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Wolfgang

Member Since 2014
Furby the 12-year old domestic longhair started drinking and urinating quite excessively a couple of weeks ago, and has now been diagnosed with diabetes. He did eat mostly better (...) quality commercial cat food (Iams, etc.), very little of the cheap stuff (Friskies and similar), and would hardly ever touch real food, such as chicken liver or real fish. His strategy was always to try to eat all the other cats' food first, then his, which is probably one of the reasons why he now has diabetes, he got up to 17+ lbs. His initial reading at the vets' was over 600. He is now on Hill's k/d - which he isn't crazy about - and initially got 1 unit of Lantus a day, which has now been increased to 1 1/2 units, since the 1 unit wasn't doing anything. He has a very good vet, who has known him since he was a little kitten, and who is very much of a fan of the go slow approach, hence the low initial dosage. I'm trying to get used to the new 'normal', those injections are nothing short of a horror movie, no wonder the demo shows them done on a hairless cat, Furby's hair is longer than the needle, he does NOT like his skin pinched, and is fully equipped with sharp nails and powerful fangs to make his point. Can't say I blame him, I'd rather ride my skateboard under a semi going 70 on a busy freeway than go anywhere near needles. Much less stressful. I'm learning the fine art of mixing the $ 200+ little tiny vial of liquid goldplatinumstockoptions and drawing the half drop or so he gets without even the tiniest air bubble. I've made myself a checklist of all the little things to remember during the injection procedure, it is, however, still much like meeting Freddy Krueger in the boiler room at midnight on Halloween, every morning. Unarmed, without a flashlight and your hands tied. I am in frequent contact with the vet, our next blood glucose re-check appointment is Tuesday and I'll probably leave her a message regarding Furby's status later this morning. I also have a handicapped cat (Minnie, Furby's half-sister, in fact), who has had bladder stones and gets frequent UT infections, so....Vets R Us........
Weekends are particularly stressful, since the so-called emergency clinic is a chamber of horrors rip-off palace where they take your pet from you, disappear behind closed doors, only to re-emerge an hour later with dire news that nothing can be done, that'll be $ 2,000, please, would you like the body cremated? There used to be more of them and better ones, but now there's only 1. Must have something to do with the economic 'recovery' I keep hearing about.
I'll ask my vet about that Fancy Feast Classics wet food recommended here, but since even the probiotics capsules Minnie gets on her food contain some type of glucosaccharides (which Furby isn't supposed to even smell), I want to get her ok before braving Walmart on a Saturday.
Thanks for reading!
 
Welcome to FDMB.

Furrby is your cat; are you Wolfgang? Or would you prefer to be addressed by a different name?

One of the things that can help with the process of testing and shooting is using low carb treats, such as freeze dried meat or fish (ex Pure Bites). Look in the dog supplies, as it will be less expensive, though you'll need to break them into smaller pieces. Then, at some non-test times, do a bit of ear massage and give a treat. This associates having the ears handled with something positive. Likewise, giving a kitty massage and rolling up a ridge of fur then releasing helps associate a positive with part of the injecting process. And a low carb treat then further reinforces that. Also, you may find that a wide toothed comb let's you part the fur to make injecting easier to see. A bit of practice doing that, then add it in to the testing routine. Always treat after you test or shoot and eventually, your cat may actually come to you when its time to that. Yes, really!

As far as foods go, let me refer you to Dr Lis Pierson's web site Cat Info. She has studied feline nutrition, plus she collected data from numerous US pet food manufacturers to make a chart with the calculated percents of calories from protein, fat, and carbohydrate. I'm feeding 15 cats, so I'm glad the Friskies pates are mostly below 10% calories from carbohydrates. I feed the Turkey and Giblets, ocassionally mixing in a bitof something else. I put it out twice a day, at shot time, and all seem to be doing well.
 
This is one heck of a scary roller coaster ride. Every day seems to be completely different, with no discernible pattern emerging. Last week, we had 3 days of Furby being as close to 'normal' as he's been in a month or so, yesterday, he was doing water bowl & litter box patrol again pretty much all day. His appetite is good, he's on k/d with a little bit of m/d, vet says no to any other food, as it might overload his kidneys, which must be working at full throttle, with all that pee. Injections have become slightly less stressful and freaky, we're now on 2 units twice a day, but I often get the impression that the Insulin is having no effect at all. Furby's not a fan of the 'tent' technique - pulling up a skin fold (while matting down enough of his 4 " hair to see skin) and injecting into the 'tent opening', but that's what the vet said to do, and that's how she does it. As usual - especially online - there are about a billion different opinions on everything, vet says to not sweat the Lantus' expiration date too much, she says that people use it upwards of 3 months or longer. She also says it's not that fragile and gently rolling is her recommendation. I read somewhere that the silicone coating inside syringes can come loose and not to inject any insulin or air back into the insulin vial. Again, vet says no problem, silicone coating won't come off THAT quick, I have the good (?) Reli-On syringes marked in half units, use them only once (of course) and the insulin's only in there for like 20 seconds. If the syringes came apart that easily, they should be off the market today.
 
My suggestion is to check out another vet's info - she deals specifically with diabetic cats. She has excellent ideas for food for cats with kidney issues, and none of them are dry. (www.catinfo.org). Not only is the KD high carb (35% carbs versus the 8-10% we try to feed) but dry food has little moisture content, something cats with kidney problems desperately need.

If you switch to a lower carb wet, keep a close eye on the numbers. When we switched Oliver from dry to wet, he dropped 100 points overnight. If we hadn't checked his amps and had given the usual dose, he would have hypoed.
 
Hi Wolfgang,

I'm Shelly, and my cat's name is Jersey. I haven't had a chance to welcome you to FDMB yet. I agree with you - this is definitely a scary ride. It does get easier over time!

Are you testing Furby's glucose at home? If you aren't, I would really encourage you to do so. Kitties' insulin needs can change quite often. If you're testing at home, you'll be able to see how well the dose is working on a day-to-day basis. It's also a great way to help keep Furby safe. If I wouldn't have been home testing, I wouldn't have realized when Jersey's pancreas finally kicked back in (which seemed to happen quite suddenly). I would have kept giving her too much insulin, and I hate to even think about what would have happened at that point.

If you are interested in home testing, please let us know. We have lots of tips and tricks that can help you. I know home testing sounds scary (especially when the shots haven't been easy), but you really do get the hang of it quickly. My Jersey is a bit of a "Jekyll-and-Hyde" kitty. I never thought I would be able to test her at home, but we both got into an easy routine with it.

Shelly
 
Um, your vets suggestion to "gently roll the Lantus insulin" sounds like a leftover technique used for the cloudy suspension type insulins like Humulin, Novolin, Vetsulin, Prozinc which do need to be mixed to resuspend the particles of insulin in the liquid.

Lantus and Levimir on the other hand are not suspensions and do not require any rolling to "mix" them. Absolutely no need to roll these two insulins before use.
 
We're still glucose testing at the vet's, Furby's numbers are still 500+, so she thinks it's not time to test at home yet. She gave me a packet of the Purina Glucotest confetti, to sprinkle into baking soda-free litter once we get to more reasonable levels. I now know that the stuff has been discontinued and is to be treated like platinum covered diamonds. I do have a meter, the ReliOn Ultima, which she says might work in an emergency, next time I'm at the store, I'll have to find out if they even still make the strips for it, or if this is like a post-70's car, where last year's model is 1000% different from this years', so nothing is compatible with anything else and they can charge more to fix it. I do trust my vet, she does appear to be one of the best in town, has performed a few minor miracles on Furby's handicapped half-sister Minnie, she does meticulous and extensive tests and is even open to some alternative/herbal treatments after she's done some research on them. Saturday was pretty good, water consumption and peeing way down, more like normal, and this morning, he seems to be ok also so far. I have in the past tried many times to feed the cats - not just Furby - normal food, things more similar to what a cat would actually eat - fresh fish, chicken, liver, eggs, etc., both raw and boiled - with very limited success. They take maybe a few bites and then won't look at it again for a month. I realize that pretty much all commercial pet food is crap that should probably come with health warning labels like cigarettes, and that the food sold by veterinarians is probably more of a money-grab than anything else, but what am I supposed to do if they simply WILL NOT eat normal food ? I'm trying to keep Furby as active as possible, but sometimes he seems to have aged 10 years in the past 2 months. If I can only get him off this hellish substance and back to being food-dependent, I don't care if he eats Brussels sprouts and sesame seeds for the rest of his life.
 
I'm using the ReliOn Confirm, which is sold unbranded as the Arkray USA Glucocard 01 or 01 mini at American Diabetes Wholesale.

Transitionig cats to different food can be a trying experience, Vet Lisa Pierson wrote it took her months and she has an extensive list of the tactics she tried on her website Cat Info. She also has a recipe for making raw food which list the supplements necessary to make it a complete diet. Taurine, in particular, must be included or you risk numerous health complications and death (a long term consequence).

For dry food, you may consider Evo Cat and Kitten (8% cal from carb) or Young Again 0 carb (5% cal from carb - we do the math differently). There is also OriJen
Freeze dried, you can try Stella & Chewey's pouches.
Another option is to take a low carb canned and bake it until dry/crunchy and use that as a start for transitioning. Each batch can be a bit less dry. You can rotate flavors so boredom isn't a factor.
 
Hi Wolfgang,

It's so frustrating, isn't it? Your vet tells you one thing, and then we all tell you something completely different. It's enough to make you want to pull your hair out!!!

I don't know if it will help, maybe, if you hear my story. Ten years ago, we had a diabetic kitty named Bugs. We gave him insulin (without testing at home), and the vet checkups showed that his sugar level was good. We were never told that cats can go into remission or that their insulin needs may decrease. Bugs died one weekend while boarded at the vet's office. I'm guessing that the stress at the vet's office caused him not to eat, which caused his sugar levels to drop. They still gave him the normal amount of insulin, and it was too much for him. When Jersey was diagnosed in November, I promised myself that this time would be different. The vet put her on Hill's w/d dry food and told me the change in food alone might be enough to put her into remission. I didn't realize at the time that the prescription food was just as bad as the Meow Mix I had been feeding her. When the food change didn't work, the vet prescribed Humulin, which lasts for about 8 hours in cats. That means she was in "good" numbers for 8 hours or less and "bad" numbers for the rest of the time. The vet also told us to give her 2 units once a day. Once I started testing at home, I realized that .25 units (just a fraction of what the vet prescribed) took her into low numbers. My vet was not thrilled that I was testing her at home. I switched to a new vet, who did tell me that Lantus was the best insulin for cats. He, however, told me that I should give her 10 units of Lantus once a day. :shock: I have no doubt she would have died if I had followed those instructions.

I found FDMB in the midst of all of this, and I started reading as much as I could. I read Dr. Pierson's information about proper nutrition (and switched all of the cats off dry food). I also read about the research study on diabetic cats by Roomp and Rand. The advice you're getting here is based on the work of these researchers. We finally started following what's known as the "Tight Regulation" protocol described by Roomp and Rand in February. It took about 8 weeks before Jersey went into remission. I truly believe we could have done that much faster if we would have started Jersey on the right food and right insulin back in November.

You did mention that your vet didn't think it was time to test at home since the numbers were over 500. If you'll look at Jersey's spreadsheet, you'll see that she had lots of 300s, 400s, and even some 500s on there. On March 25th, for example, she had a 553. Just 7 hours earlier, though, she had a 77. If I would have just known about that one high number, I would have probably increased her dose because I would have thought the dose wasn't working. By testing at home, I learned that the dose was working for her at the time. It's just that her liver panicked when it saw that "77" that day. Her body didn't recognize that number as normal anymore, and it released lots of extra glucose that brought her up to 553. (That's what we call "bouncing.") After following the protocol, her liver started to get used to the lower numbers. We began to see more and more of them, and this allowed her pancreas to heal. She is now insulin-free. I credit her remission to the people here. I simply could not find a vet knowledgeable enough to help us with every aspect of this disease. Vets have to know so much about so many different issues that it's hard for them to stay up to date with every illness. The people here live and breathe feline diabetes. They helped me through every step in this process. In fact, after getting our Lantus prescription, I only took Jersey back to the vet once for a checkup. Since I was testing at home, I didn't need to go to the vet's office. I already new exactly what her blood sugar levels were. Even better, I knew that the readings were accurate since vet stress can raise blood sugar levels.

In the end, you have to do what you feel is right. We can give you the information we have, answer what questions we can, and share lots of tips with you. I'm so glad that you've taken the time to come here, to post, and to ask questions. I hope you'll continue to do so. I know this is all overwhelming right now.

Please let us know how we can help.
Shelly
 
Sunday ended up being pretty bad after all, lots of drinking, but not as down in the dumps as on Friday. Furby's never been a fan of wind and today's 40+ mph with gusts into the 70's. He's also not a fan of cold, and the next two days, there may be snow in the mountains. Global what? My vet is definitely a fan of the start low & go slow approach to insulin, and based on what I've read about overdosing/hypos, I totally agree. I do wish, however, that this highly touted and extremely expensive medicine (Lantus) would work up to its' rep. Or at least close to it. So far...not so much. I'll be broaching a lot of subjects with her tomorrow (Sundays are always hell, not just pet-wise), or at least leave a message, she's not in on all days, but does get back to me if it's important. Which it is. I'll be asking her about injection sites, various foods and all sorts of other things. If I'll ever have pets again, I think I'll adopt some sharks. Purina does not make shark food (that I know of), and all I'll have to do to keep them safe is get a boat with some very serious fire power to keep the Japanese, Chinese, Taiwanese, Thai, etc. etc. etc. fishing fleets at bay.
 
Let us know how you get on at the vet. A few things though

1. Home test no matter what. Cats do go into remission and it can happen fast, You don't want a hypo on your hands. And you gotta change that food if you want decent control or remission. Remission happens in many cats but only with correct diet and generally within 6 months so you can't delay. Many of us here feed Friskies pates, fancy feast pates or wellness grain free canned. the latter is best quality of the three I think. Wet food is also better for the kidneys.

2. Lantus "goldplatinumstockoptions" lasts up to six months if you keep it in the fridge. Do not shake or roll

3. My Tiggy is a long hair cat. I use short needles. I pull the fur gently up so I see skin and inject at a very shallow angle to the body. It works better than trying to "tent" or "roll"
 
Vet remains adamantly opposed to any food besides k/d, with perhaps a smidge of m/d mixed in, she says anything else will overload his kidneys. Having lost a rescue cat to kidney failure (previous owners fed table scraps, possibly even chocolate), I know how extremely ugly that gets. Vet says feeding fresh chicken liver, etc. would not provide the right balance, since a feral cat would eat the whole mouse, not just the meat.I would try outside mice, but some of them carry Hanta Virus and the Plague in these parts, so that may not be so great. Also, some of the neighbors have exterminators spray poison. One of the reasons why my cats don't go outside. I will start testing at home, tried out my ReliOn Ultima on myself with an expired test strip yesterday, and it didn't do anything weird or display any 'problems', so it seems to work. My vet wants to test Furby when he's having a good day, which I'm hoping will be tomorrow - we need a 'good' day to coincide with when she's in - but it's hard to predict since Lantus seems to be kind of a dice game. Sometimes she work and sometimes she don't. The injection technique that works best for Furby's long hair and not very loose skin is what you might call a pup tent. If I pull it up too high, he whips out the scimitars and the whole thing goes to hell very quickly. Lantus is kept in the fridge at about 40F, which vet says should be fine. Pharmacist insists to throw away after 28 days. Duh. My needles are also quite short and really thin, about 1" or so, and they are the ones recommended to use in this case, pharmacist suggested them, vet likes them. Marked in 1/2 unit increments, so very small adjustments can be made easily. Medium day yesterday, although Furby was very unhappy about the amount of food he got. Seems ok so far this morning.
 
The reason the pharmacist said to throw out the Lantus after 28 days is because that is how the vial and instructions are labeled. The manufacturer never tested for longer than 28 days for use. But we here have found that 2-4 months is possible and even sometimes up to 6 months. As long as it's not cloudy and has no particles floating around in it, cat still getting good BG readings, it's probably still good to use.

Next time, get a prescription for the Lantus solostar pen, which is like a mini-vial. You use a regular insulin syringe to draw out the insulin, not the needle pen tips. The countdown of the 2-4 months does not start until you open the pen/vial, so most people can use the solostar pens to the last drop. Then they just open a new pen.
 
A wide toothed comb may be used to part the fur on a long-haired cat.

The Friskies Special Diet pates are both low phosphorus and low carb, thus reducing the workload on both the kidneys and the pancreas.
 
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