New to the MB, Needing advice!

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christyaran

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Hi, let me introduce myself... my name is Christy & I live in Miami, FL. I have an 8yr old snowshoe Siamese. I found this beauty when he was just about 2-3 months old. I have had previous cats before, & knew I wanted to try to do everything right with this beautiful boy named Coco. I neutered him at 6 months old & made him a 90% inside cat. (Being young & living with the parents, my dad used to let him out every so often). I fed him ONLY the best foods & never spoiled him with daily milk or anything other than cooked shrimp every once in a blue moon along with boiled chicken.

About 6 months ago he started losing alot of weight very rapidly, I got concerned & took him to the vet, after a nice fight & mommy owner here being bit in the hand (which eventually was infected & had to do minor hand surgery), we finally got the answer- he's diabetic. I believe the 1st time we tested him he was in the high 500's... the doc almost fell back. We got started on the PZI which now is discontinued at 2 units 2x's a day. We went back 2 weeks later & no change this time we were in the mid 600's... up to 3 units a day 2xs a day. Eventually we stopped there. He would normalize & then he wouldnt, so the vet said keep him btwn 3 & 4 units 2xs a day. Breaking the news to friends was terrible, how many ppl knew how to tell me to put him to sleep, how that annoyed me, how can ppl b so cruel, but I was determined to do what I had to for my feline baby.

Jump forward til now... recently I started noticing that hes been walking funny... I didnt think anything of it, i thought he has litter caught btwn his feet & cleaned it up & went on with life. But now within the last week its goten to the point he looked like he was walking & couldnt keep his balance, he looked drunk. I looked online & found out it was neuropathy. I was devastated. Specially not know how severe it could be. We went to the vet on Monday & the blood was at 462. Vet says up it to 5 units a day 2xs a day til Thursday, if hes not better- up again to 6 units. Mind you this is a mighty big cat too... hes been about 12-13lbs all his life. Now he is at 10 lbs.

This morning it looked like he got worse & I took him back, this time the blood was 490 & we were upto 8 units a day 2xs a day. Im in total shock.. the vet says there is nothing we can do with the neuropathy til the blood is regulated. I have him on the Hill's W/d dry food only & give him 1% goat milk every other day or when he asks for it.

I dont understand why the insulin isnt working & the vet does say my case is "special", he hasnt seen a cat react to his insulin like this in a while. I just dont understand whats wrong, why it doesnt normalize? Anyone have advice? He also lost .5lb (250 grams) within a 4 day period & the vet says that his body isnt metabolizing the food hes eating, meaning this may be bad news. That eventually his body wont accept the food & he wont have energy & little by little he may give way & I may have to put him down. I am devastated. I dont know what to think. I thought my best support system would be forum/MBoard that knows what i am going through & can help me through this time. Any advice is appreciated. I would appreciate it.

I am sorry for venting but I wanted to give some insight on the history... thanks & hope to b chatting with you all more often.
 
Are you still using whats left of your PZI or have you switched to another insulin already? He isn't metabolizing his food because he doesn't have the effective insulin levels in his body to do so, not necessarily because something else is going wrong. If you haven't switched, I would suggest you try maybe Lantus or Levemir. Not ever insulin will work the same on every cat. We might be switching in the next few weeks if my Oscar's numbers don't start to show some effect from his insulin.

Every Cat Is Different cat_pet_icon
 
I did have him on the PZI, & I didnt have issues while he was on it.. in december when it was time for a new bottle I was given ProZinc ( which is some sort of human insulin, but made for cats) I feel like ever since i started this insulin i have had more problems with him health wise... the vet has asked if we have done something wrong where the insulin would get bad & I said NO WAY.. are you crazy ($86 a bottle). He says that he will give me a sample of another insulin next week if he doesnt get better, he says its one that they have used on dogs... starts with a T I think, so who knows, maybe it may help. I am seriously thinking of changing his WD food to the wet food... but the vet hasnt recommended it...
 
I just typed a response and the computer ate it!! Oh well, here I go again. You have come to the right place. People here know more than some vets in treating diabetes in cats. Ask your vet to try Lantus, a longer acting insulin that is not as harsh as some. Then read about Lantus on the Lantus board here.

But first, do consider changing to a low carb wet food (dry food is very high carb) Vets push the special DM food, but most of us here feed low carb Fancy Feast. Look at Janet and Binky's list of carb values. Some people give a special med for neuropathy that I can't remember right now. Someone will help you out here. Do you know how to test for urine ketones and blood glucose? Donna
 
I would say that I would

1) try a new insulin like lantus or levemir. Pearl was on PZI (both Idexx and BCP) for close to two years and she really didn't do nearly as well. SOme cats do better on different insulins.

2) Learn to hometest. We have videos and tips ( viewtopic.php?f=14&t=287 ) and someone may even live near to show you how. It will *seriously* help you improve control.

3) Then switch to a low carb all wet food. It does not have to be vet food. The Janet and Binky charts ( viewtopic.php?f=14&t=115 ) have lots of 10% carb and under choices from the market or pet stores. But you really need to learn to hometest first, because cats can really respond to that change of food and their blood sugar drop.

4) As you gain control of the diabetes, it will help the neuropathy but also, a lot of people use methyl-B12 very successfully to reverse that. It would probably not be a bad idea at all to get him on some. I really hope you learn to hometest and I really think you should look at a different insulin. One type just does not fit all cats.
 
christyaran said:
I did have him on the PZI, & I didnt have issues while he was on it.. in december when it was time for a new bottle I was given ProZinc ( which is some sort of human insulin, but made for cats) I feel like ever since i started this insulin i have had more problems with him health wise... the vet has asked if we have done something wrong where the insulin would get bad & I said NO WAY.. are you crazy ($86 a bottle). He says that he will give me a sample of another insulin next week if he doesnt get better, he says its one that they have used on dogs... starts with a T I think, so who knows, maybe it may help. I am seriously thinking of changing his WD food to the wet food... but the vet hasnt recommended it...
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I would seriously ask to try lantus or levemir. Ask for a script for the pen cartridges. It's more costly up front but they LAST so they end up being 30.00 or less a month in the end. In fact, I use each entire levemir cartridge no problem. I have found levemir to stay good much longer than lantus. Here is a good veterinary guide on that to show your vet:

http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf
 
Welcome and sorry that you have to be here, but it's the best place to help Coco live with or overcome diabetes.

Others have given you the basics, but I want to suggest that the same thing is going to continue happening if the immediate reaction when he does not respond the way the vet thinks he should is to raise the dose, no matter what insulin you use, you're going to have problems. The only exception is if he has acromegaly, which you can read about here and see if any of those symptoms/physical characteristics seem familiar: http://petdiabetes.wikia.com/wiki/Acromegaly

Even beginning at 2U of the PZI could have been too much. Some cats are regulated on 1U or less.

Continually raising the dose 1U at a time is counterproductive because their body could be in rebound as it tries to protect itself from hypoglycemia. Please read about that here: http://petdiabetes.wikia.com/wiki/Somogyi

Unlike most medications, more insulin is not always better. My cat Gandalf was up to 6U of PZI and exhibiting neuropathy before I found Felinediabetes.com and began to understand how diabetes works in cats.

I'm concerned because you mention Coco walking drunkenly. Neuropathy makes them walk with their hind feet flattened and yes, may affect coordination, but walking drunkenly may also be a sign of hypoglycemia which means his blood glucose plummeted too fast and/or went too low.

Lantus also has an excellent track record of helping kitties go in to remission. It's worth considering.

In the meantime, please take advantage of all the resources and members available on the site and message board to help you understand why his blood glucose is running so high.

Did the vet explain ketones to you? If you go to the drugstore to get a home monitoring glucometer kit, please pick up some ketone test strips and test his urine to make sure he does not have ketones. Even trace amounts of ketones can become serious very fast and he needs immediate vet attention if he gets ketones. We can help you with suggestions of easy ways to test the urine.

Don't let the vet scare you about putting him to sleep. I was also told that in the beginning by a well-meaning vet and Gandalf has been diabetic over 5 years now. He just had an excellent ultrasound result today and he is 17. Feline diabetes is not a death sentence.
 
Hi Christy, and welcome!

I agree with what Karen and Vicki have posted.

Insulin goes bad. I suspect your PZI pooped out long ago, sometimes it does that in a month, and that was a big reason for your problems.

Diabetic neuropathy, the problems with walking, is a common side effect of unregulated diabetes and I am truly shocked your vet did not identify it immediately. To me this says that you had better learn every bit of information you can absorb about FD and its treatment as fast as you can, because your vet doesn't seem to be on the ball.

Start at www.catinfo.org for the basics od feline nutrition, then go to our FAQs. Read threads here from newly diagnosed folks, look through the insulin groups and ask all the questions that occur to you. Someone is always here to help.

Gia & Quirk (GA)

Guilt trips are a detour from life
 
When Patches was on PZI vet I would always use up a a whole vial and that would take over a year. I noticed no degradation in the effectivity of the PZI though out the vial. Thus, I doubt that the PZI stopped working. I suspectthere is something wrong with the kitty.

Years ago I had my Grey GHost controlled on about 3-4 units of PZI bid. However, in less than I year he became insulin resistant. Even three units of R would not really reduce his high (in 400s) BG. He went down hill fast before I could se an interest.
 
Larry and Kitties said:
When Patches was on PZI vet I would always use up a a whole vial and that would take over a year. I noticed no degradation in the effectivity of the PZI though out the vial. Thus, I doubt that the PZI stopped working. I suspectthere is something wrong with the kitty.

Years ago I had my Grey GHost controlled on about 3-4 units of PZI bid. However, in less than I year he became insulin resistant. Even three units of R would not really reduce his high (in 400s) BG. He went down hill fast before I could se an interest.
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I really don't know that I agree completely. It *could* be, but I honestly saw such a huge difference with Pearl on the different insulins, I'd sure try a different one before I decided it was something else. And I did see problems with BCP not having staying power but Idexx was stable, we just, IMO, don't know enough about ProZinc to say.
 
WELCOME, this forum is a great place to gain knowledge and really learn how to manage feline diabetes. By doing just a few things each day (that really won't take up much of your time at all), you won't need to worry about losing your precious cat, not where feline diabetes is concerned.

There are three key factors to managing diabetes: food/nutrition, home testing and insulin

1) Feline Nutrition: Now, as far as diet - definitely dump the dry food (if you are feeding any) and if the vet recommends purchasing prescription food like DM just say "no thank you". ALL cats, and especially those with diabetes, do best on a species appropriate diet that is high in protein and low in carbs. Dry food DOES NOT fit that bill and DM food, even canned, just really isn't that great as far as quality. Most here on FDMB feed low carb/high protein canned, raw bought from a pet store or they make there own.

Here great links, one is to a food chart put together by one of our board members that breaks down the carb % and protein % of most of the commercial brand foods. You want to keep the carb % below 10% and around 7% is great. The other link is to a site by a vet "Dr. Lisa DVM" ... who also posts on this board from time to time ... there is in-depth info. there about many things, including nutrition and how to make raw food.
Nutrition/food info

The good thing with feeding your diabetic cat this way, is that it is ALSO good for any non-diabetic cat too. All your cats can safely eat the same food without worry and it may save you some costs and headaches of having to do separate feedings and keeping track of what they are eating.


2. Home testing: It is impossible to convey the value of testing your cat's BG (blood glucose) level at home. Some vets will "suggest" this, but most won't even mention it. They will send you home with insulin and an amount to shoot and maybe some instructions about hypoglycemia (blood sugar dropping to a dangerously low level).

Well, the thing is, human diabetics don't EVER give themselves insulin without checking there BG to make sure it is safe to do so, so why shouldn't it be the same for our kitties. Here on FDMB it is. You will notice that the vast majority of people here test their cat's BG at least 2x/day (before giving each shot to make sure the level is safe enough) and periodically at other times to see how the cat is responding to the current dose. We use a human glucometer, test strips and lancets - which are all very readily available and easy to use.

Our kitties get lots of love and treats for "putting up" with this and most of them actually come out to be tested on their own 'cause they want those treats . Here is a collection of great links that "Carolyn and Spot" pulled together about hometesting. See what you think ... it truly is the best way to not only keep Your cat safe but also really get a handle on this disease and help him to live a healthy life with FD (feline diabetes).

Home testing Links

3. Insulin: There are several types of insulin available. Many people, myself included use Lantus or Levimer both of which are great insulins. They are gentle insulin and given twice (BID) per day in 12 hour increments. Or you could also choose PZI or the new version called Prozinc.

Please read up on the insulins available, here is a link to the Insulin Support Groups:

Insulin Support Groups

However, one caveat and again this shows how these three things are inter-related:

If you are feeding dry food or even a high carb food, BEFORE removing these foods, please make sure of your insulin dose as it will most likely need to be reduced, so as to avoid a possible hypoglycemic situation due to the removal of the dry/high carb foods that will lower the BG’s and reduce the amount of insulin required. Again, another reason why home testing is important.

I know this all seems like a lot, and that's because it is ... there is a learning curve here. But as long as you are determined and keep at it, you will have it down before you know it and you'll be seeing the results in Your cat' overall health and happiness. Ask all the questions you can think of - that's why we are here!

Also, if you haven't done it yet, take the time and fill out your profile. It will help when others come on and read this. Also, let us know where you live - city/state as there are probably people in your area who can provide on the ground support and help you to learn home testing, etc.



The last thing to mention is that diabetic neuropathy is treatable and even reversible. With insulin regulation AND Methylcobalamin B12, you can reverse this.

Here is a link to the Methyl B12 I used and recommend: http://www.vitacost.com/NSI-B12-Methylc ... 0-Capsules

I emptied one capsule into Maui's wet food daily.
 
Karen & Pearl said:
4) As you gain control of the diabetes, it will help the neuropathy but also, a lot of people use methyl-B12 very successfully to reverse that. It would probably not be a bad idea at all to get him on some. I really hope you learn to hometest and I really think you should look at a different insulin. One type just does not fit all cats.
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What is frustrating with my vet is that he cant give me an upfront answer... he says he wants to try to control the sugar 1st before we go any further on the neuropathy... I bought him some fancy feast while at the supermarket today but didnt have the list with me... I am going to start buying him wet food (for some reason all my life i was told wet food is bad for them- I guess you learn something new everyday)

I will def find out about the insulin you ladies are recommending.
 
christyaran said:
Karen & Pearl said:
4) As you gain control of the diabetes, it will help the neuropathy but also, a lot of people use methyl-B12 very successfully to reverse that. It would probably not be a bad idea at all to get him on some. I really hope you learn to hometest and I really think you should look at a different insulin. One type just does not fit all cats.
Click to expand...

What is frustrating with my vet is that he cant give me an upfront answer... he says he wants to try to control the sugar 1st before we go any further on the neuropathy... I bought him some fancy feast while at the supermarket today but didnt have the list with me... I am going to start buying him wet food (for some reason all my life i was told wet food is bad for them- I guess you learn something new everyday)

I will def find out about the insulin you ladies are recommending.
Click to expand...

You can buy methyl-b12 at health stores or online. Show your vet this. I'm serious:


http://www.felinediabetes.com/weak-back-rear-legs.htm

I wish I could find Karen's page with the startling pictures of how this condition totally improved over time from that picture to normal walking. Maybe someone has a new link. The old one is dead.

Are you going to try hometesting?
 
HI Ladies... So I just got back from the vet. We gained 3 oz over 3 days & his blood was at 500 when it was tested. He asked for me to come back on Friday & get there right after lunch, 6 hrs after the morning's dose of insulin to test. He did end up giving me a new bottle (free of charge) of the ProZinc. I was told he already has done a curve & I asked about the ketones & he said that he already knows its high but we would have to test to see how high. I will find out tomorrow the price on it. If you dont mind me asking what could happen if the ketones remain high?

Also about the neuropathy, one of the other young ladies did make a statement about how I said he walks drunk... & yes- I am starting to think he doesnt have the neuropathy but instead is just walking funny. I have found him not being able to walk much... he'll get down from the table & then walk a couple steps & lay down. The only funny thing is he now sits but his legs stay a little spread apart. He sits & his knees stick out... weird.

He asked me to drop him down tonight to 6U & another 6U tomorrow & see how he does & if not bring him back up & see how the testing on Friday goes.

You ladies have made me feel so much better about not allowing a vet to make me think that I would have to put him to sleep. I guess I will try everything possible to help him. I met a lady at the vet today that her cat was in remission for 2 yrs & then just recently got the diabetes back...

BTW- my vet gave me this weird look when I asked him about the Lantus.. never got a response! I have found out that in Miami its very hard to get any type of good insulin for cats. If you ladies know where I can get some online, please let me know. Seems like most vets in my area dont see too much diabetic cats & they all seem to prescribe regular human insulin... which my vet reminded me is the same as the ProZinc (Ughh!)
 
O Yeah I told him about the glucometer i received & he doesnt recommend it... he says it doesnt read correctly. The human one... he says itll read about 50-60 units off than an animal one. What do you ladies think?? I tried with a friend this afternoon to do the testing on his ear, but had no success... I think im going to read up on how to do it & try it... but what do you ladies know from experience?
 
Pet meters are more accurate than human meters (when used on pets). However, almost all human meters are accurate enough for use. Human meter are only accurate to +/- 20% and the same is expected for pet meters but the pet meter should have a better mean accuracy. Both pet and human meters use the same technology and use an algorism to reflect the differences between human and pet blood. With a =/- % error the absolute error with be higher at high BGs but low at low BGs. You need to know the BG better at low BGs to prevent/identify a hypo. At high BGs the large absolute difference is really not a concern since you really would not do anything different. I use human meters but I have a per meter. The strips for the pet meter are too expensive.
 
I'm not surprised he's pushing the other meter, he gets a commission for selling it, it's just like the fake prescription foods, another profit center.

What can happen if the ketones stay high is diabetic ketoacidosis (DKA), which is life threatening.
 
Cats die from DKA. A cat can have ketones with having DKA DKA stands for Diabetic KetoAcidosis. A diabetic can have ketones without being in acidosis.

Diabetic ketoacidosis is a complication of diabetes that occurs when the body cannot use sugar (glucose) as a fuel source because the body has no insulin or not enough insulin, and fat is used instead. Byproducts of fat breakdown, called ketones, build up in the body.
 
Thanks Larry... I will try to have him tested on Friday for the ketones... I dont want to take anymore chances.. I went ahead & was able to test him here at home just now & we got a 462 reading. :( Should I test again tonight & if so when?? If the ProZinc, takes 6 hrs to work should I be giving him his insulin closer in the day other than 12 hrs... we do it about 8AM/730PM... suggestions? I want to try & regulate this glucose. As I see i will be upping his insulin tonight back up to 8U... vet asked for us to go down to 6U but if i dont see him getting better than back up so i assume with these #'s... hes going back up.
 
Christy, you can test his urine at home for ketones. Any drugstore will have Baryer diastix, if you don't see them, ask the pharmacist. You don't need a prescription.
 
I don't have much advice to give, but I just wanted to point out that if you DO switch over to lantus, right now there is a 25.00 off coupon for your first prescription. The link is on this site, I believe it is under the lantus forum, and poss. the general health forum? You just print it out and take it to the pharmacy with your prescription from the vet. Hope that helps!
 
Hey everyone... thank you all for the help... We went to the vet this afternoon & we got a little bit of good news... the blood was finally at its lowest in 6-7 months... 338. The vet said to up his units a day- so back to 8U 2xs a day. We did a primarily urine test at the office & everything came back super normal, no elevated ketones, no blood in urine- the vet says he has a good color urine for a diabetic cat. We decided to go ahead & do a CBC/history to give us more info. Hes gained a total of 7 oz in the past 7 days, but he hadnt gone to the bathroom to urinate for over 15 hrs, the vet had to squeeze it out of him. No signs of urinary tract infection...

BUT- Im heartbroken. The neuropathy or whatever he has on his legs (spreading to the front) just seems to get worse. He has no energy to do anything. He walks about a couple steps & on the floor he goes. He's jumping onto the table to get his food pretty well... but i just look at him & wonder if hes suffering, I hate seeing him like this. Please tell me something to make me feel better, tell me this can be fixed? I want to start him on the methyl B12 even though the vet didnt tell me to b/c I feel like maybe it can help him.. what do you think? I did go on amazon & looked for it, is it just which ever one for humans? Any particular brand anyone prefers?

I will get results tomorrow & back to the vet Monday... I am changing his dry food little by little to the fancy feast/ new meow mix & eventually im thinking of cooking a home made meal for him. All the advice is appreciated! thanks
 
christyaran said:
Hey everyone... thank you all for the help... We went to the vet this afternoon & we got a little bit of good news... the blood was finally at its lowest in 6-7 months... 338. The vet said to up his units a day- so back to 8U 2xs a day. We did a primarily urine test at the office & everything came back super normal, no elevated ketones, no blood in urine- the vet says he has a good color urine for a diabetic cat. We decided to go ahead & do a CBC/history to give us more info. Hes gained a total of 7 oz in the past 7 days, but he hadnt gone to the bathroom to urinate for over 15 hrs, the vet had to squeeze it out of him. No signs of urinary tract infection...

BUT- Im heartbroken. The neuropathy or whatever he has on his legs (spreading to the front) just seems to get worse. He has no energy to do anything. He walks about a couple steps & on the floor he goes. He's jumping onto the table to get his food pretty well... but i just look at him & wonder if hes suffering, I hate seeing him like this. Please tell me something to make me feel better, tell me this can be fixed? I want to start him on the methyl B12 even though the vet didnt tell me to b/c I feel like maybe it can help him.. what do you think? I did go on amazon & looked for it, is it just which ever one for humans? Any particular brand anyone prefers?

I will get results tomorrow & back to the vet Monday... I am changing his dry food little by little to the fancy feast/ new meow mix & eventually im thinking of cooking a home made meal for him. All the advice is appreciated! thanks
Click to expand...

You seriously need to start hometesting. Certainly the methyl b12 isn't going to hurt but you need better tools to help you with the diabetes. I just can't help but feel that there is rebound going on keep him constantly hight. 8u 2x a day is just really a LOT. I know it's possibly necessary if he's eating dry food, but in order to get him on wet food and not overdose the insulin, you have to be testing. I'm not normally this forth right but you *need* to take some control here and learn to hometest so you can get him on a better path.
 
Karen & Ladies & gents... good evening. Karen I did start home testing this past week... my only concern & what id like to know is what time is the right/correct time to test? Hes on the Prozinc & ive been told it takes 6 hrs to work... so should i test him exactly 6hrs after giving him his morning dose? At night his doses are around 8/830, so i wouldnt be able to test b/c it'll b too late.

But I do have good news... the CBC came back normal... the vet says hes a SUPER healthy cat other than his diabetes, everything came back normal other than the blood glucose, which actually came out lower then the glucometer reading at the office that day.

I am trying to take him off the dry food but little by little, as im getting him onto wet food ONLY. I wont be back to the vet til Friday. But I want to home test... let me know what u ladies & gents think is best. Thanks.
 
I'm still relatively new to this too, but it seems that the general consensus is to test prior to every shot, just to make sure it is safe to give insulin (BG not too low already).

And then, when possible, test at different times during the day/night, so that you can get an overall picture of how he is reacting over the course of a day. You don't have to test every hour, every day... but if you are home and can test 2 hours after his shot (+2) and 4 hours after his shot (+4) one day... then another day do (+3) and (+6), and so on, then eventually you start to see the pattern. If the insulin you have is supposed to peak around +6, then I'd try to get some numbers around +4, +5, +6, +7 (maybe not all on the same day) just so you can get an idea of how low his BG goes.

If you are at home one day and can do a "curve" - testing every hour or every 2 hours, then great. (I never do a curve by testing hourly because I find that Odie starts to get too stressed, which brings up his numbers - but I can get a pretty good picture by doing it every 2 hours)

On a typical day, I test Odie AMPS (morning pre-shot) and PMPS (evening pre-shot)... and then I get one number sometime during the day and one late evening. If I'm home and curious, maybe I'll do a couple more. We're still regulating him (switching medications which affect his BG), so the more data, the better.
 
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