Newbie Owner of a Diabetic Cat

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runscottie

Member Since 2013
Hello everyone!

My name is Diana and I am the owner of a 6 year old orange tabby cat named Rice Krispies, or Krispies for short. He is a large male cat, right now he weighs 12.5 lbs but he is not overweight at this weight because of his size. After a few weeks of symptoms like over drinking, over urinating, over eating but losing weight I finally looked up the symptoms and could tell pretty much right away that it must be diabetes. I rushed him to the vet yesterday (Sat) and had what is quite possibly the most stressful vet visit I could imagine.

So a little background: About four months ago I moved to a new apartment in a new city, so this was my first visit to a new vet clinic in the area. Well, I got there and nothing was too out of the ordinary, however the neighborhood where the vet clinic is located is in a large latino community and so many of the patients and staff were speaking in fluent Spanish. I only bring this up because I found communication between my vet and I to be very troublesome. The vet that saw my cat had a thick accent and spoke in no-so-fluent English. He could get ideas across but there was definitely a bit of a language barrier, imho.

This especially became clear after my cat's blood test was done and he was found to be, indeed diabetic. The vet showed me that his BG was at 500 mg/dL (very high) and then explained they would test for kestones in his urine. I waited for nearly an hour and then the vet comes out and says that my cat needed to be hospitalized for 4 hours and I should come back to pick him up then. Then I would have to bring him back on Monday for another hospitalization. He goes over a bill with me basically telling me random dollar amounts for random services that I only half understand. Then tells me to pay and come back in 4 hours. I was so panicked!!!! I went home a wreck.

When I got back I had a clearer head and had done more research online. After hospitalization they got his BG down to around 400. I asked if they had found kestones (Answer NO, thank God. But why didn't they mention that to anxious me earlier!???), I asked what a regular BG should be. I asked what kind of food I should give him as I had been reading about low carb diets for diabetic cats. The vet told me that yes "low calorie" diets would help and that he could prescribe me some diabetic food if I liked. He seemed bothered by my questions about his diet! Then the vet then gave me a good solid explanation and demonstration of how to administer insulin (using U-40 needles) to my cat, probably the only positive experience I had with this vet. I then returned home with my cat.

Okay PHEW sorry that was so long but had to get it off my chest! Here are my newbie questions for you all:

1. Is it normal for the cat to be hospitalized like this? I need to bring him back Monday apparently. I already paid for his Monday work as they included it already in the bill so I will do it. But is this normal? Is it because his BG was so high?

2. The vet mentioned nothing about home testing, and his recommendation about food seemed very suspect. I didn't even bring up home testing after I got the response about the diet. But based on what I've read this is the way to go... However, I've read warning signs about altering the cat's diet to low carb and not adjusting insulin levels as this can send them straight to hypoglycemic state...
So at this point I'm thinking:
A. After Monday find an new vet. This is difficult because Rice Krispies does not travel well in a car (he will go to the bathroom in his carrier case if he's in the car too long) and so I'd be stuck with finding something local, where I might run into the same language barrier issues.
A. After Monday try to find a home vet who does house calls. My mom who lives in a different area has a great home vet who takes care of her dogs. I've had good experiences, however they are expensive. And the above hospital visit has zapped my financial resources unfortunately.
B. Stick with current vet but come in prepared to convince him to let me do home testing, adjust diet, etc. (I fear this to be an uphill battle)

Does anyone have any advice?

Sorry this post was so long. I'm sure you all can tell that I am completely overwhelmed. I am a single woman in my mid twenties and have never had any major medical issues with myself or with any pet I've owned. This is all super brand new. I appreciate any assistance!
 
A. After Monday find an new vet. This is difficult because Rice Krispies does not travel well in a car (he will go to the bathroom in his carrier case if he's in the car too long) and so I'd be stuck with finding something local, where I might run into the same language barrier issues.
A. After Monday try to find a home vet who does house calls. My mom who lives in a different area has a great home vet who takes care of her dogs. I've had good experiences, however they are expensive. And the above hospital visit has zapped my financial resources unfortunately.
B. Stick with current vet but come in prepared to convince him to let me do home testing, adjust diet, etc. (I fear this to be an uphill battle)

They probably want to run a curve (a day long testing of his blood sugar levels) We like to test at home because most cats are stressed at the vet and stress raises levels. So doses based on these numbers are usually much higher than those at home and can result in prescribing too much insulin. It is an expensive and, we think, unnecessary expense. If he doesn't have ketones, I would call the vet and tell them you won't be bringing him in on Monday and either contest the charge for that day on your credit card or stop the check and issue a new one for the things they did. The simple truth is that you need a vet you can easily communicate with and are comfortable with. You're the consumer. :mrgreen:

If you want to give us your city and state, we might have some vet suggestions nearby. Do you already have the insulin? What kind? If it is U40, it is probably ProZinc which would be okay. If it is Canninsulin or Vetsulin, it is much harder to regulate with, as it is a harsher, shorter lasting insulin. If you have the insulin,, you can start treating this at home with our help. (just like human diabetes, this is a disease treated at home with regular testing and monitoring and changes in dose made on the data found by testing.) We have a lot of collective experience and can help.

I would go get some testing supplies today so you can see what his levels really are. We have taught hundreds of people how, over the internet. We have a shopping list to help you out if you would like.

We'd love to help you help your Krispies. Keep reading and asking questions.
 
Hi and thank you for the reply!

Yes, I already have the U-40 ProZinc insulin and 100 of the injection needles. And yes, if I don't have to bring the cat in for Monday I would save around $300 at least based on the receipt they gave me. Not sure how easy it would be to contest the charges with them but I can try. However, if I don't go on Monday to this vet I would definitely want to take him to another vet as soon as possible to get instructions on home testing and adjusting insulin dosages. I live in Weehawken, NJ which is right across the Hudson River from NYC. NYC is close but difficult to get to due to traffic, so if anyone has recommendations about Northern NJ vets I would love to hear them.

I went to Walmart earlier today and got all home test materials based on what I've seen posted here at these forums (Relion Confirm glucometer, test strips, lancets, etc.) and I am ready learn how to do home testing but I definitely want a vet who I feel comfortable discussing these things with and can feel confident in.

I appreciate all the help and info I've found through this website and forum. I would have been even more overwhelmed and confused if I hadn't found this place!
 
Hmmm didn't realize Weehawken is mostly hispanic area. I'm in NJ too, Woodbridge area (exit 11 Tpk, 131 Parkway) just to give you an idea of distance.

There are good vets in NYC and around North Jersey, just really depends on his traveling abilities. I don't think you need to come all the way down my way for a vet, however, but I would suggest researching vets in nearby towns and asking them questions. Here is a link to questions that you can ask any vet:

http://www.indulgedfurries.com/petdiabe ... stions.htm

Additionally, since you have the supplies or most of them, we can certainly help you get started, monitor and manage your cats diabetes without a vet. Of course, it's always a good idea to have a relationship with a vet too.

Here is some basic information.

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 is a link to a site by a vet "Dr. Lisa DVM" ... who also posts on this board from time to time ... www.catinfo.org

If you look on the right side of her site, she has a food comparison chart to help you figure out what food you want to get based on the carb %.

You want to keep the carb % below 10% and around 7% is great. (Personally, I stay between 0-6% carbs.)

While on her site, you can read about in-depth info. on nutrition and how to make raw food, etc.

Here is another link that will give more information about food/nutrition

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 home testing. 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. The top three we recommend are Lantus, Levimer or Prozinc all are great insulins. They are gentle insulin and given twice (BID) per day in 12 hour increments.

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

Insulin Support Groups

As you were given Prozinc, please read up on this insulin, as it does work differently than Lantus and Levimer.

We also suggest when giving insulin to use the start low, go slow approach - meaning start at 1 unit or even 1/2 unit and with home testing to see how the dose is working, after 3-5 days on average to adjust the dose if needed.

You are probably using U-40 insulin syringes. While these are fine, if you can get the vet to write you scrip for U-100 insulin syringes with 1/2 unit markings - it should read like this: U-100 0.3cc

The syringes come in long or short needles (my preference is short needles - 5/16" length). If you use these syringes - then you will also need to convert the insulin dose, because 1 unit on a U-40 syringe is not 1 unit on a U-100 syringe, it's 2.5 units. (Here is the conversion chart that you can print): http://gorbzilla.com/conversion_calculator.htm


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 I've just given you a lot of information. Don't feel you have to understand everything at once, cause you don't. It takes time, but soon you will begin to understand and get the hang of it.

You can do this on a budget. Here is a shopping to get started:

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. Neosporin or Polysporin ointment with pain relief to heal the wound (can use generic brand)
5. 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. Treats for the cat - like freeze dried chicken, even rotisserie chicken, deli chicken, canned tuna will work
9. Karo syrup/table syrup, honey or any sugar product like jam, jelly, etc. if you dont have it at home - for hypo emergencies to bring blood sugar up fast -
10. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast


* We suggest the Relion meter and matching strips from Walmart, as they are the most economically priced meter and strips. That is assuming you have a Walmart nearby. If not, then you can purchase any human glucometer except for Freestyle with butterfly strips or any meter with TRU in the name. People have had issues in the past with these meters and best to start off with something else.

OK, that's enough for the moment. What questions do you have?
 
Well, actually Weehawken, NJ doesn't have much of a latino population. But the nearest vets are in Union City, NJ, which is a very high latino population. Unfortunately my kitty doesn't travel well (will usually go to the bathroom in his carrier after only a little while) so Woodbridge is a bit too far... Right now I am thinking of giving Heights Veterinary Associates in Jersey City, NJ a try. They are a branch office of Animal Infirmary of Hoboken and Bayonne Animal Hospital... they seem a bit more legit than the place I went to in Union City. Has anyone had any experience with them? I will call tomorrow and try asking some of those questions. But from what I'm reading here, its basically optional for me to go back to the vet? At this point should I just focus on home testing or should I try to get set up with another vet? At what frequency do people bring their sugarcats into the vet for checkups?

I am set to go on food. Prior to his diabetes I had been feeding Krispies dry food in the morning and wet food in the evening. Now I have my low carb canned cat food ready but I don't want to make the switch yet because of the warnings I see about insulin dosages. The vet yesterday told me to start with 1.5 units of U-40 syringes. Reading around this forum that seems high, should I lower to 1 unit? Then afterwards switch over to ONLY low carb canned?

Also, about the insulin. Are you saying I should switch insulin from ProZinc to something else? Or just switch syringes from U-40 to U-100? I've also been seeing stuff about "Lantus" insulin. Not sure what this is? Is this something that I need?

As for home testing, went to Walmart today and got the whole kit and kaboodle. I had actually found that list below and got everything that I could, including glucometer and testing strips. I'm going to read up around this site for how to do home tests and I will post with any questions I have.

Thank you to everyone for these helpful responses!
 
You can use Prozinc there is nothing wrong that insulin. In some ways it is actually an easier to use insulin than Lantus or Levimer. As it doesn't build up in the system and is more of an "in and out" insulin. Meaning there is no overlap or shed of prozinc. It is a more flexible insulin if you need that due to your work/school schedule.

Because there is no overlap of insulin in the system if you shoot early or late, it is not as big a deal as with lantus or levimer, which is more strict in the protocol to follow for shooting time.

No matter what you do want to stick as close to your 12 hour schedule as possible. Meaning if you shoot at 7 am, you want to shoot again at 7 pm. Of course that will depending on what the BG tests tell you.

What I meant was, if you are trying to micro dose, ie giving less than 1 unit at a time, you may find it difficult to do with the U-40 syringes you have. As those are only in 1 unit increments.

If you are able to get a scrip (needed in NJ) for U100 syringes, you can purchase these syringes with 1/2 unit markings. It will just make it easier to micro dose. Please keep in mind that you must use the conversion chart if you use U100 syringes.

While you can manage diabetes at home and don't need a vet to help you with this, it is always advisable to have a vet that you can go to in an emergency, for other illnesses, etc. I think it's a good idea to source another vet and even if you just have a quick consult at least you have a place you can rely on and go to when you need it.

If you are home testing, there really isn't a need to bring the cat to the vet for glucose testing, doing a curve, or a fructosamine test, etc. You have all the relevant information because you are home testing. You can save money this way by not needing to take the cat for a curve (which if done right is testing the BG every 2 hours over a 12 hour period.)

If you have not yet started insulin, then you may also want to start by changing the food immediately and testing to see if that is enough to bring the cat back into normal range. Sometimes a diet change alone is enough and no insulin is needed. Sometimes diet change along with insulin does it too.
 
Hello and Welcome Diana and extra sweet Krispies :-D It's great you found this place so quickly! This is all scary and confusing at the beginning and you will have lots of questions and concerns. Keep asking questions and keep reading the boards. You are in good hands now :smile: You are going to do great!

Kim and Twice
 
Hillary has given you great info. ProZinc is a good insulin and you can use your U40 syringes until you are giving doses under .25 Then U100 needles are easier to see. I agree that you could change the food now, if you are not giving insulin yet. That might lower his numbers and it will give you time to get hometesting down. Most people here go to the vet for shots if needed and emergencies. They do not rely on them for general diabetic care.

Here is a big document with links and info, all about ProZinc. Take your time absorbing it and ask any questions you need to.

http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=32799

Yes, we do suggest starting with one unit. As you are hometesting, if he runs high with one unit, then you can increase it in small increments. If you start too high, you run the risk of having a low number and then to figure out how much to shave off the dose. Much harder to do.

Hillary has given you a shopping list for testing and the link for tips on how to do it. We suggest getting him ready by picking a place you will test and taking him there, playing with his ears, giving a treat and letting him go. Then add the rice sack to warm his ears, rinse and repeat. A treat every time. Finally, after you have practiced with the meter and feel confident, try a poke. Then treats. Here are some low carb treats: Lo carb treats
 
Hello all!

I did my first home test and it went well! Mostly because my cat is a sweetie and SUPER motivated by food and treats, so I was able to keep him between my legs while kneeling on the floor and when he got restless I just gave him another dehydrated chicken treat. I used the rice sock trick and that helped a ton. His BG was at 290 according to my Relion Confirm glucometer . This was before I fed him and then gave him an insulin shot. After I fed him I gave him 1.5 units like the vet prescribed but based on what I am reading here tomorrow I will bring it to 1 unit and then home test at that level for the next few days. I'm definitely feeling more confident about this now.

All of your tips have been helpful and informative. I will find a new vet but at least I can do so now with a little less stress.

Meanwhile I have been trying to find information on home testing. This upcoming Saturday when i can be home all day I will try to do the home curve, where you test every 2 hours right? I'm trying to find info on when to home test and how to adjust insulin based on recorded BG levels. Does anyone know where I can find that kind of info?
 
Hi Diana and sugardude Rice Krispies and welcome to the message board. Sounds like you were off to a bit of a rocky start with the vet but you have been getting some good suggestions from the folks here.

Testing suggestions
1. always before you give a shot of insulin. This is so you do not shoot insulin if the BG (blood glucose) numbers are too low. We suggest > 200 for beginners in this journey and changing that limit as time goes on and you gather more experience on how your cat does on the doses of insulin. ECID. Every Cat is Different.

2. somewhere in the middle of the 12 hour cycle. This is so you know how low that dose of insulin took your cat. This low point or nadir can vary from +4 to +9 hours after the shot.

3. whenever you think something strange is going on, or your cat Krispies is not acting right.

4. when you can. This is to help build up a record of how Krispies is doing and show you and us patterns on the reaction to the insulin doses.

By the way, Welcome to the Vampire Club and your first successful home test. Glad to hear that Krispies is cooperative and food motivated. Hopefully, he'll remain that way.
 

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Fantastic! Welcome to the Vampire Club :mrgreen:

With ProZinc, the dose is determined by looking back at the previous numbers and shots, so getting data is valuable. So, for example, you got a preshot of 290 and gave 1.5 units. If you can test at the midcycle point (about 6 hours after the shot), you will see how low the insulin takes him and know How that dose worked. At the beginning, it can take a few cycles for the insulin to start working with his body. And if you change completely to wet low carb food, that can also drive the numbers down over time. Keeping your numbers is this color coded spreadsheet is a huge help:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Some other guidelines that will help. We consider a cat regulated if they are in the mid 200s at preshot and below 100 at midcycle, but not under 40 (40 is nearing hypo territory and requires intervention). We suggest that new diabetics do not shoot under 200, but wait 20 minutes without feeding and retest (food raises bg levels). Then if the number rises and is over 200, perhaps shoot a little less.

It sounds complicated but we will do our best to help. Once you get a spreadsheet up, you can post over in the PZI forum where everyone has experience with your insulin. You might check it out now to see other people's spreadsheet and how they are dosing. The forum is here:

http://www.felinediabetes.com/FDMB/viewforum.php?f=24
 
Hello all,

Okay so I have a quick question about home testing. I have successfully home tested 3 times now. My cat is a sweetie and doesn't make it too hard for me. However I'm a bit concerned about his ear.

I believe I am hitting the "sweet spot" with the lancet correctly. But should I be aiming for the same exact pin point spot each time? Right now I can see on his ear 3 little red pricks, one for each time I've done the test. How do i avoid bruising? When do the red little dots clear up? I'm afraid at this rate Krispies ear will be red all over! Does everyone just keep using the same spot over and over again?
 
Congrats on sucessful testing! You can use a small smear of Neosporin with pain relief on his ears. (they do toughen up over time and stop turning red). And if you can get blood in multiple spots, I'd spread the poking around. :-D
 
It is good that you found the "sweet spot", now you can try poking both ears, poking front to back or back to front, moving up/down the area to vary the testing site.

Neosporin with pain relief is good to rub on ear after poking to help with the bruising that you see.
 
Great job Diana! And welcome to the first small feeling of "control" over your situation. Every step you make from here on in is going to make things easier and way less overwhelming! Congrats to becoming a Vampire Club Member, and give yourself a big pat on the back for being such an awesome mamabean :-D
 
And if you would apply slight pressure, for 20-30 seconds or longer (60 seconds) if Krispies will cooperate with this. It helps to stop the bleeding a bit and you get less bruising.
 
Thank you everyone! I'm now on day 3. Good news! Yesterday I went to that not so great vet clinic and was able to recover $300+ dollars because I did not take Krispies in for an additional BG curve. I will be calling around this evening and hopefully will be able to meet with a new vet.

So, as you can see by my signature, I now have Krispies' SS up and running!

Starting Sunday night I switched him from his old Morning dry food Evening wet food diet over to ALL low carb wet ALL the time :). His BG seems to be steady around the early 300s. The vet had recommended 1.5 units but I lowered it down to 1 units after reading around this website. Should I wait until I can do a blood curve on Saturday (when I am free to do one) before making any insulin adjustments? Is it dangerous for him to be in the 300 level preshot? How soon does it take for an all low carb diet to affect BG?
 
Hooray! Spreadshee looks great - so glad you got your money back. Yes, i would wait for the weekend to do a curve, when you have time. By then, you two will be experts at this testing stuff. It will also give the wet food time to lower the numbers. One thing you could do that would give us a better picture of how the insulin is working, is to get a few midcycle numbers. If you can't get them during the day, try to get one at night. (some people set their alarm at +6 and getup, do a quick test and go back to bed.)

You are using ProZinc, right? If you could, please add that to your signature and the food he will be eating. Insulin is dosed differently depending on type.
 
If you can get a few tests in during each cycle or at least when you are home, that will be great in seeing how he is doing with the insulin dose and food change.

You don't need to be in any rush to do a curve. don't feel pressured that you have to conduct a curve at all. It really isn't necessary, if you are able to get tests in at different times during the cycles. Yes, it's interesting to see what happens during one cycle, but again not always needed. Take the pressure off yourself and get accustomed to testing and let's go from there.
 
Hello all!

So krispies continues to hang out at early to mid 300 BG levels... I'm reading that thus ours him at risk of ketones right? I got some ketones test strips when I bought the glucometer. Any tips for ketones testing? Or do I not have to worry about that yet?
 
If you can monitor midcycle, I'd consider raising the dose to 1.25 or a fat one unit (you'll have to eyeball 1.25 with U40 syringes. For a fat one unit, draw up a little more and then squirt out till it is just above the one line.)). It would be better if we had micycle numbers so we'd sure know he wasn't bouncing back at preshot from a low, but the few midcycle numbers don't look like it. It is always best to be able to monitor midcycle if you raise the dose, if possible.

No, you don't want him sitting in the 300s and you should test for ketones. Oliver would not pee if we were watching, so we got some aquarium gravel, filled a clean litter box with it and left him alone. He couldn't stand seeing the clean box so he would go. Then we'd have time to swoop in and get the sample as the urine wouldn't be absorbed in the gravel.
 
Yeah, I do need to do more home tests mid cycle. To be honest I've been reluctant as I think I feel a little guilty everytime I poke his ears. I hate seeing the little red marks on his ears. I know its just me projecting my feelings on to him because as far as I can tell krispies barely minds... But thats just how im feeling.

Anyways tonight im going to pick up some bonito flakes from an Asian supermarket. Krispies loves the powerful smell. Ironically I used to feel guilty when I would give him the flakes. I would buy them for some Japanese cooking that I do and thought I was being a bad owner by feeding him people food! Turns out these flakes are way better as treats then the high carb cat treats I've been feeding him all these years.

Once I have the treats I'll be able to motivate him to stick around for home testing. Turns out he's not so into dehydrated chicken.
 
the chicken doesn't have a strong smell like the bonita flakes. Yup sometimes human food is perfect for our furries

and yes you need to not feel guilty about poking, if you think about the necessity of it as saving his life, the bruises are minor and they have very few nerve endings in the ears, which is why it is ideal for poking. Most cats don't mind the actual poke what they hate is being held down to do it. The poke is nothing to them.
 
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