New member, could use some help/advice

[Anon191]

Hello everyone, my name's Ian and my cat is Sophie. She turned 16 this Halloween and hasn't been doing well. She barely eats and drinks a lot, while having trouble with her back legs. She has been hiding mostly and avoiding me, she pees sometimes in the box and sometimes on the floor. Went to the vet today (11/3/2023) and she was diagnosed with diabetes. It didn't really hit me until tonight, and it's honestly shaken me pretty bad. I have both Trypanophobia and Hemophobia so the news is really rough. All of this is new to me, so please excuse any ignorance.

At the vet's the doctor gave me FortiFlora and gave me a prescription order for Bexacat. She also told me to bring in her overweight dry food in exchange for diabetic dry food. (Purina Pro Plan DM). However, when searching online it seems like the dry food and Bexacat may not be the best (or even good) options. From what I've seen, the fancy feast classic pate would be a better alternative due to lower carbohydrates and wet food seems to do better with diabetic cats?

That, and from what I've read, Bexacat doesn't really treat for diabetes and just passes most of the excess glucose through urine. Though this would cause extreme stress on her kidneys, which worries me being she is 16. Also it seems you can't remission at all using it since you aren't helping the pancreas? (I'm not sure)

Any advice at all would be tremendous to me, I appreciate any input. I plan on returning her old diet food in tomorrow, and maybe drive the extra mile to petsmart to try the canned fancy feast if others recommend it. I know if I start insulin there's no more chance for the bexacat, but the symptoms seem terrible. She's very defensive and stressed and having someone nervously poke her with needles just terrifies me more. If anyone has any insight on choice I would love to hear it. Also if it helps, I'll be linking the bloodwork tests below. (I'm on mobile) They didn't update her age or weight but it's 16y old and 11 lbs. She is in her weight range and she's a small kitty. She hasn't really been eating at all so I really hope some new food will help her. The vet also gave her an appetite stimulate so hopefully that works once the sedation wears off. Thank you guys again.



Edit: I added the photos to the post below.
I want to include the vet also said her heart, kidneys, teeth and rest of the bloodwork/visit was good.

 

[Red & Rover (GA)]

Welcome, Ian.

Not a lot of cats on bexacat yet. You might start by reading this thread.
And also this one.

Tagging a couple of people for you
@Hercules
@Sienne and Gabby (GA)

Since testing glucose levels would be unpleasant for you, there is the FreeStyle Libra. It is a device that is stuck onto the cat's skin that measures glucose levels. It does have a tendency to fall off or stop working before the 14 days are up.

Quite a few of us were leery, scared, terrified about the poking at the start.

Any low carb food will do. Here is a link to a low carb chart. Low carb is considered to be under 10%.

• Cat Food - Nutritional Composition, data compiled by Dr. Lisa Pierson, DVM (2017)

Loads of scary pop ups with the links provided. (Flash drive out of date / Chrome out of date)
You can upload the images by drag and drop into the text box.

 

[Anon191]

Loads of scary pop ups with the links provided. (Flash drive out of date / Chrome out of date)
You can upload the images by drag and drop into the text box.

Thank you for the reply. I'm going to be reading through some more threads before bed tonight. I got to a PC but it seems I'm having trouble uploading it as an edit, so I went ahead and attached the images to this post.
GLU is 449 mg/dL last year bloodwork it was 183 mg/dL

 

[Sienne and Gabby (GA)]

Welcome, Ian!!

For members less familiar with the technical names and how your phobias are regarded most of the time in the literature, it involves blood/injury phobia and needles typically fall into that grouping. It's a good news/bad news situation. Providing you don't faint at the sight of blood (in which case there's a slightly different strategy), exposing yourself to what it is that you fear is the best way to overcome the fear. So, if you start handling syringes, lancets, etc, and move up to giving shots, you are very likely to overcome the fear of needles. Practicing on an orange or other piece of fruit rather than practicing on Sophie may be advisable. You can also watch videos of both injections and blood that may help.

Using a Freestyle Libre, which is one of the more readily available continuous glucose monitors (CGMs), is a good alternative. You have to replace the sensor every two weeks. The sensors sometimes don't last the 2 weeks and the set up is more expensive than a traditional glucometer. However, there are any number of members who have started out with a Libre and eventually switch over to a glucometer.

Fancy Feast and Friskies pate style food are popular choices here as they are not overly pricey and are low in carbs. You want to find foods that are under 10% carb although, most members pick foods that are in the 5% range. The list of foods that Red linked has the percent of carbs listed. You have lots of options!! And, you are correct. There are only a scant few dry foods that are low in carbs. In addition, as you correctly noted, canned foods are better for your cat. Dry food is typically very high in carbs and cats are obligate carnivores. They can't process carbs. In addition, cats don't have a huge thirst drive. Canned food is much higher in moisture content and as a result, is much better for overall health and especially for kidney health.

As best I can tell from the labs, there's nothing concerning in Sophie's bloodwork. I'm also tagging another member who can take a look. @Suzanne & Darcy

As far as options for Bexacat vs insulin, there is obviously much more information about treating feline diabetes with insulin. Bexacat is relatively new. The American Animal Hospital Assn guidelines recommend either Lantus (glargine) or Prozinc for the treatment of feline diabetes. However, Bexacat was released after the publication of their guidelines. You are also correct that some cats are able to go into remission when treated with insulin. Just be aware that not every cat is able to go into remission. Insulin treatment doesn't guarantee remission.

Please let us know how we can help. The members here are very generous with their time and knowledge.

 

[Ale & Bobo & Minnie (GA)]

What you’re describing with the back legs is called neuropathy which is a common side effect of unregulated diabetes. My Minnie had it so severe she couldn’t jump anymore. The good news is that they recover after being regulated. Minnie recovered about 90%.

 

[tiffmaxee]

Welcome. You have come to the right place. To add to what others have said diabetic dry food is quite high in carbs and expensive. Will your cat eat wet food? I’d get a few cans of fancy feast pates as many like them.

 

[Ale & Bobo & Minnie (GA)]

Unfortunately most vets do not know a lot about feline diabetes….they have many animals to look after and they all have different diseases and treatments. Vets also get their information about nutrition from the big cat food manufacturers so they are biased in what they recommend. A dry high carb diet is not good for any cat, especially a diabetic cat. That’s like feeding your diabetic child a diet of chips, ice cream and sweets.

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!

 

[Jason - Kona's Dad]

Hey Ian,

You probably already found this, but I thought it was a good informative talk on Bexacat.

 

[Anon191]

Thank you everyone for the replies, it means so much to me. Wanted to follow with an update.

This morning I went back to the vet's office and talked with her again, and we decided to go with the Purina pro plan diabetic management (wet food). She mentioned she has a veterinary forum she goes to that highly recommends it, with lots of proven results with it. And from I can tell from the chart, its low carb and pretty high in protein so it should be a good choice for her. I left it out for two hours and she's at least been nibbling/licking on it which is an improvement. I've tried two other wet food brands and she wouldn't even touch it. I'll bring out another can tonight to help keep her going, she ate about 1/3 of the first one. The vet still recommended Bexacat just to start, as we want Sophie to be as stress free around feeding time as possible. Though if she starts getting bad symptoms with it I'm going to go back and swap it for insulin treatment.

As for insulin, I've seen some people mention that Vetsulin isn't the best option and that Lantus is a better alternative. Is it better just for cost or performance?

The vet is going to call me back on Monday to see how's she is doing with the food. Though I'm positive she has neuropathy pretty bad as she won't want to leave my bedroom or climb on her cat tree (its not even jump distance) so I may see if there is something I can do to ease her pains.

Thanks again everyone I've learnt a lot in the last 24 hours. I feel bad for feeding her the overweight management dry food for so long, I should of swapped to wet food years ago.

 

[Red & Rover (GA)]

A word of warning: many cats go off the prescription diabetic wet food quite quickly.

Methylcobalamin B12 (not the cyancobalamin B12) can help with the neuropathy over time. Most of the methylcobalamin found in drug stores and health food stores contains sugar. Zobaline and Vitacost are two that do not.
Tagging @Diane Tyler's Mom for ordering details.

I hope we are not overwhelming you with information. Feline diabetes treatment is a steep learning curve but becomes second nature quite quickly.

 

[Anon191]

A word of warning: many cats go off the prescription diabetic wet food quite quickly.

Methylcobalamin B12 (not the cyancobalamin B12) can help with the neuropathy over time. Most of the methylcobalamin found in drug stores and health food stores contains sugar. Zobaline and Vitacost are two that do not.
Tagging @Diane Tyler's Mom for ordering details.

I hope we are not overwhelming you with information. Feline diabetes treatment is a steep learning curve but becomes second nature quite quickly.

When you say "go off" do you mean they reject the food after awhile or the vet takes them off of it? Just asking for clarity. Ill keep wet food brands in mind from the chart if either happens.

I saw Zobaline on amazon, I imagine that would be safe to order? There is no added sugers in the ingredients. 3mg methylcobalamin and 200mcg of folic acid.

Lastly it is a lot of information fast but I'd much rather have it and be able to act quickly if it helps her out.

 

[tiffmaxee]

Vetsulin is ok but not even the best choice for dogs and not a recommended choice for cats ever. It’s too harsh. Lantus or Prozinc are fine. There are now biosimilar insulins to Lantus that are less expensive and work the same. Before that I bought from Canada. Let me see if I can find the research on Vetsulin . I will return.

https://www.aaha.org/aaha-guidelines/diabetes-management/diabetes-management-home/

 

[Ale & Bobo & Minnie (GA)]

It’s a short lasting insulin and it doesn’t last the full 12 hours as it was made for canines who have a much slower metabolism. Here are the guidelines from the American Animal Hospital Assn for the treatment of diabetes in both dogs and cats. the AAHA no longer recommends Caninsulin/Vetsulin for treating feline diabetes.

Vets also get their information about nutrition from the big cat food manufacturers so they are biased in what they recommend. They’re mainly just more expensive and lower quality foods. If you want good quality wet food I’d look at brands like Tiki, Rawz, Weruva and Ziwi Pak

 

[Red & Rover (GA)]

When you say "go off" do you mean they reject the food after awhile or the vet takes them off of it? Just asking for clarity. Ill keep wet food brands in mind from the chart if either happens.

The cat stops eating it.

 

[Diane Tyler's Mom GA]

I saw Zobaline on amazon, I imagine that would be safe to order? There is no added sugers in the ingredients. 3mg methylcobalamin and 200mcg of folic acid.

Hi
Tyler had neuropathy , Tyler was walking like a rabbit , his back legs , like flat footed
Until Sophie gets regulated the Methyl B-12 will help
I started giving it right away
It took about 2 months for Tyler to get back to walking normal, jumping on to the couch, running around like a but lol
But every few weeks I did see a slight improvement
The Zobaline is very expensive for what you get for 60 pills
Give me a minute and I'll post what I used , another member told me about this

The only difference is , is that the Zobaline has Folic Acid in it, 200 MCG so what I did I just went to my supermarket and picked up the folic acid , I could only find 400 MCG so I just cut them in half , ground them up and added it to the Methyl B-12
Some members didn't even add it to the Vitacost Brand and it still worked
Just add water to the wet food which you probably do already and just add the B-12 and folic acid and mix it up good. It's all tasteless
The 5000 ncg is fine too give, it's water soluble so they will pee out what they don't need


It's a capsule just open it and sprinkle it on the wet food food
Vitacost. 14.49 for 100 capsules
Just sprinkle it on the wet food always add water to the wet food
One per day
https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6

Tyler had neuropathy , I would say it took about 2 months for him to totally to start walking normal, jumping on to the couch and running.



You can start using the Methyl B-12 now
Some members use Zobaline its so expensive like 34.00 for 60 pills
I was using that in the beginning then a member here told me about the Vitacost brand so I switched to that. A lot of members use the Vitacost brand now

@Anon191

 

[Diane Tyler's Mom GA]

@Anon191
Do you live in the US
I would suggest Lantus over Vetsulin
Lantus is the major brand name glargine the USA you can get generic/biosimilar glargine at very reasonable prices using GoodRx coupon. Most members use the generic because Lantus is to expensive.
https://www.goodrx.com/lantus?label...d-pens-of-100-units-ml&quantity=1&slug=lantus
Make sure that the Match your prescription pull down menue says generic glargine 1carton of 5 3ml pens.
There is no wait time test, feed, give insulin
Lantus usually doesn't kick in until 2 hours after the shot
Let us know if the vet writes the script for you because you will need U-100 syringes with half unit markings , I can tell you which ones you can use
We buy the pens but use the syringes to draw out the insulin because if you use the pen you can only adjust by full units ,we adjust the doses by 0.25 units


Also
The 5 pens will last about a year, we use the pens just like a vial, you would just insert the syringe it the gray rubber stopper on the pen and draw out your insulin
Its generic lantus



Or this one also

I see some members will call CVS, Rite Aid, Costco, Walgreen's, to get the price for 5 pens
Posted by another member
One members posted this
. I paid $175 for a box of 5 pens at Walmart pharmacy, but GoodRX coupon says you can get it for around $90 if you have a Rite Aid pharmacy near you.

Just call around for the best price

A member just posted this
Allie was using the Lantus and I just switched to the generic and using the GoodRX I got 5 pens for $81.30 at Walgreens. GoodRX has a 1-800 number to assist you in using their services to get your pets prescriptions filled if the pharmacy gives you any issues.

I think I found it for you
GoodRx / Customer service

1 (855) 268-2822

You can read all about Lantus here, all the yellow stickys
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/
Just take the cap off the pen and use a U100 syringes and pull the insulin out of the pen! You will see a small gray rubber stopper, insert the syringe there

 

[Diane Tyler's Mom GA]

If you decide on using generic Lantus
if you have a Walmart by you , you can get these , then I'll give you another place to order them from
You can get the syringes with half unit markings at a Walmart. Their ReliOn Brand syringes of 0.3 cc (30 unit) capacity come with half unit markings. Cost $12.58 for a box of 100
This is what the packaging looks like: either box is fine
They won't say it half unit on the box but the are . open then and look before you leave the store, can't be ordered on line , need to go into the store
:

Or ADW diabetes call them and tell them what you want and they will contact your vet to fax over a script , ask your vet for refills so give your vet a heads up, either one of these are fine
https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct

https://www.adwdiabetes.com/product/5739/ulticare-u100-vet-rx-half-unit-syringes-31g-3-10cc-60ct

Here is a coupon if you get them from ADW diabetes

10% off your next order!

 

[Diane Tyler's Mom GA]

Most of us use the Relion human meter from Walmart
Here is the link for the meter and test strips so you don't have to search for them
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with
Here is a video one of our members made testing her kitty
She's using a pet meter that has to be coded ,with a human meter you don't have to code it.
So ignore that
I have always used a human meter
VIDEO: How to test your cat's blood sugar


Learn how YOUR kitty is responding to insulin:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose
• How to do a Curve - a simple explanation

 

[Diane Tyler's Mom GA]

Weruva Pates
They are low carb and low phosphorus which is good for kitties
You can probably pick up some of these in Pet smart ,or Petco so you can try them out to see if your kitty likes them

BFF play chicken Checkmate
Protein 31%
Carbs 5%
Phosphorus 133%

BFF play chicken & turkey topsy turvy
Protein 32%
Carbs 5.20%
Phosphorus 134%

BFF play chicken cherish
Protein 31%
Carbs 4.90%
Phosphorus 132%

BFF chicken & turkey tiptoe
Protein 31%
Carbs 5.10%
Phosphorus 133%

BFF chicken duck & turkey take a chance
Protein 32%
Carbs 5.20%
Phosphorus 152%

BFF play chicken & lamb laugh out loud
Protein 31%
Carbs 5%
Phosphorus 152%

BFF play chicken & duck destiny
Protein 32%
Carbs 5.10%
Phosphorus 163%

BFF play chicken & beef best buds
Protein 33%
Carbs 5.30%
Phosphorus 175%

Don't know if your kitty likes pate but here is the list of the BFF line.
YOU WANT CARBS UNDER 10% AND PHOSPHORUS IDEALLY LOW 200's OR LESS

Also

https://www.amazon.com/Weruva-Focus...cphy=9003521&hvtargid=pla-1796056536677&psc=1

I know you can buy single cans of the BFF I listed at Petco, Petco, to see which ones your kitty likes , the Focused one not to sure

With weruva foods
You want the metabolizable energy profile percentage of carbs to be less than 10%, and the phosphorus which Weruva lists in Minerals to be less than 250 mg per 100 cals. So you have to look at two different places in the Weruva charts.


You can even check out the soulistic pates
https://www.soulisticpet.com/pate
When you click on one of the flavors then click on
COMPLETE NUTRITIONAL INFORMATION (link to page)
and look at the same two places like on the weruva site

 

[Diane Tyler's Mom GA]

Red is right most cats stop eating the Purina Pro Plan DM Wet
Believe me there is nothing special about.

 

[Anon191]

I've came back from petco today with four different flavors of weruva, but sadly she isn't wanting to eat anything. Low growling at me when I try to offer her anything. The vet calls back tomorrow but I'm not really sure if there's anything left I can do for her. I just hope the vet has any last ideas. She is still drinking a lot of water.

 

[Ale & Bobo & Minnie (GA)]

Is she refusing all food? It’s important that she eats anything she’ll eat right now. Diabetic cats with no insulin and no food are at risk for ketones. I’d go to the pharmacy and get a bottle or ketones test strips and start testing her for it daily as it’s a life threatening disease. Did the vet test for it at your last visit? Is she acting nauseated? Like smelling or licking the food and not wanting to eat? You can also try an antinausea med so ask your vet tomorrow for a prescription for Cerenia and also ondansetron. They work differently but can be given in conjunction so it’s worth trying both.

have you tried things like tuna and baby food? Do you think you can syringe feed her?

 

[Anon191]

Is she refusing all food? It’s important that she eats anything she’ll eat right now. Diabetic cats with no insulin and no food are at risk for ketones. I’d go to the pharmacy and get a bottle or ketones test strips and start testing her for it daily as it’s a life threatening disease. Did the vet test for it at your last visit? Is she acting nauseated? Like smelling or licking the food and not wanting to eat? You can also try an antinausea med so ask your vet tomorrow for a prescription for Cerenia and also ondansetron. They work differently but can be given in conjunction so it’s worth trying both.

have you tried things like tuna and baby food? Do you think you can syringe feed her?

Yes she is rejecting all food.
I'm looking through the data sheets she gave me, the only thing I see that may be tested for ketone is labeled "Ket" and its under glucose level, and the ket result just says negative. So I'm not sure if that is it or not, I'll bring that up to her.

She isn't acting nauseated but she is having trouble walking and her tail is always down. She sniffed the chicken flavored once and licked it a few times then moved away. She wouldn't even try the others. I tried mixing her old food in it too.

I did get a tuna flavor one but not regular canned tuna. I don't have a syringe but if she doesn't eat by tomorrow morning I'll have to get one to feed her.

It's making me nervous, I'm wondering if she needs to stay at the vet to help get her under control...

Edit: I left her old food out and she nibbled a little bit of it but didnt eat more than a few pebbles (the dry pro plan overweight management)

 

[tiffmaxee]

When cats are nauseous they don’t necessarily vomit. Some just stop eating. My cat Max did that and it turned out he had chronic pancreatitis and needed medication for it including nausea medication pain medication and sub-q fluids. I’m not saying that’s what your cat has as there are other illnesses that make them nauseous. There is a blood test for pancreatitis that I see was not done. It’s called the SpecfPL. The tests look good.

 

[Ale & Bobo & Minnie (GA)]

Yes as Elise said it’s not always obvious and a nauseated cat wont necessarily vomits, that’s why I’d give one of the 2 meds I mentioned if not both to see if it makes a difference. Ondansetron always worked better for both my IBD cats.

smelling, licking, taking a few bites and not eating are all consistent signs of nausea btw. If you’re going to syringe feed, I suggest getting a few cans of AD recovery food. It’s more palatable and easiest to mix with water and syringe feed.

 

[Ale & Bobo & Minnie (GA)]

Also, vets love to say let’s try an apetite stimulant. It doesn’t work on a nauseated cat because a nauseated cat won’t eat no matter what. So please push for the anti nausea meds. Cerenia is a pet med and you have to get it from a vet but ondansetron is a human med so you can get it at any pharmacy if she gives you the rx you can get both tomorrow.

id try tuna it’s different than tuna flavored food. My cat would always at least drink all the water. Baby food also works sometimes. The protein from Gerber are fine. Any brand works as long as it’s has no seasonings like onion or garlic.

 

[tiffmaxee]

I too used ondansetron for nausea. Sone vets now have it but you can get it at any pharmacy with an RX.