Newly diabetic cat quiet, lethargic, low appetite

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Hi, sorry for delayed reply...

I'm sorry that you're finding this so challenging, but, 'chances are' that it will soon get easier. Honestly!

The insulin shot 'typically' shouldn't hurt the cat. So, there must be some reason 'why' that's happening.
If it is the case that he really doesn't have any loose skin on the scruff then I can see that this could be an issue. It may mean that the needle is going too deep and pricking the flesh beneath.
If he has loose skin elsewhere on his body then you can try to inject there, side of chest, flank, etc. Some cats are fine with this, some aren't. It really is a 'try it and see' thing.
Before actually injecting it can be helpful to pull up skin (assuming there is skin!), and then gently press against the side of that 'tent' with the tip of your little finger. If it feels sort of 'hollow' there then that's where you need to inject, through the 'door' of that tent, into that hollow space.

Also, I wonder if you are injecting (inserting the needle) too slowly, creating some resistance and making it harder to get through the skin?
Any chance you are reusing syringes (this results in blunted needles...)

Or, maybe another injection technique could work better for you...
My first diabetic didn't actually get on well with the 'tenting' injection technique (pulling up skin and injecting into the side of that tent). He was a real fidget. In his case I had to use another method...
I'd grab some skin between the fingers and thumb of my non-dominant hand, (wherever I could find loose skin, but often the scruff or shoulder blade area), pull that up and sort of tip it up slightly, and then I injected almost directly downwards into the skin that I was holding in my hand, about mid way between fingers and thumb. Because the depth of skin in my hand was greater than the length of the needle there was no chance of my injecting too deeply. Also, if he suddenly moved (which he sometimes did) I could still give the shot as long as I was holding onto that skin... Mostly though he was fine with the shots as long as I crumbled a few treats to keep him distracted. :smuggrin:


...Another alternative - but I'm slightly hesitant to suggest it because you're new to feline diabetes and injecting - is to use different syringes...
It is possible to use U100 syringes with U40 insulin, in conjunction with a conversion chart to ensure you measure the correct dose of insulin. There are a couple of reasons why this can sometimes be helpful, but one is that the needles themselves can be much finer and also shorter than those on the U40s... This can make some cats much easier to inject.
However, there's a few things that it's necessary to understand first...

Quick explanation about insulin concentrations:
The veterinary insulins, Caninsulin and Prozinc, are 'U40'. That means they have 40 units of insulin per ml. They are made to be used with corresponding U40 syringes. But, occasionally, some folks use U100 syringes with a conversion chart.
The human insulins, Lantus and Levemir, are 'U100'. They have 100 units per ml. They must be used with corresponding U100 syringes.
So, U100 insulins are 2.5 times as 'concentrated' or as 'strong' (neither seems quite the right word!) as U40 insulins.
This means that if you want to measure a unit of Prozinc or Caninsulin in a U100 syringe you'd draw up insulin to the 2.5 unit mark. If you want 2 units you'd draw the insulin to the 5 unit mark, etc.

Most folks in the UK who use U100 syringes use BD 'demi' syringes. These are widely available. Some folks prefer Sol-Vet U100s.
Something to be aware of, however, is that the U100s may not be quite as accurate as the U40s. They are made for human use, and human insulin doses are (usually) much bigger than the tiny doses we give to our cats.

There are methods that can be used to make sure the dosing is accurate and consistent.
Some people use digital callipers to measure the insulin dose on the syringe barrel. (Digital callipers are widely available, on Amazon, etc).
Or, there's a low tech method that a few of us use... I just keep a syringe with good markings and use this for comparison when drawing doses into fresh syringes. So, I pull the plunger to the dose I want on my 'template' syringe, then I draw insulin into a fresh syringe, hold the two side by side, then compare and adjust the insulin dose as necessary. (...My close vision isn't great, so I have a craft magnifier on a stand that I keep on the kitchen worktop next to my kitty's diabetic supplies :rolleyes:).

I don't know if any of this is helpful or not... But I'm sure we can think of something to help you....

Eliz
 
Hi folks. Early this morning (about 10 hours after evening insulin dose) our little guy was sick — but only bile / flem.

He did this a few times before being diagnosed with diabetes, going back now about 14 days ago. He hasn't done it since, at least not to our knowledge.

Does anyone know what this might be? I'm guessing entirely unrelated, but everything that has happened in the past ten days has muddled us so much that we're struggling to judge these matters clearly. All we could find online is that it is a symptom of hypo (but since we did this before being on insulin, it doesn't really track) or pancreatitis.

After being sick this morning, when he was fed a few hours later, he had a very good appetite and has been okay since.
 
It could also be IBD. Both of my cats would do that and they both had it. Has he ever had an ultrasound done? Early this morning as in right before he ate? I noticed with my cats, it would happen first thing in the morning if they went for too long without food overnight, like 8-9 hours, so I started making sure they had some food at about 5-6 hours after I went to bed and it stopped happening. I would suggest an ultra sound. You could also have him tested for pancreatitis to rule that out.

it’s very common for diabetic cats to have another health issue that is what affected the pancreas in the first place, like pancreatitis or IBD.
 
Hello folks. I hope you (and your feline buddies) have all been keeping well.

It's been nearly 2 months since our cat was diagnosed with diabetes. We've increased the Prozinc insulin dose from 1.5 units to 2 units twice daily, but the improvement has been minimal (see glucose curves below, taken 10 days apart).

Current Situation
- Diet: He's on Applaws wet food (3% carb) with a small amount of Purina Proplan diabetic kibble.
- Morning Sickness: Initially, he had bouts of sickness at 5 am, so we leave some kibble out overnight, which has helped.
- Health Improvements: His voice has returned, and he's eating well. He has regained some weight, but his muscle mass is still lacking due to inactivity.
- Remaining Concerns: Despite the improvements, he appears tired, stiff, and "older" than his age of 9. His fur is often separated, and he shows little interest in toys or chasing flies as he used to do.
- Insulin Administration: The scruff area for injections seems reduced, and he now resists them, making the process challenging and stressful.

Concerns and Questions
- Slow Progress: We are concerned about the lack of significant improvement despite the increased insulin dosage. Is it normal for progress to be slow at this stage?
- Reduced Activity: His decreased interest in activities worries us. Could this be related to his diabetes or another issue?
- Injection Difficulties: Administering insulin has become challenging due to his resistance. Any advice on making this process smoother?
- Glucose Curves: We've been monitoring glucose levels, but the stress during testing might be affecting the results. Any tips on handling this better?

Recent Glucose Curves
11th July:
- 8 am: 25.4
- 10 am: 20.1
- 12 pm: 22.7
- 2 pm: 20.7
- 4 pm: 24
- 6.15 pm: 24
- 8.45 pm: 26.9

23rd July:
- 7.30 am: 21.7
- 10 am: 22.1
- 12 pm: 22
- 2.20 pm: 19.4
- 4.30 pm: 22
- 6 pm: 25
- 8 pm: 26

Flea Treatment and Diabetes
We were advised to avoid flea treatments until our cat's diabetes is better regulated. It's been 3 months since his last Advocate treatment, and we're unsure when we can resume flea treatment. Any suggestions on this matter would be appreciated.

We welcome any advice and input from fellow cat owners who might have experienced similar situations. We want to ensure we're providing the best care for our feline friend and improve his quality of life. Thank you in advance for your help!
 
We really need to see a spreadsheet with data to be able to help you with dosing. Are you able to set one up and also do your signature. The info and instructions are on the helping us to help you link shared with you previously.

Dry food is not good for any cat but especially diabetic cats so I would encourage you to transition him out of it. You want to feed a low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs. Are you testing daily? He needs to be monitored daily if you’re going transition him out of the kibbles as it can drop his bg by over 100 points.

are you giving a low carb treat immediately after each test to build up positive association? Are you warming up the ear to stimulate the blood flow? You also want to aim at the sweet spot
 
We have not yet had time to complete the spreadsheet, but we will input the figures as soon as possible.

Regarding testing, we are not doing it every day. Our vet recommended doing two curves, spaced 10 days apart, and we have completed these tests. After the first curve, the vet advised increasing his dose from 1.5 to 2 units.

Currently, our cat is on diabetic kibble (in minimal amounts) as advised by the vet. We are considering discussing with our vet whether we can take him off this diet.

Thank you for your help!
 
The only thing I can say is that vets give very different advice compared to what we recommend here. Home testing your cat everyday, especially before each insulin shot is the only way to keep it safe. It’s like having a diabetic child, would you give it insulin blindly without testing? A curve every 10 days doesn’t give you the full picture since their bg fluctuates daily. That’s what all my vets said too and it wasn’t until Minnie had a hypo that I realized it was crazy to not test her daily.

Unfortunately most vets do not know a lot about feline diabetes….they have many animals to look after and they all have different diseases and treatments. Vets also get their information about nutrition from the big cat food manufacturers so they are biased in what they recommend. high carb dry food is not good for any cat, especially a diabetic cat. That’s like feeding your diabetic child a diet of chips, ice cream and sweets.

With a diabetic cat you need:
  • A low carb wet diet that is 10% carbs or under. Most of us use around 4-7% carbs
  • A suitable insulin such as Lantus or Prozinc which are long acting, more gentle insulins than the old insulins.
  • We recommend hometesting the blood glucose with a human meter…it is not necessary to use a pet meter which is expensive to run and is no better. It will keep your kitty safe and you will know how the dose is working for your kitty. Only testing every so often will not tell you what is happening in between those times and an awful lot can happen in even a day.
  • Again, the HELP US HELP YOU has information about the spreadsheet, signature and hypo box which you will need to be able to look after your beloved kitty properly

We are happy to help you with setting up the spreadsheet, sorting out what food to buy, how to transition safely to a low carb diet, how to learn to home test and much more.

This is an excellent site for diabetic cats…it has been around for more than 25 years and has very experienced people to help you.
 
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