Not sure my Vet knows much about diabetic cats

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My 12 yr old cat Pepper was just diagnosed as diabetic last Thurs (5 days ago). It was because he was walking like he was drunken/his rear end was not "in step" with the rest of his body, that I took him to the Vet. I just lost his brother 2 months ago with kidney failure and was afraid he too had it. I was actually relieved to be told he had diabetes because I knew that could be controlled. Being a computer junkie, first thing I did when I got home was research feline diabetes. After reading many web sites, I am concerned that my Vet doesn't know how to treat him right.

Peppers glucose level was 379. He (the Vet) wants it down to 160-250. All the sites I read say it should be 50-100.

He's on 2 units of Lantus/2 times a day and free feeding Purina DM. All the sites say he should be getting a bovine insulin and VERY limited amounts of wet food that is high protein/low carb. and absolutely NO DRY FOOD!

The neuropathy has me VERY concerned as the vet says it may be permanent/it's a side effect of his diabetes and is not suggesting I give him anything for it to help it. I read that methylcobalamin should be given for it on a few sites and can actually cure it if given soon after getting it.

I understand he is going to need a LOT of care to get this under control, I am retired and have NOTHING but time to spend on my baby's care, but if I can get him into remission with all my care, I would prefer that to just "managing" it as it is looking like the vet wants to do.

If anyone living near Milwaukee, WI knows of a Vet that does go for remission, could you PLEASE tell me about him/her?

Thank you,
 
Most of us try to educate our vets -- read the "Convert A Vet" sticky post and print it out. It lists articles / studies in vet journals that support home testing, Lantus insulin and low carb canned food.

Lantus is an excellent insulin, though we recommend starting at a lower dose - 1u every 12 hours.

Any low carb canned food is good -- doesn't have to be "prescription". www.catinfo.org has excellent Feline Nutrition information published by a vet. Janet & Binky's Food Charts contain protein/carb/fat content for many foods -- more info than what is on the can labels.

Learning to test blood sugar at home is well worth your efforts and will help keep your kitty safe. Insulin can cause seizures, blindness and coma if overdosed.

The methyl B vitamin will help the neuropathy, but it needs to be given every day for weeks. Stick with it -- it will gradually improve over time.
 
Unfortunately many vets don't have much knowledge/experience with diabetic cats. They have to be like GP's - knowing a little about a lot of different problems, and they even have to deal with different species.

Our protocol calls for a mild, long lasting insulin. Actually, two of the preferred insulins here are Lantus and Levemir -human insulins. The other insulin is ProZinc, an animal insulin. Take some time to check out the Insulin Support groups for these three insulins. You can read the stickies for info on how the insulins works, and read through some of the threads to see how people are doing with them. http://www.felinediabetes.com/FDMB/viewforum.php?f=5

We have had a lot of success with wet lo carb food. (When we switched our cat from dry to wet, his blood glucose levels came down 100 points overnight.) We try for 8-10% carbs. There are two schools of thought - free feed to support the pancreas and regulated feeding to help with bg levels. It is different with different cats - whichever works best for your kitty. Here is a great website by a vet: www.catinfo.org And our food charts: Janet and Binky’s chart

And we hometest. Then we know how much insulin is safe to give, and how the insulin is working. Here is how we test: Video for hometesting

Neuropathy seems to be helped by Methyl B12. Also it improves as the blood glucose levels decrease. Neuropathy

Keep reading and asking questions. You might put your city and state in your subject line to see if someone lives near you.
 
peppers mom said:
My 12 yr old cat Pepper was just diagnosed as diabetic last Thurs (5 days ago). It was because he was walking like he was drunken/his rear end was not "in step" with the rest of his body, that I took him to the Vet. I just lost his brother 2 months ago with kidney failure and was afraid he too had it. I was actually relieved to be told he had diabetes because I knew that could be controlled. Being a computer junkie, first thing I did when I got home was research feline diabetes. After reading many web sites, I am concerned that my Vet doesn't know how to treat him right.

Peppers glucose level was 379. He (the Vet) wants it down to 160-250. All the sites I read say it should be 50-100.

The reason it should be lower than your vet recommends is those numbers give the best chance of healing Pepper's pancreas and getting him off the insulin.

peppers mom said:
He's on 2 units of Lantus/2 times a day and free feeding Purina DM. All the sites say he should be getting a bovine insulin and VERY limited amounts of wet food that is high protein/low carb. and absolutely NO DRY FOOD!

You must have read Yourdiabeticcat.com. Dr. Hodgkins is an excellent vet, especially regarding diet. However, on this message board and on a German diabetic cat forum we have made great strides using the longer acting insulins rather than ProZinc or what you may have read written as PZI. Your vet did the absolute right thing in prescribing Lantus for Pepper. Please give him a pat on the back for that. However Lantus works best when the dose is begun fairly low, 1U is preferred. We test their blood glucose at home just like human diabetics do to see how well the insulin is working and if the dose needs increased.

peppers mom said:
The neuropathy has me VERY concerned as the vet says it may be permanent/it's a side effect of his diabetes and is not suggesting I give him anything for it to help it. I read that methylcobalamin should be given for it on a few sites and can actually cure it if given soon after getting it.

Neuropathy can be cured, absolutely! I'm sorry your vet has mislead you about that. The key is to get the blood glucose as regulated as possible. The methylcobalamine (methyl-B for short) can help the neuropathy even before regulation.

peppers mom said:
I understand he is going to need a LOT of care to get this under control, I am retired and have NOTHING but time to spend on my baby's care, but if I can get him into remission with all my care, I would prefer that to just "managing" it as it is looking like the vet wants to do.

Good for you!! We can help you with every aspect. You've already done the best thing for Pepper - researched for yourself and then came here! Pepper thanks you!

peppers mom said:
If anyone living near Milwaukee, WI knows of a Vet that does go for remission, could you PLEASE tell me about him/her?

Thank you,

I don't know if we have any current members in the Milwaukee area, but if you think you might need help learning to home test, we can find out.

Ask all the questions you come across. There is a lot of information to wade through and sometimes it needs someone to interpret it in plain-speak.

Glad you want to help Pepper!
 
I think I have visited all those sites you all suggested, except the vet one, that's why I was questioning his advice...lol My vet is VERY young so maybe he hasn't had that much experience with diabetic animals...yet. Guess I will have to "teach" him with all your help...lol I will give him that article.

Pepper doesn't seem to be having a problem with any of this! The vet let my 12 yr old grandson give Pepper a practice shot with saline and the 15 yr old grandson gave him a test prick before I brought him home Friday and he just laid there like nothing was happening. :-D They will be my backups when I can't be there to do it. I have given him 2 shots a day since then and he's been the same way. It really seems like it doesn't bother him at all....YEAH!

I am having problems with the syringes tho. #1 They are too long, I have gone through his skin to the other side and had to go get another syringe and more insulin and do it again 3 times now. #2 I am also having a TERRIBLE time seeing the unit marks on them. I am using 1/2 cc 28 gauge x 1/2" syringes. I'm afraid I will overdose him because I can't see the right mark. Could you suggest a smaller size I could use?

I will be switching to the wet food as soon as I get a meter tomorrow. Pepper loves wet food so I won't be having a problem there either. :-D I have always given it as a treat 2 times a week and he wolfs it down so that will be easy to do. My only question about doing it is how fast to do it? He prefers the wet to dry so he could go directly to it if not for the insulin? Any suggestions on how fast to do it safely?

With Pepper being so willing to cooperate, I see no problems with doing any of this. I'm not scared or anything, I just want him to get better.

I am sure glad I found this site. It's really going to help that I have people that I can ask questions of.
 
I just want to reiterate that before changing his food to all wet, two important things need to happen. First, hometesting needs to be happening - at least 3 times a day, 1 before each shot and at least one in the middle of the day, around 6 or 7 hours after his shot (noted as +6 or +7). Maybe for 2 or three days you could test at +4 and +6, then +5 and +7, then maybe +6 and +8. This will give you a good idea of how well the insulin is working for Pepper. This will also allow more experienced members to suggest if his dose needs to be dropped to 1 unit - chances are if will need to be dropped before changing completely to wet food.

And the last thing that I wanted to bring to your attention is the information about how to treat a hypo. It is important to hav some Karo corn syrup on hand as well as some Fancy Feast (or other brand) in gravy. The gravy is high in carbs and is essential if Pepper happens to drop too low from his insulin dose.
 
I have read the info on catinfo.com 3 times now and understand how important it is to test often, especially as I switch his food. I plan to test every 4 hrs. for at least a few days after he switches over. Or are you saying I should test at +4 AND +6? My question was how fast can I switch him? He would prefer to go all wet yesterday! Can I do that if I test every 4 hrs? Also, would I be better to feed him like 4-6 times a day or just 2-3 times? I'm retired so I can do either.

The vet told me about hypo and told me to get some Karo before I gave him his first shot. I also printed out the file on it and tacked it to my fridge.

I also need to know about a smaller size syringe. One I can see...lol
 
Yep, smaller size syringe - Here you go. Although Hocks no longer gives FDMB a commission, they are still one of the best sellers for syringes online. But look over what's available from them, maybe it will help you if you want to try a local Wal-Mart or Sam's Club pharmacy as some people get their syringes there fairly cheap.
http://www.hocks.com/diabetic-supplies/insulin-syringes.html

You need 3/10cc instead of the half or 5/10cc type and you can also get a finer gauge needle like 30 or 31 but look for 5/16" length needles that way you won't poke through and through like you've experienced. If he's not bothered by the needle going in, you're probably OK with 28guage.

last but not least, look for ones that say "1/2 unit markings." That means .5U, 1.5U, 2.5U, etc are MARKED on the syringe as well as whole units. This is very helpful when increasing or decreasing dose as it is so small for most cats. This is the particular brand and size I use, but there are others. http://www.hocks.com/diabetic-suppl...edle-1-2-unit-markings-gnp-brand-100-box.html

Since you're in Wisconsin, you can buy syringes over the counter. But maybe print out the page from Hocks of which kind you want to buy, some members have reported confusion from pharmacy personnel about 1/2U markings. They may even have to special order them. My recommendation would be go to a big pharmacy, that's why I suggested Wal-Mart or Sam's.

Good luck!
 
About feeding - there is some debate over small more frequent meals vs feeding only twice a day. I like to recommend giving them say 2 oz, when you give shot, see if they eat that, leave it down if they don't eat it all. Then about 5 hours later they can have more food available to get them through the rest of the day but they should reach a point where there is no food left by 2 to 3 hours or so before the next shot. The midday or midcycle (5 hrs after shot) food is to make sure food is available if their blood glucose goes low. Cats on the longer acting insulins may have the need to eat if that happens and it will help level out or bring up low numbers.

Whether to feed frequently depends on how some cats eat. If they eat it all at once, maybe give smaller portions more often, but try to stay between 6 and 9oz a day. The # of ounces depends how many calories the food has, you can see that on Janet & Binky's food charts and on how overweight Pepper might be. If he's over 14 pounds he will need as much as 9oz, but if it's low carb he will still loose weight. Also some diabetics are starving in the beginning, so it's best to give them all the food they want until their blood glucose is better controlled.

I hope that helps, or did it make the issue more confusing?
 
My cat was diagnosed in April (right before easter) and I changed his food right away and also started him on Lantus right away (1 unit 2x per day). he was already eating a cas of Fancy Feast and 1/2 cup of Blue Buffalo Weight Control dry. I switched his canned food to Blue Buffalo Widlerness and Wellness, and used Blue Buffalo Wilderness dry. I had reduced the dry to 1/4 cup per day and increased the can to 5.5 (did do 6oz for a week or so, but he wasn't eating all and the food is more expensive than fancy feast). On May 19th, I only fed him 1/8 cup of dry and he hasn't had any since. If you look at his spreadsheet, you'll see the BG numbers dropped as soon as I took away the dry. The 21st was the last time he had insulin. his BG numbers have been under 100 since then. I am down to testing him once per day - I did last night and forgot his book to update his spreadsheet this am; he'll be tested tonight before dinner (not an easy thing for me). As you can see on the sheet, I started BG testing almost right away. Not only have I received alot of great advice from here ("get rid of that dry food!") but also from human diabetic friends. I have changed Cedric from 2 meals per day to 4. He gets about 5.5 in canned food a day, spread out during the day (ie 6am, then late morning, then as soon as I get home around 4:45-5, and again between 8 & 9pm). I think that helped too.

I live in FL and don't know anyone near you - sorry! But I am sure you can train your vet! If not, shop around. :smile:

Welcome and good luck!
 
http://hocks.com/hocks-healthcare/hocks ... 40030.html
this is my favorite syringe

during the early days of treatment, the kitty is starving because there is not enough insulin to let the muscles use the sugar.

so the kitty wants to eat-eat-eat, but the sugar mostly gets pee'd out unused.

It is ok to give extra food (low carb canned food is best).

When the insulin is getting to the right dose, the kitty's appetite with go back to normal.
 
Welcome. Lots of us start with readings of 400+. My Maisey was over 500 at diagnosis, so don't worry about the starting number. You are off to a good start, just by reading and posting. Everyone here is always willing to give helpful/useful advice. Testing as you have been told and read is most important. Next is switch to low carbohydrate foods and you have been given links. Do start low and go slow on the increases if/when needed. Set up a spread sheet so anyone here can check and see how things are going when you want advice on dosing. Maisey liked 4-6 mini meals and I think that helped her a lot when we started. Now, I'm generally doing 4 during the week and 5-6 on the weekends. Maisey had lost 3 lbs in two months that she could not afford to lose and has now gained them back, and looks better than ever - thanks to wet food and all these wonderful people.
 
Welcome to FDMB! I am a newbie here, so can't help much with the advising, but wanted to welcome you and tell you that you are at the right place. My Garbo was diagnosed just this April, after having been in remission for over two years (diet controlled). We used Lantus the first go around, and are sticking with it this time as well. The folks here are AWESOME!
 
My daughter is on her way to Walmart to get me a meter and can food right now...YEAH I have Pepper on a 2am/2pm shot time (I'm a night owl). I will be starting testing at 2pm. With the exception of the 3/10cc syringes, I will then have everything suggested to use by the catinfo.com article to use. I am actually getting a little excited about all this...I have always wanted to be a doctor...rofl

Pepper lost a LOT of weight before I noticed he was sick...about 3 lbs...he's only 9 lbs now and looks very thin. He already seems to be doing better walking with just the adding of insulin so I'm hoping his neuropathy will improve a lot more with the change in diet and the B-12.

I keep seeing everyone talking about spreadsheets...what/where are they?

I want to thank all of you for your help. Having people to talk to has kept me from losing my cool about all the decisions I have needed to make to get this all started.
 
Read about setting up a spreadsheet in your signature here:
viewtopic.php?f=6&t=18207
i had already had a gmail account that I hardly used, and have to say I had a problem setting this up, probably because I don't use gmail/google. I finally figured it out, but did get a PM form someone who was offereing for me to call her for help. :-D

Cedric's sheet can been seen in my signature below. Bless whoever created the sheet. all you need to do is get it set up then fill it in. All the colors automatically pop up. Mine is set to allow viewing for those who have a link. That means everyone on this board and anyone who i send the link to (meaning, my vet!).
 
We have had some problems with the spreadsheet opening on some computers. If you have issues, send me a private message (lower left hand corner of the page button PM) and maybe I can help.
 
The template won't let me use it. When I click on Use This Template it shows me a page with:


We're sorry.

We're sorry, your spreadsheet cannot be copied at this time.
 
Looks like you got the spreadsheet working now! Just want to welcome you to our little group here. All considering, it sounds like your vet knows a lot more than most. A lot of vets will start kitties on a very high dose of a harsh insulin and say good luck! (essentially) At least your vet prescribed a good insulin at a moderate dose and told you what to do about a hypo! Many vets will give food suggestions (like DM dry) because not every pet owner wants to do everything possible to help their kitty. Sometimes DM dry is better than overwhelming the owner and having them decide to want to PTS instead :YMSIGH:

Your baby is in great hands - and we'll help you every step of the way :-D
 
Hello and welcome to FDMB!

I think everyone has a lot of the basic information covered very very well (everyone here is soooo helpful) so I just wanted to add some information about your questions about the B-12 based on my personal experiences (I am not an expert by any stretch of the imagination).

This is something that someone told me when I first joined and was inquiring about B-12, my concerns about my vets reaction to starting it, and etc:
You do NOT NEED your vets approval to start your cat on B-12. Period.

There are water soluable vitamins and fat soluable vitamins. Fat soluable vitamins are stored when there are excess and can become dangerous if they are taken more than being used. B-12 is a water soluable vitamin meaning anything that is not absorbed by your cat will be excreted.

Willy has neuropathy and had it for awhile but we didn‘t recognize it until after he was diagnosed and we started home testing (we do pad pricks) which is what really launched us into researching it.

When looking for B-12 you are looking at the form rather than what it’s actually named on the label. The form, Methyl-B12 or Methylcobalamin is what you’re looking for. This form of B-12 is absorbed into the spinal fluid, which is what makes it effective. Sometimes you can find normal “B-12” (instead of “Methyl-B12) and when you look at the label it’s in methyl form. This tends to run cheaper. What you do not want is the cyanocobalamin form, it won't hurt the kitty but it won't help either because it's not absorbed in the same way. You want to make sure that the pills are free of soy, wheat, etc. and as natural as possible because they will often contain flavors and sugar.

Unfortunately, we checked GNC, Walmart, Target, etc. and the “B-12” we found at these places was not in methyl form but we did find it at our local organic store that actually has a very large vitamin/herb area inside of it. The ones we found come in 1mg (1,000 mcg) pills. We give Willy 4 pills (4,000 mcg) a day. We split the dose into 2 pills and dissolve in water either by crushing them (I have found it easier to do this in water) up or by letting them dissolve for a few hours in water and then we mix the solution into his food.

Most of the b-12 you will find is flavored and contains a little bit of sugar because it's meant to be taken by people sublingually (under the tongue). This seems to be such a small amount of sugar that it doesn't affect Willy's BG (he is carb sensitive). As long as the flavoring is natural, that should be ok too. The only concern I was given is that some forms of sugar used to flavor medications for people are harmful to cats. I cannot recall what it is, specifically (hopefully someone can help with this), and I am having a hard time locating the post about it but the kind we buy is super natural/organic so it hasn't been an issue for us. It would be an issue if we ever had to buy online but luckily this store has several brands of "methyl-b12" and 1 or 2 brands that have regular b-12 in a methyl form. We pay around $9-11 for a jar of 150 pills.

As far as the results, Willy still is a little awkward sometimes. He had the neuropathy for a long time (at least 8 months) but he’s doing remarkably better now, so don't let anyone tell you it's too late to start! When we are unable to give the B-12 for a day or so, we notice a marked deterioration in his ability to move around effectively so I know it really is helping.

Finally, a little something about the vet. I think it is more important to find a vet that is teachable, respects your wants and your goals, and is willing to work with you for the treatment that YOU would like. My vet was very knowledgeable about FD in a general sense but her methods of treating it were, to be blunt, very dated. I joined this forum and joined the Lantus support group and I realized I wanted to treat Willy based on the protocol used there because it was effective and in-line with my goals.

I spent a lot of time learning about the process and doing research on this site and gathering home testing data on my spreadsheet. When I set up a meeting with my vet, I honestly thought that I was going to be looking for a new vet because our previous encounters with me disagreeing to advice didn't go over so well. I went in with the mindset that as a professional, she would be interested in learning about this protocol that I wanted to use because I was bringing her actual medical information and not just “I heard this on the internet“. (Vets have to know so much about so many things in so many species, FD is just one thing). I made sure to approach her respectfully, because she is a knowledgeable professional, but firmly, because Willy is MY cat (and I am the one paying for the service).

I discussed my spreadsheet with her and pointed out things about it that I thought we interesting or that she should know. I then CLEARLY explained what I wanted to happen (I want Willy in the range of 50-120, preferably hovering around 70). I knew she might not be comfortable with this range (it seems some vets feel FD cats BG should be closer to 200) so I showed/explained my Hypo treatment plan and a list of what was in my kit. I then showed her a chart and medical articles of the protocol that I wanted to follow and explained, because I was home testing, this is what I wanted to do to achieve my goal. She spent several minutes reading through it and seemed unsure but I offered her the link to Willy’s spreadsheet and told her she was welcome to check in with us at any time. She has supported my decision to treat Willy this way but I don’t think it would have worked out like this if I had not brought her the information I did and explained myself and my goals clearly.

Anyways, welcome again to FDMB! You will find so many helpful hands and so much support here it will boggle your mind maybe more so than all the information that is available! We hope to see you in the Lantus forum soon!

Stephanie&Willy
 
The sweetener that is harmful to cats (and dogs) is Sorbitol. An artificial sweetener.

I would avoid ALL artificial sweeteners, just to be on the safe side.
 
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