Newly diagnosed with diabetes

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Denise11

Member Since 2017
Hello. Our 10 year old orange tabby, Pumpkin, was diagnosed with diabetes 5.5 weeks ago. Pumpkin has always eaten wet food, therefore rarely ever drank from his water bowl. In a matter of a few days I noticed him drinking water, having a decreased appetite, & sleeping a lot. I took him to the vet and his sugar was 310. He was started on a metabolic diet of prescription weight management diet and started on once-daily Lantus 1.2 units. After 1 week his sugar dropped to 140 and his symptoms were greatly improved. We continued the new diet & insulin for 1 month. He had a 1 month follow-up just 4 days ago. Yet prior to his appointment I had noticed that he was eating and drinking and urinating more 4-5 days prior to the appt. I had an idea his sugar would be up. Pumpkin lost 2 pounds in 5 weeks yet his sugar was up to 380!!! The vet bumped his Lantus up to 2 units daily and we will recheck his blood sugar in a week. My concern is why did his sugar go up after a 2 pound weight loss?? I hate that I had to increase his insulin. And since increasing his insulin 4 days ago I notice he's still drinking and urinating several times a day. I'm hoping he responds to the 2 units & we don't need to increase it!
 
Welcome Denise and Pumpkin! A diagnosis of diabetes can be overwhelming especially in the early days. We strongly advocate home testing here because BG readings taken at the vet are usually elevated due to stress and that often leads to the vet prescribing more insulin than what is needed. Home testing allows you to ensure that insulin is only given when it's safe to do so and to check how the insulin is working while kitty is relaxed in their normal environment.

A dose of 2 units daily is not unusual if given as 1u twice daily but I notice you mentioned the original dose was 1.2u once daily and that is unusual and not very effective in the majority of cats. Lantus is usually given every 12 hours so if you are giving the 2 units once daily that could be part of the reason why you are seeing higher numbers now. 2 units at once daily dosing would also be a larger dose increase than we would recommend. Both once daily dosing and increasing the dose too much can lead to bouncing.

Bouncing occurs when kitty's BG falls quickly, falls to a level the cat is no longer accustomed to or if the BG did in fact go too low at some point. There is a natural defense system that pumps out other hormones to bring BG numbers back up often to even higher levels and in a diabetic their defense system gets out of kilter and revs into action often earlier than necessary. As kitty gets reacquainted with normal BG levels the defense system will recalibrate and the bouncing phenomenon lessens with time.

The other potential impact on Pumpkin's BG may be the diet the vet prescribed. You didn't mention if the prescription food is wet or dry but many of the so called diabetic prescription diets have higher carbs than many store brands of wet food and they certainly are considerably more expensive and unnecessary. Lots of dietary info available HERE.

It's early days yet and this is a marathon...not a sprint. Each cat is a unique individual and the amount of insulin a cat requires is an individual matter.

If you are interested in learning to home test Pumpkin, we can help. Home testing not only gives you more accurate BG readings but it also decreases costs associated with repeated vet visits not to mention lessening the stress of those visits on both you and Pumpkin. A human glucometer can be used and many folks in the US use either the Relion Confirm or Micro from Walmart. We have a spreadsheet available here to keep a log of the home readings which can then be shared with your vet and viewed by the community here so if you need help at any time, we can view the data you have collected and offer whatever help you need.

Keep asking questions and let us know how we can best help you! :)
 
Welcome Denise and Pumpkin! A diagnosis of diabetes can be overwhelming especially in the early days. We strongly advocate home testing here because BG readings taken at the vet are usually elevated due to stress and that often leads to the vet prescribing more insulin than what is needed. Home testing allows you to ensure that insulin is only given when it's safe to do so and to check how the insulin is working while kitty is relaxed in their normal environment.

A dose of 2 units daily is not unusual if given as 1u twice daily but I notice you mentioned the original dose was 1.2u once daily and that is unusual and not very effective in the majority of cats. Lantus is usually given every 12 hours so if you are giving the 2 units once daily that could be part of the reason why you are seeing higher numbers now. 2 units at once daily dosing would also be a larger dose increase than we would recommend. Both once daily dosing and increasing the dose too much can lead to bouncing.

Bouncing occurs when kitty's BG falls quickly, falls to a level the cat is no longer accustomed to or if the BG did in fact go too low at some point. There is a natural defense system that pumps out other hormones to bring BG numbers back up often to even higher levels and in a diabetic their defense system gets out of kilter and revs into action often earlier than necessary. As kitty gets reacquainted with normal BG levels the defense system will recalibrate and the bouncing phenomenon lessens with time.

The other potential impact on Pumpkin's BG may be the diet the vet prescribed. You didn't mention if the prescription food is wet or dry but many of the so called diabetic prescription diets have higher carbs than many store brands of wet food and they certainly are considerably more expensive and unnecessary. Lots of dietary info available HERE.

It's early days yet and this is a marathon...not a sprint. Each cat is a unique individual and the amount of insulin a cat requires is an individual matter.

If you are interested in learning to home test Pumpkin, we can help. Home testing not only gives you more accurate BG readings but it also decreases costs associated with repeated vet visits not to mention lessening the stress of those visits on both you and Pumpkin. A human glucometer can be used and many folks in the US use either the Relion Confirm or Micro from Walmart. We have a spreadsheet available here to keep a log of the home readings which can then be shared with your vet and viewed by the community here so if you need help at any time, we can view the data you have collected and offer whatever help you need.

Keep asking questions and let us know how we can best help you! :)

Thank you very much for the reply! The odd thing about our one & only family pet being diagnosed with feline diabetes is that I'm a pediatric nurse practitioner & my husband is a pharmacist! Yet with Pumpkin being the one with the diagnosis & with the tweaking of the insulin, this is foreign to us!! I would be happy to do home BG testing. Pumpkin absolutely hates going to the vet!!! This has been true since he was a kitten. He routinely has a bowel movement when we walk in the door because he is so stressed. The diabetes diagnosis was difficult for me because I'm aware it's a chronic illness yet it was even more difficult because I knew it would require more frequent vet visits. Not good for a cat that gets stressed & nervous as soon as we enter the building!

He is currently taking the Hills Prescription Diet Metabolic/Weight Management wet canned food. Pumpkin eats 2.5-3 cans daily. At time of diagnosis he weighed 13#, and after 5 weeks of therapy now weighs 11#.
I'm anxious to get his BS regulated for his overall health but also so we don't have to visit the vet so often!
Thank you for your advice, comments.
 
Quite a few of us manage our kitty's diabetes at home because the numerous Vet visits are expensive and stressful on them :). Many of us use human glucometers too, the test strips are more affordable than the pet meter, AlphaTrak 2. The protocols written here are with human meter numbers as well. Whichever meter you decide on, we can help :). Also, instead of the prescription diet, many feed Friskies pate (non-indoor formulas) and Fancy Feast pate. This Food Chart was compiled by a DVM and many of us use it to find low carb (<10%) foods :cat:. Keep asking any questions you have!
 
As a retired R.N. myself, I felt guilty that I had not picked up on the symptoms sooner than I did with my girl. I completely understand how foreign this can all seem but being medical professionals doesn't protect our humans or pets from diabetes. Having medical backgrounds however will help you get up to speed on dealing with a diabetic cat in no time.

Many of the principles of human diabetic treatment apply to our cats too, like testing before shots to see if BG is high enough to warrant giving insulin, keeping diet consistent and taking random mid cycle tests to see how the insulin is working. Our cats however have a faster metabolism than humans which is why twice daily dosing rather than once daily is the generally accepted practice even with a long acting insulin like Lantus.

I just checked the website for the Hills Metabolic canned food and the carb load is listed at 31% which is 3 times higher than recommended for diabetic cats. Under 10% carbs is recommended and most of us are feeding our cats under 5%. It is also meant to promote weight loss. It sounds like you are trying to get Pumpkin to regain some weight so I'd recommend checking out an alternate diet as a first step to getting Pumpkin back on the right track. I just found the updated food list. HERE is the link to the latest and greatest. Getting the carb load of Pumpkin's food down could lessen the amount of insulin he needs so I would start home testing ASAP and before switching his diet.

Obviously Pumpkin will appreciate fewer vet visits so here is a link to HOME TESTING information. And here are instructions for the spreadsheet we use and info re: using the spreadsheet. If you have any trouble setting up the spreadsheet, just holler and we'll get it set up for you.

I'll leave it there for now so as not to overwhelm you. Once you get a meter and have a chance to read through the home testing info, let us know if we can help in any way. We have lots of other tips and tricks to make this as easy as possible for you and Pumpkin. :)
 
The Hill's metabolic foods are all very high in carbs, 20-30%. It makes me furious that they sell you these foods as the best for a cat with FD! They are mostly garbage - not very nutritious, lots of filler, high in carbs, and certainly NOTHING to make them "prescription" food! There are many readily-available national brands that are much better for our diabetic kitties. Click HERE for a list of foods with their protein, fat, and carbs, as well as phosphorus and calories. Cats with FD should be on a wet/canned diet that is less than 10% carbs. Some cats are more carb-sensitive than others; my cat needs foods that are 0-2% carbs or his blood glucose goes up. Some cats are fine with around 6% or more, every cat is different (ECID, you'll see that a lot here!).

Home testing is truly the only way to make sure your cat stays safe while on insulin. We follow a protocol of test/feed/shoot, with random testing throughout the cycle, as well. We enter our test results into a spreadsheet that makes it much easier to see trends and patterns as to how our kitties are metabolizing the insulin, and link the spreadsheet to our signature, so that others can also see it if we need help or have questions. Some of us also give the link to our vets so they are able to follow kitty's progress and give informed advice if we need it.

One note of caution: food changes should always be done slowly, over the course of several days or more, to avoid gastric upset and to keep blood glucose from dropping too rapidly. DO NOT change from a high-carb to a low-carb diet unless you are home testing!!! Cats have been known to drop dramatically during a food transition and become hyperglycemic, which can be fatal. (HERE is a link on dealing with hypos) Your cat will need to be closely monitored during the transition, and may well require a dose reduction.

Edit: I just saw Linda's reply to you, and realized that we've thrown a lot of links at you, lol, but I can promise they are all helpful and contain good information that you will need to know! :):):)
 
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