New to feline diabetes + history of urinary blockages

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Cheeserball

Cheeserball

Member Since 2019
Hey all! I'm new to this and still feeling overwhelmed about a month after diagnosis.

Bruce is my 9 year old handsome fella who might be on his ninth life.

PU Surgery: 9/6/12.
PU Surgery Revision: 10/10/16
Diabetes Diagnosis: 5/16/19.

(I posted a more involved story regarding the PU surgeries on the introduce yourself page.)

I noticed Bruce was eating a bit more than normal (Royal Canin SO Moderate Calorie dry/a few spoonfuls of Royal Canin SO wet twice a day). Then came increased thirst. I scheduled an appointment with the vet on his ninth birthday, 5/14/19. Diabetes suspected. Blood work and urine sample. Our vet noted that he looked underweight at 11 lbs. 2 oz, and I agreed with that. We went home and everything was fine.

The next day, he didn't come running to the kitchen for breakfast, which wasn't like him but also not completely abnormal considering the stress of the vet visit. I offered him wet food, but he didn't take it. I went to work and came home early to check on him... gave a few bites of wet food and then slowly walked away. Back to work and then back home--he was hiding under the bed, which is not like him. Third eye lids were showing. He was very lethargic and not even wanting cuddles, which is definitely not like him. I thought I was going to lose him that night. :(

The next morning I called the vet's office ASAP and explained what was going on. The tech told me they were still waiting on results... I got a call back a couple of hours later with the confirmation of diabetes because his glucose was 500+. I was told to bring him in the evening for diabetes testing; I told them I didn't want to wait that long because of how sick he seemed. They got me in early afternoon. Our vet and tech were both astonished to see his state, as he was relatively healthy two days prior (he also had a UTI, which I was told is not unusually with a diabetes diagnosis). The positive thing is that he did not have ketones in his urine. They kept Bruce for a little over a day and gave him fluids. I picked him up the next evening for our diabetes training--1 unit of ProZinc twice a day. I was told that he wasn't eating on his own and I'd have to syringe feed him (Royal Canin Recovery + water). I was told to experiment to find something to get him to eat--I can't even tell you how many different types and brands of food and treats I had to just get him to eat. I expressed concerns about what he was eating because of his blockages of past, but the tech told me that if it's wet food, he won't be able to block on wet food. Thankfully that only lasted a few days before he started eating on his own--of all things, he gobbled down Fancy Feast Classics! Within a few days, he was acting a bit more like himself. A quick glucose test at the vet on 5/20--still higher than they wanted, so a suggestion of 2 units of ProZinc. Glucose curve on 6/7--315, 320, 259, 213, 248, 244 (I think those were the numbers I heard--I was trying to write them down as quick as I can). Told to bump up to 3 units, which seemed high to me. I have been doing more and more research, and here we are! I asked about Fancy Feast vs. Royal Canin SO, because I know the SO is high in carbs. I was told that the SO is suggested, but I could do FF, but I need to stick with one or the other. I've been doing a lot of research regarding diets as suggested on these pages, and some days I feel like I got things under control, and then some days like today when Bruce pukes immediately after breakfast (not like him at all) I feel completely lost.

I just bought a ReliOn Prime today. I'm honestly torn between the food choices--I feel like a bad cat mom for not keeping him on the SO. However, he seemed to be doing well with the Fancy Feast and I'd even say he enjoyed it--I add a can of water to the can of food in the am and pm--every time he pauses like he's done, I add some more water, mix it around, and he gobbles it up. Repeat until dish is empty.

So I guess what I'm asking is if anybody knows of an cat blocking again (post PU surgery) from not eating the prescription wet food. I have been searching and searching, and I have seen people have success with the increased water, but have not found any kitties that had not one but TWO PU surgeries. I've also not really found many people with two PU surgeries on the internet, diabetes or not! I ordered pH test strips so I can test his urine--very strong stream, I might add, after eating FF for about 2 weeks. The strips should be arriving tomorrow. I'm going to be checking his glucose tonight before dinner so I can have an idea of what his numbers are at home--I know most cats get stressed out at the vet, but he gets exceptionally upset. Is there anything else I should be doing?

Thanks so much!
Alicia and Bruce
 
Hi again Alicia and Bruce. I do know about vet stress..Idjit howls all the way there, and all the way home and we have to drag him out of the carrier in the exam room. BG tests can be significantly higher at the vet, just because of stress, and this is what they base the insulin dose on.

You can start testing him at home with that shiny new ReliOn meter, so you can see that it's safe to inject the insulin and then also see how low the insulin is taking his blood sugar. As I mentioned before, sometimes those doses are too high and with the diet change the dosage may need adjusting also. We want to keep him safe and avoid any very low blood sugar events.

Here is the link to the spreadsheet instructions and a link to understanding the spreadsheet:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

and here is a link to information on testing:
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
There are many videos on how to test a cat online, I watched many YouTube videos when we started out.
It's a process of patience and practice, and don't get discouraged if you aren't successful right away. Some of us warm the ear with a rice sock heated in the microwave or use a pill bottle filled with warm water. You can also try to get that blood drop on a clean fingernail if Bruce isn't terribly patient and still, then use the meter to get the result. You will figure out what works, and as his ears "learn" to bleed because more capillaries form, it does get easier.

An important FYI, just to be prepared in case, I hope you never need it but knowledge is power.

I'm sorry I can't offer you more information about the diet, but at least he's getting all wet food, which is certainly better for his FLUTD than dry. I know you have more than one concern, but what I can offer is to recommend that you be testing and checking the blood sugar to see if his insulin dose is too high now or not. He's going to feel a whole lot better when he's on a good dose.
 
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Hi Alicia, welcome to you and Bruce! My cat Colin had several blockages ( no surgeries, but vet mentioned that was the next thing to try) and was on the cd food for years. I had weaned him off it though before the diabetes. He was eating mostly wet food then and after diagnosis he was on all wet food with added water. He never had another blockage. Here’s some good info about diet and urinary tract problems. The same site has a great section on diabetes too.
https://catinfo.org/feline-urinary-tract-diseases/
 
Hi Alicia and Bruce and welcome. @Idjit's mom and @Sharon14 have given you good advise.
I agree wet food is much better for all cats, especially cats that have blockages with their urine. They need more moisture in their diets not less. Dry food is only 7% moisture and wet is 78% moisture.. don't feel bad taking him off the SO......water is the most important thing you can add and you are doing it.
That dry food is very high in carbs too.
Years ago I had a cat that blocked up twice and had to have surgery two times. No diet was ever discussed with this cat. I also had another cat at a later time that was blocked once. Amazingly the vet never told me about increasing water but put him (the second cat) on a dry diet. This was all before Sheba got diabetes and I found this site and learned so much more about FD and cats in general.

I am concerned the insulin dose was raised so quickly up to 3 units, with him only being diagnosed a month ago. We recommmend only increasing in 1/4 unit increments so as not to go past the best dose and it is far safer for the cat.
I am really glad you are going to be testing the blood sugar levels (BSLS).. just by switching to the fancy feast from the dry will lower the BSLs. I see @Idjit's mom has given you the link to the spreadsheet..that is a great tool and will help us help you.
As you have no data at the moment on Bruce's numbers, I would not give the insulin if it is under 200. I would stall, don't feed, post and ask for help and test again in 20 minutes to see if the BSL is rising. If you need to stall, change the wording on the subject line to something like "newbie and stalling, please help" to alert people..
I am going to tag @Rachel and @Djamila as they both use Prozinc and can help guide you.
Here is a link to to a beginners guide to Prozinc
http://www.felinediabetes.com/FDMB/...prozinc-pzi-insulin-for-diabetic-cats.164995/

You are doing a great job. It is really good you have been researching and found us. You will get lots of help and support here from very experienced caregivers of FD kitties.
Bron
 
Thank you all for the kind and supportive words!

I tested him for the first time before he ate. The worst part was trying to get the wiggle worm to not wiggle, but bonito flakes helped! He tested 235 before I fed him. I think I got this spreadsheet thing idea. Directions were excellent. I even added it to our sig.

I honestly don't feel comfortable giving him 3 units. I gave him 3 the night of his glucose curve, and he seemed a bit sluggish. I was able to write it off as a stressful day at the vet. However, my boyfriend told me B seemed off in the morning as well. I did make the vet aware of this; the office said to give him 3 units. I've been giving him 2.5 because... I don't know, mama's gut feeling? I need to get better about taking note of the time I feed him and give him his shot. He's currently in my lap, grooming himself, so I think he doesn't hate me so much from the ear prick. :)
 
you are smart to reduce the dosage with a pre-shot value of 235 -- most newbies are advised not to shoot insulin at all if the pre-shot is under 200

especially if you are comparing it to the values obtained at the vet, since those numbers are usually higher than you'd find at home, due to stress (also due to the fact that the vet is most likely testing on a pet-specific meter, while you are using a human meter -- the two scales can't be compared -- the shape of the curves plotted on each, can ... )

also, with his new diet, I'd expect lower BG numbers, and that's what you are seeing

I can't speak to the actual dose, Catcat and I are cooperating on Vetsulin which has a rather different sort of action than ProZinc (from all I've read, ProZinc is better for cats)

great that you got that preshot -- glad too that Bruce responds well to the bonito flakes
 
The food change will cause the glucose levels to drop significantly. I have never used ProZinc but one thing we recommend is to start low and go slow. I also have concerns the dose was increased too quickly. Now that you are testing, I would suggest starting over at 1 unit and keep it at that dose for several days before determining if you need to increase it. If an increase is needed then only raise it by 1/4-1/2 unit. Stay at the new dose for several more days before increasing it again. The goal is to find the optimal dose that works best for your cat.
 
I tested approx 2.5 hours after feeding, and it said 30. Thinking maybe I screwed up somehow, I tested 30 minutes later (so 3 hours after feeding) to another 30. He’s acting absolutely fine—if anything, he has a good amount of energy. I’m going to try testing again in a little bit. Poor little guy is going to hate me because of the ear pricks! Not sure if I should give him some syrup if he’s acting okay? Definitely going to call for the control solution tomorrow.
 
Cheeserball said:
I tested approx 2.5 hours after feeding, and it said 30. Thinking maybe I screwed up somehow, I tested 30 minutes later (so 3 hours after feeding) to another 30. He’s acting absolutely fine—if anything, he has a good amount of energy. I’m going to try testing again in a little bit. Poor little guy is going to hate me because of the ear pricks! Not sure if I should give him some syrup if he’s acting okay? Definitely going to call for the control solution tomorrow.
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30 is too low if that's an accurate test.
If your cat is testing in low numbers there are several things you need to do. (Low numbers are under 50mg/dL or 2.8 mmol/L.)
Depending on how carbohydrate sensitive your cat is, feed approximately a teaspoon or less of gravy from high carb food or high carb food only. (If you have a cat with GI issues, using a couple of drops of syrup plus low carb food is an alternative.)
Test again in 15 – 20 min. Depending on the numbers, give more HC food.
Repeat the above steps every 15 – 20 min. until your cat tests in the 50 mg/dL (2.8 mmol/L) or above range for 2 consecutive tests. Continue to feed in small amounts to keep numbers in a safe range.
Test in 30 - 40 min. and repeat the test and feed process until there are 2 consecutive tests where numbers are stable or rising.
Test in an hour and follow the same steps.
DO NOT become complacent. If number have risen after one or two tests, it’s important to continue testing. Numbers may bobble up and down as the HC food and/or Karo wear off. DO NOT get one test where your cat has risen from low numbers into the 50s and go to sleep or leave the house. You are putting your cat in a risky situation. When in doubt, leave HC food out.

Start a new thread so you are getting the help and attention you need. Many hypos are not symptomatic..until they are. Use the BG 30 in your title. I will watch for it.
 
I saw the tag and am just popping in to say hi. It looks like you are in good hands to deal with this hypo. You may be up for a long night, so have some of this: :coffee::coffee::coffee:.

Folks here are giving you good advice, so take care and hang in there tonight! :bighug:
 
Djamila said:
I saw the tag and am just popping in to say hi. It looks like you are in good hands to deal with this hypo. You may be up for a long night, so have some of this: :coffee::coffee::coffee:.

Folks here are giving you good advice, so take care and hang in there tonight! :bighug:
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@Djamila what do you think about going back to 1 unit and starting again?
 
May I ask how long Bruce was fed Royal Canin SO dry and wet?

My cat was also fed Royal Canin SO Moderate Calorie dry and wet for approximately three months before I switched him to all low carb wet (the vet fought me tooth and nail, claiming he must stay on it to prevent a second blockage...even though no urinalysis was performed to confirm if he’s high risk)
 
He was on Hills CD dry since... hmmm... fall 2012. As much as I tried, he wouldn’t touch the wet. After surgery #2 fall 2016, I gave him a little SO wet morning and night with added water, but mainly relied on the Hills CD dry. In fall 2017, I switched to Royal Canin moderate dry after he started looking a little chunky.

I’ve been giving him Fancy Feast Classic patés for about a month now. I add a can of water to his wet food... it seems to satisfy him. He has a very strong stream of pee. I bought pH strips; one day I’ll conveniently be near them at him peeing in the box at the same time! My vet recommended the SO, but why be on something that is so high carb?

Mark and Jake said:
May I ask how long Bruce was fed Royal Canin SO dry and wet?
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Cheeserball said:
I’ve been giving him Fancy Feast Classic patés for about a month now. I add a can of water to his wet food... it seems to satisfy him. He has a very strong stream of pee. I bought pH strips; one day I’ll conveniently be near them at him peeing in the box at the same time! My vet recommended the SO, but why be on something that is so high carb?
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That’s a lot of water - and here I thought a tablespoon was too much! I’m going to try adding more.

I agree about the carbs. My vet was highly insistent on sticking with SO, even wrote nasty comments on Jakes medical file that I was sent when I switched vets.
 
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