New Member // Adopted very hungry stray, overwhelmed about where to start!

[emiliegeez]

Hi all! Very happy to have found this forum + all the resources it contains - dropping in to introduce myself + my new cat, and to ask for input/advice on his course of treatment...

Background: The cat in question (now named Tango) has been living on my block in Brooklyn as a stray that I suspect somebody abandoned for at least 6 months. He's been begging my neighbors for food / to be let inside anyone's apartment with an open door - I've been feeding him on occasion as I keep food in my car to feed a few local feral groups but have hesitated to take him in because I don't have space (two cats at home with a roommate)/a good housing option + was hoping somebody else would since he's so friendly. That being said, winter came around and his health started to visibly decline so I ended up caving and nabbing him in the week leading up to Christmas.

My initial plan was to keep him in the basement office of the bar I own close by + set him up with a foster/new home in the New Year. Took him to the vet for vaccines/blood work + that's when the diabetes diagnoses came in. That, along with some other health + behavioral issues that I think are side effects of being mistreated as a stray (I've seen people throw things at him, kick at him to shoo him, etc) have led me to decide to keep him because I don't think the odds of finding another home are very high, and I've gotten attached pretty quickly. Definitely a way bigger commitment than what I knew I was signing on for, but here we are!

Other Health/Behavioral Issues:

• He initially had fleas + tape worms (as to be expected). Vet treated with Revolution + Profender and those seem to both be cleared up
• He is voraciously hungry, all of the time, but especially in the 2-3 hours leading into meal time. He eats a whole can of his wet food in less than a minute at meal times + is mostly interested in convincing whoever is around that he needs more. I'm not sure how much of this is related to being a stray/underweight, and how much is because of his diabetes still not being regulated. He hasn't put on any weight in the 2 weeks he's been on insulin.
• His mouth/teeth are infected. The vet wants to try to wait to address them until his overall health is better but says if he's still not regulating by our next visit she wants to look at treating them as it could be a factor in his high BG readings. His two canines seem like they're jabbing his lower lip + it's all swollen/black around his mouth. Doesn't impact his appetite in the least though.
• I'm fairly certain he has asthma - my cat at home has asthma so I know what an attack looks like, and his breathing seems a bit labored. He's only had one attack that I've seen though so this seems like less of a concern for now
• He's been living outside eating garbage with unregulated diabetes for at least 6 months (probably more), so guessing there has to be some permanent nerve damage at minimum. He walks a bit flat with his hind legs, but it seems pretty mild. His energy levels/movement seem pretty good considering how much he's trying to heal from.
• While he's very sweet and loving overall, he also has a lot of triggers that cause him to get irritable/nippy. Some are definitely from being mistreated, others I think are tied to possible sensitive spots on his body (ie: mouth), and the fact that he is literally always hungry

Treatment Plan: My vet had me start him on 1 unit of Lantus twice a day, with meals. She has me feeding him 1 can of Purina DM wet food at each meal. I'm doing my best to stick to the same time every day, but given how much else I'm juggling outside of him there's a variation of an hour or two on that.
We started him on it January 3, and I just brought him in for a recheck a couple days ago - his BG reading was lower than previously, but still around 330. She showed me how to test him myself + asked me to start tracking it + bring the data in for another follow up in a couple of weeks. I really like this vet - all the advice she's given me so far lines up with what I've read on here + appreciate that she's encouraging me to home test.
For now he is going to continue living at my work (it's a clean/heated/well lit space) and I'm aiming to spend time with him there when I can before and after doses/during the day. I know it's not ideal + would like to bring him home eventually when it seems like a good time to intro him to my other cats, but I figure it's a much better chance than he had living outside in the coldest part of winter / without treatment.

Questions: Haha... I have so many... if anyone reading this has personal experience with a similar situation, or sees something obvious I should try doing differently, your input is welcome! Otherwise, would very much appreciate advice on the following:

1. As far as BG readings go- I can do literally anything I want to him while he's eating, but otherwise he gets pretty feisty with handling outside of his comfort zone. If I test him while he's eating directly before giving him his insulin, is that sufficient for now, in terms of safely dosing?
2. Is his constant hunger/food obsession likely because of the unregulated diabetes? Should I be worried about it / feeding him more than the 1 can per day? Is the Purina DM a good food choice, in your opinion?
3. Are the infected teeth likely a factor in the high BG readings? ie: will they likely need to be pulled before he gets regulated?
4. Anyone else have experience with a diabetic stray/advice on other health problems I should be looking out for based on how long he was out there?

 

[Katherine&Ruby]

Hi Emilie! Bless your heart for taking the poor guy in! Sounds like he really lucked out when you found each other!

I don't have any experience with ferals, but lots of people here do so hopefully they will chime in.

Regarding insulin and testing, we really recommend that you figure out a way of doing it, even while he is eating. Since DM is low carb, it may make his glucose levels lower than whatever he was eating before, so it's important to know what his numbers are before administering insulin. We recommend getting the Relion meter from Walmart--the meter is cheap, and the test strips are cheap--but I know in Brooklyn a Walmart may be hard to come by (I live in the NY metro area so I am familiar). You can go to CVS or Duane Reade and get any glucose meter and strips for now and transition to the Relion when you can get it shipped to you.

The constant hunger is definitely a sign of hyperglycemia. You should feed him as much as he wants to eat. Because he has insulin resistance going on, the cells of his body are not getting sugar for energy and his body is literally starving even though he is eating well. DM is really expensive, and you can do just as well by feeding him Fancy Feast Classic Pates that you can get from nearly any supermarket or bodega.

Infected teeth will contribute to high glucose readings. Lots of unregulated cats have dental work done and it usually brings instant relief. Any sort of inflammation or infection will affect glucose levels.

When you have a moment, please read this: New? How You Can Help Us Help You!

That thread has great suggestions for getting you started on this journey. Welcome to the FDMB, and ask as many questions as you need!

 

[Bron and Sheba (GA)]

Hi and welcome. Thank you for taking in Tango.
I agree with what Katherine has said.
I would get the teeth done as soon as the vet will do them. They definitely will contribute to high BGs.
And feed him during the cycles as well as before the shot. If you are not always going to be around, you might like to invest in an automatic timed feeder for him so that he can get food when you are not there.

You might like to look at setting up our spreadsheet to put in all the BGs once you start testing , then we can help you with dosing.

 

[Noah & me (GA)]

You did the right thing, not always easy. All five of ours were at minimum mildly abused, two were neighborhood strays. Some of the behavior issues we've dealt with are so deeply ingrained I doubt they'll ever go away. In the back of every cat's mind every meal could be their last, every raised hand could be another smack, every time they're left at a vet they wonder if you're ever coming back. Marco had it the worst but is now daddy's boy, crawls under the covers with me and loves being in the car. Even after five years he's terrified of spray bottles, if he goes to the vet and the bottle comes out for cleaning it's all over. Come get your cat and we'll reschedule.
Be patient with him and know ahead of time how long 'forever' is and how expensive it can be. In the end it's all worth it, if we don't share then what's the point. You're in a good place here with people who understand. Safe journey Tango.

 

[Sienne and Gabby (GA)]

You are so incredibly kind to bring Tango indoors. He would not have survived either the cold or due to the diabetes. You've literally saved his life.

From my reading over the years, I suspect Tango is much like a child who is experiencing food insecurity. He's eating fast and furiously to prevent any other animals from getting the food. You might want to consider getting a timed feeder. I think this will have a few benefits. He will have food available throughout the day at times that you specify. (Just make sure you aren't providing food 2 hours prior to shot time so the food doesn't inadvertently influence his pre-shot numbers.) Providing food especially during the first half the the cycle, when insulin is at its most active, may also be a buffer if his numbers are dropping. It may help him to relax and realize that food is available. It may also provide you with a bit of reassurance that he will eat if his numbers are dropping.

The other issue with food is that when a cat is an unregulated diabetic, they are literally starving. Insulin helps the end product of food being metabolized (i.e., glucose) move from the blood stream into the cells. If the pancreas isn't producing enough insulin to do the job, the glucose is floating around in the blood and your cat is starving. As the blood glucose (BG) numbers improve, Tango may be less hungry all the time.

If you are looking for a less expensive option than DM, there are several. It is relatively low in carbs but it's not the best quality food. There is also nothing "prescription" about it and lots of cats get tired of it. Most of the members here, especially if cost is a consideration, opt for either Fancy Feast or Friskies pate style food. This is a chart of most of the canned foods available in the US and their nutritional info. You want foods that are under 10% carbohydrate, although most members feed their cats in the 5% range. You have lots of options!

You may need to do a bit of desensitizing Tango to testing. It's important to test at shot time so you know where his numbers are and if it's safe to give insulin. Lantus dosing (and say "thank you" to your vet for starting Tango on an appropriate insulin) is based on the lowest number in the cycle (the nadir). It will be helpful if you can get some spot checks so you know how low the insulin dose is bringing your kitty's numbers. Treats may help. Any and every time you test, whether you're successful or not, Tango gets a treat. You may also want to have a "spot" where you test. The idea is to create an association between testing and a reward. Many members use freeze dried chicken as a treat. Any freeze dried protein is fine. Basically, any treat that is just protein is zero carbs. If cooking a piece of chicken is easier, that's fine too. We've had members that would buy frozen, cooked shrimp and use defrosted shrimp as a treat. Whatever works for your cat.

It may also take a bit of time to get Tango used to being handled. Hopefully, and from what you described, he had a home but was left behind. It's going to take him a bit to get over people mistreating him and starting to trust you. I also suspect that once he realizes that you're poking him for shots and tests, is causing him to feel better, that he will get acclimated.

I would talk to the vet about the teeth situation. If there's an infection, it's going to cause BG numbers to be elevated. I don't know how successful you would be at trying to pill Tango but an antibiotic might help. (You do not want the vet to suggest Convenia. It's a 2-week+ antibiotic and if the kitty is allergic, it's a huge problem. Many vets refuse to use it. Some vets like it due to it's long duration especially if pilling the cat is an issue. My vet is a feline specialist and refuses to use it. This is info on its use.) If the vet is concerned about Tango having a dental and being unregulated, you could always see a veterinary dentist. My cat was not the best regulated and she had several dentals from my vet while she was diabetic.

Usually the issues with ferals is that they have fleas, worms, etc. There is a wonderful website called TinyKittens where they do rescue work. If you look on the menu, there's a way to contact them and I suspect they may be open to questions. Or, as others have noted, there are several members who have done rescue work here.

 

[JL and Chip]

I have dealt with a lot of strays and ferals over the years and have lots of thoughts, but will narrow it down to a few questions to start:

1) Is Tango neutered? If not, the male hormones can definitely be contributing to some of the reactiveness (intact males can have a flash trigger). Even recently neutered males can continue to be a handful for awhile because it takes time for the hormones to get out of their system.

2) Was he tested for FelineLeukenia/FIV/heartworm? If so, what were the results? If not, I’d strongly suggest doing so. It’s a simple snap test that requires only a drop of blood.

3) How thorough was the mouth exam?

4) Was a comprehensive blood panel run?

5) Any guess about Tango’s age?

Good for you for intervening. So often people hope “someone” will step up to help a stray animal in need. Thank you for being that someone.

 

[Ashleigh & Ares]

What a kind soul you have. Awesome for taking in Tango.

 

[JanetNJ]

I wouldn't wait to get the dental. It can take months to get a cat regulated, and with an infection it's near impossible. No reason to wait. I would feed minimum four times a day. Esp since he's underweight he may need twice the calories of a regular cat until hes under control. How much does he weigh? Did the vet day how much he should weigh?

 

[emiliegeez]

Thank you all for the replies! Sorry I've been slow to respond - we had a bit of a 911/hypo situation yesterday that I started a new thread about... all good and stable now, so back to learning/making a long term game plan!

Answers to your questions:

@JL and Chip :

1. He is neutered, thankfully! That's why I'm confident that he is definitely someone's ditched pet... along with how comfortable he is living inside and demanding things from me, haha
2. He was tested for all of those + tested negative, also thankfully. Those were the main ones I was wondering about when we got the blood work, I didn't even know to be concerned about diabetes.
3. Mouth exam was not very thorough - she seemed to have the attitude of 'we'll cross that bridge when we get to it/if he doesn't get better' but at our next visit in a couple weeks I'm going to push to have it addressed. Pic I got of his mouth the day I got him below:
4. 
   
   
5. I believe so - what constitutes comprehensive? I meant to ask for a copy of the results but forgot to so I haven't actually seen everything they tested for
6. I'm guessing somewhere between 5-10, but beyond that it's hard to say. He acts like an old man but I know he probably feels older than he is

@JanetNJ : He is definitely underweight - at the last visit he came in at around 10.5 pounds - she didn't give me a goal weight but said he does definitely need to gain weight.

@Noah & me (GA) : Thank you for sharing about your own cats - that makes me feel good about where I'm at with him despite some of the reflexes he's developed. It makes sense that he's on his guard all the time. I already feel extremely bonded to him though... I guess that's the positive side effect of having to be so in tune with his medical needs? I do think he is aware that I'm helping him because he puts up with more than I would expect.

@Sienne and Gabby (GA) : This is all very, very helpful info - thank you for taking the time to type all of that out on our behalf. The food insecurity / diabetes combo together makes sense as far as the constant begging for food goes - the way his meows sound when he asks for food make me feel like he really does feel that hungry, but I'm sure that at least some of that has to be a result of how inconsistently he's been able to eat.

My takeaways for now:

• Sounds like the move is definitely to get the teeth worked on then... I didn't know that about infections affecting BG levels but definitely makes sense.
• Going to look at ordering a timed wet food feeder so I can do 4 meals a day, as long as that's not a problem. He is definitely underweight and I can see how this would hopefully make him feel more secure about meals as well
• Going to switch from DM to another low carb food... relieved to hear it's not necessary, it is expensive and I can see a single flavor getting boring after a while
• Work on desensitizing him to testing (and getting myself used to it...) and set up a spreadsheet. Had to test him for the first time last night when he was hypo and he was complacent but I made a mess of his ears because of how long it took me to get the hang of it while I was panicking. Someone suggested I try the Freestyle Libre 14 day sensor to get an initial curve - this is appealing because of how important it seems that I be able to test him properly right away after last night... going to ask my vet about it

 

[JL and Chip]

Glad to hear you came through the hypo situation ok. I hope you can get some more BG tests in to see if even the lowered dose is ok or too much. It can take time for the depot to adjust and, as has been noted, cats can become extra sensitive to insulin after a hypo, so best to remain vigilant.

It’s a good idea to get a copy of all of the bloodwork, urinalysis, and any other test results for your file. Some vets offer a hard copy, others will email it to you, but most of the vets I’ve dealt with over the years don’t offer it up unless asked.

“Standard” bloodwork can vary based on the vet but usually includes at least a CBC and Chemistry. Do you know whether a thyroid panel (or at least a T4) was included? In addition to tapeworm and diabetes, hyperthyroidism can make them be voraciously hungry and lose a significant amount of weight.

As for feeding… many of the strays I’ve dealt with come in starving and thin. I’ve never been a big fan of meal feeding in general, but especially with them. What happens if you give him free-choice food? Does he “Hoover” everything and puke? I know it’s hard with diabetes in the mix, but you might want to experiment with increasing the number of meals and calories, and see what it takes to satiate his hunger. Adding water to the canned food can help make them feel fuller as well and is good for hydration. Some strays will always overeat, but if he was owned before, it’s possible he’ll settle down once he isn’t frantic for food and be less reactive.

It’s of course possible that his diabetes why he was dumped outside (if that is in fact what happened). I assume the vet checked for a microchip? You might also want to check websites for lost/found animals in your area; it’s sad how many animals are lost under sad/unfortunate circumstances and have owners who are truly heartbroken and searching. Regardless, Tango is lucky to have found you.