Newbie / New Diagnosis

Status
Not open for further replies.

WileyWonderCat

Member Since 2013
I am really glad I found this board -it's already helped me so much through my initial emotional crisis. My name is Jenny and my cat Wiley (neutered male/11 yrs/black DSH) was just diagnosed with diabetes last week (9/18/13). I am feeling very guilty about it because I think his diabetes is the result of a steroid shot that he had at the beginning of August. Wiley suffers from pretty terrible skin allergies. I have not been able to determine the source of the allergies unfortunately, so the vet prescribed a depo shot (methylprednisolone). This is the second time that he has had the shot - his first one was last year and he did just fine. But this time, I knew immediately that something was wrong. He had severe side effects from the steroid, including classic diabetes symptoms (severe thirst, urination, hunger, and he was very lethargic). I took him to my vet a few times over the past month to do blood and urine tests, all of which showed elevated glucose. The vet wanted to wait until the steroid "ran its course" for about 30 days before he made an official DM diagnosis, as I guess the steroid can both mimic diabetes symptoms and/or actually cause diabetes. Unfortunately for us, the "symptoms" have not gone away. I never knew that steroids could do this - I am so sad and feel like I made a terrible decision to approve the steroids (even though they do halt the allergies).

Wiley started on Lantus on Monday (1 unit twice a day). I think I've been ok about giving the insulin...though sometimes I think it might be a "fur" shot. I have managed to give him the injection when he eats, as this is one of the only times that he isn't hiding from me right now. He's not trusting me anymore since I took him to the vet so many times over the past month. He eats and then immediately hides under the bed all day. I realize that I need to monitor him...it is very difficult for me since I work a lot. Unfortunately, my boss is not a "pet person" so doesn't really understand my need to take time off or work from home. This is pretty distressing for me.

I want to start home monitoring as much as I can - at least in the evenings and weekends. I plan to purchase a glucometer and other supplies in the next day or so. Regarding his food, I have never really had him on a high carb diet. He primarily has been eating Wellness brand (pate style) wet food with a smidgen of Royal Canin Urinary SO canned food mixed in. He had urinary infections and crystals a few years ago and I've always been afraid that if I take him off the urinary food completely, those issues might come back. I allow him to free feed on dry food but typically he ignores dry food and I end up throwing it away... so in terms of diet, I don't think I need to change much. The vet gave me Hills M/D but when I reviewed the content on this forum, its higher in carbs than the Wellness. So I'm at a loss as to whether I should even really switch him.

I'm blabbering on, but am hoping for some advice on the following:

1) How critical is it that the insulin injections are exactly 12 hours apart? Can they be within 1-2 hours give or take (e.g., 8am and 10pm)?

2) Should I take him off the Urinary wet food altogether? I found mixed results when trying to find the carb % for that food. One source said 21% and another said 4%. What?! Obviously there is an error somewhere. I wouldn't worry about it if it really is 4%.

3) Have other members dealt with diabetes and allergies? I am at a loss now for how to treat him for allergies. Poor guy can't catch a break. His allergies were gone until the past few days and now he is starting to itch and bite himself again. :sad:

I look forward to reading all of the posts and I am sure I will be back with frantic questions about home monitoring. I can barely give him an injection - not sure how I am going to manage to lancet his poor ear!
 
If the allergies are unidentified, you may need to continue steroids; they can be done orally using pill pockets or compounded liquid versions. If so, it means you may need to continue insulin.

There are some oral antihistamines which can be used, so check with your vet on that.

It may be possible to do a blood test for type of allergy - it would be sent out to a specialty lab. Some companies even make allergy shots to reduce the allergic symptoms.

Low carbohydrate canned or raw foods are recommended, per Veterinarian Lisa Pierson of Cat Info. There is a printable list of foods and the percent of calories from protein, fat, and Carbohydrate ther, along with phosphorus levels if you need to protect the kidneys. Friskes Special Diet pates can work as both low carb and kidney friendly. You do need to be testing at home if you change the carbohydrate level of the diet while giving insulin as the glucose level may drop 100 mg/dL from doing that.
 
Hi Jenny and sugardude Wiley and welcome to the message board.

The Wellness is one of the better foods that we recommend. BJM gave you a link to the food chart at catinfo.org that we like to recommend for people to find the carb content.

The Royal Canin Urinary SO urinary tract formulas are 21-25% carbs on a calorie basis for the wet foods. We recommend <10% so if possible, I'd stop that food.

The extra water in the diet from the canned food is often enough to help with the urinary tract issues. You can also add a bit of extra water to the canned food, until applesauce to thick soup consistency if you are concerned.

There is some variability in the insulin injection times. It depends on your schedule. We recommend being as consistent as your schedule allows. For some people, that is a 12/12 schedule, others might need a 11/13 or 10/14 schedule. Part of the reason for consistency, is an early shot of Lantus acts like a dose increase, and a late shot acts like a dose decrease. With the consistency in shot times, you help to even out the BG (blood glucose) levels.
 
Thanks for the replies!

I'm definitely going to talk to my vet about oral antihistamines - I'm never going back to steroid injections if I can avoid it. So far Wiley's allergies haven't been too bad the past few days. I'm hoping that continues. I've heard mixed reviews on antihistamines for cats, but I'll cross that bridge when I get to it.

I tried my first blood test tonight. It was basically a non-event. I'm trying not to get too concerned yet, and will try again later tonight or tomorrow. Wiley is SUPER squirmy! I even tried to distract him with chicken but the minute I got near his ears, he was super annoyed and kept moving away. He hated the warm rice sock, so I just rubbed his ear as much as I could. I also tried to straddle him, but that seemed to terrify him even more. I did manage to finally stick his ear but didn't get enough blood. At that point he was pretty frustrated with me. "Let me eat these treats in peace!"

How concerned should I be that I haven't been able to test yet, but I keep giving him his injections? It's just 1 unit BID, but I still worry. Luckily its the weekend now and I have no plan except to monitor him very closely and hopefully have some success with testing. He seems to have more energy since starting the insulin, so I am hopeful that is a sign that his blood sugar isn't too high or low. And his thirst and urination have decreased dramatically! Like back to normal.

Also, he didn't seem to mind the injections for the first couple of days, but the last couple of doses he has started to bolt. It's like he's finally figured out - "hey you are sticking a needle in me!" Is it common for cats to start to hate their injections even though they were ok with them at the beginning? I need to find some more low carb treats that he likes. So far I've only been giving him chicken, but I'm afraid he is going to start turning his nose up at it if its associated with needles and lancets. He can be picky about food and treats.

Wish me luck!
 
While you work on blood glucose testing, there are some other assessments you may wish to make in my signature link Secondary Monitoring Tools.

To help he be calmer, if he is OK to do it, play vigorously for a good 15-20 minutes 2 or more times a day. It may help him be less squirmy.

Also, use positive reinforcement, such as a low carb treat, or brushing, and do that every time you do something to him that helps with testing.
- Rub head, reinforce.
- Fiddle with ears, reinforce .
- Hold on lap, reinforce .
- Crawl on floor with him, treat. reinforce
- Crawl over him without restrain, reinforce .

And so on.
 
Hello and welcome to the board

Here are some testing tips that may help - but just keep trying, the cat will get used to it and his ears will learn to bleed: https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

I find it easier to shoot while they are eating their normal dinner meal - they dont notice it with their heads buried in the food bowl. What size needle are you using? He shouldnt feel it.

Ideally you shoot every 12 hours give or take 30 minutes. If you know you have to be late one night in advance you can start to move the shots by 15 minutes each time or 30 minutes a day. But if your schedule doesnt allow every 12 hours then you just need to do best you can.

Wendy
 
Here's something I wrote up a while back about finding the right place and position for testing that might help: ear testing psychology

WileyWonderCat said:
Also, he didn't seem to mind the injections for the first couple of days, but the last couple of doses he has started to bolt. It's like he's finally figured out - "hey you are sticking a needle in me!" Is it common for cats to start to hate their injections even though they were ok with them at the beginning? I need to find some more low carb treats that he likes. So far I've only been giving him chicken, but I'm afraid he is going to start turning his nose up at it if its associated with needles and lancets. He can be picky about food and treats.

Yes, this seems to be a fairly common occurrence. Some cats quickly catch on to the sneak approach for shots. One thing that works pretty well is to start announcing that it's shot time so they're not caught unaware. After about the first or second week of testing Michelangelo, he started becoming wary every time he'd go to his food bowl and would eat in a very skittish manner, anticipating a shot, even if it wasn't his shot time. I realized that he was more irritated by not knowing when it was coming than by the actual shot itself so when it was shot time, I started making a big production of it so he could see that a shot was coming and I would say out loud that it was "time for a shot."

Once he caught on to my actions preceding the poking and my verbal alert of "shot time," he stopped getting so irritated with me and even started coming to me on his own and waiting for his shot before he'd go eat. I basically allowed him to decide where and how he wanted the shot and he didn't even realize that I wasn't giving him a choice about whether or not he was getting a shot. It made him much happier to have that "control" over it than to be surprised by it being forced upon him.
 
Status
Not open for further replies.
Back
Top