Newbie, sick cat with questions

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babs

Member Since 2012
Hello: I am in a quite dire situation with my cat. She has had vomiting (occasional) and diarrhea (severe) for about 3 days. She is a mess right now (we recently lost a kitten to a serious and very similar illness). When I took her to the vet about this, they found from blood tests that she has an infection, and also diagnosed her as diabetic.

Now, we are treating her with sub cu fluids, antibiotics, and they gave her an insulin shot yesterday (2 units NPH). I have more insulin at home. I am concerned about the following things:
1. I bought a glucose meter to monitor because she isn't eating much if at all, so I don't want to over inject insulin. Her last reading was 380. But the vet told me on the phone that human test strips do not work and I need animal test strips to get reliable readings. Is this true? I think this sounds all wrong, I haven't seen any mention of pet strips on this board?
2. Should I try some insulin to bring down her blood sugar? I want to do this to reduce her peeing and therefore dehydration
3. The vet seems to think this condition could be caused by diabetes, but I am inclined to think she has the virus that killed our kitten (identical symptoms). Is severe diarrhea seen with diabetes?

Thanks everyone!
 
I can only answer your first question Human test strips work just fine with cats that's all we have ever used blood is blood :) I hope your little furbaby feels better soon
 
Your cat may have high blood glucose readings due to the illness and may not need insulin in the long term. Diarrhea is not a primary symptom or sign of diabetes.

NPH (N) is a very poor choice for treating high blood glucose in cats. Please check the forum HEALTH LINKS and look for the American Animal Hospital Association link to guidelines for treatment of diabetes in cats. Home testing is recommended and regular human meters are good enough. Animal specific meters and their test strips are very expensive.

With vomiting and diarrhea, sub-q fluids are vital. If your cat will eat anything, make sure it is WET food, low-carb and preferably gluten free.

I disapprove of vet-bashing but do you have confidence in your veterinarian?

Keep us updated.

Best,
Rebecca
 
Forgot to say, if you do use insulin, please do test. And do NOT give more than 1 unit of any type of insulin initially. N will work, it is cheap @ Walmart, but is not a good long-term choice.

Highly recommended is for you to get some keto-diastix. This will give you a rough idea of your cat's urine glucose levels and, more importantly with possible dehydration, let you check your cat's urine ketone levels. High ketones can kill a cat and should be monitored.

_R
 
Here is a link to the guidelines that Rebecca mentioned:
http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf
You will see (I think on page 218) that NPH is not recommended for use on cats, and Lantus, Levemir or Prozinc are much better insulins to treat feline diabetes. A starting dose of 3u is pretty high as well.

Is there a test your vet can do to check for the virus?

Like others have said, human meters work just fine. Just about everyone here uses them. Some use "pet meters" but most don't, and there's a huge difference in cost.

Carl
 
Thanks so much for these answers, this helps immediately. I am going to go with a unit to try to get the readings down a little, and I'm going to try a little bit of feeding by putting food in her mouth. I will keep her hydration up, she is drinking and I have the fluids. We will see.
There is a test for the virus, and I think we should do this if she doesn't improve. 4 of 6 kittens died (we adopted one) and I can't believe the vet isn't willing to entertain the idea that this is what is going on with our older cat too!
In answer to your question about the vet, I am rapidly losing confidence. I don't understand their diagnosis, I feel that they were incorrect about the pet test strips, and I am disappointed that they routinely use the NPH if it isn't recommended. We are new to the area so this is a new vet: bad timing.
OH well, thanks so much again for the help! It could make all the difference over the next few hours before we can get back to a vet. I will let you know how she does.
 
Please if you could let us know where you are located, there are people on this board from all over the world. If we know where you are maybe a member in your area can recommend a better vet.

Terri
 
Because that insulin usually only lasts 6-8 hours in a cat, picking up the food 8 hours after the shot OR dividing. The total daily dose into thirds and give it every 8 hours.

That is if, and only if, the preshot glucose level is greater than 200 AND the cat is eating.

If appetite is really poor, 0.5 units may be a better dose until you see what effect it has.
 
Hi: Great idea for the vet recommendation: We are in Somerville MA, just outside of Boston/Cambridge. If anyone has a good diabetes vet anywhere near us I would love to hear about it! Thanks!
 
Start a new post and put in your subject looking for a vet in the Somerville, MA area and hopefully someone will see it and recommend a good vet for you.

Terri
 
babs said:
Hi: Great idea for the vet recommendation: We are in Somerville MA, just outside of Boston/Cambridge. If anyone has a good diabetes vet anywhere near us I would love to hear about it! Thanks!
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PM sent with vet recommendation.
 
HI everyone: just wanted to give an update on our cat. We went to a new vet yesterday for a second opinion, she also uses NPH but will prescribe Lantus if we want, and she acknowledged there is more going on that just diabetes, which was nice! For now we are sticking with NPH until the cat is a bit more healthy generally. She has improved a lot in the last 24h: she is much less dehydrated (although we are still giving fluids as a precaution) and her diarrhea has decreased although it is still happening (I think the antibiotics she is on can also cause this so maybe that's all it is). But the main thing is, she is eating! And she is talking to us and seems like herself again. I am so relieved! So now all we need to do is learn how to manage her diabetes. We have been having trouble getting blood samples: even with vaseline, I can't often get a big enough bead of blood for our test strips. But we have managed it: yesterday we kept her between 100-200 all day by giving her 1/2 unit when she ate a reasonable amount (10.30am, 2pm) and her levels were 183 3h after the first insulin and 230 before the second, then they fell to 100 so we didn't give any more. Today we couldn't manage to get blood most of the day so I gave a total of 2 units split into 4 injections when I saw her eating (7.30am, 9am, 12pm). However, at 4.10pm we managed to get blood and she was at 38, so I have given her treats and she has eaten more... She seems totally fine, but I was a bit scared!

Any tips for managing the insulin injections? Also I can't stay home with her forever so need some sort of routine...

Thanks again to everyone who helped us through the last 48 h it was very, very reassuring to hear all that advice!
 
Glad to hear your girl has perked up some! I use Lantus so no dose advice from me, but maybe I can help with your testing struggles..

What sized lancets are you using for testing? You will want to start out with 26 or 28 gauge lancets. The smaller sizes for humans are too fine and will go right through the ear. Also, make sure you have a cotton ball or a folded up piece of tissue behind the ear where you're going to poke. I use half a cotton round - then use that to put pressure on the poke afterwards. It is also very important to warm the ear first to get the blood flowing.

Don't give up! You'll get into a routine with it in no time!
 
babs said:
Today we couldn't manage to get blood most of the day so I gave a total of 2 units split into 4 injections when I saw her eating (7.30am, 9am, 12pm).
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WAIT... you gave 4 insulin shots in single day????

Insulin is only given twice a day in cats, roughly 12 hours apart. This is important if you ever switch to a long lasting insulin such as Lantus. Pick two times that is convienent for you every day, say 6am and 6pm. If you can't give an insulin shot for some reason (cat won't eat, etc) then it's best to just skip the insulin shot. When the next insulin time comes around, make sure that your cat eats something and that you test the blood glucose level. Give the usual amount of insulin. Do not double the dose to make up for the missed insulin shot.

Here is info on how to use Humulin N for cats: http://felinediabetes.com/FDMB/viewtopic.php?f=19&t=303 Generally you feed the cat some food, wait about half an hour, test the bg level, give insulin and the rest of the food. Having some food in the tummy helps "softens" the effct of Humulin N. HUmulin N can hit the body pretty hard, especially with an empty tummy.

Here are the hometesting tips: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=287 Are you warming the ears before poking? Really really warm ears bleed best because of the increased blood flow.

However, at 4.10pm we managed to get blood and she was at 38, so I have given her treats and she has eaten more... She seems totally fine, but I was a bit scared!
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38 is hypo low. How many hours after the insulin shot was this? Was the last shot at 12pm? If so, 38 would be +4 but the fact that you gave 4 insulin shots today complicates things.

Please print out the hypo treatment sheet for future reference: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=1122 Treats don't work well to raise blood gluocse levels during a hypo. You need to use high carb gravy canned food and/or honey/corn syrup. Here is a list of things to have on hand to use for a hypo: http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=2354

Any tips for managing the insulin injections? Also I can't stay home with her forever so need some sort of routine...
Click to expand...

As said, pick two times 12 hours apart to give the insulin shots. Try to be consistent as possible. A few minutes off here and there won't make a difference but giving insulin an hour or more later than usual and then going back to the normal schedule makes a big difference in some cats.

The typical routine for most people is wake up, test cat's bg level, feed, give insulin while cat is eating, fill programmable timed feeder with canned food snacks, go about the normal day (work, school, etc), return home, when insulin shot time comes around get a bg test, feed cat, give insulin while cat is eating, maybe get a bg tset or two before bedtime. And somewhere in there the cat gets playtime and attention :smile:
 
Babs,

I'm just in the process of learning how to test and inject my cat as well. For me, at least, as testing has gotten easier so too has giving insulin. The testing routine that seems to work for me is: (1) get a heating pad (or sock with a bit of dry rice in it) and warm the ear for about 30 seconds. (I usually sing to my cat and give her cuddles while heating it up.) (2) Have a folded up tissue to hold on one side of the ear. (3) Prick the ear and then, if blood doesn't immediately bead up, massage the ear a bit. The massaging has really helped. (4) Get it on the test strip. (5) While the test strip is doing it's thing, I use the tissue to put pressure on Dusty's ear where it was pricked. After about 10 seconds I give Dusty a couple of treats and more cuddles.

People on the board are much, much more expert than I, but I think it's fairly typical to just give two injections a day. (This could just be for Lantus. Perhaps it's different for NPH?) At least for me, the two injections are pretty doable -- I give them at 8 and 8, when I can be pretty sure I'll be home.

I'm so glad she's feeling a bit better! And you've come to the right place - the folks on here are really, really helpful and kind.
 
Thanks again for the advice. I am getting better with the blood testing: I think we need new lancets though (ours are the ultrafine), so thank you for suggesting that! I have learned to keep trying and worry less about hurting her, that's the main thing! She doesn't seem to mind getting stuck 10 times instead of 1...

The reason I was doing many shots was the vet told me I needed to monitor her carefully, give her fluids, and tiny bits of insulin throughout the day, depending on the BG. I think this is because she is (was) so sick at the same time as being newly diabetic. They wanted me to take her to a hospital where they would have done this but we cannot afford any more.

Anyway, here's where we stand as of today:
She is much, much better. No longer dehydrated. Eating over half a small can per meal (twice a day-ish). Her recent BG readings have all been within range: The morning after her 38 reading, BG was 166, she ate, I gave 0.25 units as I was going to be out for 10h. When we came back, BG was 177. No insulin, she ate. This morning, she ate a lot, BG is 166 about 30 min after eating. No insulin.

Question: I am right not to give insulin, correct? She seems to be regulating pretty well herself over the last 24h?? Maybe switching to all low carb food might be enough for her right now? I will keep monitoring but could use advice.

Thanks again everyone, I don't know where I'd be without you!
 
The general rule when you are new and don't have much data is to not shoot under 200 just to be safe. Glad kitty is feeling better
 
Glad your cat seems a little better now :smile: Are you adding extra water to the canned food as well as giving subq fluids?

Vet bills are expensive unless you go to one of those low cost clinics that don't do much other than basic cbeck ups and vaccinations. The place I recommended to you does offer various forms of financial aid. There is info about that if you look at the web site link I PMd you. Do consider getting a second opinion for your cat there.

These organizations offer financial aid: http://www.felinediabetes.com/vetbills.htm

Frugal Feline Diabetes tips: http://binkyspage.tripod.com/frugal.html

Try thicker lancets. 28 gauge is a good size. Here is a lancet chart: http://www.walgreens.com/marketing/library/centers/diabetes/lancets.jsp If you prefer to use the lancet device, you may need to buy a new one that uses 28 gauge lancets. Or you could try freehanding the thicker lancet without the device. Lots of people here don't use the lancet device.
 
Given your location, one of the best veterinary practices in the country is in your neighborhood -- Angell Animal Medical Center. My sister is in Boston and uses Dr. B (who's actual last name I don't know) as her vet and has been very happy with him.

You said the vet indicated that diabetes isn't the only thing going on. Did the vet indicate other than dehydration, what is is you're dealing with?

As several of us have noted, it can be dangerous to give even a shorter acting insulin as often as your vet is telling you especially if you are having difficulty testing. I used NPH for a month or two after my cat was diagnosed. It was prescribed by an Internal Medicine specialist (not my regular vet who is a feline vet specialist). The dosing was twice a day, every 12 hours. The only time a short acting insulin is given in frequent small amounts is when you have a very sick cat, usually with diabetic ketoacidosis, and the cat is hospitalized and being constantly monitored. The risk for hypoglycemia is quite high given what you've been instructed to do. In addition, you need to not be chained to the house and with shooting that often with a harsh, fast acting insulin, I'd be terrified to leave. Seeing your cat drop to a 38 with this dose and frequency of injections makes me very nervous.

Quite frankly, my vet switched my cat off of NPH and on to Lantus. Like Rebecca mentioned, the American Animal Hospital Assn. guidelines for treating feline diabetes does not recommend NPH as a treatment for FD. Lantus is among the types of insulin recommended. However, if you are getting pre-shot values under 200, I would not give any insulin at this point unless your cat was diagnosed with diabetic ketoacidosis.

One consideration is that since it sounds like there is some medical problem, it's entirely possible that the infection has caused a rise in blood glucose. As the infection is treated and clears out of your cat's system, her numbers will drop back down. You will need to get your cat on a low carbohydrate, canned food diet from this point forward. If, in fact her numbers return to normal, with a low carb diet, she will be diet controlled and may not need insulin.
 
Sienne and Gabby said:
Given your location, one of the best veterinary practices in the country is in your neighborhood
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Sienne, that is the place and vet I recommend to the OP :-D There is an IM vet there who has a special interest in feline diabetes but any of the vets (IM or general medicine) there can help the OP's cat. I think Lantus and Prozinc are the insulin of choice there for cats.
 
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