New member:Need help my vet isn't giving.

[Donna McCord]

My 9 year old kitty, Remington, was diagnosed 6 months ago. It took 2 months for the vet to finally decide insulin wasn't working because Remy must have a growth on his Pituitary gland. So we started him on Caburgaline as well. Now, after over 6 months, I had the vet check his blood sugar in the morning before meds and food. He was at 535! We started out over 6 months ago with levels over 600. Not much progress.
I feel like the vet is not handling t our kitty well. He never spoke of home testing. And we had to wait 2 weeks between medicine dosage changes, leaving me to wonder how much damage the diabetes was doing in the mean time. The vet never did a glucose curve and never kept him long enough to see how his glucose levels changed throughout a day. My husband has diabetes, but the vet said we really couldn't test our cat at home because it requires drawing blood. 3 weeks ago, my daughter tragically lost her cat to undiagnosed diabetes, even though her cat was seen each year by a vet. I don't want to lose Remy because we didn't step up and say "We need to do more!"
So I will be reading and learning. I took my first blood from Remy's ear tonight. It was 310 at 6:30 pm before dinner. We have been giving him 5.5 units of Caburgaline each day along with 14 units of ProZinc (using U40 syringes) twice a day with meals. He weighs 15 pounds.
That's another problem; we can't even find the canned wet Hill's diet w/d the vet prescribed for Remy. We can get dried, but everything I read says the poorest wet food is better than dried. I just need help! I will keep reading the suggested articles.I don't have a clue how to dose Remy when his blood sugar readings fluctuate.
I have 2 other 2 year old cats that are overweight. I need some help choosing nutritious food in correct amounts for them. They weigh about 18-20 pounds. Please help!

 

[Larry and Kitties]

Welcome. Yes, some vets do not know how to treat a diabetic cat well.

It took 2 months for the vet to finally decide insulin wasn't working because Remy must have a growth on his Pituitary gland.

That is called acromegaly. Did your vet do the IGF-1 test mthat in the USA is only performed by Michigan State University (MSU)? However, Idexx does have a test number for IGF-1 but Idexx just send s the blood to MSU.
Another condition is Insulin resistance and the test is for Insulin Autoantibody (IAA). MSU does that test too.

We have been giving him 5.5 units of Caburgaline each day along with 14 units of ProZinc (using U40 syringes) twice a day with meals.

THe correct name of the drug is cabergoline. THe typical dose is 10mcg/kg of body weight. How much does Remington weight and what is the concentration of cabergoline that you have? It should be written on the bottle. When you say you afe giving 5.5 units of cabergoline what syringes are you using? That information is need to determine the dose of cabergoline you are giving.

My current acromegaly cat, Snuffles, is getting 10 mcg/kg and that correlates to 0.25ml (25 units on a U100 syringe). He is on about 11 units of insulin twice a day too.
My previous acromegaly cat, MurrFee, was up to 50 units twice a day. This was before cabergoline more commonly used.

Regarding dose of insulin for Reminigton. I wouod do BG test aboutn 5-6 hours after shot. That time shoud be about the lowest BG if you have the dose in the ballpark. If if dose is way too little that BG would be higher that the one before shot.

For food I feed Friskies and the amount varies by the cats. Snuffles get 150g twice daily amony with 10 pcs of Dr Elsel low carb dry. To determine amount to feed just now reduce the amount and frequently weight the cat and adjust dose as necessary to get the cats to their desired weight.

 

[Larry and Kitties]

ALso, there is a seperate form for acromegaly and other conditions that require a high dose of insulin.
https://felinediabetes.com/FDMB/forums/acromegaly-iaa-cushings-cats.12/
At the top are topics that provide information on those conditions.
Many of us jere record or measured BG in a spreadsheet. The instructions are here:
HOW TO CREATE A SPREADSHEET
HOW TO USE THE SPREADSHEET

The usual procedure is to test BG before each shot and periodically between shots. This includes periodically measuring BG every 2 hours over a 12 hour cycle. That information is necessary for us here to give dosing instructions.

 

[Ale & Bobo & Minnie (GA)]

Any low carb food will do. Minnie ate fancy feast her whole life. No need for expensive prescription foods. That’s a myth

 

[Wendy&Neko]

Like Larry asked, did your vet run the test for IGF-1? If so, what was the resulting number? If not, we cannot say whether he has acromegaly and cabergoline may not be the right drug for him. As an aside, the pituitary tumour is called hypersomatotropism, but it causes the changes called acromegaly. We just call it acromegaly because it's so much easier to say and type!

That's another problem; we can't even find the canned wet Hill's diet w/d the vet prescribed for Remy.

That's excellent news, you don't want to feed w/d anyway. It's too high in carbs and not great food. There are lots of low carb foods out there, we want to feed something under 10% in carbs. Low carb foods will also help your "fatties" lose weight too. This link points to some food lists with carb% that may help: Links to Food Charts A lot of people feed Fancy Feast pate, though I never did. But don't change his diet until you have a better handle on blood testing. Congrats on that first test! More tips here to help you: Hometesting Links and Tips

And finally, a post we put together to help new people get set up here, including links to creating a spreadsheet we use to record the blood sugar data:
New? How You Can Help Us Help You!

 

[Sienne and Gabby (GA)]

The good news about changing over your cat's diet and not feeding W/D (aside from what Wendy noted about it being very high in carbohydrates which is the last thing a diabetic needs), is that all of your cats will benefit from being on a low carbohydrate, canned food diet. It would be like putting a human on keto. Cats are obligate carnivores. Their bodies cannot process carbohydrates. The carbs raise their blood glucose and can contribute to weight gain. Moving all of your cats to the same food will get them on a healthy diet and make your life easier since you can feed all of the kitties the same food!

This is a link to a website that's written by a vet who has a very active interest in feline nutrition.

I'm not sure how up to date your vet is with feline diabetes management. The one good thing he did was prescribe a good insulin for cats. Beyond that, not giving you information about home testing is questionable. Obviously, you and your husband know how important it is to monitor his blood glucose (BG). I strongly suspect that if your vet had an infant at home who was diagnosed with diabetes, they would be testing BG levels as a way to keep his child safe. It's the same for cats. The best way to know if numbers are dropping into a low range is to home test. The only way to know if it's safe to give an insulin injection is if you test before your shoot. You do not need a prescription to buy a glucometer and strips. If you want to buy a meter just for your cat, it's fine to use a human meter. Many folks here use a Walmart brand (Relion) meter since the strips are inexpensive. (If your husband had lots of extra strips, you can use one of his spare meters!) This is a link to materials on home testing. We are very strong advocates for home testing!! Larry provided links for our spreadsheet and Wendy's link to the Helping Us to Help You post has that information and a great deal more consolidated in one place.

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