New member; sick cat

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ler

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My 17 year old male, healthy tabby started limping 2 weeks ago. I thought he injured himself, but found out he had diabetes. His sugar was over 500 and he was spilling ketones in his urine. The limping is supposedly peripheral neuropathy.

He was on one unit of glargine twice daily and I had him back to the vet this last Saturday, the 10th, 5 days or ~ 10 doses of insulin later. His BS was still off the meter (too high). I brought a human glucometer in which read a BS of 232 from a stick, but there blood draw was higher and they said that human glucometers read lower than animal ones.

Anyway, he was started on 2 units twice daily starting Saturday night. However, he is neuropathy is worse than at first (he can barely hold his rear end upright) and he just lays down and sleeps. The rest of his initial blood work was normal.

The vet is aware and said it takes a while to get animals regulated with a normal sugar. I told him I was very worried about the cats mobility and he made several suggestions, all of which I am doing. The vet states that they typically will recover from the neuropathy.

Not sure why it got worse, unless he has been a diabetic for awhile, which I didnt notice, and it was in the process of getting worse before it will get better.

I feel very bad for my cat, he looks miserable but I dont think he is in pain. I am making sure he is eating and drinking, but I am not home all day. I worry if I isolate him to one room that he will be more stressed. He does still wobble to his food and water but justs stands there looking so weak. I am not sure what else I can do.

I put him on dry DM food, which he eats, but he has lost 9 oz in one week. I bring him water to drink, which he does when he is laying down. I know that he goes down the basement steps to the litter box, but gets full of litter as he cant balance well and is not grooming. I have 2 other healthy cats.

Any advice would be appreciated.
 
Hi there

Have you read our faq yet? I'd suggest that to start

Also, a few things

1. you need to monitor blood glucose levels at home, with a human glucometer. they ARE valid for cats!
2. DM dry food isn't going to help as it is still relatively high in carbs...and the ingredients are really not great. We can help you learn more about diet, but first we need to figure out testing and insulin.

Consider posting where you live in case one of us live nearby and can help

Jen
 
As worrisome as this sounds, all these symptoms are the usual for a new diabetic cat. Luckily, there are things you can do. Your human meter is fine. Yes, it may read differently than the pet one, but all meters have a 20% variance so you would treat him the same whether you got a number from your meter or the vets. The trouble with the pet meter is that it is expensive and the strips are hard to find, particularly if you run out in an emergency. One of the reasons that the number may have been higher at the vet is that stress raises bg levels and most kitties are very stressed at the vet.

Glargine is a great insulin. We call it Lantus. But it does have an established protocol. We have a Lantus support group and they have put together a wonderful group of stickies at the top of their forum page. They explain dosing, feeding, how to deal with low and high numbers - everything you will need. viewforum.php?f=9

The neuropathy does look awful. But many cats have recovered and are as good as new! Here is some info and encouraging words: Neuropathy It is true that getting the numbers down will help; we also recommend Methyl B12. Can you put his litter box closer to the area where he is moving around between food and water?

We would encourage you to change to wet lo carb food. This vet explains why it is best for all cats, but especially diabetics: www.catinfo.org We feed under 8 - 10% carbs. When we switched Oliver from dry to wet, his blood sugar levels came down 100 points overnight.

It is wonderful that you are testing at home. It is the best thing you can do to keep your kitty safe. Keep reading and asking questions. We would love to help you help your kitty back to health.
 
Hi and welcome to the best place you never wanted to be, but will be so blessed you found.

I'm sure others will be along shortly as I'm just breezing through at the moment.

But some things to get you started. First off all dry food is really bad for diabetic cats, well its bad for cats in general but especially bad for a diabetic as it is too high in carbs. we advocate feeding low carb/high protein canned food or a RAW diet. I have 11 cats only one of which is a diabetic, everyone eats what my diabetic eats, and that is just plain old fashioned Friskies Pate Flavors. This and a short course of insulin got my boy to remission in just a few short weeks. Now not all cats get that lucky, but it is possible for a lot of them.

Congrats on home testing that is absolutely the very best thing you can do to keep your boy safe and know how the insulin is working in his body. Yes, human meters do read slightly lower than the ones for animals but not that much lower and a human meter works just fine for cats. I personally use a Relion micro from Walmart for my guy Max.

2 units is pretty high as a starting dose. Now of what it is worth if he was my cat here is what I would try. since you are monitoring at home. Get him off the dry food, go out and get him some canned pate variety food, Friskies, 9-lives, Fancy Feast, Wellness etc. Find something he likes and will eat well. (might have to try a few). Someone should be along to give you the chart we use. But in general you want to stay under 10% carbs. I personally stay within about 7-8%. Drop the dose back to 1u twice a day, and test him at home before every shot and a couple times inbetween just to see where he is headed. Ask here for advice or any questions that might pop into your head, there are no stupid questions except those that go unasked.

And just remember to breathe, you are now among a wealth of knowledge and part of a family of crazy cat parents that live and breathe feline diabetes.

Mel, Max & The Fur Gang
 
Hi Ler,

Can you tell us your sweet furry boy's name? He sounds like a trooper!

Diabetic neuropathy is reversible. Giz went from only walking a few steps on her hocks to crossing the living and dining room on her toes -- swiftly! She was 14 at dx and it was a very long living and dining room combo... With treatment, it can happen.

You mentioned he was spilling ketones. Was he treated for this? Are you catching pee with Keto-Stix or Keto-Diastix? It's really not as gross as it sounds. Particularly if he's a high sitter! It just involves sticking a very flat test strip under his buns when he feels the urge... Okay, and timing...

You also mentioned you're home testing. YAY! My Giz used to run between 100 and 150 points higher at the vet's due to vet stress. Not meter issues. I actually took my meter and a test strip and asked for a bead of blood to test my meter against the vet's meter. I think the vet's read 395 and mine read 387. Trust me and the others who will be responding, human glucometers are fine and testing your furry boy at home gives you a much truer reading. No car rides. No vet stress.

I'm guessing you have switched his diet, since you mentioned DM. He may be having issues with that as well...

Okay, dear Ler, here's what I'm going to humbly suggest. Others here might differ, but that's how we save our precious furries. You're going to get a lot of opinions and you choose what's best for your furry boy because you know him best, okay?

1. Is it possible to bring another litter box to the floor he is comfortable walking on? Three cats, an extra box could help out...

2. It is possible he's getting a bit too much insulin. But, hey, you're home testing! 232 at home is okay depending on when that test was taken. That said, 2 units might be too much...

3. Don't mess with his usual diet just yet. Let him eat whatever he wants to while he adjusts to receiving insulin. You can always change his diet s-l-o-w-l-y later. Just make sure he eats, okay?

4. Remember, he's still a cat. He's just extra sweet is all...

5. In the order your heart deems necessary... You factor into the sugar dance, too.

I'm going to be thinking good thoughts and prayers for you both. Feline diabetes is very do-able...

Welcome to the place you never wanted to be; but, will be blessed for having found.

Love and encouraging, toe-walking hugs for you both,
Deb and Nikki -- and, Giz, forever dancing and whispering in my heart...

PS: Names would be good...
 
Thanks for the great advice. First off, he (Pumpkin) did start off for 5 days at 1U twice daily a couple of which may have been "fur shots" as I did not have training. Since the vets glucometer was still over what it will read last Saturday, he upped to the 2U twice daily and warned me about hypoglycemia. I am watching the cat, but his listlessness and wobbling have not changed much since upping the dose. It was my glucometer, in the vets office that read 232. That would be more about 200 points lower than the vet one. I didn't want to take any chances and not increase his insulin to get him regulated and need to trust the vet. This Saturday, the vet will place the drawn blood (same sample at the same time) on both his meter and mine (we did it within several minutes last time).

Secondly, I now realize the importance of wet food as opposed to dry and read your web site initially with recs. However, he wont touch the Fancy Feast at all. So, right now he is actually eating the Hills Science DM. I will try the other wet foods (my vet gave me samples of the Hills wet DM which he wouldn't touch either) with the low carbs and high protein suggested.

I have 2 litterboxes and 3 cats. I have another litter box that is unused right now with a low profile that I thought I'd put shredded paper in for him, but guess who will use it too? The same ones that LOVED the wet food. Ugh! Anyway, my concern was making him more immobile-I guess I dont want his muscles to get weak, and so I thought maybe trying to walk would be something to keep his muscles from atrophing.

Anyway, I am worried about the difference in glucometers and if he is getting too much insulin or not. I can test at home, but not sure how to interpret it and dont want to lower the dose without consulting the vet or if he still is not well regulated yet.

Thanks for the reassurance re the neuropathy, I feel so bad for him
 
What meter do you use? I know there is a least one that people feel does not give accurate readings. Here is a thread with an informal survey: http://www.felinediabetes.com/phorum5/read.php?8,240487

I think it is very unusual for a human meter to read 200 points lower on the same sample of blood. We see more in the 20% range. That would be worrying to think it was that far off.......

The vet site I gave you has great ideas for transitioning. One of the most popular is to sprinkle FortiFlora on top of the food. It has the same animal digest flavor enhancer that makes dry food so irrestible. You can get it from your vet or sometimes the vets at PetSmart. It is a probiotic but also helps with the food switch.
 
a blood draw will have veinous blood, whereas using your meter, you'll be testing capillary blood and that is what your meter is callibrated for. I'm not certain how much of a difference there is in measurements. People here and their vets have done a ton of testing and 9 times out of 10, the vets and the meters are within standard allowable error for meters of +/- 20%. These meters are good enough for people and have found to be just as accurate for cats.

Nobody is telling you to change your dose yet, just a caution that vet stress can have a huge impact on blood glucose levels. Some cats will display markedly higher bgs at the vet clinic as opposed to at home. Thus if you aren't testing at home, you might mistakenly believe that the cat needs more insulin. We've seen this happen and the cats can end up overdosed. That said, not all cats exhibit such signs of stress.

Regarding food, if DM dry is all your cat will eat for now then so be it...eating is most important right now.

Right now I'm sure that everything is overwhelming; hopefully we can give you more tools to help you make the best decisions possible. :)
 
Yes, that is why we are going to test the meter again. The meters at home, I don't know the name of it. But, I will try it tonight and see what I get, although I am not sure what to do if the number is low. The vet is closed at 7:00pm central time and thats when I come home from work and cant wisk him off to the vet or call them. I haven't been testing at home with it as I wasnt sure of its accuracy. I have a friend who is a diabetes specialist at a hospital and she gave me one for free and showed me how to use it.

I am hoping to get him on a canned food. He is my only cat that, when I grill chicken or steak, somehow "knows" and patiently sits next to me when I am eating for any "handouts". I cooked some chicken breast yesterday hoping for the best, but he had no interest. I never have fed cats wet food, but plan on starting with the others to prevent diabetes.

I am brushing him daily, cleaning his paws of stuck on clumping litter all to reduce his stress levels too.
 
Well, it certainly sounds like you are doing all you can to help your sweet kitty. My last suggestion is to remember to breathe! Someone wise told me that early now in our sugar dance. It is so hard with all the information flooding in and the worry that you are responsible for his well being. You are trying hard to slide down that steep learning curve that was so overwhelming for all of us at the beginning. We'll do all we can to help and support you.
 
ler said:
Yes, that is why we are going to test the meter again. The meters at home, I don't know the name of it. But, I will try it tonight and see what I get, although I am not sure what to do if the number is low. The vet is closed at 7:00pm central time and thats when I come home from work and cant wisk him off to the vet or call them. I haven't been testing at home with it as I wasnt sure of its accuracy. I have a friend who is a diabetes specialist at a hospital and she gave me one for free and showed me how to use it.

Well, for example, if you test prior to his next shot and he's under 200, you have a bit of a dilemma. Giving a full dose at that range, without test data to support it, could be risky as 200 is relatively low, and giving a full dose might take him too low.

Another example...if you test 6 hours after his shot and he's at 50, he's close to hypoglycemia territory. If he doesn't go lower, he's fine. If he does, he's at risk for brain damage. At this point you need to observe his behaviour, give him a bit of food, and test again in 15 minutes.
I am hoping to get him on a canned food. He is my only cat that, when I grill chicken or steak, somehow "knows" and patiently sits next to me when I am eating for any "handouts". I cooked some chicken breast yesterday hoping for the best, but he had no interest. I never have fed cats wet food, but plan on starting with the others to prevent diabetes.

I am brushing him daily, cleaning his paws of stuck on clumping litter all to reduce his stress levels too.
Click to expand...
 
Dear Ler, and, of course, you too, sweet Pumpkin (love the name!),

Look for the link under Karen, Rambo and Conan's signature. I believe it holds valuable info regarding neuropathy. Giz didn't need the Methyl B12, as she got back on her toes within a few weeks of receiving insulin. Pumpkin may benefit from Karen's link as Rambo was clearly our furry poster child for neuropathy recovery... I hope her link still includes his before and after pictures. They are forever embedded in my memory...

It's a lot to take in, isn't it, the moment you hear your cat is extra sweet? I was an absolute emotional train wreck when Giz was diagnosed. Yet, somehow -- and with a lot of support here -- we danced for four more years. Diabetes didn't take her. She was like 90 and simply decided her work here was done.

I still miss her to this day...





I digress...

This is about practicing giving shots. In the early days and nights of dancing with Giz, quite frankly (?), I wasn't sure if any insulin actually was received, shaky and needlephobic as I was... But, one night when I was taking the given syringe back to the kitchen, I just grabbed a hot pad and started shooting it. Discovered that when folded, it bore a remarkable resemblance to Giz's scruff when tented. Dearest Ler, I shot the hell out of that hot pad for two weeks, morning and evening. Just kept shooting it with Gizzie's used syringes. And, then one morning or night, I honestly don't remember which, I realized I was giving her shots swiftly and assuredly. There were no breathing issues or shaking, just smoothness.

And, then, I knew we were good to dance. And, dance, we did!



Now, I dance with Nikki, who both benefits from and curses every single thing I learned from Gizzie... It's still debatable who rescued who here... Cats... Sheesh...

Much love and as many encouraging hugs for you and Pumpkin as you both can handle,
Deb and Nikki -- and, Giz, forever dancing in my heart...
 
Thanks for all your responses and suggestions. I checked his BS last evening and it was 222. This morning it was 283. I am still giving him 2U twice daily at 7am and 7pm approximately. Its an Abbot monitor called Freedom something...

Can you tell me where to buy the Methyl-B12? Does this require a prescription? Pills and liquid are almost impossible to get into him, does it come in a form that can be mixed with food (I am going out tonight and buy several brands of moist food and try again).

Thanks!
 
Freedom Freestyle is pretty popular here and if made by Abbott, is the same manufacturer as the pet meter. I would be sure that your vet uses blood from the ear when testing both meters side by side, not a blood draw. I think that could make the difference.

Most health food stores have Methyl B12. Make sure it has the Methyl part. It can be bought in capsule form and spread over the food. Here is an online link also: http://www.vitacost.com/NSI-Vitamin-B-1 ... lcobalamin
 
you're doing great, ler! i have a punkin, close to a "pumpkin," too. pics are in his profile below. yours must be an orange kitty also!

hang in there - it really is a lot to take in the first week, but it does less overwhelming pretty quickly.

I use a Freestyle Lite, I think Freedom might be in the name there too. if that's what you've got, i think it's a good one. tiny amount of blood to test, it keeps your numbers in memory and is just very easy to use. If that's it, just fyi, the cheapest strips i've found are on Hocks (link at the top of every page here.)
 
Two of my cats hated wet food for years. Found sprinkling a tiny bit of catnip on made it very appealing. Maisey was just diagnosed diabetic so am mixing 1/2 can fancy feast with some home cooked chicken and her favorite [chicken livers brazed in butter] (can't do much of these as she gets very loose stools). A couple of days this week I went back to the small sprinkle of catnip on top to temp her into eating. ps I also have a Pumpkin who was trying to live up to her name sake. Finally got her sliming down, was afraid she was also diabetic, but tested and was 86, so just new eating plan working.
 
Just wanted to say hello. My cat Max was diagnosed in January and I was right where you are now. I'm sure you're already figuring out that you've come to the best place for help with your diabetic cat. I knew next to nothing at first and was overwhelmed and stressed. This forum and following the great advice/protocol really helped me turn Max's health around. The biggest difference for him has been the change in diet. Max tested in the 450's the first 3 weeks at the vet with more and more insulin and I was getting very discouraged before I found FDMB. First, we went off the dry high carb food (had no idea it was so high in carbs). For a couple weeks, I fed Max a mix of dry M/D recommended by my vet and the low carb wet recommended here. Max really turned a corner though when we went to only low carb wet. I had no idea until all this happened but Max is pretty finicky and didn't like the wet food at first. You're doing the right thing by picking up more flavors and experimenting. After a lot of tries, I finally found the one wet food Max will eat consistently (for him Fancy Feast Classic Chicken). Keep at it and you'll find one that works for Pumpkin. Also, as others have mentioned, home testing is important as the need for insulin can change with the diet change (for Max as fast as overnight). If you ever have questions about dose (you test and get a lower or higher # than you expect), you can post here or the Lantus group. As a newbie, there was a time where I posted almost every day for help while I learned what I was doing.
 
Hi Ler, and, of course, you too, sweet Pumpkin,

ler said:
Can you tell me where to buy the Methyl-B12? Does this require a prescription? Pills and liquid are almost impossible to get into him, does it come in a form that can be mixed with food.
Click to expand...

I believe it can be purchased without prescription at either drug or health food stores. Don't know what formulations it comes in. But, hey, that's a great question! Why don't you start a new post asking just that? We could all benefit from the responses you'll get. Especially sweet Pumpkin...

Love and our continuing encouraging hugs for you both,
Deb and Nikki -- and, Giz, forever dancing in my heart...

PS: Thanks for that link, dearest Jen! Much love and countless grateful hugs for you and your precious family!
 
This is what you want; Methyl-cobalamin brand name Xobaline 3mg of pure Methyl B-12:

Vitamin Life.com....there may be other sources.


http://www.vitaminlife.com/product-exec ... t_id/37728

1-2 tablets per day....you can crush it and put into food.

Keep tightly closed in the original container and take out one pill at a time,
otherwise it absorbs moisture and becomes sticky and hard to crush into a powder.
 
Thanks again for all the suggestions. Going out for more test food tonight-printed off the list to take with me to Petsmart. Will buy the Methyl B12 soon.

I work 4 10 hour days and I am not available to test him during this time, except on weekends.

This Saturday I take him back to the vet and the plan was to take the venous blood and sample both meters with same blood, same time. However, I can also ask him to compare the capillary blood too.

It is the Freestyle Lite-I knew it was 'free" something by Abbott

I guess I am being selfish by wanting to know how I am going to manage going out after work, away on weekends with a diabetic cat and no one else to give insulin. I have a neighbor teen that could learn insulin shots but Pumpkin hides and wont come out. Any thoughts??
 
One way to get a few extra tests in on the days you work is to get a test just before you walk out the door and as you walk in the door and before you go to sleep. it is all about gathering data - whenever you can.

As far as going out, most people arrange that 12 hour window so they can go out a few hours after the shot or before. For longer time periods, you might trade pet sitting chores with the members near you. (I am thinking there were several?) Some people pay a vet tech to come in to test and give shots.

It does seem completely confining at first, mainly because you are so worried. Once you get confident about his patterns and shots and testing, you will feel much more in control.
 
Dearest Ler -- sorry, Pumpkin, parent talk...

Life can be lived in 12-hour increments!

As for your weekends away? Start having your neighbor teen come over on as regular a basis as your two schedules allow and that teen's parents allow. You know, so Pumpkin will get used to them and won't feel like hiding... Teach them how to test and shoot. You could be training a budding sugar cat rescuer!

Alternatives are boarding Pumpkin at his vet's, hiring a vet tech, and/or contacting a local shelter to see if someone there is available and knows how to test and shoot or would be willing to learn how to do so... Or, seeing if some here is close enough to be able to do it...

Or, you could take Pumpkin with you. I've been blessed with two great furry travelers... Giz preferred the chauffered/diva position riding in her carrier in the back seat with the door open... Nikki likes riding shotgun, so her carrier door is closed. It's amazing how long seat belts really are! Packing list is simple: a small cooler for the insulin, testing gear, syringes, food, and you're good to go!

Having a diabetic cat isn't the end of the world, Ler. No... It's the beginning of something so enchanting, you can't even begin to imagine. Yet...

Much love and continued encouraging hugs,
Deb and Nikki -- and, Giz, forever dancing in my heart...
 
I had the best luck giving Max his shot while he was eating. He would be happily eating away and not even notice the prick of the shot, not even a twitch. If I was a slow poke getting the injection ready and he had already finished eating, it became a game of "follow the leader" or "hide and seek." I generally made sure he got a little food in him and then would shoot while he ate. I work long hours at my job and couldn't test during the day either. I followed Sue's suggestion and would try to get a +3 or +4 test in at night and some more tests on the weekend.

The diabetes regimen can feel a little confining at first, but once you get the hang of it, you can generally plan around the shots. I did train a couple family members I trusted to help back me up when I couldn't be home. Also, my vet offers a boarding service where they would test and give insulin. I didn't have to use it, but you could look into it in your area.
 
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