New Member Intro- Hello! Also some possibly odd things?

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Ally and Tiny

Ally and Tiny

Member Since 2020
Hey! I just found this site. This got really long so I bolded some important things/highlights in the background paragraphs. My cat Fat Boy/Tiny was diagnosed in July and it's been tough. Previously I would spend every other weekend an hour away at my boyfriend's place, but it's a lot harder finding a sitter who will come feed your cat and give him a shot twice a day at specific times! But, this cat is my everything and I'd give him my kidney if he needed one (and if that were possible).

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Some facts about him:
He is 12 years old and about 17.5 pounds (down 1 pound from July!). His favorite foods are hair ties and plastic. When I bake muffins, I have to leave them to cool on top of the fridge so he doesn't lick them. He's prone to crystals in his urine.

This summer I saw him laying down to drink from his water fountain, peeing so, so much, and being very lethargic. I thought it was weird and the internet said it probably was, so I found the closest vet and I took him in. His appetite didn't seem changed, and as far as I could tell he wasn't losing weight.

The vet did a blood test and his glucose was 583 so the conclusion was diabetes. The vet started me with
-new food (Hill's GlucoSupport m/d, which also has the urinary support he needs for the crystals)
-Novalin N NPH which is people insulin I got at Walmart
-U100 needles
-3 unit starting dose twice a day
-an appointment to come back in 2 weeks 5 hours after his morning shot

It took me a few days but I got the hang of it. He's on a diet now so he gets 2 small meals a day. I give him the shot when he's chowing down and he doesn't notice at all.

-At the vet two weeks later, his glucose was 350ish (going off of memory here).
-We upped it to 5. I started to see a change in him. There was definitely less drinking and peeing, but still more than you'd expect for a usual cat. He had some more energy.
-At the vet two weeks later, his glucose was 220ish. The vet said that's pretty good considering the stress of the vet's office, and said to bump to 7 to see if we could get it closer to 200.
-I didn't really see a change in him, and two weeks later he was up around 300 again! I am greatly confused by this.
-Went up to 9, and then two weeks after that I left him with the vet to do a glucose curve. She said he started in the mid 500s before the shot (9am), swung down to mid 300s or so, and by the time I picked him up around 5 he was back up to where he started. She suggested we go to 12.
-Two weeks after that, the vet measured his glucose at 120! Which is good I'm pretty sure! We're keeping the does at 12 units twice a day and she said to come back in a month.

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I don't remember exactly when, but at some point he started to have trouble using his litterbox. He'd stand in the box, but I guess he hasn't been tucking his bum in right becomes sometimes his pee will just land completely outside the box. Not a cool thing to see in a cat with a condition that makes them pee more. I don't know if that's related somehow or possibly just evidence he's getting old :( Also, in the days leading up to the glucose curve day, my poor guy got an upper respiratory infection and was absolutely not feeling good. The vet prescribed antibiotics, and pretty soon he was the annoying, loud love machine I remember from pre-diabetes.

But in the past few days, the lethargy has come back. Not terribly, but he's not the guy I know. Usually he comes and checks in on me every few hours or stares at me from across the room, but it's been long naps all day. He's still eating, but he doesn't finish his food. He's been laying down and drinking what seems like a ton, but there's been less urine than I'd expect (maybe?), and he often smacks his lips as if his mouth were dry. He's usually very talkative and makes a lot of sounds if you touch him or talk to him, but he's been quiet. I really have no clue what is going on here. He's supposed to go to the vet next week, but I'm considering moving it up. Does anyone have an idea on what's happening here? It is 100% possible I'm blowing this out of proportion since he's still eating, drinking, and he's responsive when I interact with him. But after spending 4 years obsessed with the guy and the past 8 months working from home and spending all day with him, I notice literally any slight change with him.

P.S. From looking around here, I sense that I should be testing his glucose at home. I'm sure there's a thread I can look at to figure that out. It might help solve some mysteries for me here but it is a little scary :)!!

Anyway thank you!!! Sorry for the sheer volume of text!!!
 
Whew, lots to comment on. But first, welcome here. It's the best place you never wanted to be. :bighug:

Let's start with that home testing link (blue texts are links): Hometesting Links and Tips
And next, because he's on a HUGE dose for cat:
OK, from the top. Our formula for treating diabetic cats is a low carb wet or raw food diet, an insulin that's a good one for cats, and home testing his blood sugars to keep him safe. Because of the dose he's on, I'd run out and get a human blood glucose meter and strips first. Depending on the country you are in, we can suggest some good options there. The size of blood drop needed and costs of test strips are two key considerations. Also make sure you have higher carb food, honey or syrup around.

Don't change anything else until you can start home testing. The next things we'll work on are better insulin (and dosing) and food. With a cat and crystals, a low carb wet or raw food diet with water added will also help with crystals. My other kitty was a crystal kitty when my girl Neko was diagnosed, so I had to find a food that worked for both, and in my case, raw food did the trick. Don't change food until you are home testing. Reducing carbs in his diet can greatly reduce the amount of insulin needed. I suspect it's the food that's help keeping him safe.

As for insulin, Lantus, Levemir, or Prozinc are all much better insulins for cats. Novolin is good for dogs. Cats aren't like dogs when it comes to diabetes either.
 
I love your description of you me sweet boy!! He sounds like such a joy to have around, and I can tell you really love him!!

I’m a newbie here, and I don’t have the best in depth advice, but I will say that once I started home testing my cat Lulu, it was a game changer. I came to realize that I was probably over dosing and she might have been going hypo. She was acting very sluggish and didn’t want to be around my boyfriend and I anymore. She would eat, but most of her time was spent under the bed.

I think home testing should definitely be your first step. Like I said, I don’t know much, but I know I saved my cat’s life by doing it!
 
Wendy&Neko said:
Depending on the country you are in, we can suggest some good options there. The size of blood drop needed and costs of test strips are two key considerations. Also make sure you have higher carb food, honey or syrup around.

Don't change anything else until you can start home testing. The next things we'll work on are better insulin (and dosing) and food. With a cat and crystals, a low carb wet or raw food diet with water added will also help with crystals. My other kitty was a crystal kitty when my girl Neko was diagnosed, so I had to find a food that worked for both, and in my case, raw food did the trick. Don't change food until you are home testing. Reducing carbs in his diet can greatly reduce the amount of insulin needed. I suspect it's the food that's help keeping him safe.

As for insulin, Lantus, Levemir, or Prozinc are all much better insulins for cats. Novolin is good for dogs. Cats aren't like dogs when it comes to diabetes either.
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Thanks for the response! I am in the united states (nebraska specifically). I was going to head to walmart tomorrow for some new needles so it'd be a perfect time to pick something up! As for the insulin, what would be the best way to bring that up to my vet? Just tell her I read online that other types of insulin work better for cats and get her thoughts on that?

Sammijoenglish said:
I love your description of you me sweet boy!! He sounds like such a joy to have around, and I can tell you really love him!!

I’m a newbie here, and I don’t have the best in depth advice, but I will say that once I started home testing my cat Lulu, it was a game changer. I came to realize that I was probably over dosing and she might have been going hypo. She was acting very sluggish and didn’t want to be around my boyfriend and I anymore. She would eat, but most of her time was spent under the bed.

I think home testing should definitely be your first step. Like I said, I don’t know much, but I know I saved my cat’s life by doing it!
Click to expand...

I'm so glad you figured it out! It sounds like that could definitely be the problem, but it is a little weird that I've been giving him this dose for 4 weeks now and it's only been the last few days it's been an issue! What a wild ride this is
 
Ally and Tiny said:
As for the insulin, what would be the best way to bring that up to my vet? Just tell her I read online that other types of insulin work better for cats and get her thoughts on that?
Click to expand...

Might tell her you found this online and were wondering if you could use either Lantus or ProZinc instead

2018 AAHA Guidelines on Diabetes Management

Specific page on cat insulin therapy

Or you can call around and find a new vet. Lots of us have had to do that too. I called several and asked lots of questions to find out what kind of food they recommend, what's their "go to" insulin, etc. Here are some more Vet Interview topics
 
Hi Ally,

The lethargy is a very concerning clinical sign, especially appearing alongside the nausea (see below). I think you're right to bring the vet visit forward. I think it would be wise to get Tiny to a vet today. As a matter of urgency can you ask the vet to check Fat Boy/Tiny's negative for ketones. (Note: You can also test for ketones at home using human urine ketone strips, available at Walmart or any pharmacy.)

Ally and Tiny said:
he often smacks his lips as if his mouth were dry.
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Common symptom of cat nausea. Symptoms are treatable with ondansetron or Cerenia but the cause of the nausea also needs to be determined and treated. Common causes of nausea in diabetic cats include constipation (needs to be tackled first if present because other meds to help with difficulty eating won't work until it's sorted), pancreatitis (acute or chronic), and ketone production /
possible diabetic ketoacidosis.

A ketone level higher than 'trace' is a medical emergency and veterinary intervention should be sought immediately as it can quickly develop into diabetic ketoacidosis (a treatable but life threatening complication of diabetes). The best way to protect against DKA is to monitor for urine or blood ketones daily for not yet regulated cats.

Another thing to consider would be whether Tiny might be on the wrong dose of insulin. (Note that both too little and too much insulin may lead to a cat spending a significant number of hours each day in very high numbers, in the latter case due to the body's protective mechanisms dumping extra sugar into the bloodstream to protect the cat.) A dose of 12IU BID is a big dose for a cat. There are some diabetics who have what we call 'high dose' conditions but the majority of cats typically only need 3 units BID or less. Of concern are the very large jumps in dose made by your vet as doing so makes it much easier to skip over the optimum dose needed by the cat.)

Ally and Tiny said:
drinking what seems like a ton, but there's been less urine than I'd expect
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Any chance he could be urinating anywhere other than the litter box?

Ally and Tiny said:
She said he started in the mid 500s before the shot (9am), swung down to mid 300s or so, and by the time I picked him up around 5 he was back up to where he started. She suggested we go to 12.
Click to expand...
A bucket-shaped curve like that is very typical of Novolin. It just doesn't have sufficient duration in cats. Throwing progressively larger doses at the problem won't change that: it's a characteristic of the insulin itself. Aggressively increasing the dose instead increases the risk of hypoglycaemia during the hours when the insulin is working at its strongest (typically 1st half of each 12-hour cycle, especially anywhere between +1.5 and +5 hours after the dose was administered). Talking of which...

Two weeks after that, the vet measured his glucose at 120! Which is good I'm pretty sure!
Click to expand...
There is a possibility that that reading could have been temporarily elevated by travel/vet stress. There is the possibility that Tiny could be going lower than that at home, especially on such a high dose of insulin. Learning to home test is the only way to get past speculation and on to what's really happening with Tiny's BG levels, and it's the best thing you can do to keep him safe on insulin. Here's a very helpful resource from our FAQs:

Home Testing Links and Tips

Ally and Tiny said:
I don't remember exactly when, but at some point he started to have trouble using his litterbox. He'd stand in the box, but I guess he hasn't been tucking his bum in right becomes sometimes his pee will just land completely outside the box.
Click to expand...
Unregulated diabetes can affect the nervous system (neuropathy). This may sometimes manifest itself in cats walking slightly flat-footed or on their hocks, experiencing urinary incontinence, or sometimes not being able to squat properly in the litter box. If you've not already done so, it might help to put some pee pads on the floor around the litter box to catch any accidents. Note: This is just one possible reason why the overshoots are happening. It's important to let your vet know about unusual signs and behaviours such as this.

For general info, better BG regulation and treatment with B12 methylcobalamin can help reverse neuropathy issues.

Sorry this reply is a bit disjointed. It's the middle of the night in the UK.


Mogs
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Hi Ally and extra sweet Tiny. You've already been give excellent informational help. I'd like to add that testing your Tiny's blood sugars is the most important tool, in the management of Tiny's diabetes. Its going to give you the power you've missed since his DX.
Once you do get all your "supplies" you're going to need one of these:
FDMB SPREADSHEET INSTRUCTIONS

The only thing I have left to say is
WELCOME TO OUR FAMILY:bighug:
You will be quick to learn how important that is. We look forward to getting to know you both.
This is the best site, to learn everything you need to know, about feline diabetes and beyond.;)
jeanne:coffee:
 
Well, I went out and bought some supplies for home testing and it didn't go very well :(. I couldn't get a big enough drop of blood to form and eventually he stopped letting me near his ears. The small amount I managed to get wasn't enough for a reading. How many times a day should I take readings? Won't his little ears end up full of holes? I also got some ketone test strips so lets all pray that goes better
 
Dont worry about the ears they WILL heal, I know the gauge size of your lancet makes all the different to a newly DX'd kitty I think the higher number of the gauge the thinner the lancet. I could be wrong it may be the opposite. Someone here WILL correct me.
You may try here to see if theres anything different you are going.:
Hometesting Links and Tips.

Good luck please keep checking back for that correction. ;)
 
I think finding a good way to get the blood flowing in his ears will help as well. He is the squirmiest dude alive, so it's hard to grab onto him for long. Like with his shots, he doesn't seem to mind the poke, he just doesn't like me manhandling him haha. I called the vet and she's going to squeeze me in this afternoon! Here's hoping she doesn't need to do a urine test since he always pees in the car on the way over :facepalm: I'm going to ask her about different kinds of insulin.

PS I checked my own blood glucose so I could make sure I knew how to use the meter and I am solidly in the normal range ;)
 
I just got back from the vet. She said she can hear wheezing in his throat, and thinks his upper respiratory infection has come back. That would explain a few of the things up with him, such as the sluggishness and reduced-but-not-gone appetite (which he had a couple months ago with his last URI). She also gave me some B12 supplement stuff for his litter box thing. I asked her about switching to a different kind of insulin and she said that’s a good next step. I forgot to ask the name but she says it’s made for cats. She’s going to order it for me and we’re going to discuss doses after it comes in.

I’ll keep trying the at home glucose monitoring thing. As we start trying this new insulin, I’ll be sure to keep careful track and push back with her if she tries to raise the dose too quick. I tend to track his progress by how annoying he is (the more annoying he is, the better he feels), and I hope really soon he’s back to screaming at me at 5 in the morning :)
 
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