Newly Dx'd cat

Donnalama65

Donnalama65

Member
Hi-

Our almost 7 yo male cat was diagnosed with diabetes yesterday. His BG was 259 but he was also very stressed for the ride to vet and blood draw so not sure how much that affected the results. Vet started him on 1u of Vetsulin. She also gave fluids, Vit B inj., Convenia, Cerenia and famoditine as well as meloxicam injection and she gave SQ fluids (pretty much threw the pharmacy at him). He is still not eating well. I've force fed some A/D with bone broth today, 2mls at a time. I've ordered a pet calibrated glucose machine which should come monday. He's super lethargic and I'm concerned. His wt yesterday was 14.4#. Down almost a # from my scale last week. Our vet doesn't take emergencies and the ER is an hr away. I sorta felt like her attitude was, your cat is diabetic, here's the dose of insulin, see you in a week. Should I be monitoring his BG daily? Please advise. Thanks so much. -Donna and Ruedi
 
Hello and welcome to the best place you never wanted to be. Hello super sweet Ruedi.

I had a non diabetic cat test over 220 at the vet clinic due to stress and 52 at home the next day. Best way to know what's really happening is to home test. Glad you are planning to do that, but I wouldn't throw money away on a pet meter. Test strips are too expensive, they can be hard to get in a pinch quickly when you need more. We have a large body of knowledge in using human meters and our insulin dosing methods are written with human meter numbers, which is all that people (including vets) used to use. The Relion Premier I think is what a lot of people in the US use (from Walmart) if you have one nearby. And you can pick it up today. Basically any meter with a small blood drop requirement and cheap test strips will work. Yes to testing daily. You test before each shot to make sure it's safe to give insulin and a couple more to see how low the dose is taking him.

Did the vet mention anything about ketones? Inappetant and lethargic is worrying. Ketones can lead to bigger/more expensive problems like diabetic ketoacidosis. Here is a post on testing for ketones with urinary test strips, available at most pharmacies. Tips to catch and test a urine sample

What symptoms made you take Ruedi to the vet in the first place? Any blood draw done? Just wondering why so many meds were thrown at him. Meloxicam is a little over the top, and possibly concerning depending on dosing. It does have a black box warning on it. I'm also not a fan of giving antibiotics (especially Convenia) if not needed.

Another couple posts that might help:
 
Hi Wendy,

Thank you for your response. I took Ruedi to the vet because he's been loosing wt for a few weeks and became more lazy and then stopped grooming. We lost a cat to FIP the end of Jan. so I've been concerned about that even though I know the current research says it's most likely not transmissible from cat to cat. Ruedi started having diarrhea right after our other cat died which Flagyl helped clear up but the wt loss has been concerning.

The vet didn't mention ketones. She really didn't give me a whole lot of information in general thus me landing here! He did have a fever yesterday at the vet (103.4F) so vet gave Meloxicam for that, as well as SQ fluids. He's been licking his lips likes he's nauseated but with no vomiting so that's why she gave famotidine and Cerenia. She also gave convenia in case he had a UTI but didn't get a urine sample to support this, I suppose the fever supported the abx. (He's a difficult cat to do things to and getting blood was a challenge, which makes me wonder what his real BG was. It was 259 on yesterday's vet visit bw).

I was able to get him to eat a little dry DM food and have also force fed some A/D 3x today. He seems to be feeling slightly better after the last feeding because he snuggled with me and purred, which he hasn't been doing the last few days. His next dose is at 9:45p and I'll get BG prior. I went to CVS and got a meter and lancets etc. This will be my first attempt at an ear stick so wish me luck! thank you for your support. This is all pretty overwhelming and sad, especially given our recent loss of our beautiful Tonkinese in Jan. ugh.
 
Donnalama65 said:
A/D with bone broth today,
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I'm sorry Ruedi isn't feeling well and really glad you made it here. This forum offers amazing support and experienced advice. You're in good hands.

My cat was diagnosed in December and I had a similar experience with the vet. It's all very overwhelming right now, but it will get a little easier each day.

I was desperate to get Petey to eat and was using lots of bone broths and broth, just make sure it's not made with onions it causes anemia in cats.

Someone will make recomendations on no/low carb food.... which I'm surprised the vet didn't want to try diet management first... Petey was over 600 on diagnosis which apparently that high is rarely due to stress.

What did Ruedi go to the vet for initially?
 
Hi Laurie-

Thank you for the encouragement. I took Ruedi to the vet because he's been loosing wt for a few weeks and became more lazy and then stopped grooming. We lost a cat to FIP the end of Jan. so I've been concerned about that even though I know the current research says it's most likely not transmissible from cat to cat. Ruedi started having diarrhea right after our other cat died which Flagyl helped clear up but the wt loss has been concerning.

Thanks for the advice on the bone broth and onions!
 
Hi and welcome to the forum.
I hope Ruedi starts to feel better soon.
If he’s still not eating ask the vet for some ondansetron, for the nausea as it is a better antinausea Medication for nausea than cerenia.
Make sure he eats 1/2 hour before the dose of insulin and try and give him snacks during the cycles. Small snacks is good.
 
Donnalama65 said:
Hi Laurie-

Thank you for the encouragement. I took Ruedi to the vet because he's been loosing wt for a few weeks and became more lazy and then stopped grooming. We lost a cat to FIP the end of Jan. so I've been concerned about that even though I know the current research says it's most likely not transmissible from cat to cat. Ruedi started having diarrhea right after our other cat died which Flagyl helped clear up but the wt loss has been concerning.

Thanks for the advice on the bone broth and onions!
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I'm really sorry you lost your other cat. I hope Ruedi feels better soon, maybe he is grieving as well, poor guy. :bighug::bighug:
 
Laurie&Petey said:
I'm really sorry you lost your other cat. I hope Ruedi feels better soon, maybe he is grieving as well, poor guy. :bighug::bighug:
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Thank you. We’re heartbroken after losing Curlie. This time last yr we had 4 cats and now we’re at 1.5. We lost our Ragdoll in June last yr to old age. and our other cat is almost 15y but at least going strong.
 
Ok thank you!
Bron and Sheba (GA) said:
Hi and welcome to the forum.
I hope Ruedi starts to feel better soon.
If he’s still not eating ask the vet for some ondansetron, for the nausea as it is a better antinausea Medication for nausea than cerenia.
Make sure he eats 1/2 hour before the dose of insulin and try and give him snacks during the cycles. Small snacks is good.
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Since he’s not eating well how much in mls should I force fed him before giving insulin?
 
We prefer the term "assist feeding": Syringe/Assisted Feeding (Video and Tips) linked in case you need it.

Do you know how many calories he should be getting per day? A/D is 180 calories per can. How much does he weigh now? For a typical male cat size, he might need a full can. Maybe more.

What food was he eating before the diabetes diagnosis? Just wondering if there is another food he'd be interested in.

Normally we'd suggest starting a cat on Vetsulin with 1/2 unit if on wet food, 1 unit if on dry food. Actually, we don't recommend Vetsulin at all, but that's another hurdle we can talk about later. You are not alone having a kitty started on Vetsulin. One of the issues with Vetsulin is that it hits hard and fast, so you do want a good amount of food in him before giving the shot. More about Vetsulin here: INTRODUCTION TO CANNISULIN/VETSULIN & N/NPH
 
Lots more tips and videos about home testing here: Hometesting Links and Tips. Good luck! I had a few epic fails to start. :rolleyes:. Start with just rubbing his ears and giving a treat. Cats quickly figure out that the poke = treat. Hopefully he has an appetite for treats. On the shopping list will also be some low/no carb treats (pure freeze dried meat, such as chicken) is usually a winner.
 
Wendy&Neko said:
We prefer the term "assist feeding": Syringe/Assisted Feeding (Video and Tips) linked in case you need it.

Do you know how many calories he should be getting per day? A/D is 180 calories per can. How much does he weigh now? For a typical male cat size, he might need a full can. Maybe more.

What food was he eating before the diabetes diagnosis? Just wondering if there is another food he'd be interested in.

Normally we'd suggest starting a cat on Vetsulin with 1/2 unit if on wet food, 1 unit if on dry food. Actually, we don't recommend Vetsulin at all, but that's another hurdle we can talk about later. You are not alone having a kitty started on Vetsulin. One of the issues with Vetsulin is that it hits hard and fast, so you do want a good amount of food in him before giving the shot. More about Vetsulin here: INTRODUCTION TO CANNISULIN/VETSULIN & N/NPH
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Hi WEndy-

He was on Purina ONE Urinary tract health dry and FF canned. He has many allergies so those are the only foods he's been able to tolerate.

The attempt (4 of them to be exact) ear pricks weren't successful. Actually I did get a good drop on one prick and the stupid machine gave me error codes Argh. His patience was out so I never got a BG. I don't know if I can do this. He's a tough cat to do things to anyway and now he doesn't want to be near me. I'm struggling because I don't want to be the person he runs from every time he see's me. I had to force fed him 4x today, 4 ear pricks and 2 insulin injections. Its sucks.
 
Donnalama65 said:
Hi Wendy-

He was on Purina ONE Urinary tract health dry and FF canned. He has many allergies so those are the only foods he's been able to tolerate. Now I'm offering many varieties of canned FF, A/D, canned chicken, lunchmeat etc. He has eaten some Greenie's treat's today and a little of the Purina veterinary DM dry.

The attempt (4 of them to be exact) ear pricks weren't successful. Actually I did get a good drop on one prick and the stupid machine gave me error codes Argh. His patience was out so I never got a BG. I don't know if I can do this. He's a tough cat to do things to anyway and now he doesn't want to be near me. I'm struggling because I don't want to be the person he runs from every time he see's me. I had to force fed him 4x today, 4 ear pricks and 2 insulin injections. Its sucks.

I'm going to try to get in with another vet clinic this week as i don't feel much guidance with the vet I went to. We're in SW Va and don't really have any quality vet clinics here.
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I have no idea what his calorie requirements are. He was 14.4# yesterday.
 
Don't forget those treats after every poke attempt. And random cuddles and treats, just because, sprinkled in between. Since you are also dealing with black ears, I might suggest a very fine smear of Vaseline on the poke site. It allows the blood to beed up instead of dive and hide in the black fur. You should also be using 26 gauge lancets to start, moving to smaller ones (higher numbers) as you gain more experience. As per above, I had a few good crying sessions to start. It didn't help that I fainted when seeing blood. You WILL get there. :bighug:

Donnalama65 said:
He was on Purina ONE Urinary tract health dry and FF canned. He has many allergies so those are the only foods he's been able to tolerate.
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Which flavours of FF? FF usually has a lot of proteins in it that are common allergens.
 
Wendy&Neko said:
Don't forget those treats after every poke attempt. And random cuddles and treats, just because, sprinkled in between. Since you are also dealing with black ears, I might suggest a very fine smear of Vaseline on the poke site. It allows the blood to beed up instead of dive and hide in the black fur. You should also be using 26 gauge lancets to start, moving to smaller ones (higher numbers) as you gain more experience. As per above, I had a few good crying sessions to start. It didn't help that I fainted when seeing blood. You WILL get there. :bighug:


Which flavours of FF? FF usually has a lot of proteins in it that are common allergens.
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Chicken pate.

Now I've freaked myself out because I gave insulin and didn't get a BG. I guess I should set an alarm and ck him at 2:30 (4 hrs post Vetsulin injection?) with Karo syrup close by?



















0?
 
Thank you Wendy. He was fine. I cked on him every 2 hrs. Still eating nothing today. I FF 22 mls of A/d w/broth and some pumpkin because I he hasn't pooped in at least a day best I can tell. He broke out of the upstairs somehow yesterday and there was only urine in the box. He did pee this am and I got a sample. Going to CVS to get ketone strips. Still can't get a BG because I'm by myself today, husband at wk. I think I'm going to not give insulin this am since he's not eating. I called ER, which is an hr away, to see if I could get a phone consult but they won't since they haven't seen him. He's stable enough, just laying in his bed but is alert. Going to keep doing what I'm doing and try to get him in locally tomorrow am. It's frustrating to not have good vet service in our rural area and also not be able to get a blood sample. I'm still thinking maybe its not Diabetes since his BG on Friday at vet was 259 after a stressful ride in the car and blood draw. Would that number really even warrant putting him on insulin? I've read stress can drive up BG 50 pts. I feel something else is going on aside for suspected diabetes even though bw was otherwise unremarkable. Can I post BW here somehow? Any advice is appreciated.
 
I have the same concern as Wendy regarding lethargy and your cat not eating well. Getting the ketone strips will answer whether ketones are present. Anything over "trace" is a concern and may warrant a trip to the ER vet. (Sorry!) Ketones are dangerous so we don't mess around if they are present.

Throwing the pharmacy at your cat makes it very hard to know what is or isn't going on. This is particularly the case since some medications can contribute to nausea and poor appetite.

We regard normal blood glucose as between 50 - 120. It's hard to know just what your cat's numbers at home would be. If using the information you noted (stress bumping numbers up by 50 points) is typical for your cat, he'd still be in a diabetic range. Most vets will run a fructosamine test to determine if a cat is truly diabetic. A fructosamine is like a human hemoglobin A1c -- it gives you an average of blood glucose over a period of time versus home/office testing that tells you what the blood glucose is this minute.

This is a link to a post we refer to as helping us to help you. There's a tab on the spreadsheet for lab values. You can include your cat's blood work there. We use the spreadsheet to track home testing data, as well.
 
Sienne and Gabby (GA) said:
I have the same concern as Wendy regarding lethargy and your cat not eating well. Getting the ketone strips will answer whether ketones are present. Anything over "trace" is a concern and may warrant a trip to the ER vet. (Sorry!) Ketones are dangerous so we don't mess around if they are present.

Throwing the pharmacy at your cat makes it very hard to know what is or isn't going on. This is particularly the case since some medications can contribute to nausea and poor appetite.

We regard normal blood glucose as between 50 - 120. It's hard to know just what your cat's numbers at home would be. If using the information you noted (stress bumping numbers up by 50 points) is typical for your cat, he'd still be in a diabetic range. Most vets will run a fructosamine test to determine if a cat is truly diabetic. A fructosamine is like a human hemoglobin A1c -- it gives you an average of blood glucose over a period of time versus home/office testing that tells you what the blood glucose is this minute.

This is a link to a post we refer to as helping us to help you. There's a tab on the spreadsheet for lab values. You can include your cat's blood work there. We use the spreadsheet to track home testing data, as well.
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Thank you Sienne-

I tried to do the spreadsheet yesterday but couldn't get it to work. My brain is stress mush right now. I've never cried so as I have in the last 2 months with the loss of our other cat and now this. I'm waiting for the urine sample to come to room temp because I caught it about 1.5 hrs ago and put it in the fridge until I could get the strips.

His inappetence and weight loss is what drove us to the vet initially. He's had wt loss for a few weeks and decreased appetite for several days to weeks. Now he's just living off of greenie's which he'll eat a few on his own and what I'm FF him.
 
No ketones in urine thank goodness.
I got an ear prick yay!!! BG 216. Also bought the ReliOn monitor because the CVS one sucked. Kept giving me error codes.
New vet appt tomorrow.
 
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Well done on the BG test! :bighug:. Not a bad number either. Ideally try to get one about 4 hours after the shot if you can.

How is his appetite today? Same? Did he eat anything overnight?
 
Wendy&Neko said:
Well done on the BG test! :bighug:. Not a bad number either. Ideally try to get one about 4 hours after the shot if you can.

How is his appetite today? Same? Did he eat anything overnight?
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thank you. It definitely felt like a win and he had a small poop but No appetite today. He’s not eating on his own at all. Not even treats now. Yesterday after giving him food by syringe it sorta stimulated his appetite and he’d eat a little.
 
Donnalama65 said:
thank you. It definitely felt like a win and he had a small poop but No appetite today. He’s not eating on his own at all. Not even treats now. Yesterday after giving him food by syringe it sorta stimulated his appetite and he’d eat a little.
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If he will eat the Purina One Urinary Track Wet Food, it is low in carbs. My diabetic cat eats Purina Pro Plan Urinary Health & Purina one Urinary Track Health. These are low in carbs and fine for a diabetic cat to eat. Purina Pro Plan Urinary Health Chicken
& Gravy has the highest carbs @ 9 carbs the other wet food is between 2 to 4 carbs.
 
+4 BG is 193. This am was 216. Is that a reasonable difference? he ate a small amt on his own, got up, drank water and did some low energy play with a worm, catnip and laser pointer. He's very weak, especially in the rear end as this has been consistent for the last few days even prior to DM dx.
 
Was the urine you collected for a ketone test? If so, please read the instructions on the ketone strip container. Unless something has changed, you need a fresh sample -- like almost immediately from your cat.
 
Sienne and Gabby (GA) said:
Was the urine you collected for a ketone test? If so, please read the instructions on the ketone strip container. Unless something has changed, you need a fresh sample -- like almost immediately from your cat.
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What I read online was you can refrigerate for a short amt of time and still get accurate answers. When I worked in the vet world years ago clients would be in samples from home that they had refrigerated and no one said anything contrary to. So I’ll have to look at the box and try again if I can catch another. Thanks for that though!
 
Hi all, so I'm reading here about Vetsulin. Will someone clarify for me. So, when I test and the # is 200mg/dl or less, I do NOT feed correct? I'll post that info here?

Also, I gave this mornings dose at 11:25 because of trying to get blood etc. last night took much longer than expected. He should have gotten his pm dose last night at 9:45 so we were late due to the blood draw drama. How much earlier can I give tonight's dose? I can't stay up that late since I have to wk tomorrow.

Thanks in advance. Sorry to have so many questions.
 
Injectable B12 won't help with neuropathy. You specifically need methylcolbalamin to treat neuropathy. I'm not sure how long a cat needs to be on methylcobalamin before the neuropathy improves. Probably a few weeks along with getting the blood glucose levels under control.
 
What Squeem3 posted is correct. Methylcobalamin takes a good amount of time to start working. It will be most effective as your cat's blood glucose levels are better regulated. I would expect to see results start after about 2 months IF numbers are improving.
 
squeem3 said:
Injectable B12 won't help with neuropathy. You specifically need methylcolbalamin to treat neuropathy. I'm not sure how long a cat needs to be on methylcobalamin before the neuropathy improves. Probably a few weeks along with getting the blood glucose levels under control.
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Hi Sqeem3-
Methalcobalamin is B 12. Is there some other form you may be referring too? How do you give it? Orally or injection?
 
Vitamin B12 is available in several forms that a body can use. Cyanocobalamin is what injectable B12 is. It's typically used for GI issues. You need the methyl form of B12 (methylcobalamin) to treat neuropathy. Methylcobalamin is usually a pill. You can crush it up and mix into canned food or a lickable treat.
 
squeem3 said:
Vitamin B12 is available in several forms that a body can use. Cyanocobalamin is what injectable B12 is. It's typically used for GI issues. You need the methyl form of B12 (methylcobalamin) to treat neuropathy. Methylcobalamin is usually a pill. You can crush it up and mix into canned food or a lickable treat.
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Ok thank you. Going for a second opinion new vet this afternoon. Still isn’t eating on his own. I feel something else is going on.
 
Ask the vet to test for pancreatitis. It's fairly common in diabetic cats. Anti nausea meds and an appetite stimulant are typically prescribed to treat.

A general suggestion is to feed 20 to 25 calories per pound of ideal body weight. Your 14 lb cat may need 280 to 350 calories daily. Cats who don't get enough calories are at risk for fatty liver disease. A feeding tube may be needed in some cases. Hopefully your cat won't need a tube.
 
squeem3 said:
Ask the vet to test for pancreatitis. It's fairly common in diabetic cats. Anti nausea meds and an appetite stimulant are typically prescribed to treat.

A general suggestion is to feed 20 to 25 calories per pound of ideal body weight. Your 14 lb cat may need 280 to 350 calories daily. Cats who don't get enough calories are at risk for fatty liver disease. A feeding tube may be needed in some cases. Hopefully your cat won't need a tube.
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Ok thanks. At vet now. They’re running fructosamine and T4. He has a heart murmur too.
He did eat on his own today after I gave him Elura. Yay another battle won.
 
The fructosamine won't tell you anything new. It just gives the average blood glucose level over the past few weeks and since your cat is newly diagnosed, the fructosmaine will just show diabetic levels.

Elura is for cats with kidney disease. Does your cat have that?

Have you tried a sprinkle of FortiFlora or crushed up treats on canned food? Water down pate canned food a b it so it's easy to lap up?
 
So vet did Fructosamine which was actually low 155 range is 191-349. He says he's not diabetic. He also tested T4 which is in normal range. So this is all good news. Now to figure out the hind end ataxia. I'm still concerned with Neuro FIP since our other cat died of FIP and these symptoms started soon after. Vet says BW doesn't support an FIP dx but I also know how hard it is to dx and many vets don't know the types of FIP (wet, dry, neuro). I'm going to keep my fingers crossed and hope for the best. I did start him on Eluva this am and he's now eating on his own yay! Thank you all for all your support. I hope I never have to come back here again however :) Nothing personal but don't want to be in this DM situation scare again. I've learned a lot!!
 
squeem3 said:
The fructosamine won't tell you anything new. It just gives the average blood glucose level over the past few weeks and since your cat is newly diagnosed, the fructosmaine will just show diabetic levels.

Elura is for cats with kidney disease. Does your cat have that?

Have you tried a sprinkle of FortiFlora or crushed up treats on canned food? Water down pate canned food a b it so it's easy to lap up?
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He's not eaten on his own for about 5 days so vet Rx'd Elura and it got him eating this afternoon.
I was having to syringe feed him. I've pretty much tried everything. He refused all attempts.
 
Hi, So I'm back again after other vet on Monday did a fructosamine (result was low- 155) andvet told me to stop insulin so I did as of Monday night (last dose of Vetsulin was Monday am). Last evening Ruedi was super ataxic and could barely walk and drinking at the water bowl several times for several minutes. I check his BG and it was 253 so I gave 1 u. Recked this am and it was 269 so I gave 1u. He's now walking better and came downstairs to eat lunch (he's been inappetent so having to assist fed.)

I called hospital I saw on Monday to discuss. Vet on today won't even discuss case with me because she wasn't the one who saw him and wants to refer me to a neurologist. The possiblity of Neuro FIP is on the table also since we lost a cat to FIP in Jan. yet both vets say BW doesn't support this although FIP group says BW can look normal with neuro FIP so we're treating anyway.

My question is: How can fructosamine be low and my daily checks are high? Fructosamine checks average from last few weeks right? Can it be low because he's just crossed the threshold into active DM?

I'm so worried and frustrated with the crappy vet care we have in our area.

Thanks for any advice.
 
By any chance did your vet run a full thyroid panel -- TSH, free T3 and T4, and thyroid antibodies? Most labs only include T4. Fructosamine levels can be lower in cats that are hyperthyroid. Hyperthyroid would also explain the weight loss.
 
Sienne and Gabby (GA) said:
By any chance did your vet run a full thyroid panel -- TSH, free T3 and T4, and thyroid antibodies? Most labs only include T4. Fructosamine levels can be lower in cats that are hyperthyroid. Hyperthyroid would also explain the weight loss.
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They just did an in house T4. He is Inappetent though and not ravenous like most hyperthyroid cats I’ve had in the past.
 
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