Newbie...Diabetic cat ? insulin only choice

[Dorothy]

HI all,
I will be taking my cat to the vet on friday and expect that he will tell me she is diabetic and will need insulin...here is my story.

Chardonnay was diagnosed with asthma at the age of 1.5 yrs she was started on oral prednisone but soon had to transition to steroid shots, She has been getting these shots every 3 months like clock work since age 2, she is now about to turn 16! About a year ago the vet told me her sugars were high but only in the upper 200's so I changed her diet from dry food to fancy feast for the high protein and still let her have dry food but a high protein one that Buffalo Blue puts out. I reversed her high sugars and all was fine. A few weeks ago she started to drink like crazy and was saturating her box, I know the gig was up! Every time I would bring her to the vet he would always say I cant believe she is still alive, I cant believe she has not gotten diabetes yet! Well I believe the time has come...here is my problem, my cat is very much a "mommy's" kitty, likes no on buy me and has always been that way. She dosent even like my husband who I started dating shortly after I got her. She hisses and spits and swipes at everyone, cat sitters come in and "run" out when looking after her when we are on vacation, she even has a red "alert" sticker on her chart at the vets, sooooo my problem is if I have to start insulin what happens when I go away? who will give her insulin? I understand that I need to adjust my life style for this and I am willing to as she is the love of my life and help me through some dark days but we have a vacation planned and will be gone for 10 days in May this is all bought and paid for and we cannot loose that $ because I have to stay and give her the insulin....She loves me and only me she is like a fur collar with me when I come home from vacations she misses me so much...I know they say insulin is the only route to go but have read that sometimes Glipizide (oral) and diet can help keep it somewhat controlled. Is that true? Do I have another option? Any thoughts ideas are welcome.
Thanks
Dorothy

 

[BJM]

Welcome to FDMB, Dorothy & Chardonney

First - ditch all dry food as they put too much strain on the kidneys and may provoke bladder infections, stones, and lead to renal impairment, per Dr Pierson of Cat Info.
That said, while you transition you may find these 3 foods helpful:
Evo Cat and Kitten
Stella and Chewey's
Young Again 0 Carb (5% cal from carb, internet only)

There's also a terrific food list at the site with the percent of calories from protein, fat, and. carbohydrate.

Food switches should be done gradually - swap 20-25% of the food each day to reduce GI upset.

 

[BJM]

2nd, positive reinforcement, associational learning, and shaping are going to be your friend.

Find things you know your kitty likes - bonito flakes, freeze dried chicken, brushing, toys - anything works.

Now, take steps to encourage your cat to trust others.
Ex. at feeding time, both of you prepare and put down the food together.
Ex. during play, both of you work in concert, tossing or dragging a toy.
- This begins the process of associational learning, where she starts considering him a 'good thing' because he is associated with food or play.

Shaping is the process of defining a series of small steps which lead to a specific desired behavior.
Each step gets a week or more of doing a step and giving the reward.
Ex. Allowing your husband to pet her is the goal.
Step 1: while you hold her, he sits beside you, she gets her treat
Step 2: while you hold her, he sits beside you with his hand near you, she gets her treat
Step 3: as above, he touches her
Step 4: as above, he strokes her once
Step 5: as above, he strokes her twice, etc

 

[KPassa]

I second ditching the dry entirely, especially since she's already eating Fancy Feast. Make sure it's only the Classics varieties as the other kinds have higher carbs.

While you also work on associational learning with your hubby, you might want to start looking into home-testing as well, that way you won't have to take her to the vet as often and you can see the effect of the food change on her. She might not even need insulin with just the food change! If she does need insulin, do not get the pills as these have been proven to damage a cat's pancreas further. She might also need insulin for only a short while and might even be in remission by May.

If not, home-testing creates a unique bond and behavioral pattern with many cats (almost Pavlovian). I have a part-feral kitty that runs and hides around "strangers" (including my two roommates who have lived here since before I got him). But when it comes to testing time, he now knows the drill and complete strangers have been able to test him. Hopefully, by the time your vacation comes around, Chardonnay will either be in remission or familiar enough with home-testing that you'll be able to find someone who can care for her diabetes while you're gone.

 

[Rachel]

Welcome to FDMB!!

Glipizide doesn't really help. My vet said she had rarely seen it have any effect and I learned here it often causes the pancreas to work harder when they need rest and healing. I wouldn't bother with it...rest and healing is needed so that the pancreas can heal and maybe cause remission!

We're all here for you. We'll help!

 

[Dorothy]

Thanks for the reply's! I immediately ditched the dry food last night. I do not think I will have a hard time transitioning her over as she is use to wet food already. I had fed her fancy feast clasic beef and chicken for over a year now with the free eating dry during the night with the high protein Bufolo Blue. It should not be a problem to stop that... she will just bug me during the night but she tends not to bother me while I am sleeping so should be ok. I started to change up her food to fancy feast, one of the ones with gravy, as she was not eating that much about a month ago and now I see the correlation to giving her the high carb "gravy" feast with this increased thirst and box saturation. I will go back to the clasic feast and see. I work a 9 hour day so I am feeding her 1/2 a small can (3oz can) in morning and 1/2 when I get home so really 1.5 oz of wet am/pm.. is that enough without the dry food? Not sure how much per day she needs. I think I will buy a glucometer and ask the vet if I can try the change up in the food for a week or so and see if I have a downward trend in her sugars. She also gets the steriod shots and gets sick from them a few days later so I am not sure how the insulin/steriod combo will be for her and if the insulin will need to be cut back around the time of the shots.... I have a couple of questions...
How would I know if she is in remission once I start insulin? Would it be by testing her sugars and seeing that the amount of insulin needed drops? If she was not in remission and I were to just stop her insulin while I was away or if the cat sitter for some reason gets one shot in but cant get the second in how harmful to the cat would it be? I do not want to cause any undo stress for either the cat or the ones sitting for her. I would be devastated if something happened to her while I was away! I could probably board her for the 10 days I am away but that in itself is enough stress without the shots, I would want her to be in her own enviroment....Lots to think/do....PS: I work in health care so testing her sugar and giving insulin is not a problem for me. I run a fingerstick clinic for pts on coumadin so I am use to lancets and testing meters...its the others in my world that the cat dosent like that I worry about! Thanks in advance for all the info. I am so glad I found this board!

 

[BJM]

... high protein Bufolo Blue. ...

It may be "high protein", however, it may NOT be low carb. Contact the manufacturer for the "As fed" values.

...I am feeding her 1/2 a small can (3oz can) in morning and 1/2 when I get home so really 1.5 oz of wet am/pm.. is that enough without the dry food? Not sure how much per day she needs. ...

About 0.5 to 1.0 oz per pound of cat, depending on activity level, divided into 2 or more meals a day. Its Ok to leave the food out.

...I think I will buy a glucometer and ask the vet if I can try the change up in the food for a week or so and see if I have a downward trend in her sugars. ...

As long as she is showing no signs of other serious illness or complications, doing the food asap and testing will let you determine whether you're going to need insulin. If she routinely runs above 200 mg/dL, she probably will need it.

...She also gets the steriod shots and gets sick from them a few days later so I am not sure how the insulin/steriod combo will be for her and if the insulin will need to be cut back around the time of the shots....

Actually, she may need more insulin around the time of steroid shots, as these typically increase the blood glucose. That may be what is making her sick.

...I have a couple of questions...
How would I know if she is in remission once I start insulin?
Would it be by testing her sugars and seeing that the amount of insulin needed drops?....

It would be by seeing glucose numbers under 130 mg/dL throughout the day, with no insulin use.

...If she was not in remission and I were to just stop her insulin while I was away or if the cat sitter for some reason gets one shot in but can't get the second in how harmful to the cat would it be? ...

Do not stop insulin when needed. It is equivalent to starving your cat, since any carbohydrate cannot be used to fuel the body. Lack of insulin also could result in fat breakdown for calories. This can lead to Feline Hepatic Lipidosis (FHL) where the fat swells up the liver and prevents its normal function, causing severe metabolic disturbances which can be fatal. And/or fat breakdown creates ketones as a by-product; too many of these may lead to diabetic ketoacidosis (DKA), also potentially fatal and requiring hospitalization.

 

[Deb & Wink]

Welcome Dorothy and Chardonney to the message board. Lot's of experience here to help you get Chardonney feeling better.

The Fancy Feast gravy style foods are much higher carb than the Fancy Feast pate style foods. Yes, it's quite possible that the gravy style foods tipped the balance and caused the BG (blood glucose) levels to increase.

I do not think that 3 oz of food a day is enough, unless she is a very tiny kitty. My little civie (non-diabetic cat) Delta, eats 4-5 ounces of food a day and she weighs 7 pounds.

I recommend you increase the amount of canned food to the formula that BJM gave you in the previous post.

About 0.5 to 1.0 oz per pound of cat, depending on activity level, divided into 2 or more meals a day. Its Ok to leave the food out.

Mini-meals help to put less stress on the pancreas. If you can feed 4-6 smaller meals a day, that may also help the BG(blood glucose) levels to even out a bit.

 

[taffysmom]

Hi Dorothy the people here are wonderful and have great advice. Don't get discouraged by your kitty's dislike for others. When I read your post I just wanted to give you a big hug and let you know it will work out because my cat sounds just like yours. Only in addition to her swatting and hissing at others she does it to me as well when the tortitude comes out (which is quite often and she bites on top of all that) I cried when they told me he had diabetes because I thought there was no way this cat would let me give her shots...I was wrong. When the vets suggested me home test (b/c they didn't really like her either) I told them they were crazy that I would probably lose a finger...I was wrong but I do have some battle scars from getting her used to it - she is fine with it now. When I had to board her and she was so stressed she developed ketones among other things and they told me to get a pet sitter I thought 'yea right - no one likes this cat but me'....that took a little more work but I finally found a sitter that doesn't mind her hiss and spit episodes. With diabetes comes hunger. With this cat, hungry = aggressiveness. I have to lock her in the bathroom while I get everything prepared but as soon as I open the door she runs to her food bowl and she is so focused on eating a big hairy dog could be giving her shots and she wouldn't even notice I have the sitter come over 2 times before I leave. 1st time is to give her the freeze dried chicken treats (which Taffy is totally addicted to now) and to let Taffy know this is a nice person with something that she wants. The 2nd time is during shot time and I leave the house while the sitter gives the shot. It can take up to 15 mins for Taffy to come around for the food but once she does it is a quick stick and she is none the wiser. My pet sitter just graduated with her physicians assistance degree and owned a diabetic cat for 10 yrs and honestly she is better at the shots than I am. Hang in there and hopefully it will all work out

 

[Dorothy]

Thank you taffysmom for your post it really sets my mind at ease to know I am not alone with a difficult cat to contend with. My Chardonnay loves me and really cant get enough of me, she follows me around the house like a dog would and most times cannot get he off of me (which I do love)!. It is all the others in the world that she does not like! 2 days ago I took away her crunchy dry food and have been giving her just the FF clasic beef and she has not minded at all missing the dry food. Be it only 2 days without the dry I have already seen that she is drinking less and peeing less! She goes to the vet this afternoon and we will see where her sugar is at. I am hoping for now we can give it a week or so on just the high protein wet food and see where we are at. I plan to get a glucometer and test at home to monitor.
What is an acceptable glucose number for a cat? I am sure the vet will let me know. I do have a big group of friends that will do anything for animals, although most are dog lovers, so I am hopeful that I will be able to get one of them on board if it comes to insulin. I will keep you posted after the visit to the vets.Thanks

 

[taffysmom]

well..the vet will probably try to get you to buy an Alphatrak but I (and I think most people on here) use the relion confirm from walmart. I order everything thru the links because I really hate going to stores to shop. The meter is around $14-$16, lancets $4 and strips $40 for 100. The others will post what you need to buy and what readings mean. My cat is 'special' and is isn't like most cats on here when it comes to her diabetes - see her high dose in my signature?? It's been a frustrating battle that I know I won't win in the end but do what I can while she is still willing. You should start a spreadsheet when you start testing (they will help you with that too!). I'm on my 3rd vet practice and 4th doctor for various reasons but all have been ok with the human meter and with the cost of insulin (I go thru 1 vial in about a month) the less I have to spend on other stuff the better!

 

[Deb & Wink]

What is an acceptable glucose number for a cat?

Member BJM put together this nice reference range information.
Reference ranges for decision making

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]

* * * * * * * * * * * * * * *


How to use the glucose reference values chart:

When you get a test, look for the number on the chart that either equals, or contains, the test value you have. Read the information. As needed, make a decision and act.

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.) [/quote]

New member shopping list link so you can easily print it out.


Here's the full "shopping list" for when you're ready
1. Meter ie Walmart Relion Confirm or Micro.
2. Matching strips
3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool.
4. Cotton balls to stem the blood
5. Neosporin or Polysporin ointment with pain relief to heal the wound
6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against
7. Ketone urine test strips ie ketodiastix - Important to check ketones when blood is high
8. Sharps container - to dispose of waste syringes and lancets.
9. Treats for the cat - like freeze dried chicken
10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast

 

[Dorothy]

Thank you very much for all you thoughts... But it is with a heavy heart that I must tell
You that I had to put Chardonnay down yesterday. We saw the vet on Friday and her BG
Was 308 around the same as it has been in the past but with her complicated diagnosis of
Asthma and getting routine steroid shots we were deciding what to do. She has just gotten
Her shot so we had time as you can't give insulin to a pet until at least a month later. She was
Dehydrated when I brought her and he had a difficult time getting blood. The gave her IV
Fluids and I took her home with a plan of thinking over the weekend what to do and get the
Blood results on Monday. On Saturday she seemed a bit out of sorts but she had just been poked
And proded at the vets and also was sedated for the exam. Saturday night she vomited and had what
Looked like a seizure. I took her to bed with me as was going to see how she was through the night.
Early around 4am she vomited again with another seizure and was extremely lathargic, dazed and her gait
Was off I immediately took her to the emergency vet clinic, she was in ketoacidosis with live failure
As well as developing cardiac issues. Given her age 16 and her complicated history and the long road ahead
It was decided we needed to put her down. I held her the whole time and rocked her til it was over. It has been a long
Hard weekend and my tears are still flowing. She lived much longer than expected and I know it was due to my
Loving care. It is just such a big hole that I'm not sure I can fill. I wish I would have been able to put all your good info
Into play. Thanks so much! Dorothy

 

[Larry and Kitties]

I am saddened for both you and Chardonnary for the outcome.Sending purrs and prayers for both of your.

BTW, yo daid "Her shot so we had time as you can't give insulin to a pet until at least a month later."
I never heard of that, you can give insulin after a steroid shot.

 

[BJM]

Requiem aeternum, Chardonney.

{{hugs}}

And I'm sorry, but your vet is misinformed; you can give insulin and steroids concurrently. You may have to adjust the insulin dose due to he glucose increase from the steroid.

 

[Becky and Toby]

I'm very sorry for your loss :sad: Rest in peace, Chardonnay.

 

[Deb & Wink]

Lighting a ring of candles, in memory of your beloved Chardonnay. Goodbye sweet darling. You were so deeply loved.

 

[Liz&Gus]

Chardonnay can play in clouds of catnip with my Gus.

Remember: You set Chardonnay free not because you didn't love her, but because you loved her too much to force her to stay.