Newly Diagnosed Diabetic Cat

[stacysclass]

I just left the Vet with a newly diagnosed diabetic cat today. I have done online research and have read quite a bit of information on the topic. The cat is 11 years old and has lost 6 lbs. within the last 7 months, had increasing urination, and excessive thirst. The Vet. said he was dehydrated and gave him fluids and sent me home with a bag of Purina DM, a box of needles and Vetsulin insulin (U40); which I am supposed to inject 2 times a day. He mentioned coming back in about 3 weeks to re-test. His levels were in near 500. From what I have read a cat's levels should be between 100mg - 200mg/dL.
He has lived on a mainly dry food diet his whole life. From what I have read it is very important to switch to a wet can food high in protein and low carbohydrates. I have 4 children and cannot afford any more bills at this point. What I want to know is: Could I start my cat on the wet food diet and test his levels to see if I can get him into remission at this point? I have read it is dangerous to give insulin and do the wet food diet because of the cat becoming hypoglycemic. Or is it a good idea to go ahead with the insulin injections and start the wet food diet right away? along with checking his levels? I just do not want to start the insulin IF I could possibly try the wet canned cat food and have that work. Any information is greatly appreciated! Thank you!

 

[Dusty Bones]

Welcome! Readings around 500 will be very difficult to control just using a wet food diet. If you plan on home testing you can safely switch him to wet food and adjust his insulin dosage as you go. You definitely want to go to wet food like Fancy Feast or Friskies pate style as soon as possible, that's key to getting him regulated. Don't feed him that Purina DM, take it back and tell your vet your kitty doesn't like it, it won't do him any good because it's high in carbs.

Others can advise you on insulin dosage but you're in the right place to get info on how to treat your kitty!

 

[stacysclass]

Ok, after reading all that I have... I do plan to take the dry Purina DM food back to the vet's. I'm actually angry he did not suggest other routes or help with other information with all of this. I am new to all of this so I have a lot of things running through my mind. Can anyone help me with home testing? Like, at what reading do I NOT give a shot? Or at what reading do I decide the insulin needs to be in a higher dose or a lower dose? At what point am I able to say I want to stop the insulin shots and see if he is in remission?

 

[BJM]

Did the vet test for ketones? Those are a by-product of fat breakdown for calories. Too many may indicate diabetic ketoacidosis (DKA), a potentially fatal, expensive to treat, complication of diabetes.

Stress from the vet may raise the glucose 100 to 180 mg/dL.
Diet change may reduce the glucose about 100 mg/dL.

That means that switching to an inexpensive, over the counter, low carb canned food such as Friskies pates and testing at home may show you numbers anywhere from 0 to 280 mg/dL lower than what was found at the vet, depending on how stressed he gets.
The DM isn't bad, per se, but many cats get bored with it and it is pricey.

I'm feeding 15 cats, so I feed Friskies Turkey and Giblet pates. They're all doing really well on it, (except the one with food allergies who is also the diabetic *sigh*).

 

[BJM]

No shot below 200 mg/dL on a human glucometer until you have test data to show it is safe.

If below 50 mg/dL, treat as if HYPO (potentially fatal low glucose).

Dose increases are based on the nadir - the lowest level between 2 shots 12 hours apart.

Be advised that Vetsulin, aka Caninsulin, does not always last 12 hours in the cat. It was developed for dogs; they have a slower metabolism.

 

[stacysclass]

The Vet. never mentioned anything about ketones. I just tried to call and get the results of the urinalysis and the Vet. will be back in the office at 4:00, so I have to call back. Is there a number that is too high in the urine sample? If so, what is that number? What if he did not test for ketones?

 

[BJM]

More than trace ketones may indicate diabetic ketoacidosis (DKA), a potentially fatal, expensive to treat complication of diabetes. He should have checked for that.

If you start testing and feeding low carb food, in about 2 days, the glucose will have stabilized from that.

Many vets overestimate the amount of insulin needed. We like to see starting doses aroubd 1 unit, every 12 hours, especially when changing the food.

 

[stacysclass]

Okay, so I did the first injection this evening and it is 1 unit. The Dr. said to start him on 1 unit twice a day with food. It was easier than I had anticipated. So even if my cat (Sweetie) did have a high amount of keytones, in a few days that could get better from the insulin injections?

 

[Wendy&Tiggy(GA)]

The insulin should start helping immediately. However it's important to home test his blood to help you keep him safe as well as know how the dose is working.. And to watch for remission.

Here is a home testing shopping list. If you get these things we can advise on how to test with them! And then you can move to a low carb wet food,

Getting started shopping list
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. Cotton balls to stem the blood
5. Neosporin or Polysporin ointment with pain relief to heal the wound
6. 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. Sharps container - to dispose of waste syringes and lancets.
9. Treats for the cat - like freeze dried chicken
10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast

Wendy

 

[BJM]

...So even if my cat (Sweetie) did have a high amount of keytones, in a few days that could get better from the insulin injections?

Trace amount of ketones, yes; moderate to high levels of ketones require hospitalization to save the cat's life. Too many metabolic processes get out of whack with moderate to high ketones and diabetic ketoacidosis. It takes careful, slow treatment so that fixing one problem doesn't make another one worse.

 

[stacysclass]

Thank you for that list Wendy!! I am really hoping that Vet. did test him for ketones. I have to call back today to try & catch him to answer that question for me. With the levels Sweetie had there yesterday I'm worried about that.

 

[stacysclass]

So I was able to talk to the Vet. today who confirmed Sweetie had a negative level of ketones in his urine. Which I am happy about but also surprised because his blood level was 500. This Vet. said I should not use the human glucose meter.... is there a chart that breaks down human levels to cat levels? If so could someone pass that along please? I just can't afford to buy the one from the Vet.'s office so if I am able to use the human one I would like to.

 

[Deb & Wink]

Here's the info on comparing the Human to the Pet specific glucometers.

Reference ranges for decision making

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]

Most of us here do use the human glucometers, the main reason being those test strips are so expensive. We have found them to be accurate enough to test our cats with. Yes they will give different readings than a pet specifc glucometer, but we can adjust for that.

The Relion Confirm or Micro from Wal-Mart has inexpensive test strips and takes a small blood drop, 3 microliters, about the size of the head of a pin.

Using those human glucometers is one way we have found to make treating feline diabetes more affordable. We'd rather see you testing with a human glucometer than not testing at all because you can't afford the pet glucometer.

 

[Wendy&Tiggy(GA)]

Just because the blood sugar is high doesn't mean they always get ketones thank goodness! But whenever the blood is over about 350, you should always test the urine for ketones just to be sure.

The human meters are fine - most of us here use them because they are cheaper and there are protocols you can use specifically for the human meters. I would just get a human one and if the vet wants, he can compare it to his numbers next time you are in the vets. Usually the human meters read a little lower than the vet ones but since all meters vary by 20% anyway so would any other meter!

Wendy

 

[stacysclass]

How much wet can food should Sweetie be eating now? I have always done dry cat food so this is new to me and with him now being diabetic I want to make sure he is eating correctly. I would like to feed him twice a day (once in am and once in pm while I test & then do insulin). Thanks!

 

[BJM]

Does she need to gain or lose?

Try 3 or 4 oz each over am and pm. Its OK to split this into 2-3 meals after each shot.

When unregulated, a diabetic cat may need up yo 50% more food than normal cats so if you're still working on regulation, you can add a bit more to each feeding.