New Member - Newly Diagnosed Cat

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RJ.

RJ.

Member Since 2020
Hello! My parent's cat Boots (10 years old) was recently diagnosed with diabetes and it's been kind of overwhelming. My parents had a habit of overfeeding him, and for a long time his weight was hovering around 19 lbs. At the end of last year, he started losing weight rapidly. At first it seemed like a good thing because I was trying to get them to regulate his diet more, stop feeding him cat treats by the handful, etc. But then he became underweight very quickly. While my parents were out of town a couple months ago, he threw up and then stopped eating all together.

At this point, I took it upon myself to start taking him to the vet. The vet did some tests on June 21st (unsure exactly what, the invoice says Comprehensive plus FreeT4ED) but determined that he was having a hyperglycemic episode and was diabetic. Vet recommended Hills m/d canned food and dry food, which I'm now reading isn't exactly the best food for a diabetic cat. She also started him on 3 units of ProZinc insulin. At this point, I believe she said his blood glucose was around 318? This was after several days of not being able to get him to eat normally. He was obviously very lethargic and wobby, no appetite, etc.

After starting him on the insulin he perked up rapidly. After about a week, he was eating again, although smaller amounts, on his own. The vet tested him again and his blood glucose was elevated at 336, so she said we would test again in another week.

On July 10th, we had another glucose curve and fructosamine test. At this point he is eating full meals on his own. His blood glucose was even higher at 420. The vet bumped him up to 4 units of ProZinc and said we needed to check back in a month.

Now he's been on the 4 units for a month, and his energy has seemed to improve quite a bit, his fur is softer, no more kitty dandruff, he's chasing the other cats around the house, and he's peeing a normal amount instead of the WATERFALLS of cat pee he had before the insulin started. He's back up to a normal weight (15 lbs... he's a very long cat). But his fructosamine results came back from yesterday at 511 umol/L?!

Now the vet would like to do a urine test for infections because his blood glucose doesn't seem to be well regulated and I'm kind of at a loss. It's really frustrating to see his mood and health seemingly improve, but his blood glucose seems so poor? He gets his ProZinc every 12 hours like he's supposed to without fail. Is it the food? I've had him on the same Hills m/d diet since he was started on insulin, which again, I've read isn't the best, but I would think that being on the same diet for a month and a half would keep his blood sugar around the same at least, even if elevated, instead of rapidly increasing it... Is there anything else I should have the vet test for that could cause this? I just got a home test kit for testing his blood glucose at home, so I'm going to try that tonight. WISH ME LUCK, and any suggestions would be MUCH appreciated.

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A starting dose of 3, followed by 4 units seems very high. Generally they start at around 1-1.5 units. Definitely do some searching on this forum on food advice, dosing advise, and just overall techniques to do home testing. It is very overwhelming at first, one major thing is the diet, m/d is still too high in carbs. Fancy Feast Classic pate is one of the lowest carb food. You want to stay under 10% (https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf)

My guy is around 14# and gets 2.75 cans of FF a day. Smaller meals throughout the day helps my guy. When they aren’t regulated, they will eat more. When I took him off dry food, his BG dropped around 100 points just with that food change. No more crunchy treats. He gets frozen chicken cubes or PureBites.
 
Thanks for your response. Yeah, I went with the Hill m/d because the vet recommended it and she said she had a cat with diabetes, so I assumed she knew what she was talking about. :( I'm in the middle of switching him to purely wet food. I just tried testing and it didn't go well. After poking him twice, I decided to let it be since he was getting stressed out. After I get more comfortable with testing I'll have to look into switching to a lower carb food. I want to make sure I'm comfortable being able to test before I lower his carbs.

I thought 3-4 units was high too! But his glucose still seems off the charts. Maybe completely getting him off the dry food will start to make a dent in his levels.
 
RJ. said:
Thanks for your response. Yeah, I went with the Hill m/d because the vet recommended it and she said she had a cat with diabetes, so I assumed she knew what she was talking about. :(
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The treatment of feline diabetes has changed a lot in recent years ... unfortunately most veterinarians are not up to date with it. It's extremely frustrating and so, so common.

RJ. said:
I just tried testing and it didn't go well. After poking him twice, I decided to let it be since he was getting stressed out.
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That is absolutely the right thing to do! Baby steps, and always reward with a treat, successful test or not. He'll start to see it as a good thing. :)

Okay, first off Boots is ADORABLE. Second, I want you to take those fructosamine tests and chuck them as far away as possible. Past diagnosis they're a waste of money. Especially now that you're going to be home testing. NoahFL has already touched on the food aspect, but on the subject of insulin dosage yes, 3 units is way too high to start. 0.5 to 1 unit is ideal starting, and then slow increases by 0.25 units, not full units. Cats are tiny things! They don't need much.

Some homework for you, if you'll take it. Start getting pre-shot tests - even if they aren't successful (it's a learning curve at first but quickly becomes second nature, trust me) and then get midday spot-checks. No more glucose curves at the vet needed. Vet visits = stress = elevated BG = incorrect assumption of needing more insulin = overdosing. You can peek at my spreadsheet below to see how we do testing - always a pre-shot, plus a couple during the day, more if possible (depends on your own schedule a lot). Once we have that information we can determine what's going wrong with Boots' numbers.

We would also really benefit from a filled out signature. This just tells us the basics - diagnose date, insulin type, etc. You can find the walkthrough here.
One last thing: a spreadsheet. This is a record of Boots' blood sugar numbers. By using this spreadsheet, we can find patterns in his numbers and determine if he is getting too much, too little, or just the right amount. It's a fructosamine in real-time, with day-to-day tracking instead of a mushed up number "average". Instructions are here but if you need assistance a mod is always happy to set one up for you. :)
 
RJ. said:
I just tried testing and it didn't go well. After poking him twice, I decided to let it be since he was getting stressed out.
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You'll get there!! The first week of trying to test is tough going, I remember it all too well (it was only about 6 weeks ago!) but now it is a normal part of our routine. It is so so worth it to test at home, so keep on powering through :) From my experience the majority of your first attempts you won't get any blood at all then the day you do get some blood it won't be enough and the reader will ERROR at you. Then finally you will get some blood and the meter will read it but the reading will be HIGH, but that's OK because you did it!!

You've got this!!
 
Hello RJ! Youve already been given good sound advice I just wanted to say welcome to the best site on this planet to learn everything there is to know about feline diabetes. Good working practical advice any FD parent needs to know.
Theres a wealth of information here with good people to help you decipher it all.

LOL BOOTS! What a scamp . Raiding the pantry! Hes adorable and VERY regal looking on the bed there . We look forward to helping you and Boots achieve the best Boots, Boots can be!;)
jeanne:coffee:
 
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I second every word Panic typed! So I’m not going to repeat it all. I’ll just add that it’s only 2 months so not that long and to get a diabetic cat regulated takes a while sometimes. As we all say here, feline diabetes is a marathon not a sprint. Be patient and you’ll get there. You’re already on the right path considering low carb food transition, home testing, etc. no need for the fructosamine test and you’ll be doing the curves at home soon. It’s a lot less stressful for your cat and you’ll get real numbers not elevated ones influenced by the stress of being at the vet. I did repeat some stuff even though I said I wouldn’t ha!

for testing, it takes time too and his ears will eventually “learn” to bleed as they grow more capilares. I just want to make sure, are you giving him a treat right after fail or not? Are you warming up the ear with a nuked sock filled with rice? Getting the ear warm to the touch is always key for me. If it’s not warm and I think oh it’s fine, it’s not and it’s the difference between getting a nice juicy droplet and barely enough to see with the naked eye!

what’s Boots weight now? Does he need to gain more back? A good rule of thumb is 20 times the ideal weight, which your vet should be able to give you, and that’s the daily calorie intake he should be getting. If he needs to gain, I’d add a bit more to whatever that number is. More smaller meals through the day are very helpful! Remember that diabetic cats can’t process the nutrients in food properly so they eat, but are always hungry and still lose weight. They also burn calories just by peeing since there’s sugar in their urine.

You could be on too high a dose and could have skipped right past the ideal dose by starting at 3, but we’ll know more once you start getting tests results in.

Welcome again!!! Boots is the cutest little guy! :bighug::bighug::bighug:
 
Thank you guys so much for all the tips. I'm slowly going through each of your posts and reading the material. During the week is rough because I work a lot, so I think I can test max, twice a day before each shot. The weekends I can do more.

The cat in my avatar is actually my female cat Ada! We have one ginger boy, my parent's cat Boots... One ginger girl, my cat Ada... and one chunky boy named Sammy. He was my grandma's cat, but she recently passed away, so we took him in.

I tried testing Boots again yesterday and ended up not getting enough blood for a valid result. HOWEVER! I was able to get a good test today on the first try. I tested him right before feeding/insulin and he was at 140 mg/dL, which seems good, right? I'm using a ReliOn Premier Classic. Should I be worried about it being calibrated correctly? 140 seems like a shockingly good number right before his dinner.

Since we have him on an all wet diet, I generally give him a few pieces of dry food after the ear test and a couple pieces after he gets his shot. He loves his dry food. Once we run out of the dry stuff, I think I'll look into getting him some lower carb treats. I know NoahFL said something about PureBites. I'm assuming maybe that's a good choice?

I think he's finally at his ideal weight. He's around 15.1 lbs. The vet seems to think this is a good weight for him. He's finally not boney anymore and he seems to get gaining some muscle back. He is ALWAYS HUNGRY THOUGH.

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Do what you can with your schedule - we have members here that work 12 hr shifts so you're not alone!

Yikes, a 140 pre-shot! Normally that'd be a really good thing but he's been untested on a high dose so that makes me nervous. The no-shoot number for new diabetics is 200 due to lack of data. I wonder if he'd be better off on a lower dose since you're just starting out (and CONGRATS on that first test!!). Let me ping some people who might be comfortable with a suggestion.

@Wendy&Neko
@Nan & Amber (GA)
@Deb and Ace (GA)
@JanetNJ

(I really need to make myself a cheat sheet so I can remember which one of you are comfortable suggesting doses for Prozinc!)

Yes, PureBites is a great choice! The chicken variety is a favorite. You can also buy frozen chicken and bake it to pull into treat-sized pieces. PureBites gets expensive after a while.

And that is one GOOD LOOKING family right there! :cat:
 
Hello and welcome!

You've gotten tons of good advice already, and congratulations on your first test! I agree with @Panic, the 140 is a great number, but concerning in this situation. Does he ever seem really hungry a few hours after his shot or act differently otherwise?

I am not a ProZinc person, but step 1 is just figuring out whether or not the dose is too high. On the next shot cycle, can you do both a pre-shot (post here before shooting if it's under 200 again) and then another test a few hours into the cycle to see what the insulin is doing?
 
I agree with Nan and Panic. A 140 at night would make me concerned. I’d give a token dose only especially if you’re going to sleep. If you get a number like that again, I suggest a token dose until you know better. It should be 10-20% of his regular dose. Unless you can stall for 20 minutes with no food and test again to see if numbers are going up. I could be wrong but my gut tells me he’s likely on too high a dose. See what a difference testing makes? You’d never know that otherwise!! Let us know what numbers you get today
 
Okay, update time!
  • Signature and spreadsheet are set up
  • We are getting some PureBites at the end of the week, so we can get him off the last bits of dry food
  • Still trying to decide on the best low carb food to switch him to. Not going to switch him until I can do another curve so I can monitor the switch
  • Going to try to get him back under 15 lbs. Today he weighed in at 15.8. I think his sweet spot is between 14-15 lbs
  • We are doing at home curve today! If anyone wants to keep tabs, I started testing at 8am and will do the last test at 8pm today (PST)
Thank you to everyone in this thread and Diane Tyler's Mom, Chris & China (GA), and jt and trouble (GA) in the other thread (unsure how to tag them on the forums). You guys have provided me with so many good links and tips.
 
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Can someone check on my spreadsheet? I just did the last test before his PMPS and his blood sugar is actually pretty low. What should I aim for his blood sugar to be when I dose him after PM feeding (what's the lowest his blood sugar can be for a full dose vs a token dose)? I'm starting to wonder if his glucose is just high at PMPS because he gets so excited for food.
 
Boots dropped into the low blues today, 8/16/20.
Token doses are 10-25% of the regular dose.
So 10% of 4U is 0.4U and 20% of 4U is 0.8U.
So a smidge below the 1U line on the syringe for the 0.8U dose.
A smidge below the 0.5U line on the syringe for the 0.4U dose.

Dose of 4U looks kind of high to me.
For now, go with one of the token doses listed above.
 
Is it best to give a token dose only if under 200 at PMPS or is it best to give a token dose if I'm seeing lots of blues through the day?

Also, should I post in the ProZinc part of the forum? Unsure where most of the ProZinc people watch for threads. :)
 
I'm not sure if Deb wanted you to stick with a token dose either way, she did say she suspected dose was too high (4 units is very high for a new diabetic). I might stick with a token dose she listed and see what happens, but that's just me.

You can post in the Prozinc forum if you like but it doesn't get as much traffic as here.
 
I ended up giving him one whole unit. Him getting down to 109 freaked me out a little, but I feel better dosing him at the actual line. I'll test him again in the morning and see where we're at. I also think 4 units is too high. Especially since this vet tried to get me to up him again to 5 units. I kind of wish I had kept him on 3 units long enough to do a home curve. :( I'm debating if I should bump him back down and try another curve next weekend.
 
That sounds like a safe bet to me.

Are you able to get any spot checks during the week? If you're getting in a couple tests during the day not including pre-shots you don't need to do all-day curves.
A good thing to start doing too is getting a +2 at night, it's usually indicative if he's going to be in safe numbers while you're asleep. Night-time snacks are important too. Most of us use autofeeders so we can get some sleep.
 
During the week, probably not. I leave immediately after his morning dose and don't get back until 2 hours before his next dose. I don't really live close enough to work to stop at home for lunch or anything. I can try doing the +2 after the night dose though.

I ordered an autofeeder this weekend that I hope works out. Kind of concerned how I'm going to split up his food. With the current stuff it looks like he's going to be at 1.5-2 cans of the 5.5 oz cans per day. Do I give him half a can at feeding/dosing time and split the other half into like 2 feedings through the next 12 hours? Is it more helpful to feed him closer to his low point, or just evenly space them out? The other two cats are 100% grazers, but Boots just seems to down any food placed in front of him.
 
That's understandable, do what your schedule allows. Just remember about those token doses if you ever get a lower pre-shot than you're used to and can't stay to monitor.

Which autofeeder did you get? Most of us use Petsafe 5 since it offers 4 scheduled feeding spots.
Giving half the can at feeding time and splitting the rest sounds like a good plan. We recommend most feedings in the first half of the cycle - so if Boots' low point is at +6, you want to offer the bulk of the food before then. So (as an example) you'd make sure he gets snacks at +2, +4, and +5. Something like that. We're not sure how the insulin works for him just yet though so it's hard to say when his low point is. But hopefully that makes sense.
 
RJ. said:
Is it best to give a token dose only if under 200 at PMPS or is it best to give a token dose if I'm seeing lots of blues through the day?
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Token dose is if your cat is below the BG level threshold you have set. In Feline Health (Welcome & Main) forum, that is 200 for most insulins. (NOT NPH type insulins)
Over in the Prozinc forum, the BG level threshold for decision making is 150 mg/dL.

I don't think you are ready for the Prozinc ISG forum just yet. You want to have more experience and testing under your belt before you start to post in one of the Insulin Support Groups (ISG's).

No harm in reading the stickies in the insulin specific forum for the insulin you are using though. In fact, there is a lot of good information in those stickies. Go ahead and read and maybe print out a copy or 2 of some of the stickies. So you have them to refer to if no one answers your question in a timely manner.

"Fur shots happen". We've all done them. Won't be the first time, nor the last. (Yes, we really do look at the SS and the notes in the Remarks column.)
Most of us have stuck ourselves accidentally with the lancet and or the insulin syringe too. :(

Is Boots losing weight still, gaining again, or at a steady weight? You might need to feed him more. Uncontrolled diabetics can need twice as much food as a normal cat would. Don't try to underfeed him, he needs the extra food right now.
 
He's had no problem gaining weight. In fact, I think he is probably too fat now. He's at 15.8 and I think he should probably be around 14.5 lbs. At this point it's a little difficult to feel his ribs. He's just always been really interested in food. I'm sure the diabetes makes it worse.
 
RJ. said:
He's had no problem gaining weight. In fact, I think he is probably too fat now. He's at 15.8 and I think he should probably be around 14.5 lbs. At this point it's a little difficult to feel his ribs. He's just always been really interested in food. I'm sure the diabetes makes it worse.
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Ya know? this is very interesting because Trouble never really lost weight. I dont know if its because we just happened to catch it early or what. But he was always extra "fluffy" and never showed the "signs" by weight loss.
j
 
At the end of last year, before his diagnosis, my parents put him on a diet because he was 19 lbs. Unfortunately, I don't think they did it gradually enough. At first he didn't lose any weight, and then all of a sudden he dropped a lot. He seemed to be gaining back a little bit and then he had that hyperglycemic episode and wouldn't eat anything. But after getting on the insulin, he's back to being his hungry self.

He's always been ravenous. My parents used to free feed him. He's not the kind of cat you can free feed. I free feed my female cat and she grazes when she's hungry and her weight never changes. Free feeding just made him super fat. I think at one point he was 21 lbs. He's pretty steadily gained weight since starting insulin. When he went in June to the vet, he was ~11.6 lbs? Now he's back up to 15.8 lbs as of last Sunday.
 
I bet hes a 14-15 lb kitty. The vet kept telling me Waldo (the handsome devil to my left) was obese. He weighed 12 lbs! I thought he was perfect. The Vet (not the same vet that Trouble had) kept telling me he would end up diabetic. I told the vet well that wont be a death sentence ... I've guided my Trouble into remission I can do it again. lol the vet was none too amused. AAAND of course he became Waldos EXvet!:p
 
Yeah, I think I agree. 14-15 lbs seems to be his sweet spot. It's impossible to tell with just weight. My female cat is 12 lbs. When I took her to the vet around 1 year of age, the vet thought she was a male cat. She's just a very long girl. You can really see the difference when they're next to my grandma's cat. He's a big chonk, but his bone structure is much smaller than Boots. Boots at 16 lbs and Sammy and 16 lbs are WORLDS apart in fat mass.
 
Were Boots/Waldo fixed as adults? I've heard that un-neutered males grow bigger than males fixed as kittens, and it's definitely true for my boys. My tomcat Fenton was neutered when he was around 2, and my mom's boy Socks was neutered at 6 months. I thought Socks was surely going to be as big as Fenton but he's nothing of the sort. He's tall but skinny, has a more "feminine" face. Fenton is a big muscley boy with a full face. When he was younger picking him up felt like he was made of solid muscle. :p It would make sense for un-neutered males to weigh more.
 
He definitely looks like it in the face! Big-looking fella :)
I know the next time I get myself a male kitten I'm going to wait until he's over a year old so he can fill out. We used to have stray toms around a lot (before the dogs started patrolling the property) and they were HUGE. Luckily Fenton was just as big and could hold his own, but I'd be afraid for Socks if they were still around. :nailbiting:
 
Panic said:
Were Boots/Waldo fixed as adults? I've heard that un-neutered males grow bigger than males fixed as kittens, and it's definitely true for my boys. My tomcat Fenton was neutered when he was around 2, and my mom's boy Socks was neutered at 6 months. I thought Socks was surely going to be as big as Fenton but he's nothing of the sort. He's tall but skinny, has a more "feminine" face. Fenton is a big muscley boy with a full face. When he was younger picking him up felt like he was made of solid muscle. :p It would make sense for un-neutered males to weigh more.
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Welll ? I ...uhhh...catnapped Waldo. He came from a dubious home (old owners of the house next door they raised pit bulls and...kittens :eek:) He was VERY small but I took him and had him "altered" THEN went to the owners and pleaded his case. He was over at my house everyday anyway. She just looked at us and said sure take him.:rolleyes: I wouldnt call him an adult. But he was cute as a button. lol
 
Panic said:
He definitely looks like it in the face! Big-looking fella :)
I know the next time I get myself a male kitten I'm going to wait until he's over a year old so he can fill out. We used to have stray toms around a lot (before the dogs started patrolling the property) and they were HUGE. Luckily Fenton was just as big and could hold his own, but I'd be afraid for Socks if they were still around. :nailbiting:
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I love myself a big boy. I've always wanted to get a maine coon or something massive, but we live in the desert (current heat wave 104-110 F), so unless we're gonna shave cats all summer, it's short hair all the way. :p
 
Here's a body condition chart.

The cat will be in the optimum 'shape range' at ideal weight. In addition to the visual check - some cats are literally fluffier than others - one should also feel the area around the ribcage. With very gentle fingertip pressure applied, one should just be able to feel the ribs under the skin.


Mogs
.
 
jt and trouble (GA) said:
wow i live

Wow I live in the desert too!:)
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OH WE'RE BOTH IN SO CAL! I'm in the High Desert, so everything is on fire right now. Woke up with ash on my car.


Critter Mom said:
Here's a body condition chart.

The cat will be in the optimum 'shape range' at ideal weight. In addition to the visual check - some cats are literally fluffier than others - one should also feel the area around the ribcage. With very gentle fingertip pressure applied, one should just be able to feel the ribs under the skin.


Mogs
.
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Thanks Mogs! This is the chart I have printed out now. I think I'm just passed being able to easily feel his ribs, so once he's back under 15 lbs I think he'll be good. :bighug:
 
RJ. said:
OH WE'RE BOTH IN SO CAL! I'm in the High Desert, so everything is on fire right now. Woke up with ash on my car.




Thanks Mogs! This is the chart I have printed out now. I think I'm just passed being able to easily feel his ribs, so once he's back under 15 lbs I think he'll be good. :bighug:
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I'm in Cathedral City right next to PS.
 
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