newly diagnosed kitty

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maomao

Member Since 2012
Hi all. I've been on this site non-stop for the last 5 days. Thank you for all the suggestions and encouragement.

Our vet phoned us last week after we had a senior blood analysis done and said our cat's blood sugars were high and she suspected diabetes. I asked her about home testing and food and she said no question insulin is the only way to treat it and they have home testing materials that they sell and we should never use human testing materials. She set up an appointment this week to get us set up. We started to research and switched her to wet food following what we read on here and she's stopped her non-stop drinking. In fact, she's acting totally normal. My question is, now that she is not eating her dry kibble, should we have the blood test done again before we start insulin to see if her BG is still high?
 
Fantastic that you have done a lot of reading and already started wet low carb foods! The easiest and cheapest way to find out if your kitty has diabetic numbers is to get a human glucometer (yes, it reads differently than the pet ones, but we are looking for ranges, not precise numbers so it works great for our purposes and is so much cheaper) and do some testing of her numbers at home. That should tell you what range she is in. We consider a cat not in diabetic numbers if they range from 40 - 120 with the majority of the time in double digits, when off insulin.

Here is a shopping list for hometesting:


A human glucometer. Any one that sips and takes a tiny sample is fine. We do stay away from any meter with True in the name and the Freestyle meters. They have proven to be very unreliable and read lower than other meters. The meters are often free at drug stores; it’s the strips that are expensive. You can, however, buy them on ebay at less than half the price of stores. Lots of people here also like the ReliOn from Walmart. It is an inexpensive meter and its strips are the cheapest around. Try the meter out on yourself or someone else before you try it on your cat. You want to be familiar with it before you poke the cat.

Lancets and a lancet device. Usually, until the ears “learn” to bleed, a 26-28 gauge is good. Any brand will work as long as the lancets match your device.

Ketone strips. (Ketostix) Just like human diabetics use. You will sometimes need to test urine if the numbers are high.

Rice sack. Make this out of thinnish sock, filled with raw rice or oatmeal and then knotted. You heat this in the microwave until very warm but not hot. Then heat the ears before poking. You can also use a prescription bottle filled with very warm water. It provides a good surface to poke against.

Also nice to have. Flashlight: so you can look at the ears and find the little capillaries that come off the vein running down the ear. Vaseline: Put a tiny smear where you want to poke. It will help the blood bead up.

And some lo carb treats to give your kitty, successful test or not Lo carb treats

Here is a video that shows how we do it: Video for hometesting



Let us know how we can help!
 
If you can, buy some KetoDiastix......that tests the urine for not only ketones but it shows if there is glucose in the urine as well. A meter is going to be your best friend in helping you find out what the bg's are at home, not from vet stress which may very well jump the numbers up by 100 points or more.
 
Thanks for the information. We'll try to get those things ASAP. You're suggesting, then, that we start home testing immediately and not wait for our vet appt on Friday?
 
I would. The test at your vet - if it is a standard blood test done on the ear- can be higher than your tests at home because cats are usually stressed at the vet and stress raises blood glucose levels. So it is not nearly as valuable as the tests you get at home. Your vet can do a fructosamine test which will give you the average levels over the past couple of weeks, but a few cycles of numbers at home will give a clearer picture. (The fructosamine test is one that goes out to the lab and is more expensive.) Since you started wet food, you are really interested in the numbers since the food change, not necessarily numbers two weeks ago. Make sense?

It means going against your vet somewhat because you will be sharing the numbers you got at home rather than having a test done at the vet. But you are your kitty's best advocate and you are the customer, so you should be able to get what you want and need.
 
Ok, thank you so much for the first hand advice. I am super nervous about doing the blood tests since our cat is sweet and adoring until you try to handle her. She likes her contact with us to be on her terms! But I'm determined to give this a try.

Our vet has not seemed too open to discussion on the phone so we will see how the appt goes. She definitively wants us using their glucometer and their prescription food so maybe in person we can talk it out. I'd like to work with her not against her but may be looking for a new vet next week.
 
Here are some ideas for getting ready for that first poke:

First pick a place where you want to test. Some people use the kitchen counter, a blanket on the floor, between your legs while sitting – whatever works for you. Take the kitty there and give him/her lots of praise while you play with his/her ears. Give a treat and release. Next time, add the rice sack (thin sock filled with raw rice, heated in the microwave until very warm but not hot) or a prescription pill bottle filled with very warm water. Lots of praise, treat and release. Finally add the lancet so he/she will get used to the noise. The hope is that when you finally poke, they will be used to the process and know a treat is coming!

The vast majority of us spent several days poking before we were successful or consistently successful with testing. If you have any trouble, be sure to come on and ask for help. Everyone has ideas that helped them.

Their glucometer will be very expensive compared to human glucometers, not only for the meter but also for the strips. Most of us just don't see that it is worth it. You can take your meter to the office and compare on the same sample of blood. For many meters, there is just not much difference. I assume you have seen this food site by a vet: www.catinfo.org You might share it with your vet?
 
Yes, spent a lot of time on catinfo.org as well. I'm in Canada and not sure if we can get the Walmart relion - or at least can't find it on the website. I'll go down to the pharmacy tomorrow and see what they stock. Thank you again for the support and suggestions.
 
Ahh thank-you. That is exactly the info I was looking for. Besides being a newbie with the diabetic cat, I am also a newbie with website posting. Thank you for your patience and help!
 
Just buy some strips if you buy a brand name meter - enough to get you through a few days. After that, you can buy the strips on ebay for less than half the price of the strips in the store
 
Thank you so much for your help. We got the supplies today and did our first blood test. It showed 10.3 (about 185). She isn't on insulin yet. Her appointment in not until Friday. From reading over the boards it seems like maybe it isn't recommended to give insulin if the reading is under 11.1? Do you think she should have insulin given to her on Friday?
 
What a nice number! Welcome to the Vampire Club! You did it!

That would not be a number we would suggest you shoot, as a new diabetic, but it is close. Our cut off in the beginning is 200. When did you do the diet switch? Is she on all wet low carb? No dry at all - even snacks? (I am wondering if the diet has completely kicked in yet, or if she will continue to drop some. Some cats drop immediately when the diet is changed, some take a week or more.)

Here is a general guideline: We consider a cat in remission if their blood glucose levels range between 40 -120 with the majority of the time in double digits, without insulin.

It is a close call. You could wait a few more days and see if the numbers go lower, into the remission range. You could give a lower carb food than you are giving right now to see if that would bring her numbers down a little. (Say you are doing 8% carb now - try for 3-6% carbs) If you give insulin, I would be very cautious and start at a very low dose - less than .5 units - and plan to monitor carefully.

The other thing to be careful about: She may be a lot higher on Friday when the vet gets a reading. Stress raises bg levels and most cats are very stressed at the vet. So you don't want the vet to suggest a beginning dose based on his number; you want him to suggest a tiny dose based on your numbers from home.
 
Yay! The whole thing went better than we hoped for. She didn't love it and is not going to be one of those cats that lays there purring while we test her but no biting, peeing, or scratching. The only kicker is I had my husband help and tomorrow I will attempt it solo. I'd like to get a few more readings before we go to the vet to show consistency. She told us on the phone we'd be starting at 2 units/day (2 needles, 1 unit each time). That may be a bit high but she is going on numbers from before we switched her food.

We switched her on Sunday. Since then she's had a handful of dry treats every day (maybe 6-8) and 1 bowl of kibble one night when she refused the wet. Other then that, 100% wet food. We bought some Merrick and some Wellness. She doesn't seem hungry although she is eating less (i.e. not crying to be fed, and she usually does!). I'll follow your suggestions on using one of the lower carb types.

Your help has been unbelievable. We were overwhelmed/upset/scared etc. I didn't know if we could do this and I'm sure it will be up and down but right now we feel confident and that is very much thanks to this site.
 
At our house, we like PureBites and Stella and Chewy's for low carb treats. If it has only been 3 days and she did have some of the dry stuff, she may go down some more on her own. Fingers and paws crossed - that would be great! :-D
 
I wouldn't start her insulin on Friday just yet. Go ahead and get the prescription (as long as it is for Lantus, Levemir, or ProZinc)but don't buy any and continue to change her food completely and monitor her levels- waiting a week won't hurt her at the numbers you say she is.

1- she actually had a low number and that was even with the dry food that she had. Once you get her to all wet her numbers could go even lower. It might also take a while for the carbs to get totally out of her system- mine held on to those darn carbs for a week before her numbers would come down.

2- that is WAY to high of a starting dose :o :shock: . We tell people to start at .5u or 1u (so getting syringes that have a half unit marking is something you need to look for) and 2u on that LOW of a BG could send her down into hypo. Since she is so low I would actually start at .5u twice a day.

3- just go easy with the testing- don't be scared because your kitty will pick up on that and be antsy as well. Take a few big calming breathes before hand and warm up the ears well- that is the biggest as cold ears will not bleed that well :lol:

Good luck!

heather
 
Is she overweight at all? If so, and you're getting numbers under 200 at home, I would recommend trying diet change a weight loss plan before starting insulin. Carrying around even an extra couple pounds can make a huge difference in blood glucose numbers. Here is a great link on how to do that: http://catinfo.org/?link=felineobesity#Implementing_a_Safe_Weight-Loss_Program

maomao said:
She told us on the phone we'd be starting at 2 units/day (2 needles, 1 unit each time). That may be a bit high but she is going on numbers from before we switched her food.
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What is the type of insulin? If Lantus (glargine) or Levemir (detemir), then the starting dose is based off of ideal weight, NOT blood glucose levels. 2u is the maximum starting dose for a cat, and only very large framed cats like Maine Coons or Bengals should start out on that much insulin. Most cats should be starting at .5u-1u of insulin.

maomao said:
She definitively wants us using their glucometer and their prescription food so maybe in person we can talk it out.
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Here is a link to the Lantus (glargine) dosing protocol for cats, which has both the proper starting dose formula and mentions the use of human meters. http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf. I would also ask the vet what special ingredients the prescription food has that makes it better than a low carb commercial food? Her answer should be very telling, because the answer is none, and most are even too high in carbs for diabetics (Purina DM canned is the only prescription food low enough in carbs for a diabetic).
 
Wow - thanks for the info everyone! I am very concerned about overdosing her with insulin so I am going to talk to the vet about not starting the insulin yet until she is completely adjusted to the wet and we know what Mao's numbers are.

She is definitely overweight. She's 18 lbs and we've been told in the past she should be about 12-14. So we are working at it. She actually gained a pound in the last 3 months, which is strange with the diabetes. I am hoping that with the food switch she will drop some weight. I'm worried about putting her on a diet and trying to get her regulated at the same time but I will look over that link to get some ideas.

The vet didn't say what type of insulin she would be prescribing. She just said to bring her in Friday and she'd show us how to give the needles and get us the food. I am a little concerned about what her reaction will be if we say we want to wait on giving insulin and monitor her at home. I had asked her about home testing on the phone. She said that would be for another day, the first step would be for us to learn to give the insulin and bring her in once or twice a week for them to check her. Then, once we had that down, we could start home testing but she repeated a few times that we had to buy the stuff from them and that we could not use a human meter because it will not work for a cat.

I'd already read about changing to wet food and so I did a little more reading and was convinced. The vet did not even mention trying that. We switched her the next day (Sunday) and immediately she stopped drinking and peeing non-stop. It was incredible. As I did a little more research I was encouraged to try home testing and assured that the human meters will work. So that's where I am at now. I don't want to have issues with this vet so on Friday I am hoping to share with her what's happened and what we've learned but I'm not sure what her response will be.

Thank you all again for the help & support!

Mandy & Mao
 
maomao said:
She is definitely overweight. She's 18 lbs and we've been told in the past she should be about 12-14. So we are working at it. She actually gained a pound in the last 3 months, which is strange with the diabetes. I am hoping that with the food switch she will drop some weight. I'm worried about putting her on a diet and trying to get her regulated at the same time but I will look over that link to get some ideas.
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If she is overweight and staying under 200 at home I would NOT start insulin, and start a weight loss plan. The reason she has gained weight is because diabetic weight loss does not occur until the diabetes has become clinical (BG is mostly 250 or above) and causing organ damage. You do not want her to get to that point. If her numbers at home are staying under 240 (below the renal threshold), but higher than 120, she is subclinical. Subclinical cats do not have the same symptoms as clinical diabetics. If you don't start her on a healthy weight loss plan and get her down to a healthy weight, you will not likely be able to get the diabetes under control, and it will more likely worsen to the point where you need insulin.

Each extra pound she is carrying around is adding points to her blood sugar. As she loses the weight (safely!), her blood sugar will return to normal. If my Bandit is just one or two lbs overweight, it raises his blood glucose range by 40 points. At his ideal weight, all his numbers are in a normal range (60-120). At this point, your largest concern should be weight loss.

Here is the American Animal Hospital Association recommended treatment plan for cats with subclinical diabetes (p. 216-217):



Management of the cat with subclinical DM
Overall goals of treatment
• Prevent the onset of clinical DM.
• Address obesity and optimize body weight.
Reverse or mitigate other causes of insulin resistance.
• To obtain normal BG concentrations without need for
insulin.

Cats with subclinical DM may attain euglycemia without
the use of insulin. Begin management with diet change.
Evaluate and manage body weight, identify and cease any
existing diabetogenic drug therapy, and correct concurrent
insulin-resistant disease. Perform a recheck examination with
urine analysis and BG measurement every 2 weeks. If clinical DM occurs despite dietary intervention, initiate insulin
therapy.

Diet therapy goals and management
• Optimize body weight with appropriate protein and carbohydrate levels, fat restriction, and calorie control].
° Weigh at least monthly and adjust intake to maintain
optimal weight.
° Management goal of weight loss in obese cats: 1% to
2% loss per week or a maximum of 4% to 8% per
month (hepatic lipidosis risk is minimized with the
recommended high-protein diet).

• Minimize postprandial hyperglycemia by managing protein and carbohydrate intake.

• Feed a high-protein diet (defined as >45% protein metabolizable energy [ME]) to maximize metabolic rate,
improve satiety, and prevent lean muscle-mass loss.
° This is necessary to prevent protein malnutrition and
loss of lean body mass.
° Protein normalizes fat metabolism and provides a
consistent energy source.
° Arginine stimulates insulin secretion.

• Limit carbohydrate intake.
° Dietary carbohydrate may contribute to hyperglycemia and glucose toxicity in cats.
° Provide the lowest amount of carbohydrate levels in
the diet that the cat will eat.
° Carbohydrate levels can be loosely classified as
ultralow (<5% ME), low (5% to 25% ME), moderate
(26% to 50% ME), and high (>50% ME).
Portion control by feeding meals.
° Allows monitoring of appetite and intake.
° Essential to achieve weight loss in obese cats.

• Canned foods are preferred over dry foods. Canned foods
provide:
° Lower carbohydrate levels.
° Ease of portion control.
° Lower caloric density; cat can eat a higher volume of
canned food for the same caloric intake.
° Additional water intake.

• Adjust diet recommendations based on concurrent disease (e.g., chronic kidney disease, pancreatitis, intestinal
disease).
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Also, it is MUCH easier to get a cat to lose weight if you feed a high protein, low fat diet. You don't need to restrict calories as much. Merrick's Cowboy Cookout, Surf and Turf, and Grammy's Pot Pie are three excellent foods for weight loss--they are very high protein, low fat, and low carb. I highly recommend them for an obese cat, and it's fantastic you've already found a place that sells them. Here's a store finder if you want to enter your zip code and price compare around: http://www.merrickpetcare.com/find-our-products/

The Wellness is low carb, but has lower protein and is very high in calories and fat, so it's not so great for weight loss. I would take that back and stick strictly to the Merricks.
 
Just did my second blood test - 7.1! Down from 10.3 yesterday. As some have you mentioned, maybe the carbs are still getting out of her system since she has only been on wet food since last Sunday.
 
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