New to forum, overwhelmed with new info

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Lisa and Dr. Love

Member Since 2022
The big question is at the end, the wordy background is in the middle. Also, I was diagnosed with T2 myself in June of 2020, and was able to completely reverse my diagnosis within five months with a low carb/keto diet and no medication. I don't test my own BG anymore, I simply no longer eat things that provoke any significant insulin response, and I back it up with an A1c check at my yearly checkups. So I'm not completely uninformed re: T2 in general, but I'm still learning about dealing with it in cats.

I'm new to this forum, but Dr. Love's diagnosis is not new. However...one doesn't know what one doesn't know, and I'm suddenly finding out how much I don't know. We run the Old Pets Home, it seems...Jake the 17 yr old dog passed last year, and Agent Mooshie the 15 yr old cat passed a couple months ago. We're left with the 13 year old cats: dsh Dr. Love, who was diagnosed T2 two years ago, and ragdoll Queen Fancypants, who has no health issues. For several years life here has been a stream of medications and accommodations for various geriatric pet issues. We just deal. We've been owned by cats for over 40 years, and we're not likely to give that up anytime soon!

Dr. Love was diagnosed in Dec. 2020 after a heckin' big weight loss that didn't seem to have other issues surrounding it. He's a Yeti Cat; it's very difficult to observe him eating, drinking, doing his biz, because he prefers to be secretive and somewhat nocturnal. Which means we can miss stuff, even when we're trying to hawkeye him.

Our severely understaffed and overworked vet clinic may have been doing their best, and they might also have been working with what knowledge they have. They admitted him for a day and observed and cared for him, then gave him back with a few instructions. But...I was told to put him on dry diabetic formula food, and that I could supplement with a little bit of Fancy Feast in the pate style. I was told to let him free feed, which we've always done so no biggie there, but we do official feedings/bowl refreshing twice a day and he gets tiny amounts of Fancy Feast with his evening feeding. I was told to give him Vetsulin before his meal times. It was NOT suggested that I do home BG monitoring, and basic numbers/values weren't really explained to me. It was NOT suggested that I switch him to a wet food diet. I've never even heard of a "curve". His fructosamine and BG numbers didn't improve fast enough for the vet that was monitoring him, so she kept increasing his insulin dosage. We quickly began dealing with what we were sure were hypoglycemic episodes, but the vet techs would test his BG (usually the next day, after he was doing better) and declare him "fine". It wasn't until I managed to video an episode and email it to the vet (hello, 2020...couldn't actually go see the vet myself!) that I felt like I was being taken seriously. But eventually we got him to a good place, and he started putting on some weight and looking and acting better...as much better as a Yeti Cat ever acts!

Doc is now stable and has been for a good while. The vet clinic is satisfied with his numbers and health. We've got a system of care and stick to it, and it's probably as simple as it gets--perhaps too simple, but it lets us feed both cats the same diet at the same time, in different rooms. He's now a bit chubby, although we really don't see him eating a ton. He doesn't care much about treats. He submits to injections without any fuss. It's been a long time since we saw anything that smacked of a hypoglycemic episode, but we now know what to do if we see the onset of one.

So why mess with what appears to be success? Because a few days ago I began to question if a little chaotic kitten energy might be good for our household of geriatrics pets (go ahead, laugh at me). I questioned how to feed a diabetic cat and a kitten without the diabetic cat eating what he shouldn't, and vice versa, so I started to research, which led me to much info, including here. Y'ALL. In almost FORTY YEARS of keeping cats, NEVER have I ever been told that wet food is better than dry! NOT ONCE. In fact, I was told the opposite! Nor have I been told that free-feeding isn't optimal. But knowing what I know about reversing my own diagnosis with keto and intermittent fasting, and then learning about the carb levels of dry cat food, I'm beyond appalled. This is the equivalent of a human continuing to eat a high carb, highly-processed uncontrolled-portion diet and taking a pill...and being satisfied that the numbers are "controlled" even though diabetes is actually still wreaking havoc on other systems of the body because there are still too many carbs to process properly.

Because Doc's Vetsulin doses are now much lower (2 units in the am, 1 unit in the pm--which happens to be when he gets his little bit of wet food combined with the Hills dry diabetic food), I suspect that the dude's diagnosis could potentially be completely controlled with a twice per day wet food diet, or at least significantly improved. But I am completely overwhelmed on how to get there.

Even though I've read and read here, I am totally overwhelmed by all the information that's new to me. I'm willing to attempt to transition these clowns to an all-wet diet, but I honestly don't know how to get from where we are (dx controlled, but probably not in the healthiest way) to where I hope to go (dx controlled by improved diet and Doc's own body in a healthy manner) without causing issues in the process. Keeping the system simple and consistent is rather important because we have multiple people helping care for the cats, so the fewer variables to consider and communicate, the better.

Where the heck do I even start? And can someone help me simplify this process so I'm not trying to do all the things at once? I need this change to be accomplished in bite-sized chunks that my whole household can handle, if possible.

Thank you to anyone who can make sense of my rambling and help me out!
 
Welcome to FDMB!

Good for you for doing research. I realize that bite size chunks are optimal. Most of us tend to be overly generous with providing information so apologies up front if we dump a ton of data on you.

Where to start....

Food: First, you've figured out the food issue. There is a wonderful website on feline nutrition you may have already discovered. Dr. Lisa's site is essentially everything you ever wanted to know about feline nutrition. Even better, there's a chart that contains nutritional information, including carbs. She only lists canned foods. Low carb food is below 10% carbs; high carb is over 15%. You'll want to have some high carb on hand in case you need to bump up low numbers. Most of the members here feed their cat in the 5% carb range. At least with a cat, it's really not necessary to feed only twice a day. Free feeding is fine. Remember, a cat's metabolism is fast. Feeding during the active part of the cycle (before nadir) can help to keep the numbers propped up but this largely depends on the cat's response to both insulin and food. If Doc is happiest grazing, it's fine. You just want to make sure he doesn't eat 2 hours prior to shot time. You don't want his pre-shot test numbers to be inflated by food. It's also fine to feed both cats the same low carb diet. I drove myself nuts trying to feed Gabby one thing and Gizmo something else. Someone here pointed out the error of my ways! Cats are obligate carnivores. You can feed the nondiabetic the same thing as the diabetic.

Insulin: To be honest, Vetsulin is not a great insulin for cats. It's harsh and fast acting. The latter meaning that it doesn't last a full 12 hours. As a result, there's a swing in your cat's numbers. Cat's have done well on it but the American Animal Hospital Association recommends either Prozinc or Lantus (glargine -- Lantus is now available as a generic/biosimilar and is far less expensive than the name brand). These both last much longer and are gentler. If you're comfortable using Vetsulin, I've linked the support group page. There are sticky notes at the top of the page that will provide more information about the insulin and dosing.

Home testing: We're huge fans. It's the only way to keep Doc safe. Many people here use the Walmart brand meter -- Relion. The strips are the least expensive around. However, any human meter is fine. There are pet meters. They are good. The cost of the strips is outrageous -- about $1 each. I tested a lot and I would have been broke if I had used a pet specific meter. In addition, most of our dosing information is based on a human meter. This is a link to lots of information, including videos, on home testing. You'll need a glucometer, test strips specific to the glucometer, and lancets. The latter are used to poke your cat's ear. You'll want to start with a 28 or 29 gauge lancet. Once your cat's ear starts to bleed more easily, you can move up to a thinner lancet -- 30 or 31. It takes a couple of weeks for the capillary bed to build up and for your cat's ear to bleed more readily.

There are also two additional basics. It looks like you already figured out one -- you set up your signature. The other is a spreadsheet. This is a link to a post on helping us to help you. It contains some basic information along with the instructions for setting up your spreadsheet and what the columns mean.

Please let us know what questions you have. The people here are very generous with their time and their knowledge. We're here to help.
 
Home testing is essential especially if you are changing his food to a low carb wet food. A food change can significantly lower glucose levels. By testing before every shot yow will know if it is safe to give the dose. By not testing you risk your cat becoming hypoglycemic. As said above, there are much better insulins than Vetsulin. Most cats respond well to long acting insulin like Lantus, Levemir and Prozinc. Short acting insulin like Vetsulin have steep drops in glucose levels but also wear off quickly in a cats body.
 
Insulin: To be honest, Vetsulin is not a great insulin for cats. It's harsh and fast acting. The latter meaning that it doesn't last a full 12 hours. As a result, there's a swing in your cat's numbers.

My vet clinic didn't mention there were different kinds of insulin for cats, so needless to say, I wasn't given any choices. I just followed instructions and used what they gave me. Since insulin wasn't part of my own journey with T2, I really don't know as much about it as I do about the lifestyle changes that ultimately made insulin and other medications unnecessary for me.

My gut says that if we follow this rabbit hole all the way down, Doc is unlikely to still need insulin at all, although it will take a process and some time to see if I'm correct. But...the tiny bit of wet food he gets with his evening meal (1/8 of a can of Fancy Feast) was enough to necessitate lowering his dose by half, 2 units to 1. Of course, I had no idea the insulin+wet food was what was causing those bouts of hypo at the time, but now it make perfect sense. He was mostly eating the low carb part of his meal and only nibbling a bit of the accompanying dry food, if he ate any at all. I do understand that part of diabetes: if you don't consume things that provoke a significant insulin response, then your blood sugar tends to stay under control much better.

My test strips for my Freestyle Lite are all out of date since I don't use them myself anymore. I recall they were danged expensive, so I will check out the Relion. I've got a ton of 28g lancets, so that's good. Doc might have a different opinion. :smuggrin:

Dr. Lisa's site is actually what led me here, I found it through a google search. I still have more to explore there, but I was very impressed by how thorough and readable it was.

Thanks for the resources, information, and encouragement. Especially the encouragement, because this all feels like it suddenly got a whole lot more complicated.
 
Unfortunately a lot of vets treat diabetes in cats the same way as dogs. Vetsulin works fine with dogs. However cats process insulin differently than dogs. Also don't be surprised if your vet tries to discourage home testing or even forbid it. You do not need permission to home test. He is your cat.

It is possible that a cat can become diet controlled with a diet change but most cats do not. However the diet change will help to control glucose levels. With a proper diet, the right insulin & dose and home testing, his diabetes can be easily managed.
 
Hi and welcome to the group! I'm not one of the experts here, just someone who has been through it with their kitty and came out the other side with a kitty in diabetic remission thanks to the advice I got here at the FDMB. These people are angels walking the Earth, giving their time and energy to strangers and their cats. You are in good hands.
 
Unfortunately a lot of vets treat diabetes in cats the same way as dogs. Vetsulin works fine with dogs. However cats process insulin differently than dogs. Also don't be surprised if your vet tries to discourage home testing or even forbid it. You do not need permission to home test. He is your cat.

It is possible that a cat can become diet controlled with a diet change but most cats do not. However the diet change will help to control glucose levels. With a proper diet, the right insulin & dose and home testing, his diabetes can be easily managed.
Thank you for telling me that, this helps me understand a bit better. If this is basically how vets treat diabetic dogs, then I can at least see why I was taught what I was taught. When I add in the general confusion of the pandemic and how that affected office practices, and also that all the founding vets retired over the past few years and the clinic hasn't been able to get a stable rotation of new vets, I can see where that might leave someone like me with mediocre information that keeps Doc alive and reasonably stable, but not thriving like he could be.

I don't intend to ask for permission to home test Doc, or to learn to manage his health better. Like you say, he's MY cat! I don't think the clinic would fight me on it, but I also no longer trust that they are as informed on this subject as they could be...or perhaps it's just that they are so stressed in this season of the practice/business that they don't have time for the amount of hand-holding it might take. I'm also starting to wonder if pet nutrition tends to be a weak area for vets just as it often is for human doctors. Because at the heart of it all, it may be an endocrine issue now, but it started as a nutrition issue. And I can improve that for Doc, Fancy, and all future members of our zoo.
 
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