My 12-year-old shorthair cat Ducky was urinating and drinking water a little more than usual for a few weeks but everything else seemed normal. It seemed to be getting a little better but I brought her in to the vet to run some blood tests just to be cautious. As a note, she is EXTREMELY afraid of the vets and has to be given gabapentin beforehand and even then she'll be growling and freaking out the whole time.
They gave me a call and said she's diabetic. They had me come in the next day to learn how to give insulin, but said I didn't need to worry about having my own glucose monitor or anything yet and that after administering insulin for a week and a half we would check up on her at the vet. They didn't give me a copy of her blood results or anything, but I just did not feel comfortable blindly giving her insulin without checking first so I bought an Alphatrak glucose monitor to try and see if it was a lower level at home.
I haven't administered any insulin yet, and took a prick from her ear 12 hours after eating anything to test for the first time and got a reading of 188. Definitely higher than it should be and I'm sure it could be a little inaccurate but is this high enough that would need insulin? It seems like 250 is the threshold. I know it can spike after eating, but everywhere seems to say to check blood sugar before eating, did I get the timing wrong? I'm just super paranoid that she'll get hypoglycaemic especially because i know that stress and anxiety at the vets can throw off blood sugar levels and I don't even know what tests they ran. I'll call my vet tomorrow for more info, but basically would appreciate any input from other people that have dealt with this before.
I would personally feel okay giving insulin at 188 but it depends on the cat!!! I have data that shows my kitty is okay to shoot at 188, but not having any data yet I understand your hesitance. How much insulin did they start you on and what kind is it? You can always wait 30 mins, test again, and then update us.
you'll want to monitor and test as much as you can these next few days so you can get an idea of how the insulin affects your cat! I have an app called "PetDiabetes" for tracking and have also made a spreadsheet to share here as that's what most members will want to see.
If you can check with your vet, did they get a blood glucose test -- much like what you're doing at home -- or did they get a fructosamine level? Fructosamine is very much like getting a hemoglobin A1c in humans -- it gives an average of what the blood glucose is over a period of several weeks. (Just be aware that the numbers are not the same as when you test the same way that the calibration on an A1c differs.) The reason this is important is that a test in the office when a cat is very stressed out can be wildly inaccurate. A fructosamine level is a solid diagnostic test for feline diabetes.
I would get a couple of days worth of home testing and see what Ducky's numbers look like. A few other things to consider:
What are you feeding your cat? Not all food is created equal and most of the "diabetic" cat foods are rather high in carbohydrates. You want to be feeding your cat a low carb diet. We consider under 10% to be low carb although most people here feed their cat in the range of 5% carb. This is a list of most canned foods that are available in the US. There are only a handful of dry food that is low in carbs.
Changing from a higher carb diet to a low carb diet can have a major impact on blood glucose numbers. If your cat is eating high carb foods, you may want to make a switch to a lower carb diet before starting insulin.
What insulin are you planning on using? Lantus (and it's biosimilars/generics) and Prozinc are the only insulins that are recommended by the American Animal Hospital Assn.
What dose are you starting at?
If you could look over this post on helping us to help you there is useful information that both you and the members here will need in order to provide feedback. It will give you information to include in your signature so we don't pester you by asking the same things repeatedly. It will also provide instructions for setting up a spreadsheet so you can track Ducky's progress and so we can see the spreadsheet and follow along. There's also information on what supplies to have on hand if your cat drops into low numbers.
Please let us know if you have questions. I'm tagging @Bandit's Mom in case you need help getting your spreadsheet set up.
Thanks for the messages. She was prescribed one unit of Lantus twice daily. I'm just very overwhelmed by the diagnosis because she's not the kind of cat that can be easily picked up and vet visits stress her out to the point she sometimes gets physically ill. It was recommended that she switch to an all-wet diet but unfortunately she really doesn't like wet food despite my trying to incorporate it as much as possible so I'm kind of at a loss and not sure what to do, it breaks my heart to see her so stressed. Will call the vet tomorrow for more information.
What are you feeding Ducky at the moment?
Have you tried feeding some raw meat to see if he likes that?
If you are not going to start the insulin straight away, I would buy some Ketostix from Walmart or a pharmacy and test the urine for ketones. Diabetic cats not getting insulin can get ketones which can be dangerous. If you check the urine daily, you would be Ok to hold off on starting the insulin for a week, and seeing if the blood glucose levels come back down to normal with a low carb.
I would try persevering with the wet diet if you can….try sprinkling some of the crushed dry food on top.
There are a couple of dry foods that are low carb….Young Again zero carbs which are 5% carbs and Dr Elsey Clean Protein.
There are also air dried raw food available now by Ziwi Peak and Stella and Chewy freeze dried raw.
Continue to test the BG before you feed him twice a day and see if it lowers on the low carb food.
If the BGs continue to rise, I would not leave it too long before starting the insulin….as long as the BG is high enough.
And continue to check for ketones in the urine.
Continue to ask questions here. Don’t let the vet talk you into buying the diabetic dry food for cats…it is too high in carbs.
Thank you for the advice. I will look into the Ketostix. Unfortunately last night she had a little bit of diarhea and vomiting, this has happened in the past after stressful vet visits as I think she has a very nervous stomach. She hasn't eaten much and is just resting this morning. I called the vet but the one I work with isn't in today so they will have her call me tomorrow about the test results but did mention they didn't do a fructosamine test. Should I ask that they take one to be sure?
They said for vomiting I could come pick up some medication for her today so I'll do that. They offered to have her come in to get fluids but I'm worried that's just going to worsen the problem. I just feel bad for causing her so much stress I bought some easily digestible canned food but she doesn't seem to have an appetite back yet.
Don’t delay getting the Ketostix. Ketones, if they are present won’t go away on their own. They just get worse.
I think getting some fluids at the vet is a good idea. And get them to give an injection of cerenia for the nausea and vomiting. And ask for some oral cerenia and ondansetron.
Diabetic cats need to eat and not get dehydrated.
I bought some easily digestible canned food but she doesn't seem to have an appetite back yet.