Newly Diagnosed Senior Cat

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Danoodle009

Danoodle009

Member Since 2023
Hello! My name is Danielle, and my cat Pinky (15) was just diagnosed with diabetes. He is my fiancé's childhood cat, but we just brought him into our home after Thanksgiving. He came with some health issues that we were aware of, but we switched him fairly quickly from Meow Mix to a much healthier option. We planned to take him to the vet once the holidays were over so that he could get a proper check up and his vaccines up to date. About a week ago, however, he started exhibiting signs of jaundice, and lots of vet trips later, we discovered he is diabetic, with a likelihood of pancreatitis. Thankfully, he is no longer yellow and doing better now on the medications and high quality wet food; in fact, he is already doing better than when we brought him home a little over a month ago.

I have an appointment later this afternoon to bring him in so that the vet can show me how to give him insulin. I've been doing a lot of research, and am a bit overwhelmed, but I just want my buddy to be okay! She kept saying that insulin doesn't always work, so that's making me more anxious. I just want to give it a shot, and any advice would be appreciated. Thank you so much!
 
Hi and welcome to the FDMB!

What kind of insulin was prescribed and what is the dose?

What wet food are you feeding specifically, how often do you feed, and how much?

When my boy Hendrick was diagnosed, I was told to only feed every 12 hours, when giving the insulin. It turns out that this is very common advice from vets but it is an old and outdated approach, today we know that a cat's pancreas is much happier with multiple small meals throughout the day -- and it is more natural as this is how a cat would feed in the wild. We still gave two main meals at insulin shot time, but also a couple smaller meals in between.

I would recommend you consider your insulin shot time carefully. Food should be withheld for at least 2 hours before the shot, and it is best if the evening dose of insulin is not too too late or else you may be up until the wee hours if Pinky were to need monitoring post-shot. And my monitoring I am referring to home testing the blood glucose by getting a drop of blood (from ear or paw pad) and testing to see if Pinky is high or low or what.

The folks here are big proponents of testing your cat's BG (blood glucose) at home so you know what is going in that little body. Many vets say this is not needed, but if a parent has a diabetic child, they wouldn't dream of injecting insulin without first checking the BG to ensure it is safe to do so. It is good to check before every shot of insulin, and then check again after a couple hours to see how it is hitting.

There is going to be a ton of information thrown at you by members here just take it slow, you'll be up to speed in no time!

p.s. there are two cats in your photo I'm guessing Pinky is the orage/white one? Pretty kitty!

pps there is a video in my signature of me testing my cat's BG, if I can do it....so can you :D
 
Hello! Thank you!

He actually hasn't been prescribed anything just yet. We just got his blood tests back today that confirmed his status, and I will be dropping him off Monday evening and then picking him back up Friday morning to do the glucose curve. I have been taking him to a local humane society to help curb costs through this process; so far, they have been great about advising me how to care for him. Is there a specific insulin I should request/avoid when talking to them?

Right now, I have him eating Weruva; it was one of the options the vet gave us to have him try when he wasn't eating, and it was his favorite. I aimed for the flavors that are high in protein and low in carbs. Right now I have him on the pouches, but I will be transitioning him to the cans soon that have more protein and are a little more cost-effective. Right now, we are feeding him three times a day. He generally eats all of his food in the morning and evenings, but will take a few hours to eat his midday meal. I guess we are already on that feeding schedule now! My main concern is feeding him the appropriate amount; the vet said to follow the guidelines on the package, which is 15 ounces a day based on his weight, but I can typically only get him to eat around 9–10 ounces a day. I tried to find out online what his caloric intake should be, but I've seen a lot of mixed answers.

I am already looking at BG testers; the vet recommends that I get the animal one, but I am planning on just picking up the human ones from Walmart, as it seems that is what everyone does here and has success with. If it means keeping my buddy safe, I'm glad to check his BG several times a day.

Yes, Inky (our little void girl) is his littermate; we've had her for 5 years, and I was able to successfully get her off the yucky stuff, and so she doesn't have as many health problems as he does. I wanted to get Pinky sooner, but the timing never worked. He's ours now, and thankfully I work from home, so that will make his care a little bit easier.
 
I recommend Lantus or another brand of insulin glargine like the generics semglee or basaglar. People seem to have great success with those for the most part, also ProZinc.

Avoid vetsuiln/canisulin it is not great for cats, and is a better insulin for dogs.

Great plan to get a Relion from Walmart they are good meters, lots of members use them! I thought getting a blood drop from my boy's ear and testing the blood sounded flat out impossible but after a few attempts and a TON of help from the FDMB we learned how and he got to the point where he would go sit at the "pokey spot" and anticipate the test because he knew he got a yummy treat after (we used freeze-dried chicken treats he goes nuts for them)

The "pokey spot" was the spot we picked to always do the ear-poke and BG test...it helps to pick a spot and stick with it (stick, get it, haha) because cats are creatures of habit and routine and they will quickly learn a pattern and get conditioned. The spot should be a happy place of pats, purrs, treats! And then the jab of the lancet is an afterthought to kitty.

Sounds like Pink is in good hands with you, you seem very competent and knowledgeable already. :)
 
Thank you for all this information! I have been out of my mind for days trying to get him to eat enough and make sure he's doing okay. I'm happy to give him the care he needs, but it is a little overwhelming. Once I get him on insulin, I definitely plan to keep track of the spreadsheet. I'm at least thankful the vet seems to be knowledgeable; she wants to monitor him for several days to keep track of his levels, and she also wanted to give it some time as we had to abruptly switch food to get him to eat something, and she mentioned that can cause fluctuations in BG. I'm just nervous to leave him there for so long, but I know he'll be in good hands.

This forum has been very helpful in ensuring that I will be giving him the proper care. I'm very glad that it exists. :)
 
Danoodle009 said:
I will be dropping him off Monday evening and then picking him back up Friday morning to do the glucose curve.
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Testing blood glucose while at the vet is unreliable and basically useless. (besides being very expensive) The stress of being at the vet can raise the blood glucose up to 200 points so I'd cancel that appointment. NO cat can be regulated at the vet and you can do a curve at home that will be a lot more accurate and we can help you learn to home test.
The biggest problem comes when you bring Pinky home. Example: while at the vet and under stress, his blood glucose runs in the high 300's and the vet ends up giving 3U to get the results he wants....then you take Pinky home, he relaxes and you give the 3U and you have the recipe for a tragedy. It's just never a good idea to try to regulate a cat while it's stressed out and there's not much that's more stressful than being away from your home, sitting in a cage all day, listening to dogs barking and strange cats howling and every few hours, a strange person comes in and pokes your ear (or paw) for a blood sample.

Danoodle009 said:
the vet said to follow the guidelines on the package,
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The guidelines on the packages almost always tell you to feed too much. After all, they're in the business of selling food. The more they tell you to try to feed, the more you have to buy! A good starting point is [13.6 x ideal weight in pounds] + 70. Weigh once a week and adjust as needed.
 
Okay, this is great to know! Unfortunately, I tend to trust the vet since I don't have any real experience myself. How can I start monitoring him effectively at home? I plan to get a monitor from Walmart either this evening or first thing in the morning. Do I get the insulin from the vet after I do the glucose curve at home, or is there a better place where I can order insulin?

In addition, how can I gauge what would be an ideal weight for him? Right now, he's almost 16 lbs.
 
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Danoodle009 said:
Do I get the insulin from the vet after I do the glucose curve at home, or is there a better place where I can order insulin?
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It depends upon the insulin. A human insulin like glargine (Lantus is one brand name of glargine) is procured from a pharmacy. YOu can get generic glargine which is a lot less expensive than real Lantus especially if you use a GoodRx coupon. YOu can use the GoodRx phone app or go to goodrx.com. You search for Lantus and in the pull down menu you select glargine insulin (generic). Also in the pull down menu select carton vice vial. A carton contains 5, 3ml pens. You draw out the insulin from the end of the pen like you would a vila. You can usually use up one 3ml pen before it goes bad.
 
Should I monitor his BG this weekend before giving insulin to determine what the right dosage is? I'm just not sure where to start.
 
I guess I should be more specific. The vet told me that his blood sugar levels are in the low to mid 200s but I don't know much other than that. I also just don't know where to start. I have the BG monitor from WalMart; should I start tomorrow before feeding him and throughout the day? And then record and report back? Thank you to everyone who has been giving me advice, I really appreciate your time.
 
Danoodle009 said:
I will be dropping him off Monday evening and then picking him back up Friday morning to do the glucose curve.
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That's a lot of money once you include the likely outrageous boarding fees.

Yes, by all means, take some tests this weekend. Maybe the vet will accept your curve. BTW: all vets used human meters before there were pet-specific meters. If nothing else, it will help both of you become accustomed to testing. Give a low carb treat after each test. Freeze-dried, single ingredient treats are zero carb. As is a bit of tuna or cooked chicken. No food for the two hours before breakfast (so that the number is not food influenced). A curve gives you a picture of one day. It is not indicative of every day, especially if a depot insulin like Lantus is used. It takes about 5 days to fill. Lantus and Prozinc are good insulins for cats. Vetsulin (caninsulin = canine) and the short-acting Humulin N are not.

Information about the insulins and dosing can be found in these links. Go into the vet's with knowledge.
 
After reading these replies and other posts, I am going to try to record his BG both tomorrow and Sunday. I would like to not have him at the vet for that long; he has a heart murmur and I am always concerned about stress on his little body.

So if I am understanding all of this correctly, I should take frequent tests this weekend and then call the vet Monday with a more informed picture and look into insulin at that point?
 
Personally, I would start insulin therapy ASAP and testing too. No need to do one then the other.

This is a marathon not a sprint, and home testing of the BG is super important but the data is most useful when there is lots of it. So doing a few tests this weekend is not likely to provide enough data to really make much of a difference in how you proceed, but it is still VERY important to get started recording the data.

And getting the hang of home BG testing, getting your cat conditioned to be ok with it and even look forward to testing, is going to take some time. So good to get that process started.
 
Welcome to FDMB!

I'm curious. Is there a reason that your vet wants to keep Pinky at the clinic for several days or was I misreading that Pinky was going to be there from Mon - Fri? Is there some medical reason for an extended hospitalization? When my cat was diagnosed, she was emergently hospitalized for 3 days and it cost thousands of dollars and that was quite a few years ago. Given the jaundice, has Pinky recovered from what I'm presuming was hepatic lipidosis? Do you know if Pinky had a bout of diabetic ketoacidosis? If your cat's acting normally, eating well, not lethargic, I would wonder why he needs to stay at the vet's office. And, frankly, if the vet is going to be administering insulin, is there 24/7 staff there? I would be hesitant to have a cat that is newly diagnosed and just starting insulin at a facility where the cat will not be monitored overnight.

If you're just starting out with home testing, you may find this link to our materials helpful.

Is there a specific insulin I should request/avoid when talking to them?
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Red & Rover provided you with great information about which insulins are best for cats. You may want to print out the AAHA Guidelines paper and bring it with you in case your vet is promoting Vetsulin/Caninsulin. As others have noted, Lantus (glargine) and Prozinc are the two best insulins for cats. Your vet should have Prozinc stocked or you can purchase through Chewy's. Larry provided great information about buying Lantus/glargine. It's a human insulin and available at most pharmacies. The biosimilar (generic) is much less expensive.

As for starting insulin, if you've just changed Pinky over to a low carb diet, it's a great plan to get some blood glucose (BG) test data over the weekend. Some cats have a remarkable response to a change in diet. We consider normal BG to be in the 50 - 120 range. If Pinky was testing in the 200s at the vet's office, the diet change may have a big influence on his numbers.

If your vet also keeps pushing for you to use an animal meter, you might ask him if he knows how much the strips cost. The pet meter strips usually cost at least $1 per strip. The Relion strips are about 17 cents per strip. If you are not independently wealthy, the choice is obvious. Vets are typically not aware of what some of these costs are.
 
Thanks everyone for replying! After reading this, I am actually not sure why they want to keep him for a week. He is no longer yellow, and he is acting and moving much better. He is eating enough, using the litter box fine, and acting happy.

The blood work was done before we switched him to quality, low carb wet food. He's been on the new food about a week and I've already seen a change in him. The blood work was also done at the vet (after going back and forth between the ER and my home vet) so I imagine his stress level was high. That's why I want to do some blood work on him this weekend; though his blood sugar was high it wasn't as high as it could have been (especially since he was at the vet) and I would love to know where his blood sugar range is before I start administering, especially since the wet food is making such a significant difference in his quality of life. But I just don't know if that's the move and if I should immediately get insulin?

Sorry for all the questions, I just want to make sure I do this right. :)
 
As Hendrick said, I’d start testing and get him on insulin as soon as possible but you’ll need a prescription from the vet for the insulin. Really push for the better ones which are Lantus and prozync. Do not let them talk you into getting Vetsulin, also called caninsulin because it was made for canines. Change in food alone can drop a cat’s bg significantly that’s why you want to test at home. I agree 100% with Sienne about hospitalization. There’s no need to keep a cat at a hospital for 5 days. A curve is done in 12 hours so I’d really recommend you question that and maybe don’t do it at all. Tell them you want to start him on insulin and monitor him at home and it’s also way way more cost efficient. And better for him.

here are some testing tips. Make sure you warm up the ear before pricking it with the lancet. A lot of us fill an old sock with some rice and nuke for 20-30 seconds then hold it up to her ear till it’s warm to the touch. Use a larger gauge lancet to start, like 26 or 28, because it’s easier to get a decent size droplet. Always give him a treat immediately after to build positive association. You want to aim for the sweet spot. It gets easier with time as the capilares in the ear learn to bleed and you get the hang of it. If he tends to move or flick his ear, you can try to scoop up the blood droplet onto a clean nail and test from there. It’s a good idea to use a cotton ball or oval as padding behind the ear when you test. Let us know if you have more questions! You got this and we here for you
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So far this morning, his blood sugar has gone from 180 before breakfast (though I think he ate some of his sister's breakfast and I plan to be more hypervigilant about keeping him away from the dog food in the future), to now 150 +3 hours after eating. Should I just keep monitoring through tomorrow? From the sounds of it I likely won't be able to get the insulin until Monday when I can chat with the vet anyway. I just would be super unsure about the dosage.
 
Those numbers are high enough to need insulin but not incredibly high. The more numbers you have for the vet, the better. (You don't want to go by the numbers at the clinic and you want to prove to the vet that you are dedicated and can do this at home.)
 
Well done! For reference, a smart starting dose is .5 or 1 unit, but not higher than that. We see a lot of folks who are told to start at 2 units and that is too high for a starting dose. with numbers averaging under 200, I think it wound be wise to start him off on .5 units only so he doesn’t drop too low.

I think if you can do 4 tests a day, that would be good info to have in your back pocket for the vet on Monday. They can also see he’s not incredibly high and should not need a whole lot of insulin
 
So glad to hear that! You’re doing amazing and he’s not even on insulin yet. Also very happy to hear you’re able to test and it’s going well and that his numbers are not super high. Ask as many questions as you need!
 
Pinky is an incredibly patient buddy. He doesn't like it, but I have had no issues so far in poking him and getting a sample from him. When I did the second one, he jumped on the bed and was ready and was looking for his treat immediately after.

I have been nursing him out of jaundice all week and have been giving him subq fluids, so at this point, this probably seems routine to him, and does to me as well. They never actually told me why he was jaundice but cited that it was likely from being diabetic. It was a chaotic few days, but I am mostly glad he's no longer jaundice and is acting better than he was when we brought him home the first time a little over a month ago.
 
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I hope your fiancée knows how lucky he is to have such a caring and loving stepmom for his four legged babies. That’s exactly it. People get scared when they hear the words home test, but it becomes part of the routine, like feeding or giving insulin. I totally relate having gone through so many health issues with Minnie. I was always just over the moon every time a treatment worked and she felt like herself again :bighug::bighug::bighug:
 
The jaundice was likely a result of hepatic lipidosis ("fatty liver"). Chances are that if Pinky also had pancreatitis, he wasn't feeling great and not eating or not eating very much since pancreatitis can be incredibly painful. If a cat goes without food for more than a few days, there's a risk for hepatic lipidosis developing. Any time the liver is compromised, jaundice can result.

If your vet didn't give you more information, ask! You should be given explanations for what's going on with your cat. It's the nature of informed consent. If you don't have an explanation for what the problems are and how they are being treated, you're not able to make a good decision about Pinky's care. It's the same issue with the vet wanting to keep Pinky for almost a week. You haven't been told why this is necessary. If the vet tells you it's to get the right dose, that's not a reasonable explanation. Unless a cat is quite ill, most vets decide on a starting dose (which should be around 0.5 - 1.0u) and send you home.
 
Thank you! I will definitely chat with the vet on Monday.

Is there anything I can/should use to make sure where I stick him stays clean on his ears? I don't want to risk infection but I am not sure what others use.
 
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