Newly diagnosed cat with an overwhelmed owner

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Bastet

Member Since 2016
Hi, I am new to this forum and am seeking some advice about our newly-diagnosed diabetic cat, Kooser.

I took Kooser to the vet yesterday because we had noticed some frequent vomiting and general lethargy over the past month or so. The vet ran some blood work and radiology scans and found that he had an elevated white blood cell count and a high glucose level (423) and diagnosed him with diabetes and a likely bacterial infection. They started him on antibiotics and recommended that we bring him back at the beginning of next week for an all-day glucose monitoring and start of treatment. For now, they just sent us home with some diabetic canned food, which we swapped out for his dry food last night.

My husband has reacted very poorly to all of this news. He picked Kooser up from the vet, and when he asked the vet if we could try something a little less aggressive than the in-hospital treatment, they told him no and pushed us to bring him in next week. My husband wants to try treating Kooser's diabetes with a low-carb, high protein diet only - he thinks injecting him with insulin daily is a big change, and that the diagnosis might be a bit off considering that he was sick and stressed at the time of the blood work. I just want to do what is best for Kooser. Is treating with dietary changes only to start with ok, or are we endangering Kooser's life by putting off the insulin treatment? Is the vet right to insist on a hospitalization to get treatment started?

My apologies if I am repeating questions that have already been answered elsewhere on the forum - I'm a bit overwhelmed by all of this and just looking to do what's right by my 'lil furkid. Thanks!
 
Hi and welcome. First of all I think we all feel a little overwhelmed at first but treating the infection and swapping to a wet food (which one have they given you?) will help to bring his glucose down and being admitted for a curve - the all day monitoring, is entirely normal. Do you have results of other tests or which were run and results awaited? Read the sticky threads in the fora as they have a wealth of information - there is a lot to learn to start with but once you get used to it then you do get into a routine. Diabetes is very treatable with the right approach and a determination to do what is best for your kitty so you have made a good start by joining the forum. There are a lot of experienced kitty parents here who will be along to contribute and help you. Can you tell us a bit more about Kooser, age, any other health issues and what else you have noticed in the way of symptoms? Just ask any questions you need to - we are all learning and there is no such thing as a silly question, worry is part of the reaction. One thing you can do is to read up about home testing of glucose as this will make you feel much more in control if you can start doing it. There are members here from all over the world so if you can tell us where you are you can get some country specific advice. You can do this with the support of the amazing people here. It is now nearly 2 months since my kitty was diagnosed and I am still learning but being on this forum has helped keep me sane, so ask away.
 
Thanks for the quick reply and word of encouragement. Glad to hear your kitty is doing well.

Kooser is 8 years old and generally in decent health, apart from the recent vomiting. He's overweight (always has been) and a very large kitty in general, clocking in at around 17-18lbs. All other health issues are mild - he has a dry coat and isn't terribly active, but otherwise seems happy and healthy. We are located in the U.S.

I don't know that the vet ran tests other than blood work and radiology, both of which came back fine other than the high WBC count and glucose level. Glad to hear the curve test is normal, but I guess my primary question is whether we need to do the glucose curve test and start insulin so soon. Can we wait a while to see what effect the improved diet has? Have others on the forum had success with diet only treatment?
 
The guidelines say do a curve a week after treatment starts, I started insulin the day my kitty was diagnosed but she was already on a wet diet. There are cats who have gone into remission (not needing insulin at all) after a variable amount of time but they have started out on insulin - do you know which one the vets recommends? In the US you have a greater degree of freedom with what insulin you start with. I have had to start with cansulin (vetsulin in the US) but most of the cats here seem to be on Lantus, or Prozinc which are viewed as better and have a better chance of getting the cat into remission. Did the vet say why they were delaying starting the insulin?
 
Welcome!

I don't think there's any harm in waiting a week or so to start insulin and see how the diet change and antibiotics work to lower his blood sugar levels. This will actually help you make a better determination on his starting dose. I would not wait longer than a week or so to start insulin if he is consistently testing above 200-250 at home.

However, I would start home testing him and monitoring his ketones during this week! Hometesting will help you determine if his blood sugar was inflated because of vet stress, which is very common (Bandit has been known to shoot up as much as 300 points at the vet before!). Hometesting seems hard at first but it becomes really easy with even the most difficult of cats if you condition them to accept the testing with (diabetic safe) treats. There's a lot of tips and tricks here that can help you with that. You don't need a pet meter (many vets tell you that you have to purchase one of these). A human meter works just fine for home testing. The Relion brand from Walmart is pretty popular among the US members here, because it works well and the strips are inexpensive and easy to find. You can pick ketone strips up at any big box or drug store--they just require you catch a urine sample for them.

However, if your cat does need insulin, it's not as huge a change as you think it is! Learning to home test will help you keep him safe and determine the correct dose. Regardless of whether your cat needs insulin or not, I would not leave him at the vet for his initial treatment. This is cheaper and more accurately done at home with your home glucometer. Cats blood sugar is inaccurate at the vet due to stress, which can lead to chronic overdosing. It is much safer and more accurate to start him out and test him at home. If you need to convince your vet of this, here's a copy of the AAHA diabetes guidelines to print out and bring to them (see under "Insulin Therapy in the cat--Precautions and Details"). I have no idea why so many vets don't recommend home testing--it is absolutely crucial in treating diabetes in cats, just like in humans.

All you need from your vet to get started is the script for his insulin. Many vets will prescribe the "cheaper" insulins to their clients (Humulin/Novolin or Vetsulin) at this point because they are afraid the owners will balk at the cost of the better insulins, but you definitely do not want to cut corners on insulin! Lantus and Levemir work best in cats, and Prozinc also has some decent results. Vetsulin and Novolin are good for dogs but NOT recommended for cats. This is important because most cats go into remission on the right insulin, diet, and dose adjustments via daily home testing.

Lantus is really pricy in the US, but you can purchase it here online from Canada with a script from your vet for a fraction of the cost. The most economical way to purchase it is to get a 5 pack of the solostar pens--you'll use these as mini-vials and draw the insulin out with a syringe just like you would a vial. It costs about $170 after shipping for the 5 pack of pens, but with good handling these will last you a year or more, which works out to be less than $15 a month for insulin. This turns out to be less expensive than the "cheap" insulins that don't work well in cats! It takes about a week to arrive, so you'll want to order as soon as you have an idea of what his blood sugar is like after a few days on the antibiotics and low carb, canned diet.

With the right treatment, a diabetic cat can be just as healthy as any other cat, and as I mentioned, most end up not needing insulin if you're good about diet, insulin and the right home testing regime. Bandit's been diabetic now for over 7 years, and he's needed insulin at various times for less than 2 of those 7 years.

What type of food are you going to feed him? There's a lot of good low carb, canned commercial foods out there! You'll want to avoid dry food completely if your cat will readily eat canned food--most is too high in carbs and even the low carb ones are hard on a cat's kidneys and urinary tract, and can present problems with regulation in some diabetic cats.
 
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Bastet said:
I guess my primary question is whether we need to do the glucose curve test and start insulin so soon. Can we wait a while to see what effect the improved diet has? Have others on the forum had success with diet only treatment?
Click to expand...

About 25% of diabetic cats go into remission from changing to a low carb, canned diet alone, without needing insulin. Because there's an infection in play as well, he may well be a candidate for remission from diet. You'll be able to determine this if you're home testing within the first week after the diet change. Because of the infection, I would definitely make sure you're testing his ketones along with his blood sugar, because cats with infections are at risk of a dangerous complication from diabetes called diabetic ketoacidosis. Cats with this condition need to go to the vet and get on insulin immediately.
 
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Hello and welcome. When my cat was first diagnosed he also had the vomiting and it was infection plus the diabetes. Diabetes is very treatable. Now what the vet is telling you compared to what you will learn here will be two different things. You can safely do a home curve yourself at home and probably get better numbers then they would at the vet. Most vets are not up to date on how to treat feline diabetes. The only thing you need from the vet is a prescription for insulin which you can get elsewhere cheaper and food and supplies and needles.
Read these:
http://jfm.sagepub.com/content/17/3/235.full.pdf+html
http://www.catinfo.org/#Prescription/Therapeutic_Diets_
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
 
Switching to a low carb wet or raw diet can have a profound effect on BG. I think the only prescription diet low enough in carbs for diabetic cats is purina dm. But it's really no better than many store bought foods. You want a food less than 10% of calories from carbs. Many people here feed fancy feast classic or friskies pates. You don't want anything with gravy. Wellness grainfree pate is good also. Going up in price is tiki cat, but it works well if your cat doesn't like pate.

You could do what I did... buy a human glucometer, strips and some 28 gauge lancets and test during diet change. With Billy the majority of the bg reducyion happened the first three days. But your cat may react differently. As others have mentioned also test for keytones.
 
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