New sugar baby, not on insulin yet - test, watch & wait?

[Caitlin & Mr. Kink]

Hi guys! Can't tell you how glad my sis and I are that we found this board. Our Mr. Kink was just diagnosed over a week ago, and I've been reading threads for hours.

Our story (sorry for the novel):

We have Mr. Kink (aka Kinky, Kinksters, Mr. Tinkers...LOL), 10 years old, born in our family's apt. He's just the most affectionate, sweetest guy, and he enjoys ripping up our couch, EATING, play-fighting with his best friend Angel (our non-diabetic 15 year old tabby). He was on kibble for the first few years of his life, then has been on wet food for the last 6 or so years (Fancy Feast, then Trader Joe's) aside from the last 5 months when he was eating what we now know is essentially poison for him - UGH. He's always been a big guy - usually hovering around 16-17 lbs.

We took Mr. Kink to the vet in November '11 for a stomach licking issue, which the vet determined was just allergies. While we were there, we complained about Mr. Kink always being hungry even though he was getting 6 oz of Trader Joe's wet food a day (which I now know was probably too little), so he convinced us to change to Science Diet® Mature Adult Active Longevity™ Original :evil: - lo and behold, 5 months later, and Mr. Kink is drinking TONS of water, peeing LAKES in the litter box, and having trouble jumping up on things and down to 14 lbs.

We took him to a vet that was closer by (our other one was 45 minutes away) - they do bloodwork on him, and we find out he has diabetes - his BG was 512!!! There were lots of tears, because we didn't know what that meant for our little friend, or how expensive it would be to keep him alive...and at what cost to his little quality of life? They scheduled us for an appointment at another vet across the street because they don't treat diabetics (??) but they were talking about insulin and glucose curves, and we freaked out and cancelled it, and started doing our own research.

Here's where we are now:

DX: 5/2/12

DIET: Switched from that blasted Science Diet® Mature Adult Active Longevity™ Original to Fancy Feast Classics on 5/3. We started out giving him 2 cans/day (6 oz) but I started reading, and I THINK I've figured out that that's not enough food? So we upped it to 3 cans/day (9 oz). He's still STARVING. So, starting this morning, we're giving him 4 cans/day (12 oz) and going to see how that goes. I know he needs more food because he's diabetic, so hopefully he'll start feeling better! He's not drinking TONS of water anymore (actually, I'm not seeing him really drink much at all).

Questions: is he getting enough food? Is it absolutely necessary for him to eat smaller meals throughout the day or is twice/day fine?

INSULIN: Like I said, we haven't been to see a vet yet about insulin. I'm worried about not finding a vet who knows what they're talking about because it was our original vet who put him on the poison to begin with! From what I read, I thought it might be a good idea to home test him just with the diet change and go from there.

Questions: Anyone know where can I find a vet who's knowledgeable about feline diabetes in Middle Tennessee? How long do you guys think is safe for us to home test without insulin before taking him to a vet?

HOME TESTING: We bought a TRUE2go Blood Glucose Monitoring System from Walgreens, and actually successfully home tested for the first time yesterday! He was kinda iffy about it the first time, but we've tested twice more and he was SO GOOD. So unbelievably proud of him.

Some stats -

(on 3 cans of food/day)
5/8/12
7pm - before dinner - 243
8:45 pm - after dinner - 231

(on 4 cans of food/day)
5/9/12
2pm (no food since 8:30 am) - 168
5:30 pm (still no food) - 202

Questions: I would LOVE to record these on one of those nifty spreadsheets you guys use! Anyone have a blank one they can send me? We've just been kind of randomly testing. Not sure when we should be testing other than before and after food and maybe once during the day? Not sure what the conversion rate is for human meters - I read 30 pts higher, so can I assume he's been under 300 since we changed his diet?

Other questions: what can we do about his neuropathy? I saw something about some supplements? Will it get better on its own? Check out his bloodwork - they didn't mention it, but could he also have hyperthyroidism? He's always been a hungry guy, but never had any trouble with randomly losing weight - he was usually a little over. How do we manage that + diabetes?

Mr. Kink's most recent bloodwork: https://docs.google.com/open?id=0B6juuz ... 1ZwS3VDa2c

Thank you so much for any and all input! You guys have already helped us so much in realizing that we CAN do this, that it IS worth it, and that our little man can be happy and healthy again. We've come full circle in just a week from being completely despondent and overwhelmed to feeling angry and duped to now proactive and hopeful. You guys are amazing.

 

[Caitlin & Mr. Kink]

Re: New sugar baby = LOTS of questions!

For some reason my Google Docs link isn't working. How about this one? https://docs.google.com/open?id=0B6juuz ... 1ZwS3VDa2c

 

[copernicus]

Re: New sugar baby = LOTS of questions!

I truly hope the diet works, please keep posting.

Good luck.

 

[Sue and Oliver (GA)]

Re: New sugar baby = LOTS of questions!

Here's the spreadsheet. If you need help, just ask. http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

He is really close to non diabetic numbers. We consider a cat in remission if they range from 40-120, without insulin, with the majority of the time in double digits.

How long has he been back on wet low carb? If it's only been a week or so, you might continue monitoring and see if the diet brings his numbers down just a little more. It's difficult to give tiny doses of insulin with the low numbers you are getting - it takes a lot of monitoring and you have little data to base dosing decisions on.

 

[Caitlin Meghan & Mr. Kink]

Re: New sugar baby = LOTS of questions!

I truly hope the diet works, please keep posting.

Good luck.

Thank you, and I will! I'm definitely hoping that because he was only on the evil kibble for 5 months that he can make a quick recovery, but I'm not ruling anything out.

Here's the spreadsheet.

Thank you! I'll start using it and seeing if we can get on a regular schedule of testing him.

We consider a cat in remission if they range from 40-120

Gotcha. I'm still a little confused with my glucose meter - I'm supposed to be adding 30 points to his number, right? I guess to me, almost 275 is still pretty bad, but you guys would know better than I would. :?

How long has he been back on wet low carb?

He's been back on the wet food since 5/3 - so about 6 days. I'll definitely just keep home testing to see how his numbers do for another week or so. If I don't see them changing at all, will it be time to take him to the vet then?

Thank you guys so much!

 

[MommaOfMuse]

Gotcha. I'm still a little confused with my glucose meter - I'm supposed to be adding 30 points to his number, right? I guess to me, almost 275 is still pretty bad, but you guys would know better than I would.

Nope you just go with the numbers on your meter Sue gave you the normal range for a cat on a human meter. You only need to add the 30 points when comparing a human meter to a pet only meter. Normal range for a cat on a pet only meter is between 70-150

Mel, Maxwell, Musette, Autumn & The Fur Gang

 

[MikeysMom]

Re: New sugar baby = LOTS of questions!

You don't have to convert the numbers. Just remember that the normal range on a human meter is 40-120 and on a pet meter it would be 70-150. We don't convert our numbers on our spreadsheets; we record the reading we get. The really important thing to know is that if they dip below 50 on a human meter you need to keep a close eye on them and probably feed a little medium-carb or sometimes even high-carb canned to keep them from dipping lower if they aren't yet at the nadir, or lowest point in their cycle. That 40-50 range isn't dangerous in and of itself for most cats, but dropping below that poses a potentially If they dip below 40, you need to treat for hypoglycemia. On a pet meter, below 70 is considered hypo. As long as you know when you are entering dangerous territory, conversion doesn't matter. In fact, the Lantus insulin protocol has two separate versions depending on if you're using a human or pet meter.

You may, however, want to test your meter against the vet's. Someone on the board had the same meter as you and found the readings to be inaccurate compared to other meters. In general, we recommend avoiding the meters with Tru or True in the name as well as the Freestyle meters as they have shown some inaccuracies with multiple people. Many people on here use the Relion meters from Walmart as they have the cheapest strips and are pretty accurate. I use the Arkray Vital as the strips are even cheaper ($49 for 250 including shipping) and I get them autoshipped every 30 days from American Diabetes Wholesale...if you click on the Shop link at the top of the page, there is a link to the site.

You sound like you're doing well! We were all overwhelmed at first!

 

[Ry & Scooter]

Questions: is he getting enough food? Is it absolutely necessary for him to eat smaller meals throughout the day or is twice/day fine?

Small meals are best. Diabetics cannot properly process the food they are eating. So feeding a starving, insulin deprived, underweight cat only twice a day doesn't make much sense. Feeding twice a day is also a big overload for an already struggling pancreas. Most don't recommend limiting food intake at all in the early stages of a diabetes diagnosis. They need as much food as they can get.

HOME TESTING: We bought a TRUE2go Blood Glucose Monitoring System from Walgreens, and actually successfully home tested for the first time yesterday! He was kinda iffy about it the first time, but we've tested twice more and he was SO GOOD. So unbelievably proud of him.

A good start, however.... those meters are known to read substantially (100 ish) points lower than other meters. Unfortunately, that means you are probably seeing false results because of it. You may want to purchase a second meter recommended for cats for comparison. Walmart has two, the Relion Confirm and Relion Micro. They are both very cheap as well. Avoid anything with "Tru" in the name, and also avoid the Freestyle Lite as it reads low too.

what can we do about his neuropathy? I saw something about some supplements? Will it get better on its own?

Neuropathy usually goes away as blood glucose gets under control. Some recommend methyl B12 suppliments but I haven't seen any scientific documents showing its effectiveness yet.

Gotcha. I'm still a little confused with my glucose meter - I'm supposed to be adding 30 points to his number, right? I guess to me, almost 275 is still pretty bad, but you guys would know better than I would. :?

No, you do not need to add anything. Most documents on the site already account for the point difference between human and cat meters.

 

[MikeysMom]

275 really isn't that bad for a newly diagnosed cat. As I was often reminded, many people are thrilled to drop into the 200's, especially early on, and that's on insulin. If your cat stays in the 200's, you will likely need to start insulin, and the sooner you start, the better chance you have for remission.

 

[Caitlin & Mr. Kink]

Wow, lots of info!

I went out and bought a Relion Micro tonight, and tested him - 333. So that's definitely a big difference!

We'll definitely start spreading his 4 Fancy Feast cans out - do you guys think that's enough food for him? Or basically, if he's hungry, give him something to eat? (that just goes so against everything we've ever done with him because he's always been a glutton, stealing the other cat's food, etc)

I think we're gonna go ahead and keep testing at home for about a week, and start calling around to try and find a vet we might want to take him to, but we definitely won't leave it too long, especially if his readings continue to come back so high. Thanks again, everyone!

 

[Jenn & Baxter]

Hi & welcome!
You are doing a really good job so far. Way to go for doing research & educating your self to give the best care to Mr. Kinks.
His numbers really arent bad. I would stick with the plan of testing. Even though Mr. Kink isnt on insulin right now I would do a curve just to see where his BG is hitting throughout the day before & after food. You would want to test about every 2-3 hours. Collect your data & record it in the SS that you are going to set up. This way if & when you go to the vet for insulin you can take the SS & have the vet look over the numbers. It will also help with dosing & maybe even on insulin selection.

You can create a new post if you are in the market for a new vet in your area. Just state which city, area etc you are looking for a expeirenced FD vet in. A member on the board might be able to recommend one to you.

My answered to your neuropthy question. Many members use Zobaline.
http://www.ilifelink.com/zobaline-for_d ... blets.html
Some use Methyl B-12, but you have to becareful because lots of Methyl B12 is flavored or has sugar alchol or forms of sugar alchol in it. Which is toxic to cats.

Please keep us updated.
Good Luck,
Jenn & Baxter cat_pet_icon

 

[Julia & Bandit (GA)]

Some recommend methyl B12 suppliments but I haven't seen any scientific documents showing its effectiveness yet.

http://www.sciencedirect.com/science/article/pii/030384679290066C

http://ntur.lib.ntu.edu.tw/bitstream/246246/81685/1/16.pdf

http://www.ncbi.nlm.nih.gov/pubmed/3568063

My answered to your neuropthy question. Many members use Zobaline.
http://www.ilifelink.com/zobaline-for_d ... blets.html
Some use Methyl B-12, but you have to becareful because lots of Methyl B12 is flavored or has sugar alchol or forms of sugar alchol in it. Which is toxic to cats.

Zobaline is Methyl B12. It's just packaged specifically for cats. There is no difference in content between Zobaline and the supplement I linked to, other than the dose (3mg vs 5mg).

The capsules of Methyl B12 will not have sugar or artificial sweeteners in it. You do want to avoid the liquid form for this reason. However, it is always a good idea to look at the ingredients for any supplement you get to make sure there are no additives.

 

[Caitlin & Mr. Kink]

I would do a curve just to see where his BG is hitting throughout the day before & after food. You would want to test about every 2-3 hours. Collect your data & record it in the SS that you are going to set up.

Alrighty, I'm doing one today! Luckily I work from home pc_work, so I have alarms set on my phone for every two hours. So far his numbers are about 100 pts higher than I was getting before, so I'm glad you guys suggested the monitor change. So far #'s in the 300s :-| But he's scratching on his new scratching post and currently sitting in the window sill enjoying the sunlight and fresh air. So at least there's that! :thumbup

You can create a new post if you are in the market for a new vet in your area. Just state which city, area etc you are looking for a expeirenced FD vet in. A member on the board might be able to recommend one to you.

Just post a new Topic in the Feline Health main forum?

I'll check out the neuropathy solutions you suggested. Thank you, Jenn!!

 

[hmjohnston]

Wow, lots of info!

We'll definitely start spreading his 4 Fancy Feast cans out - do you guys think that's enough food for him? Or basically, if he's hungry, give him something to eat? (that just goes so against everything we've ever done with him because he's always been a glutton, stealing the other cat's food, etc)

Welcome!

That might not be enough food for right now. My Sneakers (first time around) was eating 12-15 oz per day (at 6lbs), and I mixed water in with each ounce- almost an ounce of water to an ounce of food- this makes sure she got in her water. Then she got into a neighbors dry cat food and we lost any and all progression and she started eating 15-18 oz per day (at 8lbs). The first time Sneakers went from 12-15 oz to 8-10oz in the space of a day (freaked me out :shock: ) second time she is taking it slow and she is now down to 10-12 and sometimes eats less. Lesson learned? NO KITTY CRACK CONTRABAND!!! She lost her outdoor privileges and now she only goes out unless I am there. So Mr Kink will eventually decrease his intake once his body is no longer starving for nutrients it can't get from the food. So if he wants to eat, let him. Sneakers also grazes on her wet through the day- just freeze it into ice cubes (add water) and let it melt if you are out of the house and worry about old food.

I think I read once that they will only drink when extremely thirsty (or unless there is running water!) so he might be thirsty, but with the wet not getting really thirsty enough to drink more. Most people on the board add it to the food anyway. Sneakers won't eat her food without it watered down- she considers it gravy :lol: .

 

[Ry & Scooter]

Thanks for the links Julia! I see a lot of things recommended around here but without the documents... I just like to see them before I suggest the same


Yes, unfortunately, those meters people call the heartbreakers... people have even mistakenly thought their cats were in remission because of the false low readings... 300's will need to see insulin treatment. But at least you've had some time to prepare and get used to ear pokes, which you're doing great at, I might add. Doing a curve will help us see what dose of insulin he should be started at (usually it is 0.5 or 1u though). You're doing great

 

[Julia & Bandit (GA)]

Thanks for the links Julia! I see a lot of things recommended around here but without the documents... I just like to see them before I suggest the same

I highly recommend Google Scholar. It's a wonderful resource that often returns better results than many university databases. You can request articles that are not available for free online via Inter-libary loan at your local library. Most places will have the article scanned and emailed to you within 48 hours.

 

[Caitlin & Mr. Kink]

@Julia

BTW, Mr. Kink's brother, Bruce, who lives with my dad, looks JUST like Bandit. Mr. Kink is the big boy on the right of my profile photo cuddling with Angel. ;-)

 

[Julia & Bandit (GA)]

@Julia

BTW, Mr. Kink's brother, Bruce, who lives with my dad, looks JUST like Bandit. Mr. Kink is the big boy on the right of my profile photo cuddling with Angel. ;-)

He is a very handsome guy! Is he a blue point?

I came home last night to find Bandit in formal wear:

Apparently my boyfriend decided that treats should have a dress requirement.

 

[Caitlin & Mr. Kink]

GAH, SO FUNNY.

We dress ours up, too sometimes. In elf ears. Guilty as charged.

Here's Mr. Kink and Bruce as little wee ones together.

 

[Jenn & Baxter]

Julia I have always told you Bandit is so darn cute! And I remember the stories you shared about him. Especially the Christmas cookie story....he is a funny cat. :lol:

Mr.Kinks & Bruce are so cute in that picture. They look just like my cat before Baxter. His name was Kacoo. His personality was a lot more funny then Baxters. I need to put him in the gallery with Baxters pictures.

 

[Caitlin & Mr. Kink]

Alright guys. I tested Mr. Kink ALL DAAAAAY LONG. He was such a trooper. I really think he's actually starting to enjoy his petting/prick/treat time. Good thing, too, because I'm now obsessed with knowing where his BG is! He also got 4 cans of FF throughout the day, about 2 hours apart/can.

He stayed pretty consistently in the mid to lower 300s for most of the day, and got as high as 395. :sad: (check out his chart in my sig - the strikethrough numbers are from the True2Go, so I discarded them, and since he's not on insulin yet, I'm basing it on time of day and feedings vs insulin shots). I think I'm going to do another full day of testing tomorrow, just to gather more data. Unfortunately, I have to go out of town on Saturday and won't be back 'til Sunday night because of a death in the family, so a friend is going to feed him 2 cans Sat night and 2 cans Sunday morning. It's not ideal, but I don't really have any other option as I don't have an automatic pet feeder (yet!)

And then, come Monday, it'll be time to look for a vet. Do you guys have any suggestions for what to ask a potential vet and how to gauge whether they're knowledgeable about feline diabetes before making an appointment?

What key things should I know when going to the vet? I'll have my BG meter, my chart...should I ask for a specific type of insulin?

The whole idea of going to the vet just freaks me out. I'm so afraid of someone not knowing what they're talking about, and just feeling frustrated and overwhelmed. :YMSIGH:

 

[Sue and Oliver (GA)]

I would call around and ask the vet office if they support home testing and wet low carb diets. Ask how many diabetic cats they have treated and what success they have had. That should give you a quick idea whether you can work with them or not. You don't need a vet that is completely up to date on diabetes but you need one that is open and willing to learn.


Go into the vet confident and armed with information, and aware that no one cares more about Mr. Kink's health than you do. You are his advocate. Ask for Lantus, Levemir or ProZinc. All three are mild and long lasting insulins. Tell the vet you will be hometesting and you'll be glad to share your numbers. Insist on a wet low carb diet. There are vet resources and studies on all these topics available here if they want it.

 

[Just-As-Appy]

A couple more thoughts for you. If you are not going to be home and don't have a timed feeder, you can freeze the food and put out the frozen pucks. Then he can eat it during the day as it thaws.

As for finding a new vet. Ask if the vet supports home testing, and say that you already are doing so and have several days of data. Many vets will ask that you leave the cat at the clinic for a day to have a curve done - you already know that this is unnecessary. If the vet insists that your cat stay, then its not the vet for you. There is no need to pay a fortune for useless data - it is useless b/c stress of being at the clinic gives inaccurate results.

 

[Caitlin & Mr. Kink]

I'll definitely stick to my guns and not let them strong arm me into doing an office glucose curve - and you're right, that would be a good indicator of a vet I might not want to have anything to do with.

Unfortunately, I also have a non-diabetic cat who gets fed 2 cans/day (she's about 8lbs) so leaving food out isn't doable. They can't graze on their wet, because he'll gobble all of hers in 2.5 seconds. :roll:

Thanks for all of the advice about going into the vet confidently! I'm starting to feel much better, armed with lots of info, and knowing you guys are here for support and answers. :YMHUG:

 

[Julia & Bandit (GA)]

I'll definitely stick to my guns and not let them strong arm me into doing an office glucose curve - and you're right, that would be a good indicator of a vet I might not want to have anything to do with.

Unfortunately, I also have a non-diabetic cat who gets fed 2 cans/day (she's about 8lbs) so leaving food out isn't doable. They can't graze on their wet, because he'll gobble all of hers in 2.5 seconds. :roll:

Thanks for all of the advice about going into the vet confidently! I'm starting to feel much better, armed with lots of info, and knowing you guys are here for support and answers. :YMHUG:

I had the same problem with Bandit (a gobbler), and Gabby (who was far less aggressive when it came to food). What I did was buy 2 auto feeders, one for each cat. I froze cat food and set each feeder to go off at exactly the same time. I fed each cat every meal (even the non-feeder ones) at opposite ends of the kitchen, so that they would each go to their "spot" when they were hungry. I also had a food call (here kitty kitty!), and my auto feeder also has an option to record a voice message that plays when the food is released, so when the cats heard the feeders go off, they would each run to their feeder and eat. Bandit ate faster than Gabby, but she was usually almost done by the time he would wander over and try and finish her food.

 

[Caitlin & Mr. Kink]

Julia. You may have just changed our kitty feeding lives.

I just bought two of these: http://www.amazon.com/gp/product/B001EM ... 00_s00_i00

Mr. Kink does eat MUCH faster than Angel, but she'll be eating 1/2 can per meal, and he'll be eating a whole, so *hopefully* she'll be able to eat enough of it before he waddles over.

TYSM!

BTW how to do you freeze your wet food? I was thinking of just dumping the fancy feast can in a ziplock and freezing, but I suspect there might be a better way to go about it.

 

[Blue]

ice cube trays or any items you like.

 

[hmjohnston]

I use ice cube trays. fill 1/2 full of food, add to the top with water and fork it to mix, pop in freezer and in 2 hours you have kittycicles :lol:

If you have different kinds I keep them in a ziplock bag separately and so i know what I've fed.