Newly Diagnosed Sugarcat - Lots of Questions!

Status
Not open for further replies.
Ok doky hang on - when did she last have the steroid shots? Thats a good diabetes trigger...

You could do this
7.30am test shoot feed
feed any time during the day ie 4.45pm
5.30pm take food away if still there
7.30pm test shoot feed

Wendy
 
The last time he had a steroid shot was mid 2011. He still had horrible skin issues, he would twitch everywhere because he was so itchy and had sores on his back, the steroids helped it heal but it came right back. So I felt like the steroids were too risky and only a band aid solution. Turns out food was the answer, not what my vet had thought he might have. I hope that it wasn't the reason he has diabetes now :( I'm just glad food was the answer, wish I had figured that out earlier though. I hope being on the wet food only doesn't start his issues up again... I'm guessing gluten is the issue, but I really don't know, I just know that Blue Buffalo Freedom dry made everything all better for the first time in years.

I can do that schedule. I feel guilty saying this because I'd do anything for my kitty, but I feel a bit sad looking at the schedule, even though I know it has to be done... I've been separated just over a year and have wanted to date but it will be hard now. I do feel guilty feeling this but I'm sure someone on here has felt overwhelmed with the commitment this requires, even though I'm so glad that he will be around for me to be committed to! I just have no one to talk to about all this, most people I talk to think I'm crazy for not putting him down since he's 14, but he's not dying, he's just a bit sick and can have a good life :) Feel free to share open opinions and tell me I'm being stupid lol.
 
Emily,
You're still allowed to date ;-)
Diabetes doesn't mean your life gets put on hold. If there's a conflict with your plans, we can help you with working around it.

And any guy worth a damn will realize how important Zoey is to you, and if he's really special, you'll find you have a partner in this. And worth dating a second time!
 
2011? Nah that was too long ago then.

Dont worry about the schedule, it will get routine. And if you get a date, then as long as you know in advance you can move his shot time by 30minutes a day to say 11am and 11pm and then go on your date ;) And if your date doesnt understand your diabetic kitty and those needs.. then he aint good enough lol.

You are totally right to not put him to sleep, he can easily have a good 6 years of healthy life - once he is regulated asides from the shots you will forget he is diabetic and noone will be able to tell. He will be the cat you had before all this happened.

But lets aim for remission / diet control for now. A good percentage of cats go into remission within the first 4-6 months if you change to a low carb wet food (very important!!) and get on a good insulin such as Lantus or Levemir - which is exactly what you are doing - and remission is why its important to test. But you also need to be strict on dosing and be willing to change the dose if its not working. Take a look at the two protocols we use and decide which you prefer to use. Personally I like to push kitties hard and fast with Tight Regulation. its more time intensive but theres no messing around and I think its your best chance to get him regulated or into remission.

Tight Regulation Protocol – get him regulated fast - more aggressive method. http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581
SLGS – Start Low go Slow – slow and steady towards regulation. http://binkyspage.tripod.com/SLGS.html

Wendy
 
(((hugs))) don't feel sad. You'll do fine, and you are doing fine. And you're not crazy. You're a very loving person.
And I agree, you want someone who is like you and will do anything for their pets and dependants. Hang in there.
 
Thank you for the support :) It's all very overwhelming right now but I will adjust! Tomorrow is a big day, I really hope my vet will be cooperative! Going to test once more tonight to have a few numbers to give her.

Thanks again for all the support this weekend! I'm sure I'll be posting tomorrow once he starts treatment and will have a new set of questions! So thankful that I found this wonderful site!!!!
 
Please test, feed and then shoot. You want to make sure he is eating before shooting. Bad news if you shoot before feeding and then Zoey decides he doesn't want to eat. Can't get the insulin back out of him nailbite_smile

As for his age, my Baby(GA) was dx at 13 and lived another great 5 1/2 years with shots every single day but you would never know she had anything wrong with her. Lost her to heart problem.
 
Test, feed then shoot? Wendy suggested not feeding for two hours before shooting? So test, feed, wait two hours or more, then shoot? Shouldn't I test right before I shoot? Sorry I'm so confused!!
 
That makes more sense, lol. As I was driving Zoey to the vet I was thinking and realized that must be what everyone meant, lol. Sorry for my confusion! I'll blame it on the fact its Monday morning lol.

So the good news is that my vet support home testing! She uses the Bayer Contour to test as well, so that is good! Not so good news, they use Caninsulin there BUT the vet tech said to talk to the vet (she wasn't in yet when I dropped him off) because she has written presciptions for people to get a different kind if they choose. So that is good!!

Here's hoping Zoey does well today!! Thanks again everyone!
 
Tell your vet you want to use Lantus or Levemir. And remind them you dont need prescriptions for those in Canada - you can buy them freely from the pharmacy anywhere like Walmart shoppers costco etc etc. Maybe they want to give you a script cos they get $ or can charge you for that?

When you get him home, let us know what the dose is they recommend before you shoot. Some vets start at too high a dose - the cat is stressed at the vets all day and his BG is high cause of it and they base their insulin needs on that. But when the cat gets home the BG drops and now the insulin is too much!!

Wendy
 
I just spoke with my vet and she is pleased with his numbers this morning BUT he hasn't eaten all day(!) so is she is only getting low numbers (252) because he hasn't eaten? She feels that with the low numbers today and the numbers from my two of the tests I did after he ate (380 and 358) on the weekend, that we can try him on oral medication? What is the general idea feeling about doing that?? With his numbers being high after he eats, is the oral medication going to help regulate that enough for him?
She is very happy that I did home testing and said he won't have to go in for curves if I'm monitoring at home; so glad she is supportive of that!
 
oral medication??? Does she mean glipizide?? Thats not good at all!!! We dont recommend it as basically it tries to stimulate the pancreas to work,and given the pancreas is damaged, it stresses it even more and you can forget remission. I would absolutely not want that. I can get others to chip in on this but I know they will feel the same.

You want insulin, even if its a small amount.

Wendy

EDITED TO ADD: 252 isnt that low really. A normal cat is 50-130.
 
I just spoke with her again and she does want to try glipizide... I asked about during a small amount of insulin but she says she is worried about hypo for him due to low numbers? I don't know what to do! I would like to try insulin... but I don't think I'm going to have her support on that... How bad would it be if I did insulin anyways? I know its my cat and I pay her, I would just rather have her on my side with everything and not get her upset if I go against her advice. She already thinks I'm a huge worrier and probably thinks I research too much lol. Now I have new confusion! Lol.
 
This is from the board's FAQ -
Q2.1. Can I give oral medication instead of insulin?

A2.1. Possibly. You should discuss this with your vet. Oral medications such as glipizide or glyburide will allegedly work for about 30% of diabetic cats. However, because these drugs can cause liver damage (and even further damage to the pancreas), and because giving an injection is often easier than giving a pill, most people on this board prefer insulin. Several people who switched to insulin after using drugs have reported that they thought the oral medication only delayed regulation. Others believe that starting with drugs rather than insulin made it impossible for their cats' diabetes to be controlled with changes in diet alone. Another drug, acarbose, works by blocking or delaying the absorption of carbohydrates from food. It probably is not necessary for a cat who is on a low-carbohydrate diet.

Oral medications are not a good idea for cats with elevated liver values (due to the possibility of liver damage), or ketoacidosis or neuropathy (due to the need to bring glucose levels down immediately). See the Pets with Diabetes site for a more detailed explanation. If your cat shows uncharacteristic lack of appetite, vomiting, lethargy or jaundice, discontinue the medicine and call your vet. You should also have liver enzymes monitored frequently during the early months
Click to expand...
.

I've seen other members who have come here in the past couple of years that tried glipizide, and can't recall any that found it successful. All eventually switched to insulin with much better results. Oral meds just don't seem to work well on cats.
 
FWIW, they can also hypo on Glip and there are helpful pics and info on how to give just a teeny, teeny drop of insulin. How about seeing how he does with the numbers once he is settled back home and you test?
 
Yes, thats right Hope we had another member recently whose cat had a hypo on Glipizide. It is not recommended for use in cats as it can cause liver failure as the others have said.
I would not use it in my cat for sure.

Terri
 
She already thinks I'm a huge worrier and probably thinks I research too much lol.
Click to expand...

And we're probably all thinking she doesn't research enough :lol:

Does anyone have the link to the AAHA guidelines handy? I don't have it bookmarked on my tablet. Maybe Emily can share that with her vet?
 
Ok, so no to the oral medication. Can anyone give me a suggestion on how to get her to support this? It sounds like she has only ever treated diabetic animals with the oral medication and caninsulin. Caninsulin is a fast acting insulin, correct? Maybe her suggestion of oral medication is because she would be using the fast acting caninsulin which could cause hypo since it is harsh? I would really like her to be in support of my decision to do insulin in case something happens and I need her, but I don't want to insult her as she has ALWAYS been amazing... Any suggestions on how to approach this diplomatically?
 
Her numbers arent that low. He wont hypo because you are going to be testing him and you will start him on a low dose. Heres the thing, you dont know us from Adam but I find a lot of vets just arent specialized in this. They are great generalists but not specialized. And they make broad assumptions about your knowledge and what you are willing to do. And is so much easier for them and some owners to just give him a pill.

You could follow her advice, and it might be ok. But from our experience he would end up on insulin anyway and never have remission. And I disagree - these numbers arent that low.

Or you could follow our suggestions and he could go into remission! We see a good 30-40% of cats go into remission within 4-6 months with insulin and diet.
If you decide to try the insulin
1. we will be here to support you as much as you need - and then some.
2. Our experienced members have seen hundreds if not thousands of diabetic cats. They look at cat blood sugar levels all day long. WAY more experienced than the average vet.
3. He wont hypo because you are going to be following our advice and testing.
4. You will not shoot under 200 unless you talk to us first and a member will be sitting with you and coaching you the whole way. They will stay up with you all night if need be.
5.You will be updating your SS daily and posting on our Tight Regulation forum where we can look and advise on a daily basis.
Tell me - What vet would do all this??? For free!!

Its up to you. What do you want for your cat?

Wendy
 
If someone can link you to the guidelines I mentioned, share that info with her. If I'm not mistaken, you can get lantus in canada without a 'script. If she reads the guidelines, I think she'll support that choice of insulin. Caninsulin is okay for dogs, but doesn't work very well on cats. Cat's metabolize insulin twice as fast as dogs or humans do.
 
Lantus and Levemir are long lasting gentler insulins. Hopefully one of the the Lantus users will come on here and explain more about how they work. Cats are less likely to hypo on these insulins. They are also more likely to go into remission(not need insulin at some point)

Terri
 
hi Emily

its a real worry at first, not following the vet's advice but a lot of us here made that choice and pretty much everyone is happy they did.
I am, my cat has been in remission for 2 months - that would not have happened had I followed my vets advice.

Basically, I didn't tell the vet anything - just did my own testing, dosing based on advice from here and fed her based on Dr. Lisa's food charts.
And, as Wendy wrote, people will stay up with you all night to help if needed - that certainly happened with me.
You are in great hands \M/
 
Your vet sounds like she is a bit out of date. And you pay her so she works for you - you are her boss so dont worry about insulting her!!

Caninsulin is fast and harsh on cats - it hits them hard and wears off fast - if there ever was an insulin that would cause hypos this would be it!!

So maybe tell her you really want to go on Lantus. And email her the following links as well as the ones provided above ( fyi glargine = lantus)

http://www.ncbi.nlm.nih.gov/pubmed/19592286
http://www.uq.edu.au/ccah/index.html?page=41544 - lots of good links - this Australian university is leading the way!!

Also maybe you want her to call Guelph and ask them about it. After all many vets use Lantus nowadays and if anyone supports it and is up to date that she would believe , it will be the University of Guelph.

Wendy
 
I am very willing to do what I have to do and insulin is what I will do based on all your wonderful information. I will try to talk to her but if she is not for it, I will still be doing it. Ok, so now the tough part. Where do I get insulin and syringes in Ontario, Canada? For the short term, I can just walk into any pharmacy and get them? Long term, any ideas on pricing or links to websites I can research? I'm just at work so I'm stealthily posting right now, but can't really do any real research, sorry for seeming to be lazy lol.

And now the BIG question. How on earth do I give my cat an insulin shot? Does anyone live near me at all that could help? I will definitely watch any video there is, but if by chance someone is close I'd much rather have a hands on lesson if possible. I think that is going to be a long shot though unfortunately :( Simcoe is about an hour and a half from Toronto but if anyone lives there I'd be willing to travel if need be.
 
You can get them in any pharmacy i.e. walmart, shoppers, Pharma plus , Costco (cheapest) , Sobeys ....wherever has a pharmacy.

Syringes: In walmart the syringes are in the pharmacy diabetic section. In shoppers and costco etc you have to ask from the pharmacist counter. Syringes: BD Ultra fine 3/10cc short.Its a purple and white box with a "short/court" label. $33 for a box of 100 in Costco. $39 at Walmart. I use each syringe twice. Shoppers gives points though so you need to do the math!

Insulin: You can get a Lantus 10ml vial or Solostar 5*3 pack of pens. The pens are bit more expensive but last longer since you only open one at a time. You have to ask the pharmacist as they keep it in the fridge. Costco the pens are $99 . Shoppers the vial is $75 but there is less in it. Should last 6 months if you keep them in the the fridge... not the door.

Sharps box : free at Shoppers if you buy supplies there. Once you fill it, they will replace the full one with a new one.


Wendy
 
Ok, so I need the pen and syringes? I feel so dumb with all this lol.

Do you think I can successfully learn to give him a shot just by watching videos?
 
Yep - here is how to use the pens:http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=151
You dont need to buy needle tips for the pens, they arent accurate enough for cats so we use syringes instead with 1/2 unit markings. On that page, there is a picture like this below that shows a syringe going into the pen . When you remove the pen cap there is a little purple rubber end you insert the syringe into.

4113.jpg


Have you ever given any kind of shot before? Its really easy - the needles are short. I would suggest you come up here to Oshawa and I could show you but its a long way from Simcoe . I would come down there but I dont drive.

My vet showed me - same as watching a you tube video I guess - but you dont know what its like till you try it yourself! here are some shooting tips: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=85113
 
That makes more sense now! I thought you shot with the pen and was confused about the need for syringes lol. I get it now!

I am going to speak to my vet and show her some information and hope against hope that she will be in agreement... If she isn't and seems upset I will just not tell her I plan to do it anyways I suppose. In that case I may be making a trip to Oshawa, although it is a 2 hour drive unfortunately. If I start insuline should it be on a day I am home all day? I can't really take any time off work, I don't have back up right now... I do live 5 minutes from my house, leave for work at 7:45 and I could go home at 10, 12 and 3 and be home at 4:45... but should he be watched 24/7 for the first little while?
 
You could try giving your vet the links and ask her to look into it? "I found this stuff - can like you to ask around and look at your vet database to see what it says?"
My vets ( i have 2 cos I have rabbits) always refer to some vet database when they arent sure. This is a good test to see how good your vet really is ;) Will she look at the research? Will she do the research herself on her vet sites? Will she support you? Or will she dismiss it out of hand?! Then its "Fine but I am doing this anyway and I would like your support."

He wont need to be watched 24/7. But for your own peace of mind you might want to start him on a Saturday when you can watch and test more often. Until we find the correct dose you will need to get a few more tests in - like say at 12.30pm (?5hours after morning shot) and before bed say at 10.00pm.

BTW Are you testing his urine for ketones? We recommend that twice a week or if they are over 360. You can get keto-diastix from any pharmacy.

Friday is pizza night if you want to come up then? ;)
 
Ok, we are back from the vet. Zoey did not eat a single thing all day while he was there :( He did just eat about a 1/4 can and seems his normal sweet self.

So the discussion with my vet didn't go badly, but she would still like me to try him on the oral medication (Glipizide) for 2 weeks and she agreed to read the research I brought for her. She has never had someone that did home testing and has no experience with Lantus, except once or twice when she was at an office where the cats came in to the office because they were hypo. She didn't know though if they were doing home testing and adjusting the dose. I didn't fill the script for the medication, I'm not sure what to do. She knows I really want to try the Lantus, I think she's just nervous because she can't really advise me well on what to do... She is very happy with his numbers and thinks they are very low (at the lower level) for a cat with diabetes and feels the medication will bring them down. She would like him to be at 9-10 (162-180) all the time and thinks the meds will take him there. She has never had a cat go into remission but will be happy if I prove her wrong.

Now I don't know what is best for Zoey... Is there research someone has that says their numbers are supposed to be lower? I think she's really worried that he will go hypo. I love her as my vet and want her to be in support! His numbers at the vet today were 262 and 288 without any food and with a lot of stress most likely...

Should I try the meds or do insulin? I have severe issues making decisions and am lost on what to do...
 
I am not surprised he didnt eat - way too much stress.

I really would advise against the glipizide.. you dont want to damage his pancreas any more. I know you like her but just because she isnt experienced isnt a good excuse not to use it. She needs to do her research.

Now you are home testing. You arent going to get into that situation of hypos. I tihnk some vets prescribe too high doses of insulin and dont have their clients home test and then there is a hypo situation. You are going to start on a nice low dose and test and increase slowly. It will be fine.

Remember you can still have hypos on glipizide, i have seen that on here.. so I dont see the difference. It might well bring him into range but also might make him diabetic for life and have to go on insulin forever.

Starting insulin now is the best chance he has for remission. And the good thing is that I am only a call or short drive away.

Heres a thought. Test him for ketones and try low carb diet for a few more days. Lets see if moving to only low carb food will bring him down any further. That gives her time to read the research. And you to think about it. As long as he doesnt have ketones a few more days wont do any harm.

Wendy
 
Oh and I wanted to add that if you do go on glipizide, he could hypo anyway. And if/when it doesnt work you will still have to go on insulin, and there is a hypo possibility there if you didnt test... especially with the insulin your vet uses.

Cut to the point. Start the good insulin now and get Zoey regulated or into remission if he is lucky. I read today most cats go into remission in 4-6 weeks of starting the insulin.. do you want to waste two weeks and the short time frame for his best chance for remission? Sounds like your vet had a bad experience You can teach her something here.

Also have you looked at the food chart? Its key he is under 10% ( even better under 8%) calories from carbs.

Wendy
 
Oh ya, I forgot to answer you on the ketones. I did test him yesterday and he has no trace. The vet tested him again today and he still has no trace. I really think insulin is the best option for him... We will keep with the canned and wait to see how he does over the next few days then :) I will keep testing his ketones to make sure he is doing alright. I am not going to start the medication. I will probably start the insulin this weekend.

My civvies are trying to tell me they are starving to death lol. I took away their dry free feeding and am meal feeding a can of Friskies a day. Gryffin has desperately trying to convince me he will die if he doesn't get more food lol. Drama king!

Thank you again for all your support!! I feel better knowing you aren't far away Wendy :)
 
Great! So when you get Lantus we need to calculate a dose.

The formula is 0.25 unit per kg of the cat's ideal weight. What would that be for Zoey? But usually 1 unit every 12 hours if the math works out more than that.

Here is information on the protocol for you to read: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

I am also going to suggest you start posting daily (if possible) on the tight regulation forum where there are some seriously experienced members who will help and advise every day but keep on here for now until you get the insulin.

How heavy are the civvies? 1 can doesnt seem like a lot but it depends on their ideal weight and we can do the math.
 
I'm not sure what their ideal weight is! Is there a way to calculate that? They are all strays so I'm not sure on their exact breeds. Zoey is similar to a Norwegian Forest cat maybe with Maine Coon, Zukey appears to be Maine Coon (probably both have domestic long haired also) and Gryffin is just a big short haired domestic. Does their body length come into play on ideal weight?
 
Well what do you think? Is she fat? Did the vet say she needed to lose weight? Or did the vet say she had lost too much? Do you think she is skinny? Judging by your response I suspect she is just fine - whats her weight right now?
 
He's 14 lbs and I can feel the bones in his back now, but he's so darn fluffy that its hard to tell lol. The vet said he's pretty good, could maybe lose a pound but she thinks he's alright. I know Gryffin is overweight at 18lbs(!) and Zukey is about 14 lbs. I think Gryffin could lose about 3-4 lbs at least, so I would say ideal for all might be around 14 lbs. How much would they get to eat based on that?
 
what flavour of friskies do they get?

The math is Required calories per day = [13.6 X ideal weight in lbs] + 70

Edited to add: So joey at 14lb = 6.4kg *0.25 would be at 1.6IU twice a day. I think 1 unit would be safe to start. I will ask a more experienced dosing member to comment.
 
I got the classic pate seafood mix: salmon dinner, seafood supreme and white fish and tuna dinner for Zukey and Gryffin, are those good ones? Zoey I still have on the Lick Your Chops one that his skin tolerates, not sure what the calories are on that one though. Maybe I should be feeding Zuke and Gryff a can and a half by looking at Lisa Pierson's food chart...
 
I hope Sugarcat gets better! My cat Shadow was just diagnosed on 3/4/13 and was put on insulin that day at the vets. I was shown how to do the injections and had to start him on 2 u of Prozinc. It's been stressful learning to give the shots and test his blood sugar, so if you need help I can certainly help you. When I took Shadow into the vet his blood sugar was over 600, and was spilling sugar in his urine. Don't wait too long to have his blood tested, Sugarcat can suffer from neuropathy from having sugars too high for too long.
 
Emily,
I haven't heard back from Lick Your Chops folks yet on the calories. But I'd guess it's somewhere in the 150-200 calories a can range. If Joey is 14 pounds right now, he could probably use 1 and a 1/2 cans a day? Less most likely once he's "better" but he'll need more than normal until then. Bob weighs 14 pounds (no longer on insulin) and he gets about 250 calories a day. It's not an exact science, because it can also depend on how active a cat is. 15-20 calories per pound per day is a nice ballpark number to use.
 
Status
Not open for further replies.
Back
Top