Newly diagnosed, overwhelmed and looking for advice

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Butterscotch's Pawrents

Member Since 2019
Butterscotch is a 14yr old female, likely Maine Coon mix. She began drinking excessive amounts of water, sleeping in her water bowl, begging for food, and becoming less interested in play time when she was misdiagnosed with chronic kidney disease in March 2019. We put her on a renal diet at that time and her health began to decline. Her symptoms were increased drinking/peeing, extremely lethargic, restless, not sleeping, hiding, not grooming, not meowing, begging for food but refusing to eat a variety of the tastiest things put in front of her, intermittent diarrhea. We brought her to a new vet at the beginning of Aug 2019. We were told she has normal older cat kidney's but nothing to worry about, some constriction in her lungs, abdominal bloating with an ileus, dehydration, weight loss/muscle loss, and diabetes. Her blood sugar was 440 and she had glucose in her urine but no ketones. We started her on 1 unit of lantus twice daily on Aug 8 as well as SubQ fluids. Getting her to eat anything was an extreme battle despite the fact that she was begging for food. Her blood sugars a week later were between 383-441 and Lantus was increased to 2 units twice daily on Aug 15. She is more alert and more willing to actually eat at this point. Her sugars are 334-402 on the 2 units. She eats very low carb Weruva and Tiki canned food twice daily. Still losing weight and drinking tons of water, diarrhea started again and had first pee accident next to her box.
We love our sweet Butterscotch so much and hope she isn't suffering while we try to improve her quality of life.

We have some spreadsheets at home and will start uploading data to our profile soon.

She did one glucose curve in the office last week. I've been testing her once a day at a different time over the last few days as practice and I'm doing my first curve (her second curve) at home today.
Biggest thing we're trying to figure out right now is which meter to use.
We like that the AT will only produce a result if it collected enough blood saving you from a false low reading but the strips are too expensive. I've read some about using freestyle lite strips in the AT but wondering how valid that is.
We were gifted a PetTest monitor but have no strips for it. The strips also seem expensive and only marginally cheaper than the AT strips. Biggest concern with it is I've read that it will give you a glucose reading even if the blood sample is too small and will result in a inaccurate low reading.
I initially liked the idea of a cheaper human meter for daily testing but I have anxiety and I fear that I will question every slightly low/high result and end up wanting to retest with a pet specific reader to confirm and thus wasting more strips.
Looking for a meter that uses 0.3uL blood sample because her ears don't consistently bleed well.

Other concerns include, new diarrhea today (she had diarrhea 2 weeks ago when first diagnosed and not eating well but all normal stools since then) and some pee outside her box today - she's never had an accident in the 11 yrs we've had her.
Losing weight but begging for food. She was a healthy 13lbs all her life (larger breed part Main Coon vet always said was a perfect weight) and lost 2lbs per her weigh in last week. Feeding 300cal per day per online research. She begs for food all day long. Not sure what to do. I understand if her sugars are over 300 she can't use the glucose from her food properly.
Eating has been better since we started rotating foods. Initially just prior to diagnosis she was acting super hungry/begging but no matter what we put in front of her she turned away and proceeded to beg for new food. Tried baby food, human tuna, bonito flakes, variety of cans, you name it and she didn't want it. She is still kinda doing this, begs and turns away from some foods or needs to be hand fed, but the problem is improving. She has not previously been a picky cat.

Thank you all for any advice.
 
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two human meters that take a .3 blood droplet -- the Freestyle Lite and the (now discontinued) ReliOn Confirm or Micro -- the ReliOns, and the same meter from the actual manufacturer, the Arkray GlucoCard01, can be purchased from other vendors online; the strips are still available from Walmart online ($14.95/50 .. rolled back from $19.99) as well as from Arkray -- there may be one or two other meters that I'm not aware of
 
Welcome! Many of us feed several mini meals a day rather than twice a day feedings. It can help keep the glucose more even as well as keep kitty happier. For testing you should get a test before feeding and giving the shot so you know if Butterscotch’s bg is high enough for the insulin and then a test midcycle to give you an idea of how well the dose is working. @JanetNJ has some info on alternate strips for the AT meter.
 
Many of the members here use the ReliOn Prime meter and strips from Walmart. I got the ReliOn Confirm (which has been discontinued :() and used it because I just couldn't keep up with the AT2 strip cost. My DH uses it too for daily BG testing as he is borderline diabetic. Currently testing Idjit again with the AT2 to use up strips before they expire. When we run out of Confirm strips, we are going to use the Prime meter for both DH and Idjit. The difference between a 0.3 m. and a 0.5 ml sample is not that much and the important thing is to be testing, to track those BG numbers, help prevent any hypo events and see how the insulin is working.

Here is some information about pet meters and human meters:
Human meters do read lower than pet meters, and BG range in the dosing protocols are adjusted accordingly. For example, a normal range on a human meter is 50-120, while on a pet meter it is 68-150. You cannot compare numbers from a human to a pet meter because you're using a different point of reference for them. It's more important that a meter be consistent, (we are generally looking for trends in data to adjust the dose, not single, exact numbers). There is also a +/- 20% variable allowed in any glucose meter, including pet meters.
You can't translate numbers from a human meter to what they would be on a pet meter. Then are no studies which provide a correlation between the two. However, it's equally important to note that 50 on a human meter does not equal 68 on a pet meter. Those are the numbers which have been determined to provide a safety net.
 
Aw, poor sweet Butterscotch! I love her picture, she is absolutely adorable!

You say:

begging for food but refusing to eat a variety of the tastiest things put in front of her, intermittent diarrhea.

Hungry but turning away sounds like nausea, did the vet give you any medications for that? Good ones for cats include ondansetron and Cerenia.

Did the vet test for pancreatitis? Nausea and diarrhea fits, they usually lose appetite with that, but of course there's the diabetes in the mix and that might be making her feel hungry anyway.

I'm also wondering about food sensitivities-- you say she has some allergies/asthma already, hmm. If she was eating things that started to make her feel yucky, she might have developed an aversion to those or similar foods (much like humans do).

Hope she's feeling better soon-- so hard to see them when they are like this :(.
 
Hi! I just bought a pet meter that takes 0.3 microliter sample called Nova Max plus (also tests for ketones) here: https://www.adwdiabetes.com/product/1587/free-nova-max-diabetes-meter-kit, the meter was free with the purchase of strips (4 times less expensive than AT). I still have to use it now.

Regarding the food, have you tried to squeeze Tiki sticks on top of the food? low carb dry food (Dr Elsey's) crumbled? Plain turkey? I hope you can find something she'll accept :(
 
Welcome! Many of us feed several mini meals a day rather than twice a day feedings. It can help keep the glucose more even as well as keep kitty happier. For testing you should get a test before feeding and giving the shot so you know if Butterscotch’s bg is high enough for the insulin and then a test midcycle to give you an idea of how well the dose is working. @JanetNJ has some info on alternate strips for the AT meter.

We plan to do testing that way once we have our own meter. Borrowing the vets meter right now and don't have an unlimited amount of strips.
Ideally I would feed her many small meals, she's always been a grazer when she ate kibble. It's impossible for us to feed her wet food during the day every day since we both work full time. We feed half her food before her insulin and half after both morning and evening and I leave our some freeze dried chicken pieces for her to nibble on when we're not home.
 
You can freeze a mix of wet food with a little extra water in ice cube trays and leave out cubes to thaw during the day.

Many members use a timed feeder that is set to open at set times so that kitty has wet food when the human servants can't be there to serve up the fuds. We use a CatMateC20 that has a little ice pack for under the food tray, it keeps the wet food chilled and Idjit loves it. There are other feeders with 2 and 5 portion trays that have the little ice packs, and are a good option for kitties whose parents are away at work all day, and for night feedings also. Check out CatMate and PetSafe brands and models. I'm sure there are other brands, just not as familiar with them.
 
Aw, poor sweet Butterscotch! I love her picture, she is absolutely adorable!

You say:



Hungry but turning away sounds like nausea, did the vet give you any medications for that? Good ones for cats include ondansetron and Cerenia.

Did the vet test for pancreatitis? Nausea and diarrhea fits, they usually lose appetite with that, but of course there's the diabetes in the mix and that might be making her feel hungry anyway.

I'm also wondering about food sensitivities-- you say she has some allergies/asthma already, hmm. If she was eating things that started to make her feel yucky, she might have developed an aversion to those or similar foods (much like humans do).

Hope she's feeling better soon-- so hard to see them when they are like this :(.

She was initially on Cerenia for nausea for a couple days and flagyl for the diarrhea. We also added pecid incase she had increased acid. The diarrhea stopped when I switched foods (but oddly the suspected culprit food was a canned food she'd eaten every day for years with no diarrhea. We had switched to different foods after her diagnosis with no diarrhea but when she stopped eating them we went to her original food just to get her to eat and that's when the diarrhea started and it stopped when we quit that food). I stopped all the meds after a few days because there was no improvement and she started hating eating even more so I thought maybe the taste of the pills on her tongue made any food taste bad too. We finally found some varieties she likes and as long as we rotate them she seems to be more willing to eat them. But every feeding time I become stressed that she won't eat again.
She has dry, dandruff, itchy skin and ears her whole life and an autoimmune skin disorder called Eosinophil Granuloma Complex that causes ulcers on her skin. She's had probably about 4 steroid shots in the past 11 years to treat any really bad ulcers. Per her Xray her lungs were restricted and vet said they looked like those of a much older cat. Sometimes she coughs like she got a hairball, it's really gurgley sounding but she doesn't vomit. She snores and makes congested snoring breath sounds while awake.
Vet did not specifically test for pancreatitis that I know of. I am suspicious of this though as well. Do you know what tests she should have to rule this out?
 
Hi! I just bought a pet meter that takes 0.3 microliter sample called Nova Max plus (also tests for ketones) here: https://www.adwdiabetes.com/product/1587/free-nova-max-diabetes-meter-kit, the meter was free with the purchase of strips (4 times less expensive than AT). I still have to use it now.

Regarding the food, have you tried to squeeze Tiki sticks on top of the food? low carb dry food (Dr Elsey's) crumbled? Plain turkey? I hope you can find something she'll accept :(

She does eat Tiki Cat products at the moment. But her trend has been to eat something for a week and then refuse it. We've tried so many foods at this point that we have kinda run out of options if she decides she won't eat this anymore. So we're trying to rotate a few flavors to keep it interesting.
She completely refuses to eat any kibble at all which is odd because she at kibble just fine her whole life. -but I know kibble is bad for her diabetes anyway so not trying to reintroduce it.
 
You can freeze a mix of wet food with a little extra water in ice cube trays and leave out cubes to thaw during the day.

Many members use a timed feeder that is set to open at set times so that kitty has wet food when the human servants can't be there to serve up the fuds. We use a CatMateC20 that has a little ice pack for under the food tray, it keeps the wet food chilled and Idjit loves it. There are other feeders with 2 and 5 portion trays that have the little ice packs, and are a good option for kitties whose parents are away at work all day, and for night feedings also. Check out CatMate and PetSafe brands and models. I'm sure there are other brands, just not as familiar with them.

What great ideas, thank you!
These probably won't work for us at the moment because she still needs coaxing and hand feeding to get through a meal but maybe down the line when she's doing better.
 
Vet did not specifically test for pancreatitis that I know of. I am suspicious of this though as well. Do you know what tests she should have to rule this out?

There are two: the SNAP fPL, which can often be done in-house and gives a yes/no answer, and the Spec fPL, which gives a quantitative score and a sense of the severity of the result if positive. The Spec fPL has to be sent out so it takes a few days.

Here's a link to a primer on pancreatitis from the Health Links/FAQs forum: A Primer On Pancreatitis
 
with her dry dandruff skin have you tried adding some extra virgin olive oil to her food? some cats will eat it by itself! also many of the dried fish treats (sardines, whitefish, salmon) have extra Omega 3 and 6 which also helps with skin issues .. at least they did for Catcat .. possibly also to rub the olive oil on skin, or drop it on paws, fine to lick off ... I added probiotics to the food as well, seems to help
 
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