulin syringes. 3/10cc with half unit markings are the ideal ones to use. Ulticare is one brand but there are others. Here's the product on Chewy: https://www.chewy.com/ulticare-vetrx-insulin-syringes-u-40/dp/206319

There is a way to use U100 insulin syringes with U40 insulin but there is a conversion you need to do. Someone can point you to the conversion chart.

Stella and Chewy's freeze dried is fine to feed. Other brands of freeze dried raw are good. For crunch, you can look into air dried raw food. The pieces are hard and crunchy just like dry food.

Here's one list of low carb Fancy Feast: https://felinediabetes.com/glutenfree.htm The chicken is pate style. There's a more comprehensive food chart here but it hasn't been updated since 2017 so some foods may no longer be available: https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Is ordering food online an option? Lots of people order food by the case from Chewy, Petco, Petsmart, etc. Even Amazon has pet food but watch out for marked up prices from third party sellers.

I see that your cat also has IBD. Is that being controlled by medicine? Lots of IBD cats have sensitive tummies so be aware of feeding new foods. My diabetic / IBD cat will throw up if he eats a dust bunny :p
 
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Testing: I seem to have figured out testing. My main issue is getting blood, but the warm washcloth is really helping (though Emily is getting really annoyed that I keep spending way too long messing with her ears, so hopefully I'll get faster).
Food: Thanks for the information! I will go back to the BFF puree. Because Em's a picky eater, I tend to grab a couple of cans to try flavors so I can get whatever she eats the most of. I have Petco Vital Care, so I get most of Em's stuff online from Petco. I'm just 45 minutes away from the nearest store, so it's more complicated to get individual cans (This is also where our emergency vet is, which is why I was looking for ways to test her blood sugar without sticking her in a cat for an hour and a half). She loves tuna water from the can, but will not eat any sort of fish or seafood cat food. She loves the turkey freeze dried food and treats more than chicken, but likes chicken pate more than turkey and also likes beef pate. I just used up the last can of BFF so I really just want to grab something to last her until I can get something shipped.
Syringes: I was previously using the 1/2cc and they gave me the 1cc last time. I'm also hoping to find somewhere cheaper and easier to get her supplies, if I can. Right now I'm getting them from the vet and it's about $78 for insulin and $28 for syringes.
IBD: I updated my signature. Her IBD issues mainly are constipation and vomiting, so she gets a little miralax and prednisolone every day. Part of the feeding issues is she still vomits if she eats too fast and boy was that fun trying to explain to the vet when they said she needed to stop free feeding. She's always been a slow eater which is why I was trying to keep her on the better dry foods before now (Blue Buffalo, First Mate, and Tiki Cat). I tried to mostly switch her to wet food when she started having IBD issues five years five years ago, but I've also had to focus on just finding something she would eat. I was pretty happy during the summer when she started eating all her wet food and we could switch completely to wet food, but then her blood sugar started getting out of control and she stopped eating completely. And I got told she had to be on the diabetic maintenance food even though I was worried about her losing weight, not liking it, and having the ingredients irritate her stomach.
On top of this, I'm also working full time, taking a couple of classes, and trying to by a condo+prepping to move next month (and had my own health mini-emergencies last week), so it's a little overwhelming. And just in general, it's been four or so months of trying to get her blood sugar under control and keep having these panics were she stops eating because it's still too high and I just need her to gain some weight. And all she really wants to eat is peanut butter and popcorn (which, I mean, mood).
 
The DM wet food isn’t too bad on carbs, but the dry is too high. The prednisolone will definitely raise blood glucose so that will add to the struggle to get her regulated, but I understand that it is necessary for her IBD so you just have to adjust her insulin dose and work around it. You’re not the only one in that situation. How much pred does she get? Daily? You haven’t been able to go to every other day dosing? My IBD cat is down to 2.5 mg prednisolone every other day. The only way we got there was to add in Visbiome Vet probiotic capsule daily (mixed in food.). Before that, he got diarrhea and would vomit if I tried to taper him down to every other day dosing.
 
Welcome to FDMB.

I'm going to offer some thoughts that will likely not be appreciated by your vet.

Vetsulin is not a great insulin for managing feline diabetes. It's not been recommended by the American Animal Hospital Assn since their 2018 guidelines for the treatment of diabetes was published. Vetsulin doesn't have sufficient duration given a cat's fast metabolism. The AAHA recommends either Lantus (glargine) or Prozinc.

Most cats that have IBD need to be on a novel protein diet. Think of proteins such as venison, rabbit, pork, kangaroo, etc. The vomiting that you mentioned may be due to your cat's reaction to proteins that mess with her system. Canned or raw food is fine. Red & Rover provided a link in her post above to a great webpage on IBD. They tend to focus on a raw diet but the basics for managing IBD are there along with recommendations for probiotics and other supplements.

Please ditch the dry food. There is nothing magical in any of the prescription diabetic foods -- canned or dry. In fact, the manufacturers lost a class action suit for calling their foods "prescription" since there is nothing prescription worthy in the ingredients of their food. In general, the prescription foods are of poor quality and you're paying a lot for a poor quality food. I'd also suggest avoiding foods that contain gums (e.g., guar gum) or carrageenan. They can aggravate IBD.
 
Her blood sugar is better today after not giving her dry food and following the normal insulin schedule (I skipped Friday night before getting a monitor since she wasn't eating). She still doesn't have much of an appetite. I'm going to try and do a ketone test if I can catch her in the litterbox and unless she suddenly is better in the morning, I'll call the vet when they open. She could just be dehydrated again, which seems to be a regular issue.
 
Ask the vet if there are other medicines for the IBD. My diabetic was taking prednisolone (which caused the diabetes) and the vet switched him to budesonide which is supposed to not affect bgs too much but every cat is different.

A good IBD web site is https://www.ibdkitties.net/

It's ok to agree to disagree with the vet on food :) Prescription food is junk and not worth it. Low carb canned food is best for all cats. IBD cats have sensitive tummies so you need to find a food that is low carb for the diabetes and ideally novel protein to keep the IBD flare ups to a minimum. I personally feed my diabetic / IBD cat a commercially available freeze dried raw diet in rabbit.
 
Current plan of attack:
I ordered new food. I might try the Stella and Chewy freeze dried rabbit, but I need her appetite to go back up.
We're going into to get fluids in an hour because she also stopped drinking and I'm going to set up an appointment then. I have managed to get her to drink some water by putting tuna in it. I'm going to ask about the other steroid at the appointment.
I ordered a probiotic (capsule, rather than powder because it looks like all the powders have maltodextrin in them)
I also got that smaller needles.
Right now she's a bit wobbly, but I don't think she's eaten much in the last 24 hours. I know she usually pops right back the moment she get fluids, so I expect that will help her appetite. I'm really tempted to ask if I can just give her fluids.
 
Maybe an appetite stimulant will help? Ask the vet. A little sprinkle of Fortiflora almost always works to get cats to eat. You can buy FortiFlora online.

Have you tried syringing watered down canned food into your cat? Getting some food and calories in is important. Maybe offer food on a spoon? I heard of someone who pretended to eat the canned food off a spoon and only then would the cat eat.

Does your cat seem nauseous? Sometimes IBD cats just feel icky and not want to eat.

Probiotic capsules can be opened and the powder directly mixed into moist food of some kind. No pilling needed :) Which probiotic did you buy? With Human ones, you generally don't give an entire capsule. Maybe half a capsule at most. The capsule can be put back together and the remaining powder saved for next time. Just keep the partial capsule separate from the rest of the bottle so you know which one to use.

Hope the vet can sort out your cat :bighug:
 
Emily Kittinson said:
Current plan of attack:
I ordered new food. I might try the Stella and Chewy freeze dried rabbit, but I need her appetite to go back up.
We're going into to get fluids in an hour because she also stopped drinking and I'm going to set up an appointment then. I have managed to get her to drink some water by putting tuna in it. I'm going to ask about the other steroid at the appointment.
I ordered a probiotic (capsule, rather than powder because it looks like all the powders have maltodextrin in them)
I also got that smaller needles.
Right now she's a bit wobbly, but I don't think she's eaten much in the last 24 hours. I know she usually pops right back the moment she get fluids, so I expect that will help her appetite. I'm really tempted to ask if I can just give her fluids.
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Have you tried baby food. Pure meat formulas?
 
Just spent a bunch of time and money at the vet. I took her in for fluids and luckily, they also did an exam and blood work. Her temperature was low and her liver levels were high. She also had low blood sugar since she hasn't been eating.

So we did fluids today and I'll bring her back for fluids tomorrow. I'm not supposed to give her insulin tonight. I took more time off work than I was expecting, so I had to leave her with a bunch of water, tuna, and other food. I'll check in her in a couple of hours to make sure she's eating. I also got some anti nausea meds. I asked about the steroid, but I think we're more focus on getting her better right now.

I got the Nutramax probiotic. Everything should arrive at the end of the week. I haven't tried baby food, but I did feed her Pure Bites for awhile and I still have a can. I'll also probably get some more tuna, if that continues to keep her drinking.
 
She has stayed in her carrier since we got home from the vet, but I have managed to get her to eat and drink. I'm not sure how much she's had to drink, but we will be going to the vet to get her more fluids. I'm trying to do a ketone test, I just made the mistake of putting the strips across the room, so now they're next to the litterbox. She has peed a few days, both in the box and in front of the box. I need to find a litterbox solution. I'm guessing the problem is that she doesn't want to step up into the litterbox, but she's also bad at aiming and will position herself wrong and pee right out of it.
 
Emily Kittinson said:
She has stayed in her carrier since we got home from the vet, but I have managed to get her to eat and drink. I'm not sure how much she's had to drink, but we will be going to the vet to get her more fluids. I'm trying to do a ketone test, I just made the mistake of putting the strips across the room, so now they're next to the litterbox. She has peed a few days, both in the box and in front of the box. I need to find a litterbox solution. I'm guessing the problem is that she doesn't want to step up into the litterbox, but she's also bad at aiming and will position herself wrong and pee right out of it.
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I’m sorry she’s been so sick and I hope she perks up soon. Mirtaz is an appetite stimulant (prescription) you rub in their ear—not sure if your vet would think it’s ok. Petco (and I’m sure others) sells low entry litter boxes—my boy kicks litter out more easily but he can step over the entrance (high on three sides). With a girl you may overcome the aim just with a low pan and pee pads all around. Fortiflora (as others mentioned) was my savior last Dec …it’s not just the probiotics but the flavor stimulates the appetite. It’s liver flavored so you could also maybe try liver flavored food instead if it otherwise meets her needs or they also make liver powder to sprinkle on food (again not sure if this would be ok with her diet and meds)

edit: also my vet finally taught me when cats don’t eat suspect nausea. My boys in the past perked up after cerenia. My niece’s hyperthyroid cat gets nauseated easily, and my hypothyroid cat gets nauseated if he takes his full dose of synthroid once a day instead of twice. I don’t know about cats but some humans who are hyperthyroid complain about nausea.
So much going on in your life right now…I hope things get better soon
 
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:bighug:

Try adding a "step" to the litter box to make entering and exiting easier. A stack of (old) books, small sturdy box, etc. I've used those huge Yellow Pages books in the past (ugh, I'm old :facepalm:).

One urine collection tip: buy a new litter box, put some non-absorbent cat litter or clean fish tank pebbles into it, confine the cat to the bathroom with the new box, and just wait for pee.
 
She ended up starving today and eating all her food. I took her in during lunch and turns out her blood sugar is low again! (I did like three tests because I thought I was doing something wrong). So she's supposed to stay off insulin until we do more blood tests next week.

I think it's a mix of switching her to Fancy Feast and that she didn't get her steroids this weekend and I'm supposed to try and half the amount she's been getting. So I'll just keep an eye on her numbers.
 
Just checked her after I got home from work and it's still in the low hundreds, even though she's eaten a second meal. I'll check her again in a couple hours. At least she's eating? If she's still dehydrated the next time we go to the vet I'm going to ask about giving her fluids at home. I think I managed a ketone test earlier before the low blood sugar scare and it came back normal. (Now I'm just going to worry because I don't feel like she's peed enough, even though she's definitely peeing and it looks fine. She's just old AF and it takes her awhile to recover from things and her blood sugar is just bouncing around.)
 
Today's update, I put a space heater near her carrier to try and keep her warm. I can only have it on when I'm home and awake, though. (She can easily leave it if she's gets too warm.) She's still feeling chilly, but she is definitely aware and eating and drinking. Her blood sugar is up a little more and I'm not sure at what point I need to start giving her insulin. The vet wants me to hold off a week, but I also don't want it to go so high she stops eating.

She has been moving around, so that seems to be a good sign. She still slept in her carrier instead of with me last night. I'm hoping she'll come back to bed tonight. She has been leaving the carrier and cuddling with me today. I might bring her to work with me tomorrow to keep an eye on her, it just involves bringing so much stuff and stressing her out. I did check her ketones twice and she's still negative. She's back to going in the litterbox, so that's also a good sign. Her new food should be here tomorrow. I'm just going to give her the anti nausea meds until I see the vet again in a week.
 
A safer alternative to the space heater is a microwavable pet heating pad such as the SnuggleSafe or a heated pet bed. With a microwavable pad, you'll want to wrap it in a folded towel to prevent burns.
 
She had two heated cat beds and she stopped using them after Christmas, for whatever weird cat reason. I actually got her a second last year so she would have one in the bedroom and one in the main room because she likes to be in the same room as me. I just got home from work and she has finally moved from the carrier back to my bed and her ears are feeling warm, so I'm a little less stressed. She was using the human heating pad all weekend (she even was snuggling when I was sleeping, which is weird for her). She didn't eat as much today and I do need to work on that, but I feel slightly better than she's not hiding herself away in the carrier. To be honest, when she didn't come in on Tuesday morning when my alarm went off, I was scared I lost her overnight.
 
The vet said to stop giving Em insulin this week, but she's been in the 300 range so I'm trying to slowly figure out what she needs. I think I'm going to stay with .5-1 unit until she gets tested again. I just know if her numbers get too high, she'll stop eating and drinking and we'll have to do this all over again. Her paws and ears are started to feel chilly again. Maybe it's just an age thing. She still won't use her heated beds. I'm going to wash the covers for them this weekend and see if that helps. She is back to acting normal, other than her feeling cold. I'm also waiting to see if they think she's dehydrated on Tuesday because I really cannot tell. I've tried the skin test and the gums test, but I don't know.
 
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