Newly Diagnosed Diabetic Cat

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Tammie

Tammie

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Hello, my name is Tammie and I'm in northern Ontario, Canada. I have 3 cats: Mischief, a 6 year old female solid black domestic long haired, Frosty (Mischief's sister), a 6 year old female diluted Tortoiseshell and Muffin, a 4 year old male Orange Tabby.

Mischief was officially diagnosed with diabetes last Wednesday and I'm heartbroken. I'm working with my vet (who only comes to town once per week) and a friend with a diabetic cat to get Mischief's illness under control as quickly as possible.

I'm hoping to find great information here and methods of dealing with the emotions that are coming with my girl's diagnosis.

Thanks in advance for your help.

Tammie in N. Ontario
 
Hi Tammie, and welcome. Sorry you have to be here but it IS the best place you couldhave ended up to learn all about feline Diabetes and how to get it under control. We have all been where you are right now: scared and overwhelmed, but this is a very treatable disease and you will not be alone in how to handle it. There are many caring and smart people here to help. Ask as many questions as you need - there are no stupid questions!
First, read everything on this site, in the health links about diet and home testing. Did your vet give you insulin? Did he mention hometesting?
What kind of food are you feeding Mischief?

Here's some links to start:
Feline diet:
http://felinediabetes.com/diet.htm
Homestesting Link viewtopic.php?f=14&t=287

I found it handy to copy and paste everything into word docs so I could read and absorb it later.
Now, breathe - you and Mischief will be ok. You are lucky you have a friend with a diabetic cat to show you the ropes. Does she hometest?
 
Please take heart - this is a disease which can be managed for a cat's normal lifespan (just as it can be for humans). We've had folks with diabetic cats of more than 10 years duration!

Everyone here will look for ways to help you - food advice, insulin advice, tips on talking with the vet or finding a new one that really knows or is open to learning about contemporary feline diabetes management - and more.

So step 1? Breathe!

Step 2? Start reading carefully about home testing, diet adjustments, and the insulin your cat is or will be on. It doesn't have to be all done today.

If you're already using insulin, focus on home testing. You need to know how well the insulin is working and if it is safe to give it.

If you aren't using insulin yet, focus on dietary adjustments to low carb, canned or raw food. See Binkys Page for info on various food. See Cat Info for info on transitioning off dry food, to quality canned food. Some cats can be diet controlled by doing this. There really is no need to feed a veterinary prescription diet for diabetes as many canned foods are low carb, have better ingredients, and cost less.
 
Hi Jayne, thanks for the quick response.

I am already home testing Mischief and her sugars are ranging between 25.2 (last night) and 17.9 (this morning). I have her on a mainly canned food diet right now because she is dehydrated (waiting to hear from the vet about that). Her water consumption has come down but it's up a bit again today but not alarmingly so.

Mischief is a different girl. She and her sister, Frosty, are half feral and all 3 of my cats are strictly indoors. I believe the girls' mother was domesticated, their father was wild. They have very different dispositions than Muffin who is fully domesticated and the biggest suck in the world. Mischief has a nasty temper, can't stand being held for more than 20 seconds or so and has fits at the vet's like he's torturing her. She needs what I call the football helmet (it replaced the muzzle and is somewhat better). Last week, they finally had to knock her out just to get a blood sample. She throws MAJOR tantrums. She's been pretty good with me since she trusts me the most. She's been my baby from day 1 (we adopted her and Frosty when they were only 7 weeks old). She still growls every time I try to do something with her .... even combing which she used to love. I'm terrified that I'm hurting even more with the blood test and insulin shots even tho' I know how necessary they are. At least, I'm not shaking so badly now when doing these things. It all just makes me so sad. :(

The vet put her on Caninsulin, U40, 3 units twice daily. Unfortunately, the syringes he gave me last week are huge ... 28 gauge! They are so painful for her, especially since she is dehydrated and her skin is tougher right now and hard to pinch. My friend told me about smaller needles so I went and spoke with my pharmacist today. He worked out the formula to use her insulin in a U100 syringe with a smaller tip until I can get the needles I want for her from the vet.

We are both very new to this illness in a cat altho' family history is strong for people so we have a lot of background. I'm told it can take upwards of 2 months to get her under control?? I've been doing so much reading about this that I think I'm almost cross-eyed but I'll keep researching.
 
Great job on hometesting already! You are way ahead of most newcomers here - that's good!
Canned food diet is GOOD, that's what you want. Check out some varieties on Janet & Binky's list from BJM's post for the low carb ones. The lower, the better for diabetes. Maybe she will be one of the lucky ones and will only need insulin for a little while - paws crossed!
There is a forum of the kind of insulin you use. I can't help with the syringes, Sweety is diet controlled, but I'm sure others can help you with getting the right size.
Awww, sounds like Mischief hates all this handling, poor baby. I hope it gets easier for you both. Hang in there! You are a good mom to take care of her like she needs, even though she may not appear like she appreciates it...She will feel better though after a while, I'm sure.
 
when your caninsulin runs out, we would highly recommend switching to a long lasting human insulin that you can pick up at any pharmacy - either Lantus (aka glargine) or Levemir (aka detemir).

you can use human syringes for these too - 31ga needles are the tiniest and most kitties don't feel the poke.

we do recommend starting insulin at a low dose like 1u every 12 hours and increase as needed to find the right dose. Starting at 3u, you may have missed the best dose for your kitty.

My diabetic, Tiggy, is well regulated on only 0.5u Levemir every 12 hours (BID). He does eat only low carb high protein canned food.

Welcome, and you're in the right place -- post any questions

By the way -- most of us post blood sugar using "English" units -- which is 18x the numbers that you mention
 
Hi Tammie,
I"m in the Toronto area of the province, and my Thomas has been on insulin now for over 10 years, so diabetes is very controllable. With the newer insulins many cats go into remission. You are doing well, and the cats tend to get used to the whole diabetic routine.
Welcome,
Dana
 
Nice to meet you all.

I have an appointment with the vet for Mischief tomorrow afternoon. He wants to check her dehydration and treat it if necessary. Today, at his request, I will test her blood at the 6 hour mark after her morning insulin shot and see where she is throughout the day (she was at 17.2 (310?) this morning). He also told me to keep feedings to ONLY shot times, 12 hours apart. I was feeding them every 6 hours. This will get dramatic as they think they are all being starved (altho' Muffin and Frosty both need to lose weight too)!

Since our vet only comes into town once per week (we are quite remote), I'm going to talk to him about putting Mischief on a type of insulin that I can easily get at my or any other pharmacy. I don't want to be left in the cold at any time if he can't make it in here one week. I keep hearing that Lantus is the best so I will look into that.
 
Hi From ALberta, previously your neighbour in Manitoba :)

Please do insist that your girl gets fluid if she's dehydrated...dehydration won't help at all and can make things more difficult.

Please make sure you get ketone strips from the pharmacist so that you can test her urine for ketones, and yes, please do talk about getting either lantus or levemir. These insulins are gaining popularity for use in felines and are so much better than caninsulin.

Is there anything we can do to help you prep for the vet visit?

Jen
 
Hi Jen,

Vet visits for Mischief NEVER go well. Being half feral, she is a very sensitive (and violent!) girl. She's scared of everything ... loud noises or voices, new people, new smells, etc., she's terrified to leave the house and whenever she (or her sister, Frosty, for that matter) goes to the vet, she reacts with pure anger. She has a vicious temper so she has to be put in the little 'football helmet' that thankfully replaces the awful muzzle ... I think she's really gotten to hate the vet already. :(

I was really hoping I wouldn't have to take her back to the vet so soon .... give her time to get over last week's VERY temperamental visit and original diagnosis which was all SO traumatic for her .... and for me too! But, the dehydration is worrisome and I need to know she's okay even if the signs are there that she's improving.

Thanks for your comments!
 
Just so people don't get the wrong impression of my Mischief!

Yes, she has a temper and gets very violent at the vet's but she is THE sweetest girl with me. She purrs and she chirps and she cuddles and begs to be combed almost every day. She truly is a sweet, loving and wonderful little girl even tho' her evil twin sometimes comes roaring out! bcatrun_gif
 
don't worry, there are lots of cats here with dual personalities :)

You may be able to find rescue remedy in a forgotten corner of your pharmacy or grocery store..if you can get it, use it on her before vet visits to help with her stress.
 
Tammie said:
... He also told me to keep feedings to ONLY shot times, 12 hours apart...
Click to expand...
That may go along with the Caninsulin - the fact that your vet is using that suggests he may be a bit out of date on feline diabetes management. Many, many of us have encountered that in our dealings with vets!

Until your cat is regulated, she'll be very hungry. Many of us feed throughout the day, either with a timed feeder or by freezing some food so it can't be eaten all at once, at least the first half of the period between shots.

Many of us successfully use Lantus, Levemir, or Prozinc. The attached article about Lantus (glargine) is one to print out, read over and take to the vet on your next visit.
Lantus/Levemir testing & dosing protocol Roomp & Rand
 
Thanks for the link .... I've printed it out and will take it with me tomorrow.

Is there a standard feeding schedule (wet and/or dry) that people generally follow?
 
I don't know that there are standard schedules, it tends to be insulin and cat dependent. Ie some insulins require different feeding schedules. I do know that feeding more than twice a day is a GOOD idea because that way there is less of a dump into the system and so insulin requirements get more spaced out...kind of like with people.
 
Okay, so I just tested Mischief again at midway through the insulin cycle. I can't believe the plummet! She's down to 4.2 (76)! I cannot let her go another 6 hours without food so I fed the three of them. She cleaned out her own dish and then nibbled at the others a bit as well. VERY hungry.

Is this significant drop because of the Caninsulin only being an intermediate and not lasting the full 12 hours? How low would she have gone if I hadn't tested and then didn't feed her for another 6 hours?
 
Wow, I'm so glad you are testing! 76 isn't a bad number for +6 but I wonder if she was lower at say +4 or +5? What was her preshot this morning?

I know with caninsulin that some people would give a snack a few hours post shot to smooth out the drop...
 
I think you need to do a curve - a set of serial glucose tests, every 2 hours, to see when the Caninsulin hits its nadir (lowest point).

If you're going below 50 at the lowest, you'll want to discuss reducing the insulin, because going any lower runs the risk of hypoglycemia, which can kill.
 
My vet did mention doing a glucose curve ... I wasn't sure when it should be done tho'. How long should Mischief be on the insulin before we do it? It's a week tomorrow that she's been on it.
 
Here's some curve info for you:

How to do a Curve
Example of a typical curve:
+0 - PreShot number.
+1 – Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 – Nadir/Peak (the lowest number of cycle).
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (may dip around +10 or +11).
+12 - PreShot number.

Now don't think that your cat is going to be exactly like the above example; it's just a guideline and several cats have a nadir near mid cycle or maybe a bit sooner, but some cats, like one of mine has a late nadir, around +10.

What you will need to do, over time, is do maybe weekly curves to see where your cat is. You could test at +3, +6, +9 and also before each shot.

Try to remove food for the 2 hours before shot times as food will give you an artificial preshot number.

Now Caninsulin does not last long, less than the 12 hours, so you would be better to use Lantus or Levemir and you don't need to have your vet's permission. Just go to the nearest pharmacy and buy it.

I started using Caninsulin on one of my cats and did not have good results at all. I switched to Lantus which is a very good insulin, but am now using Levemir for both my cats as it's better for higher doses.

I should mention that I am in Toronto, so at least I am in the same province!

What exactly is the reason you need to take your cat to the vet when in town? If it's for blood draws or tests for some other issue, I guess there is no avoiding the trip, but if it's for testing or a curve, you can do that at home.

If your cat is dehydrated, you can get fluids and give them yourself at home; you can talk to your vet about that issue when you have your next visit.

Ask lots of questions and people can give you some answers so that you will be all ready for your next visit to the vet.
 
Hi Gayle,

Anything to do with Mischief's blood, I am testing here at home. I won't take her back to the vet for that unless absolutely necessary. I'm taking her in tomorrow to gauge how bad her dehydration is and see if she needs immediate treatment. I'm still so new at this and so very worried about her that I'd like to get his take on it. With any luck tho', tomorrow will be the last vet appointment she needs for a while. I'm not taking her every week ... good Lord, she'd never forgive me! ;) But right now after only being diagnosed a week ago, I'd like him to check her over one more time.

I think I will do Mischief's first curve on Thursday and see where we are. I am also pretty sure that I will switch her over to Lantus. One question: do dosages change with different types of insulin?

Thanks so much for all the information. I've been researching and reading so much the past few days that my head is spinning! @-)
 
Hi Tammie,
What I meant about blood draws was for overall testing of the cat's health. I keep copies of all the full blood results in a binder for each of my cats so I can compare any that are above range with the next testing done. I was not clear why you needed to take your cat to see the vet again so that's why I asked. Ask if you can get copies of the last bloodwork taken by the vet so you can look at your cat's values.

As for weekly visits to the vet.... if I had to take mine weekly, I am sure they would run away from home! No, I don't need to take mine unless they are sick or for dentals or maybe blood tests and urine tests for non diabetes issues.

Ok if it's just to check on hydration, it would be great if you could arrange to get a fluid kit to give at home if your cat's dehydrated, especially if you can see your vet only once a week.... best to be prepared and have all you need at home, just in case. I always have fluids and pain meds on hand because my two have issues with pancreatitis.

I suppose you will need to put together a 'shopping list'. Once you have everything at home, you can settle into lots of reading.

Lantus uses different syringes, so with the Lantus, you will need to pick up U100 syringes.
Also, Ketostix or Ketodiastix to test urine for ketones.
Last is Pepcid AC 10mg strength.... don't get the extra strength one. Pepcid is great for upset stomachs, and often I see 1/4tab settle down an upset stomach enough to eat their foods.

With doses, each insulin is different, but for Lantus and Levemir, it's usually started at a small dose, maybe 1u BID.
If you read over the protocol on one of the links I posted, you will see that the dose is held for 5-7days or 10-14 shots because of the shed needing to build up. For now though, just getting settled, doing a curve, reading all the info will keep you busy. Keep in mind that your curve on Caninsulin won't be anything like when you switch over to Lantus so you can expect to see differences.

I am sure it must be tough when you have to be ready for the day when the vet's in town and if you forget something, it has to wait till the next week, so I hope you have a good list of stuff. There are always people around here, so ask your questions and we will help you be prepared for your visit tomorrow ... what time IS your vet visit?
 
I take her in at 1:00 pm Eastern Time. If it wasn't for the dehydration, I would just go to talk to the vet myself and not put her through that visit again but I need to be sure she's okay.

If I decide to switch her over to Lantus, should I wait until this vial of Caninsulin is mainly done or should I do it soon, like next week? And should I do her curve test before or after the change or both?

I hate to mention this part but it IS getting very expensive. How often does a diabetic cat normally need to see vet for the diabetes? 3 visits, 3 weeks in a row is starting to hurt. :oops:

Again, thank you so much for the information. This site is proving to be invaluable!
 
Hi Tammie!

Whereabouts in Northern Ontario are you? I'm in North bay, and 2 weeks ago I was where you are.

It is scary and overwhelming to have to read and understand all these concepts-it will come with time. My cat was diagnosed and within the first week (after he switched to wet food) the vet dropped his dose of insulin in half. With the help of all these incredibly knowledgeable cat owners, you are in the best hands.

I found that Basil dropped fairly quick into his 12 hour curve, so took the advice of the group and froze the catfood in muffin tins and left it out during the day. So far we've had no problems and his numbers look good. He is now working on getting his back legs in shape, using the Methyl B12, and keeping our fingers crossed. I do a curve at least once a week, and drop the numbers off to my vet, and otherwise test pre-feeding and if I am home, a couple of hours later just to see where he's at. Basil much prefers testing at home as opposed to a trip to the vet. (although he doesn't yet LOVE getting his ear picked!)

This is treatable, and you have all of us rooting for you!

No matter how silly you think a question may be, ask it-the answer is here for you!

:)

Leanne
 
OK first the expense of visits..... I don't see why you need to take your cat to the vet if not sick, and being diabetic is not really being sick, yes? Once you get settled that your cat has no other issues, like teeth or infections or something, then there is no need to waste your money on vet visits. Any expenses will just be for your insulin, lancets, test strips, and then your normal cat expenses like food and litter. It's been months since the last time I had mine to the vet; the last visit was for a complete checkup with blood work and urine tests for Oliver's annual checkup in February I think.... he was not sick.

If your cat is dehydrated, you can get fluids and needles, and give the fluids yourself at home. Talk to your vet tomorrow about having supplies at your home, and what arrangements you need to make ahead of time.

About finishing off the caninsulin, that's up to you.... you can use it up if you like and can still do a curve as you planned, and then afterwards, you can decide, based on the curve numbers if it would be a good idea to switch to Lantus sooner. Caninsulin is not the best of insulins, but you will see how your cat is doing before deciding. No matter if you stay with the Caninsulin to use it up, when you switch, people here can help you with the switch. You will likely be starting at a lesser dose with Lantus, then work your way up to the good dose for your cat.

Do you have far to go to the pharmacy for supplies? I think you could get all your supplies now, get the Lantus - ask for a package of 5 cartridges, I think cartridges are available in Canada - and also your U100 syringes, and then you are all ready to switch at a moment's notice. The Lantus will keep in your frig unopened till the expiry date on the box... 2012 or whatever it is.
 
Hi Leanne,

I'm in Manitouwadge .... just north of Lake Superior, east of Thunder Bay. A little further north than you are. :-D

I have to admit that I'm still a nervous wreck with Mischief's illness but I'm getting used to it. This morning, she was so good handling the tests, etc. ... this evening she fought me just a little bit. I doubt she'll handle the curve test too well but we'll get through it.

scissorchik said:
Hi Tammie!

Whereabouts in Northern Ontario are you? I'm in North bay, and 2 weeks ago I was where you are.

Leanne
Click to expand...
 
Gayle and Shadoe said:
Do you have far to go to the pharmacy for supplies?
Click to expand...

Hi again, Gayle,

No, the pharmacy is not far ..... walking distance. I'm very glad to know that as long as Mischief is fine in all other ways tomorrow, she should not have to go back to the vet for a while. It's so traumatic for her!

After all my research and and learning from the experience of many diabetic cat owners, I am planning on switching to Lantus, it's just a matter of when (yes, we can get it in cartridges here). I'll let the vet know about that tomorrow and see about keeping fluids here for Mischief until her dehydration clears up. I can see her fur is starting to perk up again instead of just draping flat over her ... that's a good sign!

Here are her numbers today.

8:20 am, preshot: 17.2
2:30 pm, +6: 4.2
8:20 pm, preshot: 19.6

I'm curious to do her curve test but dreading it all at the same time.
 
Tammie,
The coat is just the first of many improvements you will begin to see, even before you see better BG numbers.

You will feel better to see the numbers on the curve because you will then know how things are going and will be able to make adjustments for even better results.
 
Just a tip for when you do the curve - pick up some antibiotic cream with topical anesthetic. Put a dab on the ear you want to test about 5-10 minutes before you test. It'll slightly numb it, making it less stressful for your cat ... and you!
 
Jen & Squeak said:
Tammie, you don't have to test every hour :)
Click to expand...

Thank God for that, Jen, because I honestly don't think Mischief will let me test her every hour even if I wanted to. She put up a pretty good battle this morning for both the blood test and the shot but she's learning: food comes after the blood test and slivers of ham come after the needle. I guess when yesterday morning was so easy, she was just in a particularly good mood. She was really squirmy and growly this morning but we got it done. Her bg was 21.6 (389).

Is the Lantus known for keeping their bg more stable throughout the day? I'm finding right now, after yesterday afternoon's test of 4.2 (76) that she's really spiky. A curve test will tell me tomorrow. Not sure if that will be tomorrow or not. She's not a happy girl now and will be even more stressed after seeing the vet today. We have to be a way a good part of Friday so maybe I'll leave it for Saturday, when she settles down again.
 
Mischief did fairly well at the vet, being her normal hissing, growling self. ;) He checked her over and agreed that yes, she is somewhat dehydrated so got 2 shots of fluid and electrolytes .. one shot on each back hip. It's comical ... she's still 'leaking' on one side, poor girl. She was starved when we got home so I gave her some lunch and now, she's sleeping for the afternoon. The vet still swears that she should only be fed every 12 hours but I don't agree .... especially when she's THAT hungry mid afternoon.

The vet was very willing to switch her to Lantus and he was calling the order in to the pharmacy for me today so I can switch her whenever I'm ready. I returned the box of 28 gauge needles he gave me last week and am using the 30 gauge from the pharmacist right now. Hopefully, this will all steady her a little better so she's not so spiky.

Mischief handled the visit fairly well. She growled and she hissed and made lots of noise but only really flinched when the needles were put in her hips for the fluids. As long as I could stay face to face with her, she was somewhat calm, just making noise. Thankfully, it looks like this is her last vet visit for a while unless something else comes up .......... God Forbid!!
 
This sounds great and very promising. Be sure to print off the stickies in Lantus so you have them handy - there is one on shooting low numbers, and how to deal with high numbers, starting out, etc.

Time to get a spreadsheet up and going. Here are the directions: viewtopic.php?f=6&t=18207 It hasn't been coming up for some users, so be sure to ask for help if you need it. I think you are in Canada so ask for the world version.
 
Woo hoo!!!! Mischief was at 12 (216) this morning!! **Happy Dance**

Fingers crossed this holds but not really holding my breath. Feels good tho'!
 
Good start!

Come on over to the Lantus forum once you pick the Lantus up and start posting there. You'll get lots of help with monitoring and adjusting the dose.
 
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