New to FDMB and New to Feline Diabetes!

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DiegoBones

DiegoBones

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Greetings,
I have just this morning begun Insulin injections on my dear-sweet Diego, am new to the board and new to Feline Diabetes altogether. I noticed that the hand-out supplied by my veterinarian appeared to be printed off of this very website which lead me to believe this would be a safe place to ask a few questions :) Diego is a BIG boy, about 23 pounds and 9 years old. We caught his Diabetes by chance on his annual visit, he has had no real symptoms (a bit of an increase in drinking and peeing) but no weight loss or behavioural changes. He was a happy playful kitty when he went in for his curve testing yesterday, and was a happy and playful kitty when I injected him this morning. We did a blood test to check his liver and kidney functions and found out his glucose was high, I believe she said 26 (I have little knowledge of what this means), so we did a Fructosamine which came back at 649. I am injecting him (Lantus 100) with 3 doses, every 12 hours - the vet's reasoning being his large size. I have fed him grocery store brand food his entire life as previous attempts at switching him proved to be a challenge. Evo Innova made him quite ill - bloody stools, so I integrated more wet food into his diet and less kibble, all was well. Now with the Diabetes the vet has recommended we attempt diet change again and has given me the Hills M/D. After looking around this site however, I am unsure that this is the best choice for him and was wondering what other members have thought. Diego LOVES wet food, it was something I used to "treat" him in the past when he was only on kibble, now he has been eating primarily wet food for the past 2 years, with kibble available. He would get wet food at 5am and 5 pm. I'm thinking that I should stick with the wet-food diet and eliminate kibble altogether? Because we caught it early, and he has had no real problems I am hoping to do my very best by him and hopefully he won't need injections for the rest of his life. It seems to me something low in carbs and high in protein is the way to go, and the Hills m/d wet food seems to be higher in carbs than MANY other brands, but my vet made it seem as if my only choice is between Hills and Purina prescription diets, she also suggested the dry food (all of these things are sold through her office, so I am skeptical). We feed our other cat Wellness brand kitten food (he is a Siberian and requires kitten food for the 1st 3 years) and we like the brand. I guess I am wondering what is the best route to go here? I dont want to defy my vet's recommendation when I know so little about FD, but I don't want to feed Diego a certain food for the sole purpose of my vet's office turning over more Hills stock. I'm sure it is "good enough" but I would like to give him the best... It is the least I can do as it is my fault that he is Diabetic in the first place :( Live and learn.
I was also wondering about "curve testing"... I can't express enough how little I understand this whole process, I had hardly even heard of cats having Diabetes. I have bought a Glucose meter and all that jazz and think that I have a pretty good grasp of how to do it. What I don't so much understand is when to do it..? (Before he eats? After he eats? Both? Midday?) and even then the machine shoots out an arbitrary number that I can't really comprehend. What kind of numbers am I even looking for? (As I type this I realize the extent to which I am in completely over my head, I just can't imagine my life without Diego around! It's all the harder because he has had few physical symptoms and I have no visual proof that he even needs any of this, as glucose numbers and so on are completely foreign to me.. He's playing with a ribbon as I type this and lose all my hair from stress!)
Anyways, incredibly long story short (sorry for the HUGE post), what kind of foods do people recommend? (Especially for a kitty that has had no complications and was caught early) and what times are you supposed to be doing blood-glucose tests? Lastly, I live in constant fear of giving him too much insulin; he likes to sleep after he eats, so this morning I fed him, gave him 10 minutes, injected him, and now he will be asleep for a few hours... Will I be able to tell if he is hypoglycaemic if he is asleep?
Thanks in advance to anyone that can offer me some guidance.
Cheers
Laura and Diego.
 
Hi and welcome :) It is overwhelming at first but you will learn the routine very quickly.

The most popular foods seem to be gravy free pate style foods - for example, Fancy Feast, Friskies, Whiskas, Sophistacat (Petsmart brand), or Special Kitty (Walmart brand). These are low-medium cost foods. You'll want to look at Janet and Binky's list for low carb varieties, but most of the Chicken Dinner, Turkey and Giblets, etc. pates are all fine. You want less than 10% calories from carbs, ideally less than 7 though. Since Diego is getting older you might want to look for low phosphorous foods too. There are also "premium" foods such as Merricks, Innova Evo, Wellness, etc. but they are pricy, and not all of them are superior to cheaper foods.

You want to, in the very very least, test before each insulin shot. These are called preshots, and they are done so you know that you are shooting a safe number. You do not want to give any food within 2-3 hours of the preshot tests, because you don't want a food influenced preshot number. But you always feed some time between the pretest and the shot. Some do the shot 15 minutes after the food. I prefer to shoot Scooter while he is distracted with his face in the food bowl. Test, feed, shoot.

I think 50-120 is about the "normal" range for undiabetic kitties. They will mostly be between 50-90 though. I assume you are in Canada or somewhere that mmol/L measurement is used. The USA and most of this forum uses mg/dl, to convert your numbers to numbers the forum can understand, multiply them by 18. So your vet's reading of 26 would be 468, and that is the number the forum would go by. That's a very high number, by the way. When he is consistently that high you want to be regularly testing for ketones with urine testing Ketostix from a pharmacy.

Lantus is dosed based on the nadir (lowest point) of a kitty's cycle, so you will also need to do some spot check tests (generally around +4-+6) so you know that your kitty isn't going too low or hypo. I was told that if your +2 test is very close to your preshot number, you can assume your kitty is not going to drop drastically. Those are the nights I sleep peacefully :D

With home testing and analysis of your results, you can predict and prevent hypos. Some kitties don't even show symptoms of hypo, so it's not safe at all to rely on kitty's reaction. Always have high carb (HC) food on hand, like a meat in gravy type food, and corn syrup like karo.
 
Welcome, Laura and Diego!

I am pretty new to this site, too! Hershey (almost 10) was diagnosed Nov, 2010 and we are on our 2nd week of insulin. Glad you found this forum, they have been so much to help to us already.

I had never heard of FD until Hershey was diagnosed, but immediately starting reading up on it ... and reading... and reading. He, too, was on dry with wet as a treat. We switched him to all wet and while I'm not sure how much it is impacted his numbers, his coat is super soft and the dander is almost gone! (Hershey had lost about 4 pounds, making him 8.5 pounds, was getting bony and had lots of dander - plus drinking/peeing a lot.)

I know others will be responding shortly, in the meantime there's lots to read on here. :smile: We chose a food before finding this site and Binky's list comparing foods and were happy to find it on there. We also set up a spread sheet to record what's going on with him and allow others to see it, too. That way, they can give feedback and kind of see what we're seeing.

You asked when to test. A couple of things I have learned - always test before giving the insulin. We also try to test at +6 and sometimes another random time or two, depending on what's going on. My husband does all of the testing and injecting; I keep up with the 'paperwork,' but plan to try to test this week. nailbite_smile

The other thing I was told was to relax, but that's often easier said than done.

Libby

If I did this correctly, here's the link to Binky's food list : http://binkyspage.tripod.com/CanFoodNew.html
There's another one, but I can't seem to put my hands on it right now, sorry.

Here's the link to set up your spread sheet: viewtopic.php?f=6&t=50130

New to site AND not terribly computer savvy, what a combination!! ;-)
 
I skimmed your post and what jumped out at me, is that your starting dose is I assume you mean 3 units, not 3 doses, correct?

If you are starting at 3 units, we actually consider that a very high starting dose. Typically we recommend starting at 1 unit or 1/2 unit and with regular home testing and diet change adjusting the dose in small increments, again 1/4, 1/2 units at a time.

So, what this means:

1) what kind of syringes do you have? Do you have U100, with 1/2 unit markings? If not, then I suggest you get a supply of these type - now you may need to get a prescription in order for the pharmacy to sell them to you. That's fine - have the vet call it in - if you have a walmart nearby, you can get a box of 100 syringes for $13. And as an aside - ask for 30 or 31 gauge short needles too. Get that written on the scrip.

2) are you home testing? If not, are you willing to learn? Home testing is vital to ensuring that you are not blindly injecting insulin and not knowing what it is doing to the cat - ie. causing a hypo issue etc.

viewtopic.php?f=14&t=287 - hometesting links and tips

viewtopic.php?f=14&t=1122 - how to treat hypos

viewtopic.php?f=14&t=2354 - hypo toolkit

Think about home testing this way - if it were you who was diabetic, the doctor would NEVER tell you not to home test and to inject yourself with insulin blindly, it's no different because the patient is an animal.

3) Food - you don't need to spend the money on prescription food - it's expensive and not any better quality than what you can get at the store.

Dry food is not good for any cat and wet or canned food is best. You want to feed low carb - typically 10% carb or less.

viewtopic.php?f=14&t=115 - food and nutrition information, including Binky's food chart

Additionally, while yes you want to have high carb canned food on hand - to put in your hypo tool kit, you don't want to feed it to your cat unless you have to to raise the bg levels.

Friskies, Fancy Feast, Pet Smart Sophisitcat and Walmart brand (don't recall name) are common brands that many use for their diabetes - again low carb - which is usually the pate style - with fancy feast - it's the "classic" style for example.
 
Thank you all so much for your responses.

Regarding the food, specifically Special Kitty brand or Friskies, the medium to low cost foods, I have heard that they are bad for cats in that they use inferior protein sources and the carbs in them would be of the most detrimental sort. Does the low protein value trump the poor quality of the ingredients? (If they are even of a poor quality, it is equally likely that I have been misinformed) I've also read that I would have to feed Diego MORE of the cheaper food than I would of the more expensive brands for him to get his nutritional requirements, with weight loss being a goal, would it follow that I should favour the EVO brand, or something of higher quality? (I have been feeding him Friskies Whitefish and Tune for 2 years, and it seems reasonably low in carbs, and is certainly affordable, however it is the very food the Vet has finger-pointed as being a major problem.... SO CONFUSED!)

Starting tonight I will begin drawing his blood to get his glucose numbers. His original reading of 26 I was told is very high, however, it was done at the vet's office and Diego gets VERY stressed leaving the home - hyper-ventilating, pulling his claws out, yowling, the whole thing is quite the ordeal. Hence, why home testing is something I fully-intend to do! (He was a rescue, had been badly burned, trusting people has been a challenge for him his entire life.) I'm expecting his glucose to read much lower. (I am in Canada, so I guess my values are different! Gosh, I am clueless!) The impression I am getting is to definitely test before each injection and then a few periodically throughout the day to see check for rises and falls?
So far, that is my plan! Thanks again SO very much to everyone!
 
Welcome, Laura!!

Many of us started this process with our vets recommending that we buy prescription foods from them. Gabby loves to eat and she was not a big fan of D/M or M/D. No wonder -- look at the ingredients! They are primarily animal by-products. If you are feeding your Siberian Wellness, then you know the difference in the quality of a premium, human grade food and Hills or Purina. I feed both of my cats Wellness. (The carb count is 4%.) How much you feed is based on calories. Protein is protein -- at least when it comes to quantity. I would also not feed an exclusively fish diet to a male cat. It can lead to urinary track crystals. I'd suggest you take a look at Lisa Pierson, DVM's site on feline nutrition. I think the information there will answer the majority of your questions about food and nutrition.

Like Hillary said, 3.0u is a big starting dose. It's possible that your vet was using a weight-based formula for starting dose. However, is 23 lbs Diego's ideal weight or is he, ummmmm, "round?" (The weight based formula is relevant if you are planning on following a Tight Regulation Protocol for Lantus. That probably doesn't mean anything to you yet -- don't worry about it. There's a lot you need to get familiar with before figuring out how you want to approach managing Diego's diabetes.)

It does sound like Diego's initial blood glucose (BG) was fairly high at the vet's office. Using the calibration we use in the US (which are the numbers you'll see on this Board), Diego's BG was 468 -- definitely in the diabetic range. (To convert the numbers, you multiply the reading on your glucometer by 18.) For now, I'd encourage you to get comfortable with home testing. The glucometer will be your best method of keeping Diego safe and for giving you control over managing his diabetes. You will probably want to set up a [urlhttp://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207]spreadsheet[/url] so you can keep track of Diego's test data so you will be able to make good decisions about dose. I linked the instructions for setting up a spreadsheet. If you are outside of the U.S., there is a World version of the template in the Google document template gallery. (You want the World template that is owned by RKader.)
 
Welcome Laura and sweet Diego (love the name!) to the FDMB family! cat_pet_icon

You've already received excellent advice and suggestions regarding foods, home testing, and insulin amounts so I'm just saying hi and howdy. :-D
 
Hmm... late reply, but..

Yes, cheaper foods like Friskies and Special Kitty are slightly inferior in that they don't contain a lot of "high quality" muscle meat protein, most of it comes from byproducts, yes. But even then, these foods are no less in quality than Hills M/D. M/D contains just as much, if not more byproducts and liver, hence why cats don't like to eat it for very long. Even the low quality canned foods are FAR better than the high quality dry foods.

Hills W/D - Water, Pork Liver, Pork By-Products, Chicken...
Friskies Poultry Platter - Turkey, poultry by-products, water sufficient for processing, meat by-products, liver, fish...

See what I mean?

I find the "middle ground" as far as food quality and price goes is something like Fancy Feast or Sophistacat Supreme, with the first ingredients whole meat and not byproducts- but unfortunately I find they only come in the small cans, which tend to be pretty expensive.

If you can afford Wellness or Blue Wilderness or those pricy foods, go for it! But I know I can't. So I try to find the middle ground. What I like to do is buy a small amount of a high quality food like Wellness, and give that alongside a cheaper food like Friskies. Give them core "meals" of the good food, and let them snack on the cheap food. Far easier on the wallet.
 
@ Ry and Scooter - Thanks for your reply! It is funny that you say "find that middle ground" as that is just what I have been trying to do - I would like to put Diego fully on Wellness canned food but, like you said, it is expensive. I've actually ended up deciding on just what you said - I'm mixing the Wellness with a Friskies canned food that he has had all his life. It'll hopefully absorb a bit of the cost of the Wellness and still be better for him than just the Friskies alone :)
 
An update for anyone still following... Diego is no longer on insulin!

He only received his full prescribed dose of 3 units one time as, thankfully I decided to home test his blood (on the advice of this website) and his numbers never came close to warranting such a high dose. I am so happy that I decided to home test! The most I ever gave him was one unit, from twice a day, to once a day and his numbers have held ever since all on their own. It has been about a week :) We are still keeping an eye on him and testing every few days, but so far so good. It has been really interesting seeing how his body is reacting to the insulin (via the blood testing) and if we hadn't Diego would surely have been in trouble. I don't even want to think what would have happened had we just blindly injected him over and over. The meter and strips weren't terribly expensive (much cheaper than curve testing at the vet's office) and after a couple tries I got the hang of it, and after a couple of days Diego got used to it. (I added a little bit of fresh salmon to the ritual... He was quite agreeable!)

He loves his new diet - all wet food (Wellness Brand) with a bit of Friskies Whitefish and Tuna (his favorite) mixed in to help me manage the cost. I feed him three times a day, as people had recommended a more steady food intake than only twice a day - which seems logical knowing human diabetics are given the same type of advice. He's peeing a lot less and, while he had very few symptoms to begin with, he is generally happier and more active. Although, he has been spoiled rotten the last few months. (Ever heard of the SunnySeat cat bed? Yeah... I have 5 of them... I have a beautiful view of the Halifax harbour that only my cats can see... lol). It's funny the good that comes of bad things sometimes, I am more thankful for Diego than I have been in a long time and I am thankful for the reminder of just how important and precious my time with Diego is.

Everything I did to help him, all the changes that I made, and all the choices I made are in some way because of this website. The only decision I made entirely on my own was the decision to treat Diego and to do it the best way possible. I read many of the articles, I have the "General Rule of Thumb for Treating Hypoglycaemia" posted on my fridge door, I based my food choice off of this websites and its users recommendations. I chose the test Diego's blood based on the advice of users here, who made it quite plain that to not test would make little sense. If I was going to treat Diego, I should really treat him. I really felt that since he had little symptoms and we caught it on a routine visit that he would have a great chance of getting better, all I needed was the tools to make good decisions. I got those tools mainly from this site. So thank you,thank you, thank you!

Laura and Diego
 
Hey this is great news! Isn't it amazing what cat's can do, their systems can be so surprising. Go Diego!
 
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