New Member - 5/16/2024 newly diagnosed - basic questions for a not so basic cat

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louisstools

Member Since 2024
Hi :)

My 12 year old girl was diagnosed with diabetes the other day. Tomorrow we start insulin. I don't know the particulars other than it'll be two shots a day. At the vet appointment tomorrow morning obviously I will know more! I will have some questions at the end of this that might make sense once a little introduction is done. Sorry for the incoming wall of text!

A little background and introduction

My cat has had next to zero appetite for the past 2 years. She has been on an appetite stimulant (mirataz, on the ear) for over a year. That has helped a bit but when it comes time to a meal she just wants a few bites and that's that. She wants 10-15 meals a day spread out during the day. I worked with our vet and a behaviorist and we tried to get her on meal times but she never took. She just wants her 10-15 meals. She is also very picky about her food. She will not do wet food consistently. We tried to switch her 2 years ago to wet food but she never took to it. So we switched her back to the Purina UR ST/OX prescription kibble that she has eaten for 11 out of the past 12 years. Historically she UTI problems so that's why she is on the rx food. This food she will eat as consistently as she will eat anything. So this is the food she is on.

How I suspected my cat might be diabetic or "sick" was her appetite decreased suddenly about a month ago at the same time her thirst started to increase. Eventually she started to guzzle water and her pee amount increased. Her appetite has remained poor (like I said, she has a low appetite). In that month she lost half a pound and this is on an appetite stimulant. Heh, had she had the increase in appetite that normally goes along with diabetes I probably wouldn't have taken her to the vet.

In talking with our vet the other day, she is not inclined to change the cat's diet because it's been a disaster in the past. The plan is to get her used to the insulin and re-evaluate as necessary. (The cat also has bronchitis but we need to get the blood sugars under control before we treat that.) The vet did not say anything about the meal times as she likely knows that's not going to change anytime soon either.

So here are a few questions. I don't know much yet about diabetes so feel free to chime in with things that are relevant but I failed to ask.

  • how much of a problem will her eating schedule be? She eats breakfast from 6am-8am and it takes 4 meals, then she eats about every 2-3 hours as she gets hungry (she just comes and gets me, I work from home).
  • (edit) - she normally doesn't eat overnight and she normally has her last meal before I go to bed
  • (edit) the amount she eats varies wildly at a meal from less than 0.1oz (by weight/scale) to 0.4oz (by weight/scale)
  • on the whole, she eats around 2.6oz (by weight/scale), roughly 231kcal
  • eating around the shot - do they eat before or after?
  • If they need to eat before, how much variance between shot times is allowed? My cat doesn't always eat at a regular interval so she might eat at 4pm, 6pm, 8pm, 9pm one day and then 4pm, 8pm, 9pm the next. Breakfast is always at the same time if that helps.
  • Given she already has a low appetite, will this decrease her appetite or will it possibly increase it? I've suspected her decrease in appetite over the past month was due to her increase in drinking (tummy can only hold so much).
  • (edit) - any questions I should ask our vet based on what I've posted here??
I sincerely appreciate the time you spent considering our matter. I'm sure I'll be posting around off and on as we navigate this "new normal."
 
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Hi :)

My 12 year old girl was diagnosed with diabetes the other day. Tomorrow we start insulin. I don't know the particulars other than it'll be two shots a day. At the vet appointment tomorrow morning obviously I will know more! I will have some questions at the end of this that might make sense once a little introduction is done. Sorry for the incoming wall of text!

A little background and introduction

My cat has had next to zero appetite for the past 2 years. She has been on an appetite stimulant (mirataz, on the ear) for over a year. That has helped a bit but when it comes time to a meal she just wants a few bites and that's that. She wants 10-15 meals a day spread out during the day. I worked with our vet and a behaviorist and we tried to get her on meal times but she never took. She just wants her 10-15 meals. She is also very picky about her food. She will not do wet food consistently. We tried to switch her 2 years ago to wet food but she never took to it. So we switched her back to the Purina UR ST/OX prescription kibble that she has eaten for 11 out of the past 12 years. Historically she UTI problems so that's why she is on the rx food. This food she will eat as consistently as she will eat anything. So this is the food she is on.

How I suspected my cat might be diabetic or "sick" was her appetite decreased suddenly about a month ago at the same time her thirst started to increase. Eventually she started to guzzle water and her pee amount increased. Her appetite has remained poor (like I said, she has a low appetite). In that month she lost half a pound and this is on an appetite stimulant. Heh, had she had the increase in appetite that normally goes along with diabetes I probably wouldn't have taken her to the vet.

In talking with our vet the other day, she is not inclined to change the cat's diet because it's been a disaster in the past. The plan is to get her used to the insulin and re-evaluate as necessary. (The cat also has bronchitis but we need to get the blood sugars under control before we treat that.) The vet did not say anything about the meal times as she likely knows that's not going to change anytime soon either.

So here are a few questions. I don't know much yet about diabetes so feel free to chime in with things that are relevant but I failed to ask.

  • how much of a problem will her eating schedule be? She eats breakfast from 6am-8am and it takes 4 meals, then she eats about every 2-3 hours as she gets hungry (she just comes and gets me, I work from home).
  • (edit) - she normally doesn't eat overnight and she normally has her last meal before I go to bed
  • (edit) the amount she eats varies wildly at a meal from less than 0.1oz (by weight/scale) to 0.4oz (by weight/scale)
  • on the whole, she eats around 2.6oz (by weight/scale), roughly 231kcal
  • eating around the shot - do they eat before or after?
  • If they need to eat before, how much variance between shot times is allowed? My cat doesn't always eat at a regular interval so she might eat at 4pm, 6pm, 8pm, 9pm one day and then 4pm, 8pm, 9pm the next. Breakfast is always at the same time if that helps.
  • Given she already has a low appetite, will this decrease her appetite or will it possibly increase it? I've suspected her decrease in appetite over the past month was due to her increase in drinking (tummy can only hold so much).
  • (edit) - any questions I should ask our vet based on what I've posted here??
I sincerely appreciate the time you spent considering our matter. I'm sure I'll be posting around off and on as we navigate this "new normal."
@Bron and Sheba (GA)
@Bandit's Mom
@Wendy&Neko
 
Hi and welcome to the forum.
You are right, the kibble she is eating is over 20% carbs which is high carb. I can’t see anything in the ingredients that is special to be honest. Diabetic cats need 10% or under carbs
Have they ever tried to give her an anti nausea medication to see if that helps or have they given her probiotics? Probiotics made a massive difference to one of my kitties.
***I would also ask your vet to treat the bronchitis NOW and not wait for your kitty to be regulated…that could take ages and it is not a good idea to have a diabetic cat with an infection that is not treated. I would get that addressed immediately.

how much of a problem will her eating schedule be? She eats breakfast from 6am-8am and it takes 4 meals, then she eats about every 2-3 hours as she gets hungry (she just comes and gets me, I work from home).
The eating schedule should not be a problem.we recommend diabetic cats snack throughout the day and evening except for the 2 hours before the shot is due.
edit) - she normally doesn't eat overnight and she normally has her last meal before I go to bed
can you leave food out for her overnight? Would she eat it?
the amount she eats varies wildly at a meal from less than 0.1oz (by weight/scale) to 0.4oz (by weight/scale)
It is good to eat a good meal before the shots if possible

eating around the shot - do they eat before or after?
You feed before you give the dose of insulin. How long you wait after feeding depends on the type of insulin. Hopefully your vet will give you Lantus or Prozinc. If she suggests vetsulin….,that is NOT a good insulin for cats, especially cats who do not eat all that well.
If they need to eat before, how much variance between shot times is allowed? My cat doesn't always eat at a regular interval so she might eat at 4pm, 6pm, 8pm, 9pm one day and then 4pm, 8pm, 9pm the next. Breakfast is always at the same time if that helps.
You can work out a schedule that suits you and your kitty. Doses are 12 hours apart, give or take 15 minutes.
Given she already has a low appetite, will this decrease her appetite or will it possibly increase it? I've suspected her decrease in appetite over the past month was due to her increase in drinking (tummy can only hold so much).
Hopefully her appetite will increase. Ask the vet about getting anti nausea medications and an appetite stimulant.
any questions I should ask our vet based on what I've posted here??
Ask about the anti nausea meds and appetite stimulant. And request either Lantus or generic of same or Prozinc. Refuse vetsulin.
Only let them start on a small dose of insulin…1/2 to 1 unit
Post back here and tell us how the visit went.
I would also buy some ketostix from Walmart or a pharmacy to test the urine for ketones.
And ask the vet to treat the bronchitis now. It is crazy to leave it until later.
Lots more to tell you but don’t want to overwhelm you.

Keep asking us questions. We are happy to help you,
Good luck at the vet.
Bron
 
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Agree with everything Bron said. Also decline an insulin called “Humulin “N” or “Novolin N” if suggested. It too is not ideal for cats.

You’ll need insulin syringes that match the strength of the insulin you’re prescribed. Let us know what insulin you get and we can help make sure you have the correct syringes.
 
Hi and thanks!

She's on a appetite stimulant already, has been for a year. I do leave food out overnight but she rarely eats it. She prefers to eat with me standing next to her. We have tried probiotics but she wouldn't even try the food with it on it. She is the picky cat that sets the curve.

Bronchitis - vet said the steroids she would give would raise the blood sugar. That's why she wanted to get the diabetes in check. I'll ask her again. Good call out.

regarding eating before the shot, I really have no control over how much she will eat. Is it more important to keep the shots on time or that she eats before it? this is a cat that when she wants to eat, she wants to eat right now. She doesn’t want to eat five minutes right now or five minutes after. and sometimes when she eats, it’s only like five or six kibble is that enough before the shot?
 
Bronchitis - vet said the steroids she would give would raise the blood sugar. That's why she wanted to get the diabetes in check. I'll ask her again. Good call out.
Ask the vet if she thinks it is bacterial or viral bronchitis. If the vet did a blood test she will be able to see the white cell count. Your kitty may need antibiotics or she may need a puffer. Either way it should not stop the start of the insulin. We have cats on puffers and steroids here and we just work around it.
regarding eating before the shot, I really have no control over how much she will eat. Is it more important to keep the shots on time or that she eats before it? this is a cat that when she wants to eat, she wants to eat right now. She doesn’t want to eat five minutes right now or five minutes after. and sometimes when she eats, it’s only like five or six kibble is that enough before the shot?
The beauty of Lantus is your kitty won’t have to eat all the meal at once as the onset of the insulin is 2 hours after the dose. So you have time to get her to eat. With vetsulin, humulin N and novolin N, Kitty has to have a good meal on board well before the dose of insulin as it hits hard and fast. Once you decide when the doses are going to be given each 12 hours you will just have to work around your kitty with the meals.
 
thank you for the reply. I think the insulin that my vet wants is called Prozinc. I’ll obviously confirm more in an hour when we’re at the actual visit.

But I cannot stress. I have no control over when the cat eats. She eats when she eats and that’s that. and she just has such a low appetite getting anything in her is a tremendous success.

She might go 10 to 15 hours without eating and when she finally eats, she wants five kibble. she also tends to eat all of her meals before about 8 o’clock at night. So she regularly goes 10 hours a day with very little 0.2 ounces by scale, or nothing. she did that last night and it’s been very difficult to get her to eat breakfast. She’s just not really hungry. and again this is on an appetite stimulant.

breakfast starts at six and it normally ends up finishing around eight. I’m thinking the first shot will be sometime in that time. After she’s had something to eat, but probably before she’s finished. And then the next shot will be 12-ish hours later but I can’t set her eating on a clock. That’s what I can’t get past she eats when she eats. And it’s possible by the time the second shot is due she’s in a mode where she is not going to eat for 10 hours.
 
Either Prozinc or Lantus (glargine) are good choices for treating feline diabetes. Each has its pros and cons. With respect to your cat's eating, the biggest difference is that Lantus takes about 2 hours to start working. Prozinc can give you more flexibility with adjusting a dose so it may balance things out. Lantus does best if you keep shot times within a pretty rigid window.

Having a long break between when she eats isn't an issue. We have plenty of cats here who graze.

Just out of curiosity, did you cat have an initially good response to mirtazapine? Sometimes, the effect of the drug wears off or you cat may need either a break from the medication or an increase in dose.
 
Thanks for the reply again @Sienne and Gabby (GA) :) (what does ga mean? Georiga?)

Historically she was a food motivated cat and very hungry all the time but that changed in Fall 2021 as she hit 9. We started the mirataz in Spring 2023 b/c she went from Fall 2021 to Spring 2023 (and now) not wanting to eat and eating small amounts when she did eat. The first like four days she was her old self from years ago with eating. But after those four days she chilled and it gives her a bit of a boost but nothing crazy. On days when she is being difficult, like today, we do give her a larger dose. The normal full dose is 1.5 inches and her dose is .25 inches. So you can see she's just getting a tiny dose to give her a boost.

Ok, so prozinc has some flexibility that's great because her eating varies wildly especially in the evening which is when the second shot will be due. How much food do they need in their tummys before the shot? Since my cat is a grazer and nearly always has food in her tummy will that be enough if she just has a small ~5 kibble snack before the shot?

I just have a lot of anxiety and stress because I've been lurking here and it just seems that so many people are very scheduled with the timing of things and that's just not going to be possible for me. If the shots have to be at x and y time consistently, and she has to eat around that time... I can't make her eat, period and I sure as heck can't make her eat when I need her to eat.
 
Right now, she gets two shots of "1 unit" of Prozinc. So baby amounts. We will follow up with our normal vet next Wednesday and discuss a whole host of topics from bg monitoring, diet changes, meal time changes, dosage changes, etc.

The shot wasn't too bad either. She didn't give me any "practice attempts" with saline or anything. I just "did it live"
 
@Bron and Sheba (GA) I think so. I doubt that will be super difficult.

The hard part for me is just trying to time the shot to her eating. That terrifies me. She has a low appetite, even on a stimulant. Our vet today had to rush things, she is not our normal vet, and she couldn't give me the specifics on what to do in this situation. I posted a specific question/thread in the forum for Prozinc hoping someone can help out. I might end up calling our Animal ER and getting clarity from them at least on what to do for tonight.
 
well, I just gave her the second shot. Technically, technically she ate. She ate exactly 5 kibble.

She hasn’t been wanting to eat all day and generally, in the evenings, she doesn’t eat very well. I have no Flippin idea how the second shot is going to work because in all honesty, there’s no guarantee that 12 hours after the first shot she’s going to be willing to eat Before breakfast the following morning let alone at a specific time that evening
 
If you can test you will know how the insulin is working. That will take the guesswork and stress out of the equation. I’m going to tag @Suzanne & Darcy for you as she is a Prozinc user. In the meantime I would try and get her to eat a bit more.
I’m going to post a couple of links fir you below
 
If you can test you will know how the insulin is working. That will take the guesswork and stress out of the equation. I’m going to tag @Suzanne & Darcy for you as she is a Prozinc user. In the meantime I would try and get her to eat a bit more.
I’m going to post a couple of links fir you below
yeah, when I go back to the vet next week, they’re going to teach me how to test. My normal vet is way better about teaching me and explaining things because she understands The challenges of my cat.
 
HOMETESTING HINTS AND LINKS
If you live in the US the ReliOn meter you can buy at Walmart is good and cheap. Also get lancets size 26 or 28, some test strips and some cotton balls to hold behind the ear.
I’m also going to tag @Bandit's Mom to help you with the spreadsheet.
Can you also add to your signature the food you are feeding, date of diagnosis and when you get the meter, what type please? Thanks
 
yeah, when I go back to the vet next week, they’re going to teach me how to test. My normal vet is way better about teaching me and explaining things because she understands The challenges of my cat.
I wonder if they test in the ear. We have videos to show you. I would go ahead and get one sooner than next week. You need to know what the BGs are.
Also don’t let the vet tell you a human meter is not suitable for a cat. It is. And most of us use them here. Pet meters are too expensive to run and our dosing methods are based on the human meter.
 
I wonder if they test in the ear. We have videos to show you. I would go ahead and get one sooner than next week. You need to know what the BGs are.
Also don’t let the vet tell you a human meter is not suitable for a cat. It is. And most of us use them here. Pet meters are too expensive to run and our dosing methods are based on the human meter.
I will do that. It seems pretty reasonable. I also updated my signature so hopefully that helps everybody.
 
Did you ask the vet about an antinausea medication?
we’ve talked about an anti-nausea medicine for years now. But from what I’ve been able to gather the cat doesn’t have nausea. And I have cameras on the food bowls, and the vet didn’t see the signs of nausea that she was expecting. I think the cat just doesn’t really have much hunger, she is extremely sedentary.
 
Is your cat amenable to syringe feeding?I have surnge fed one of my cats for 5 years or so. Now I have another one whcu I syringe feed a substantial portion of his food. He was also a slow eating who eats a lot of dry by himself. I have another cat, Nala which is on a chemo pill for SCL and I have to syringe feed her sometimes especially after she gets one of her pills.
 
Is your cat amenable to syringe feeding?I have surnge fed one of my cats for 5 years or so. Now I have another one whcu I syringe feed a substantial portion of his food. He was also a slow eating who eats a lot of dry by himself. I have another cat, Nala which is on a chemo pill for SCL and I have to syringe feed her sometimes especially after she gets one of her pills.

I don’t think she is. She doesn’t like anyone near her mouth. I can’t pill her and the vet takes normally two people to pill her or to even check her teeth.
 
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