Newly diagnosed, new to the board & completely overwhelmed..

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Rapunzel

Member Since 2013
so i'm sure i should probably try to look through some of the other topics on here, but i am so overwhelmed by the immensity of the information available here that i don't even know where to start! So I'm just going to post my sob story here for you guys, and if anyone has any advice or tips, please let me know!

So here are my fur balls, we have Will & Grace who are about 6 years old and rotund.
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And this is lovely calico Samantha, she is about 12 1/2 years old now and she has just been diagnosed with diabetes.
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We had noticed that Samantha had started to have issues with her walking about a month and a half ago. She started walking on her haunches and at first we thought she had injured herself or that it was arthritis, but then i started to realize that I didn't think she could even feel her feet properly because she was way too docile about people handling them and she had litter stuck to her toes, etc. We brought her in to the vet and they confirmed that it is diabetes ($427 later) and now we have her on Purina DM canned and dry (i am a bit concerned about that because i just read in the faq that dry is bad, so i don't understand why the vet suggested it?!). We were told to feed her 1/3 can twice a day, 1/4 cup of the dry twice a day and we are giving her the insulin injections at 7 am and 7pm when we feed her. The vet suggested to administer the shot while she is eating and distracted.

Right away, i noticed a difference, she seems happier, purring more, loves her new food (especially the dry) and i thought her walking seemed a bit better. She has been on the new regimen for a little over two weeks now and last night, I noticed that her front paws are acting up, almost like she is walking on her ankles. Does this mean the insulin isn't working? Maybe the wrong dosages? I'm panicking, because I'm too poor to bring her in to the vet at $500 pop. I accidentally left the insulin out of the fridge overnight for maybe 8 hours, does this change its effectiveness? I'm afraid she's going to get worse and not be able to walk before pay day :roll: ..

She is our daily pet and I travel a lot for work and I know my mother doesn't have the same patience for this as I do.. she doesn't feel that its worth spending so much money to try to manage this and i'm afraid i'm going to go away on business and come home and find that she's been put down.. but again, none of us can afford to take her into the vet frequently, if this is the kind of astronomical costs that are going to be behind it. I don't know what to do?!

any suggestions would be appreciated.
 
Re: Newly diagnosed, new to the board & completely overwhelm

Did the vet mention "neuropathy"? That's what it sounds like may be going on. It isn't an issue for all diabetic cats, but it is fairly common. There are meds for that. And I don't believe they are expensive.

What type of insulin did they give you, and what is the current dose?

There are ways to lower the cost of this. One is "home testing" of blood glucose with a regular human glucometer. That avoids the cost of having the vet check it.

Another is the food. Prescription food is expensive and you can feed brands like Friskees pate or Fancy Feast classics. They aren't any lower quality than the Purina DM, and they are much cheaper. And they are all low carb.
 
Re: Newly diagnosed, new to the board & completely overwhelm

Breathe. It's OK. Just breathe.

Your vet suggested dry food because they sell it, and a lot of vets don't know any better. Canned food is MUCH better for all cats, and especially for diabetics. You don't have to feed the fancy prescription cans, though. Any low-carb canned variety is good. A lot of people here feed Friskies pates or Fancy Feast pates with great results. Just make sure it's the pate kind - the slices or chunks or whatever in gravy is high-carb and not appropriate for diabetics. However, if you take the dry away, her blood sugar might come down, which leads me to...

Most of us here save a lot of money and keep our cats much safer by home testing our cats Blood Glucose. By testing before every shot, we know that it is (or is not!) safe to give insulin. By running other BG tests during the day (or night), we can track the way the insulin works in our cat. These extra tests are called "running a curve" and it's the best way to see how a dose is working or if a dose change is in order. You can use a human glucometer - most of the work just fine. A number of people here use the ReliOn Confirm, Micro or Prime models from Walmart. They are reliable, inexpensive and easy to get.

Please do read the thread on "Hypos can kill". I don't want to scare you, but this is serious business and it's best to be prepared. Then make sure to read "A message from your cat".

There's someone here who has a great shopping list and I'm sure she'll be around.
Welcome on!
 
Re: Newly diagnosed, new to the board & completely overwhelm

Without giving too much information at one time. Here are the things I suggest:

1) return the prescription food - just tell the vet the cat doesn't like it - they should give a refund it's guaranteed.

2) Check out Dr. Lisa's site about feline health and for now scroll down the right side of the page to the food comparison chart that lists carb values - What you want is to feed wet/canned foods only and use foods that are under 10% carbs (as specified on the chart). The good thing is you can use the same food for all your cats. :-D Everyone will do much better eating a low carb diet - think of it as Atkins for cats! Personally, I give my cats foods that are between 4-6% carbs. :-D

Here is the link to the website: www.catinfo.org

3) If you are not already home testing, then let's get you started. Are you willing to learn? We have lots of tips and tricks and videos to teach you. In addition, if you tell us your city/state we may have a member close by who can show you in person.

I won't get into the details of what you need yet, but if you are willing to learn, we can go there.

4) what kind of insulin were you prescribed and how much are you dosing and how often?
It is important for us to know this, as we recommend a starting dose of 1 unit or even 1/2 unit - never higher and to give insulin twice (BID) a day every 12 hours. Why because you can always increase the dose if needed (based on home testing, but you can never remove the insulin once injected if you give too much.

Also, when you change the food as suggested above, the amount of insulin needed may need to be reduced. Why - removing dry food, feeding lower carb food can reduce the BG (blood glucose) levels by as much as 100 points or more. And the only way to know if it is safe to give insulin and the dose to give is by home testing.

Before I continue, please answers the questions I asked and Carl asked.

Thanks,
 
Re: Newly diagnosed, new to the board & completely overwhelm

Ahh thanks so much everyone, this is helpful already. I was out of town for the initial vet visit, but I know the vet did not prescribe anything that might be for neuropathy, only the insulin. And not to sound like a total idiot, as far as the dosage goes, the first number shown on the syringe is a 5 and the dose we are giving her is the first line on the syringe, so I'm guessing that is 1 unit, twice a day, 12 hours apart. It is called Caninsulin, just what the vet gave us.

i have no problem home testing and i am definitely willing to learn, but as i mentioned before at least one week, sometimes 2 weeks a month, I travel and during those times, the caregiver may not be willing to do any testing. I'm not sure how often testing needs to be done, but I assume that maybe once we get things figured out a bit more, it won't have to be as frequent?

I am located in Oakville, Ontario, Canada. About half an hour west of Toronto, and hour east of the Buffalo, NY border.

And thank you for the food recommendations, that has been the biggest struggle so far. i had them all on a prescription dry food because Will had crystals in his urinary tract from high ash content when he was young, then it turned out the prescription food was too rich for Samantha and so we put them all on a new pre-cursor diabetes prevention prescription dry food. And now I have her on the DM and the other two on the other one and the vet said the DM would be terrible for the others to eat, so its such a production trying to separate everyone, make sure everyone is eating what they're supposed to, so if I can get all three on the same diet and maybe help the two giants lose a little weight, it would be an all around win.
 
Re: Newly diagnosed, new to the board & completely overwhelm

For neuropathy you want to give him Vitamin B12 Methylcobalamin. There are many types of b12 on the market, but this is the one used for neuropathy.

There is a brand called Zobaline that you can use. Here is a link - you can also do a search and may find it cheaper elsewhere - http://www.ilifelink.com/zobaline-for_d ... blets.html

If you don't want to use this brand, just look for one that only contains Methylcobalamin B12 and no sugars (as some have sweeteners in it). It comes in pill or capsule form. If you get the pill form, melt it in water and mix with wet food. If you get capsule, empty the capsule into wet food.

1 pill once a day to start - if the other cats eat it, no worries, the body will pee out what it doesn't need.

We have several Canada members, let me see if I can round some up for you.
 
Re: Newly diagnosed, new to the board & completely overwhelm

I am also located in Oakville. My diabetic kitty passed away a few years ago.

You have been receiving some good advice from others regarding home testing, food, neuropathy, etc. Some things are a bit different for you in Ontario. Carl mentioned some foods that you can feed. Look for Fancy Feast pate varieties if you want to try that brand - they are not labelled as Fancy Feast "Classics" here. The Relion meter from Walmart that was mentioned is not available in Canada. If your travels take you to the USA, you could purchase one there (the strips for it are much less expensive than strips you will find in Canada). As far as I know, the Zobaline brand of methylcobalamin (vitamin B12) is not available here either. I am not sure how expensive it would be for you to have it shipped from the US. I have found methylcobalamin tablets here at Shoppers Drug Mart in the past, but it may take some hunting around - most of the vitamin B12 tablets being sold are cyanocobalamin, which you don't want. Check labels closely.

I am not an expert on neuropathy. The fact that her front legs are newly affected now may be something that you need to bring to your vet's attention when it becomes possible for you, as there may be other medical conditions which can cause front leg weakness. Neuropathy can cause both front limb and hind limb weakness, though the hind end "walking on hocks" is a more classic sign. Insulin lasts longer if refrigerated, but I don't think that leaving it out for 8 hours would have made it ineffective. There is a good website about feline diabetic neuropathy:

http://www.laurieulrich.com/jasper/

Home testing is very valuable in helping you know how well her diabetes is being managed. It can be more expensive to buy the test strips in Canada, unfortunately. You should not have to pay for a meter - look for an offer of free meter with strips at the pharmacy, or it is also possible to go online for some meter manufacturers and print out a coupon for a free meter. Where they will get you is on the cost of test strips. I believe that Costco has the best (relatively speaking) prices, if you are a member, or maybe Walmart. If you have a Shoppers Optimum card, you can at least use that strategically on days when they have various deals on points to get the best value. I think that some people here have been successful in finding strips on E bay. Others in Ontario with more recent experience could perhaps help. You could always make a post with a subject line asking for help from Canadians or Ontarians.

Somewhere down the line, some may suggest that you consider trying a different type of insulin rather than the Caninsulin. Just so you know, if you ever decide to do that, you can buy insulin over the counter without a prescription in any pharmacy in Ontario. Keep in the back of your mind that if you change insulins, you will also have to buy a different type of syringe to go with it, and you can also get those at a drugstore (Caninsulin requires a special type of syringe known as a U40 syringe).

It is very normal for you to be feeling panicked or overwhelmed right now. You have made some important first steps by researching things and posting here. You will get a lot of info, but take everything a tiny bit at a time. We all started in the same boat here!
 
Re: Newly diagnosed, new to the board & completely overwhelm

Just wanted to say I understand how you feel. My kitty is newly diagnosed too and it is overwhelming and scary. Please know that the people in this community are very helpful and patiently answer questions from us newbies so you came to the right place. Best of luck to you and your kitty! :YMHUG:
 
Re: Newly diagnosed, new to the board & completely overwhelm

Hi Rapunzel!

I know how you feel - I am pretty new to all this too, and there is just so much to read and learn and take in, especially at first!
It does get easier though, and you are in the right place here for awesome advice and friendly support - everyone is really helpful :-D

(your kitties are very cute btw and look very content!)

The replies you've had already have better advice than I can give, and lots of good info about testing, insulin and food. My cat Jazz also has diabetic neuropathy, so I completely understand about the symptoms you describe and the worrying you are going through. It's really is an awful thing to watch your cat slipping around and having trouble just walking :sad: You can do something that might help though!

Jazz had a lot of apparent stiffness in her hindlegs/hindquarters, and her back legs were slipping out from under her when she was walking around. When she was going somewhere, every few metres, she'd lie down on the floor to rest. She avoided jumping and even had trouble squatting to go to the toilet at one stage. It was terrible, and I hated to see her like that. :cry:

When she was diagnosed with diabetes at the vet, the vet thought that she had age-related osteo-arthritis (Jazz is 17 and only had 'stiffness' at that stage, the actual slipping/trembling developed almost immediately after the vet visit for some reason). She was prescribed custom compounded drugs (combination pain relief and anti-inflammatory I think) but I did a lot of reading and research before picking them up, and found the info about B12 that has already been mentioned here. (do read Jasper's page on the link that Linda & Bear Man gave). I explained it all to the vet (who wasn't familiar with it incidentally) and we agreed to try the B12 and see how it went before starting any osteo-arthritis drugs. Please understand that every cat is different of course and you may not have the same kind of results as Jazz has - though I really hope you do!

I have been giving Jazz 3 mg B12 (methylcobalamin) daily since then and the difference is amazing. Granted I don't know if it's from the B12 or insulin or a combination, but she is now literally running around the garden and jumping on/off beds and sofas :-D I am sooo happy to see that of course!!! So do give the B12 a try, I didn't think it was working at first, but we persisted and after maybe 3 weeks I really started to see positive changes. All this is without the osteo-arthritis drugs, and I really think the issue was neuropathic, not arthritis related.

Be aware that if your cat has lost muscle condition in her hindlegs though (from a combination of not using them as much/in normal ways and breaking down body tissue to 'feed' herself as a result of the diabetes), she will continue to be weaker in that area, even if the neuropathy clears up, until the muscle condition is regained - so she might be a little wobbly as a result. You should be able to see that it's to do with that, rather than the nerve damage though.

I hope that is not too long, but I just wanted to share that the B12 really can help, and it's possible your cat's neuropathy will improve. Not sure where you are, but on the off chance you are in Australia, you can get B12 formulated just for cats here: http://www.custommedicine.com.au/ (I just emailed him direct to discuss what I wanted). I use one 3 mg capsule per day, open it up and sprinkle half the powder on each meal. She eats it with no problem, doesn't seem to mind it at all. It does turn a hot pink colour when it absorbs moisture though so don't be alarmed!

Whatever type you get, make sure it is the methylcobalamin B12 (better utilized by the body, esp. for neuropathy) and that it does NOT contain xylitol (toxic to cats). I really hope that the B12 will help your kitty - definitely worth a try though!

All the best :YMHUG:
 
Re: Newly diagnosed, new to the board & completely overwhelm

Hi guys

Ok so I got my free Accu Check Aveva with my test strips today and as I mentioned before I have her on the Purina DM canned and dry and she is getting 1 unit of can insulin every 12 hours. I plan on taking her off the dry food, but wanted to keep her regime the same until I was able to do some testing to get an idea of where she is at.

So I tested her and she is really high - when the vet tested her she was in the high teens and today she was 20.3mmol/L which, if I'm not mistaken is something around 365mg/dL - and if what I have read so far is correct that's incredibly high, I believe a healthy number is between 100-200. I tested my other two who were at 3.8mmol/L.

I was thinking that if I take her off the high carb food tomorrow, and stop feeding the dry, that it would help bring down her level and I will keep testing to see if there is a change.. and then start to figure out what to do about insulin dosage... I just feel that our vet didn't give us very much information to work with and I want to find a way to help get her to a normal level and maintain it through home testing. Would you guys recommend upping her insulin dose? and if so, how much do you usually alter a dose when you are increasing?

I am going to work on changing the diet now and monitor her levels and see how that effects them before doing anything about her insulin dose. I figure that her levels should decrease with the removal of the carbohydrates through the dry food, and putting her on a low carb canned. So I guess we will see.

I just checked her again after eating (about an hour since the first test), canned purina DM and giving her insulin and she is down to 19mmol/L.

Am I on the right track?
 
Re: Newly diagnosed, new to the board & completely overwhelm

Hey there

I used to live in Oakville (upper middle) and moved to Oshawa a few years back. As a Canadian here are a few things

1. Food - I agree with Linda - Fancy feast pates, friskies pates and wellness grain free are good low carb foods for diabetics. You can sometimes get sales of them in petValu, Petsmart or walmart too. I am always checking!

2. Insulin - I am not loving the fact they prescribed caninsulin. Its harsh on cats and doesnt work well - i think your vet is a bit out of date. Other insulins like Lantus levemir or prozinc work better and have a good chance of remission if started early ( up to 40% of cats!!) .Linda can you recommend a better vet in Oakville? You can get Lantus from any pharmacy without a prescription. For example a vial at Costco is around $75 and will last you six months.

3. Meter - that one you got is pretty good. I have a bayer contour I got free. Heres how. I buy the strips on ebay for $50 for 100 and free lancets but you can also get them at Shoppers etc with the bonus that you get points. Go to http://www.bayerdiabetes.ca/BDoffer and use code "BDS 11-14" And then if you register the meter when it arrives, you get a free USB wall charger. Its a reliable meter. I would get one of these too since its good to have a backup meter!


Wendy
 
Re: Newly diagnosed, new to the board & completely overwhelm

Congrats on the testing!

You are right, 20 is fairly high but then she is getting dry food.. when did she last get insulin?

Since you are testing now, you could stop the dry at any time, but just be prepared for her blood sugar to drop over the next few days so keep a close eye on her - this is where a spreadsheet to track trends will help. Also in order to adjust dose the spreadsheet will help track your results, then we can look and see how she is responding to the insulin. http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

I would not up her dose yet - lets see how the food change works over the next few days first.
Wendy
 
Re: Newly diagnosed, new to the board & completely overwhelm

Hi everyone

Well she is doing ok with the wet food and she has been getting her b12 supplements. The counts are still high and lower obviously following her insulin. The neuropathy is getting worse. Her front feet are bad and this morning she couldn't get into the litter box, so I will be finding her a new accessible box this weekend and keeping an eye on her.

It turns out that my vet has actually been much more helpful than I anticipated. I was afraid she might be a little irked that I had veered from her suggestions and instead consulted the internet, but she has been supportive of the decision to take her off the kibble and is glad we are home testing and even said she would prefer we do that and get more accurate, less stress related readings. She wants me to test her levels this weekend every 2 hours for a 12 hour period and to call her and we will decide how much we can up her insulin dose. I was really surprised that she was so willing to give me phone advice free of charge, but i really appreciate it. Hopefully we can get her levels maintained sooner than later and work on helping her neuropathy. its so hard to watch her struggle with it.
 
Re: Newly diagnosed, new to the board & completely overwhelm

We have a wonderful color coded spreadsheet that we use to track the BG (blood glucose) readings.

Here are directions to set this up and link it into your signature so other people can view it and make suggestions. http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207 There are people here that can help you set this spreadsheet up. Just ask.
 
Re: Newly diagnosed, new to the board & completely overwhelm

The methylcobalamin takes 4-6 weeks to work but you also need to get the blood sugar under control.

Any chance of that spreadsheet? Let us know if you need help.

Also did you ask your vet about Lantus - the caninsulin probably isnt helping.

Wendy
 
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