New member - new to everything...

[AleksZ]

Hi everyone I'm Aleks

My kitty of 17 years has just been diagnosed, he was started on canisulin 3 weeks ago, but I'm not seeing any improvement so far, to be honest, he's still drinking a lot, now losing a bit of weight (around 200g in the last 2 weeks). I'm scheduled for another blood test to see how he's doing next Wednesday, but decided to bring this forward to this week (hope I'm not overreacting, as I know it's early).

Since his symptoms started he has not been sleeping with me, and I don't know if it's diabetes related or not. Has anyone had this? He comes to bed as normal but gets up and goes to sleep on the floor after around 15mins, he does this a few times throughout the night. Something seems to be not right here and I don't know what to do.

Also the vet hasn't said anything about the food we should give him, and so far everywhere I've read that he should've been prescribed low-carb food. Should I bring this up at the next appointment and mention home glucose testing - again, I had to find this out on here because the vet didn't tell me anything.

Looking forward to any advice, feeling overwhelmed right now

 

[Robo & B]

Hi Aleks welcome, your cat won't have become diabetic overnight making him better also won't happen overnight. It can take time to find the right dose to get blood sugars under control. This is a marathon not a race.

Caninsulin isn't the best insulin for cats it tends to hit hard and fast and not last for 12 hours. I think you are in the uk? Prozinc is a better insulin and is licensed for cats in the UK, lantus is also very good but your vet may not be willing to prescribe it. If you are seeing your vet this week ask for prozinc or lantus.

My cats main first symptom was heat intolerance. What you describe is exactly what he was doing- do you think he might be feeling too warm and that's why he's moving to the floor? It doesn't seem common but it is just what my cat was doing.

Food- it doesn't need to be prescription. Low carb wet (so under 10% carb) is what we recommend. Some of the purina gourmet varieties are ok carb wise, some aren't. Which ones are you feeding?

We absolutely recommend home testing, your vet may disagree and you can ignore them on this some vets are oddly against home testing. A human glucometer is best- the test strips are much cheaper than the animal glucometers and they work perfectly well for cats.

We all felt overwhelmed at the beginning it gets better I promise. I've tried not to make it any worse with too much info! Below is a link you can try and read though when you have time.

Sticky - New? How You Can Help Us Help You!

 

[CORKY]

Welcome to FDMB
Hi Alexs, I do not think there's not one person that has not become overwhelmed when we are told our precious fur ball is diagnosed with Feline Diabetes, but the great news is that is very manageable, with the correct diet, home testing and insulin, and lots of love Robo has giving you valuable information, and when you go the your Vet keep in mind, that know your cat better than him and you are in control, so ask questions let him know what you have read and learned from this Forum, this is a world wide forum, perhaps he might not be too familiar or updated on FD, which is not uncommon, Caninsulin is for dogs and as Robo said it hits very hard and fast on a cat and last less than 12 hours. So insist on Lantus or ProZinc is a 12 insulin. In our Main Forum you will find stick notes with much valuable information, perhaps you should read them before your vet. We are here for you to help you on this journey, you will do great

 

[Wendy&Neko]

Hello and welcome. If you are in the UK (or even Europe), here are couple posts that can help:

• UK Diabetic Cat Food Info (includes some supplies) and UK Cat Food List

You want to ideally feed food under 10% carbs. But if he's getting higher carb food now, it's best to learn how to home test before switching foods, as insulin doses can drop quite a bit.

You also don't need the vet's permission to home test and it's the best way to keep him safe. Some information and videos in this post: Hometesting Links and Tips. Cats often test higher at the vet due to stress.

 

[AleksZ]

Hi Aleks welcome, your cat won't have become diabetic overnight making him better also won't happen overnight. It can take time to find the right dose to get blood sugars under control. This is a marathon not a race.

Caninsulin isn't the best insulin for cats it tends to hit hard and fast and not last for 12 hours. I think you are in the uk? Prozinc is a better insulin and is licensed for cats in the UK, lantus is also very good but your vet may not be willing to prescribe it. If you are seeing your vet this week ask for prozinc or lantus.

My cats main first symptom was heat intolerance. What you describe is exactly what he was doing- do you think he might be feeling too warm and that's why he's moving to the floor? It doesn't seem common but it is just what my cat was doing.

Food- it doesn't need to be prescription. Low carb wet (so under 10% carb) is what we recommend. Some of the purina gourmet varieties are ok carb wise, some aren't. Which ones are you feeding?

We absolutely recommend home testing, your vet may disagree and you can ignore them on this some vets are oddly against home testing. A human glucometer is best- the test strips are much cheaper than the animal glucometers and they work perfectly well for cats.

We all felt overwhelmed at the beginning it gets better I promise. I've tried not to make it any worse with too much info! Below is a link you can try and read though when you have time.

Sticky - New? How You Can Help Us Help You!

Hi Robo,
Yes we are in the UK,

It's reassuring that your cat was doing the same thing because he was too hot. I think this might be the case with mine, did your cat eventually go back to sleeping normally?

I've ordered some cooling mats for now in case that helps a bit, these past few days he's been spending a bit more time on the bed so I'm hopeful.

He's been eating the purina gourmet perle sachets in gravy for many years now, although I acc can't find info on the carb %, so I'm thinking of maybe trying a different food to be safe.

I'm seeing the vet today so ill ask about other insulin opions.

Thank you for the lovely reply

 

[CORKY]

Hi Robo,
Yes we are in the UK,

It's reassuring that your cat was doing the same thing because he was too hot. I think this might be the case with mine, did your cat eventually go back to sleeping normally?

I've ordered some cooling mats for now in case that helps a bit, these past few days he's been spending a bit more time on the bed so I'm hopeful.

He's been eating the purina gourmet perle sachets in gravy for many years now, although I acc can't find info on the carb %, so I'm thinking of maybe trying a different food to be safe.

I'm seeing the vet today so ill ask about other insulin opions.

Thank you for the lovely reply

Apparently you are feeding High carb foods, all gravy cat foods are high, below is a cat carb calculator link, you will use the nutrients in the food, insert in the cells, the Dry Matter Carb, is what we look for. If you discuss diet with your vet, please do get sold "Prescribed" food, there is no such thing as prescribed food for a diabetic cat or human, they do not buy prescribed food, they watch their carb intake, for that matter, these foods have a very high content of carbs anything betwee17-25% carbs or higher, and diabetic cats cannot digest carbs, the best insulin for cats are Lantus and Prozinc, they are a 12 hour insulin
https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

 

[Robo & B]

There are so many different varieties of Purina gourmet perle! This specific one just meets the under the 10% carb requirement. I can check the one you're feeding if you can tell me exactly which one it is. Or look on the back and use the calc corky has linked. They never tell you the carb amount but it's easy to work out with the calculator.

 

[Robo & B]

Hi Robo,
Yes we are in the UK,

It's reassuring that your cat was doing the same thing because he was too hot. I think this might be the case with mine, did your cat eventually go back to sleeping normally?

I've ordered some cooling mats for now in case that helps a bit, these past few days he's been spending a bit more time on the bed so I'm hopeful.

He's been eating the purina gourmet perle sachets in gravy for many years now, although I acc can't find info on the carb %, so I'm thinking of maybe trying a different food to be safe.

I'm seeing the vet today so ill ask about other insulin opions.

Thank you for the lovely reply

I'm still early on in my diabetes journey, I've not got Bub well regulated yet unfortunately. But he is better than he was. He's managing a big cuddle for 20+minutes now then only needing about the same cool off time. Before he was barely sitting with me for a minute before having to get down.

Definitely ask about different insulin. Your cat will be much easier to regulate on an insulin that is suited to cats ( prozinc or lantus).

I would also get a glucometer ordered. We can guide you through the process with lots of hints and tips if you do struggle with testing.

 

[Robo & B]

Apparently you are feeding High carb foods, all gravy cat foods are high, below is a cat carb calculator link, you will use the nutrients in the food, insert in the cells, the Dry Matter Carb, is what we look for. If you discuss diet with your vet, please do get sold "Prescribed" food, there is no such thing as prescribed food for a diabetic cat or human, they do not buy prescribed food, they watch their carb intake, for that matter, these foods have a very high content of carbs anything betwee17-25% carbs or higher, and diabetic cats cannot digest carbs, the best insulin for cats are Lantus and Prozinc, they are a 12 hour insulin
https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

The gravy=high, jelly = low doesn't always seem to be the case here (UK). So best to check, which that calc you often link is great for

 

[CORKY]

I calculated the carbs for this food and remember what we need are the dry matter carbs this food contains 25% carbs, so we need to make a slow transition to 0-10% carbs, it is very important also to home test, especially before each shot, you want to know his glucose number to avoid hypoglycemia, which can lead to other complications, most members here use a human monitor, so no need to purchase an expensive Pet Meter tge strips are outrageously expensive, please let us know how your vets visit went

 

[Robo & B]

I calculated the carbs for this food and remember what we need are the dry matter carbs this food contains 25% carbs, so we need to make a slow transition to 0-10% carbs, it is very important also to home test, especially before each shot, you want to know his glucose number to avoid hypoglycemia, which can lead to other complications, most members here use a human monitor, so no need to purchase an expensive Pet Meter tge strips are outrageously expensive, please let us know how your vets visit went

I'm not sure which food you've analysed there corky?

Anyway here's the link for the calculator I was talking about Cat Food Nutrition Calculator | Elizabeth C Scheyder

 

[AleksZ]

There are so many different varieties of Purina gourmet perle! This specific one just meets the under the 10% carb requirement. I can check the one you're feeding if you can tell me exactly which one it is. Or look on the back and use the calc corky has linked. They never tell you the carb amount but it's easy to work out with the calculator.View attachment 75507

Yes I'm pretty sure it's the same food.

For reference this is the exact one we get:

 

[Robo & B]

Analysis:
Chef's Collection:
Moisture (80%), protein (13%), fat content (3%), crude ash (2.1%), crude fibers (0.05%).

%carbs by dry weight = 9.25
%cals from carbs = 8.36
% cals from fat = 32.91
% cals from protein= 58.73
Cals per 100g = 77.48

That one looks just ok. You can easily get better though, there are plenty of options under 5% you can get from zooplus but for now if your cats happy on that one it might be best to stick with it.

How did the vets go? Did they agree to a better insulin?

 

[CORKY]

To get the right carb % what we have to look for is the Dry Matter carbs not the Wet Matter carbs, make sure that is the correct calculation you are looking for!

 

[Wendy&Neko]

You don't have to use the Dry Matter Carbs 0- this post tells you more: Calculating % Calories from Carbohydrates

 

[CORKY]

Wow! I have been using the cat carb calculator with the same calculations of nutrients for 3 years And the first thing I was told was that we needed to look for the DMC, not the WCM

 

[AleksZ]

Been to the vet, they said to increase the dose by 0.5 units as his blood test showed no changes whatsoever ;( and call in two weeks to update on his behaviour. He was fine all day yesterday and at night, but today he seems very tired and uninterested in anything apart from lying down and getting his food. Is this normal after a dose change? I also ordered different food, a glucose meter and ketone test strips.

 

[Robo & B]

Been to the vet, they said to increase the dose by 0.5 units as his blood test showed no changes whatsoever ;( and call in two weeks to update on his behaviour. He was fine all day yesterday and at night, but today he seems very tired and uninterested in anything apart from lying down and getting his food. Is this normal after a dose change? I also ordered different food, a glucose meter and ketone test strips.

Fantastic work on ordering the supplies

It's really difficult to say without knowing how his insulin dose is affecting his blood sugar (why we need the glucose meter). When cats numbers have been high for a while them dropping lower can make them feel tired to begin with or the insulin dose could be dropping him too low and that's a symptom of a hypo or his numbers could still be high and thats why he doesn't feel good.

I take it your vet has refused to change to a better cat appropriate insulin? What's your cats current dose of caninsulin and how much does he weigh? Personally I would be most worried about hypos in your situation I wouldn't increase the dose at all until you have the glucometer. Also we only increase in 0.25Unit increments for safety. Long term high blood sugar does do damage but short term it's low blood sugar (hypo's) that are the real danger (you haven't mentioned DKA / ketones so I'm hoping they aren't present)

I'm going to tag a couple of more experienced members because lethargy is a symptom of hypoglycaemia and I'm worried I think someone more knowledgeable should plug in here

@Suzanne & Darcy
@Wendy&Neko
@Sienne and Gabby (GA)

 

[Robo & B]

if you haven't already please get this hypo kit together. Better to have it and not need it than need it and not have it!

Sticky - jojo and bunny's HYPO TOOL BOX

here's a link with symptoms
Sticky - How to treat HYPOS - THEY CAN KILL! Print this Out!!

also tagging @squeem3

 

[AleksZ]

Hi Rob,
Thanks for replying so quickly. The vet seems reluctant about insulin change for another 2 weeks.

Other than sleeping a lot, he is otherwise normal so I'm hoping it's not hypo as other symptoms are absent. His starting dose was 1.5 and now up to 2.0 (I'm assumin the vet went for this as his glucose is even higher now). The main concern was that he lost more weight so getting him to eat has been a priority. He now weighs 5.8kg (6.1 kg at diagnosis). I have made the spreadsheet with all the info now if anyone wants to have a look.

Also the glucose meter is only being delivered on Wednesday so I think I will amazon prime another one for tomorrow just in case.

 

[Robo & B]

We do have to work with the vets and what they are willing to prescribe, they can be difficult and not always up to date unfortunately.

Yes he definitely needs to eat. You are feeding before giving his insulin aren't you? Also you mentioned changing foods have you chosen one with a lower carb content ? Because it is probably best to not to change that yet until we can start testing his nadirs (the lowest blood sugar number his insulin takes him during the 12 hour dose cycle). Going too low can actually cause his numbers to then rise even further afterwards -we call it a bounce and it's a protective mechanism. But it's why one off high numbers without having other data don't mean a dose increase.

Your spreadsheet looks great

 

[AleksZ]

We do have to work with the vets and what they are willing to prescribe, they can be difficult and not always up to date unfortunately.

Yes he definitely needs to eat. You are feeding before giving his insulin aren't you? Also you mentioned changing foods have you chosen one with a lower carb content ? Because it is probably best to not to change that yet until we can start testing his nadirs (the lowest blood sugar number his insulin takes him during the 12 hour dose cycle). Going too low can actually cause his numbers to then rise even further afterwards -we call it a bounce and it's a protective mechanism. But it's why one off high numbers without having other data don't mean a dose increase.

Your spreadsheet looks great

Yes, I always wait until he's eaten at least 40% of the meal and then shoot, he's a grazer so he comes back for the rest within 15min. I ordered the purina pro plan for diabetic cats just to try but haven't given any yet as the advice is not to. Would it be safe to give him his original dose of 1.5 tonight instead of 2.0?

He's eaten his lunch as normal, and plenty treats.

 

[Robo & B]

here's the sticky for caninsulin
Sticky - BEGINNER'S GUIDE TO CANINSULIN/VETSULIN

I'm copying this bit as you need to feed first then wait to shoot the insulin
Because this insulin can drop BG quickly, it is important to feed your cat 20 - 30 minutes before giving insulin. This ensures there is food on board for when the insulin starts to work. So, the sequence would be: (1) Test BG. (2) Feed. (3) Wait 20 - 30 mins. (4) Give the insulin shot. (If you are not yet home testing it is still advisable to feed and then wait before giving the shot).

I really can't advise on dose I'm sorry. I'm hoping one of the members I've tagged will be along soon. How long do you have till you normally dose? You've ordered ketone test strips which is great did you vet test for ketones?

 

[AleksZ]

here's the sticky for caninsulin
Sticky - BEGINNER'S GUIDE TO CANINSULIN/VETSULIN

I'm copying this bit as you need to feed first then wait to shoot the insulin
Because this insulin can drop BG quickly, it is important to feed your cat 20 - 30 minutes before giving insulin. This ensures there is food on board for when the insulin starts to work. So, the sequence would be: (1) Test BG. (2) Feed. (3) Wait 20 - 30 mins. (4) Give the insulin shot. (If you are not yet home testing it is still advisable to feed and then wait before giving the shot).

I really can't advise on dose I'm sorry. I'm hoping one of the members I've tagged will be along soon. How long do you have till you normally dose? You've ordered ketone test strips which is great did you vet test for ketones?

Should be getting his shot at 7pm so still a few hours. Vet didn't test for ketones. Ordered another glucose meter to be here tomorrow morning so will start home
testing asap. Also kitty seems a bit better, hes been walking about and went outside twice so seems to be slowly going back to normal. I'm still watching like a hawk though

 

[Robo & B]

Ok so that sounds like the insulin wearing off. That doesn't necessarily mean he was too low as when a cat has been high for a while even lower but still high/ok numbers can make them feel tired.

The other consideration (which is why I'm not just saying to reduce the dose) is ketones. Here's another link
Ketones, Ketoacidosis, and Diabetic Cats: A Primer on Ketones
sorry I know I'm firing a massive amount of information to you at the moment. The lethargy that you described can also be a sign of ketones, and since they've not been tested for yet we just don't know if any are present. Reducing insulin if there are ketones can be dangerous.

If we go just by timeline of symptoms it sounds like the tiredness was due to the insulin lowering blood sugar but I'm way too new to this to be comfortable telling you what to dose. You have a few hours till dose time hopefully someone else will be along who's more able to advise.

 

[CORKY]

We do have to work with the vets and what they are willing to prescribe, they can be difficult and not always up to date unfortunately.

Yes he definitely needs to eat. You are feeding before giving his insulin aren't you? Also you mentioned changing foods have you chosen one with a lower carb content ? Because it is probably best to not to change that yet until we can start testing his nadirs (the lowest blood sugar number his insulin takes him during the 12 hour dose cycle). Going too low can actually cause his numbers to then rise even further afterwards -we call it a bounce and it's a protective mechanism. But it's why one off high numbers without having other data don't mean a dose increase.

Your spreadsheet looks great

No! Not necessary! He may be your vet, but we do not have to work with if we have a complete studied knowledge that he is incorrect, If your vet had knowledge about FD he has to know that Caninsulin is a DOG insulin it his hard and fast on a cat!, This Forum is world wide it has saved man cats lives including Corky’s keeping these high BLACK BG numbers you are risking more damage to his pancreas and that results in more complicated illness. You need to confront your vet, he needs either ProZinc or Lantus, also with the BG Numbers he has hypoglycemia is far from happening, if you can fill in your SS Would be great, all we see are two Black BGS, sometimes we need to take control of the care of our cats, you know your cat better than your vet, you want what’s best for him, by continuing to make unnecessary vet visits over it stresses him a lot, and when tge vet tests him he will have a high BG, tge pro plan diabetic food is way too high on carbs, and expensive, and there’s nothing in it for a diabetic cats, humans when they are diabetic they do not eat Fl”food for diabetics” they just eat low carb foods, you are working so hard and you are doing great, but trust this forum the members here are very well updated on FD, they know at times more than vets, you want to regulate him and we know you can, give this Forums advice a chance, I have trusted these members blindly, Corky has not been to a diabetic related visit to the vet once he was release from the hospital, please feel free to review his SS, he’s doing incredible

 

[Wendy&Neko]

Have you been giving the same dose in the PM? Right now the spreadsheet shows blank in the U(nits) column after PMPS.

 

[AleksZ]

Hi guys,
So it's been a while, I have a bit of an update but also need more advice now.

I started home testing, with a lot of failed attempts to get enough blood from his ear onto the strip, I was able to get a pre-shot reading and a 6hr reading. I've been to the vets twice since posting, and at first, he increased the dose to 2.0, which got some good results in terms of my cat's behaviour; it was genuinely looking good for like 2 weeks.

Then it just went back to the way it was. Went to the vet again, and they didn't do anything, no dose adjustment, no blood test, no advice or plan, nothing. And I got the impression that they don't really want to do anything because he's old, I'm constantly having to find out about things from the internet, like how canninsulin shouldn't be used, home testing, ketone testing etc.

I'm really disappointed about their attitude and lack of advice or just general info!!!

I've contacted another practice to get a second opinion and to get a prescription for Prozinc.

Maniek is very uncooperative with his home testing, so I will need the help of another person to do a full glucose curve at home, hopefully this week.

We have tried a few brands of food with much lower carb content, and so far he will only eat Sheba fine flakes in jelly, and Untamed (gravy variety). He has lost a bit more weight but it's become more stable with higher protein food and im happy that he actually finishes his meals so for now we will stick with sheba and Untamed.

But I just need some advice, did anyone have this experience with their vets and were you able to stabilise your cats in the end?

Thanks for all the info so far, and just actually being responsive and giving advice.

 

[Robo & B]

Hi again Aleks. I think a new vet and better insulin is a good choice. A lot of people here will be able to tell you similar stories about struggling with vets lack of knowledge in the area of feline diabetes. Unfortunately it isn't something they receive much training on.

I'm glad you've managed to stabalize his weight that's a big positive

I'm going to copy in a guide for ear testing as you've said he's difficult and you're struggling with it. You can also warm the ear before hand which really helps (rice in a knotted sock microwaved for 30 seconds). Are you using the clicky device or going freehand?

1.) Go in at a 45 degree angle. The lancet device doesn't allow you to do this; you don't want to go through the ear (which is possible with the lancet device, not possible for most cats with most lancets at 45 degrees, increases the effective thickness of the ear by about 41%).

2.) Make sure you're going near the sweet spot; pain nerves are minimal and there are lots of blood vessels.

4.) Use a flashlight to see where the vein is. Always go near the outer edge past the vein.

5.) I test sam with him against a wall, that way I can push him gently down with a bit of force and he can't move (he could, he just doesn't, something about being on a carpet up against a wall calms him down).

If it's taking several minutes to stop the bleeding and you have bruising then you're probably going right into the vein. Take a flashlight, shine it from behind your cats ear. You'll be able to see the main vein that goes around the edge of the ear (and to the left or right of the vein, whichever way brings you closer to the edge of the ear) is where you want to poke.

If you use a flashlight you will see something like this. The big red vein going all the way around the ear is likely where you're poking, that might be why it's bleeding so much.

 

[AleksZ]

Hi again Aleks. I think a new vet and better insulin is a good choice. A lot of people here will be able to tell you similar stories about struggling with vets lack of knowledge in the area of feline diabetes. Unfortunately it isn't something they receive much training on.

I'm glad you've managed to stabalize his weight that's a big positive

I'm going to copy in a guide for ear testing as you've said he's difficult and you're struggling with it. You can also warm the ear before hand which really helps (rice in a knotted sock microwaved for 30 seconds). Are you using the clicky device or going freehand?

Hi Robo

I've been using the clicky device, but I've had to poke one ear 5 times to get enough blood, so I will attempt to go freehand and with a rice bag. Thank you for the guide, I didn't even think of using a flashlight!

Hope I will get booked in with another vet soon and he actually listens.

Will update

 

[Wendy&Neko]

We have lots of tips and videos on home testing in this post: Hometesting Links and Tips A few things are key, warming the ear as the above poster says is important. As is starting out with a larger gauge lancet, around 26 gauge to start. You can get smaller lancets (higher number) once his ears learn to bleed. My girl had black ears and blood tended to disappear in her fur. A very tiny smear of Vaseline on the ear where I poked helped the blood bead up and give me enough to test with.

Regarding vets, it is not uncommon for people to have to shop around for a vet they can work with. So much so that we created this post: Vet Interview/Screening Topics & Check List. I found my vet hard to reach when I needed help with dosing, so ended up depending on the dosing methods and people on FDMB.

 

[squeem3]

You may want to look into this device to help with ear testing: illumavein home - product for diabetic felines and canines

The lancet device has to be pressed firmly against the ear. Holding the rice sock under the ear provides a firm surface to poke against. The above device will also work if you prefer something solid to prevent finger sticks.

If the lancet device has depth settings, try each one.