Recently acquired grandma's 16 yr old diabetic cat

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rozie99

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OK, here's a REALLY long post- thank you in advance to anyone willing to read it all and tell me what you think. :-)

I recently took my grandma's two cats when she had to go to the nursing home. One is Cricket, who was in pretty bad shape. My family grew up on farms and although I still think they do OK by their pets for the most part, but don't go as far as I would.

So- I knew he was in rough shape but it was a shock to see him- he's a big guy, both tall and well rounded and last I saw him a couple of years ago, was about 17 lbs. I knew one aunt took him in for blood work and his sugar was 'kinda high'. My grandma's vet sent him home with Hill's W/D diabetic cat food and that was that. I got him nearly 2 months later- and his blood sugar at his last test was 391. When I got him to my vet, he was at 520 and a mere 10.2 lbs.

We started Lantus insulin 1 unit, 2x daily. We switched to low carb, grain free wet food. He's sharing a room with my grandma's other cat, who is semi-feral and will take time to come around to my herd of 11 other cats (giving me a total of 13).The other cats are free feed dry Royal Canin Intestinal HE formula to accomodate our youngest's IBS and another's struvite crystals. That's what will be out once both join the general population of cats, so that's what's in his room for his roommate.

First 2 week recheck and his BS was around 440. We had a small crisis (he got ill, vomiting/ diarrhea/ refusing to eat) so he had another check a week later and was around 338. A week ago, we were down to 220ish. We're up to 2.5 units of Lantus 2x daily. We're feeding him 1/2 can of wet food with each shot and another 1/2 can at bedtime.

At first- it was more triage care. He was SO thin, drinking entire bowls of water, eyes dull, fur dull, ears chemically burned to hell from my well intentioned aunt putting some kind of mite meds in them for over SIX months, matted fur on his tummy, no fur around hs neck/ chin from scratching some rashy looking skin thing, cement booties of kitty litter from his clumpable litter and huge pees... Poor guy. He just seemed ready for the end, which is where he was headed if I hadn't risked family war to intervene. Now his fur is shining, his eyes are bright, he's purring and talking, his fur on his ears and neck is starting to grow, tummy was shaved but also growing- so he's come a LONG way since he came to us on April 28th. We started him on Cosequin too, which has done wonders for my 18 yr old in terms of mobility.

Now that we're settling into a groove, I'm looking to do better- trying to research the best machine to use, more info on foods, etc. etc. We are NOT wealthy- but my husband and I don't have kids, we have cats. So we were already spending around $350-400/ month on food and litter. We'd dropped quite a bit of $$ on Cricket so far and had to hit savings for $1K so far, but to see his eyes shine and hear him purr- priceless. Still- we're trying to be a bit more frugal for an ongoing approach to his care and so a few key areas I'd love, love love advice:
1- We use Lantus but it's pricey- $125 is the cheapest I've found per vial in our area (Iowa). The bottle says you can only use it 30 days after you start using it?!?! Is this true or do you folks keep using it longer?
2- I've read what AlphaTRAK says about human/ canine/ feline glucose and it makes sense. I'd much rather use a cheaper human meter- but don't know how to even start picking. Help?
3- Food and feeding! I feel bad NOT feeding this skinny guy. He's large enough that I searched out what type of litter boxes Maine Coon Cats use to get him one he won't pee/ poop out of, because he's so long. I can feel every knob on his spine. But he is a bit of a grazer. So in theory- two main meals at insulin time, and a third before bed to reduce any temptation to eat the dry and try to put some weight back on him. Last weigh in, he was up to 10.8 lbs, so that's good. The grain free is a bit expensive, but he likes that and a Merrick brand from Petco noting a low glycemic index. We give the other half of each can to my 18 yr old, who's just thinning down a bit due to age, I think (and he thinks it's an awesome idea!). What do y'all feed them, how do you deal with multiple cats with different diet needs, etc??

Many thanks in advance. :-)

Lori
 
Great job taking in grandma's cats. I think that there are certainly ways to help you with costs.

First: the food. Dry food is not recommended for any cats. Even the most inexpensive wet food is better. You may want to check www.catinfo.org (written by a vet who occasionally posts on this board) about urinary health and wet vs dry food. There is a food list put together by Janet and Binky that lists the carb content of many of the commercial wet (canned) foods. For the diabetic, less than 10% is good, and there are many foods that fall into that category. Many people feed Friskies pate or any of the Fancy Feast pates. The Walmart brand is also used - again the pate variety. I believe that the large cans are quite economical. I feed my cats the local store brand pates and some of the Walmart Special Kitty, with an occasional Fancy Feast for a treat. You will find that wet food has a bonus at the 'other end' so to speak. There is so much less filler and waste products in the food that the litter box deposits are much smaller so you save on cat litter as well.

Second: the insulin. I think that most people use it for far longer than the 30 days. Someonewho uses Lantus can give you the details. I use Levemir and because I'm in Canada I can just go to the pharmacy and buy it without a prescription. It comes in 5 3 ml cartridges and so lasts a long time. If Lantus is working for the cat, you can stick with it or think about changing to Levemir. Others can help with that aspect.

Third: the meter. Many people use the Relion from Walmart. The meter itself is quite inexpensive, as are the strips. It seems to give quite consistent results. The Alphatrack is ver expensive, and the strips are even mre expensive! The real drawback is that the strips are not easily available and inevitably you will run short on a weekend evening. With the Walmart brand, obtainng strips at any hour is fairly doable. The other big advantage of having your own meter and testing the cat at home is that you will save $$$ at the vet because it is no longer necessary to take the cat to the vet for testing. You do it at home in familiar surroundings and then phone or email the data to the vet.

I'm sure others will have more suggestions for you.
 
To answer your questions

1. Lantus has a 28 day expiry when kept AT ROOM TEMPERATURE. That is fine for humans, because humans use much larger doses and will use the whole vial within that time. But cats don't, so as long as you keep it in the fridge, it will last up to 6 months. You have to be careful not to let it sit out too long, and NEVER shoot insulin out of the syringe back into the vial as that contaminates it. Shoot excess drawn insulin into a paper towel or the sink or whatever. As long as you handle it properly it should last you quite a while, but if you notice any white floaties/cloudiness in it or if it seems to stop working, you may need a new vial. Make sure to warm the insulin up before shooting, cold insulin stings. After drawing, hold the syringe between your fingers for 20 seconds or so to warm it. Unfortunately the Lantus pens were discontinued in the USA so you can't get the pen cartridges any more.

2. The ReliOn Micro and Confirm from Walmart are two accurate, very cheap meters. I think they are like $36 for 100 strips and usually the meter comes free if you buy them. That's up to 100 tests for $36. At the vet, you'd pay close to $36 for a SINGLE test. Imagine how much money you'd save. American Diabetes Wholesale also sells cheap stuff. You can buy strips for even cheaper from other folks on eBay and stuff, just make sure they are not expired. And if you can wait, FDMB can send you a meter, strips, etc. at shipping charge if you click on the image at the top of each page. I'm not sure what meters they send out so you may end up with one that uses expensive strips.

3. If he is getting any of the other cats' dry food, please do your best to stop him. It will make regulating him easier and be cheaper on your wallet in the long run because his insulin need will go down. I know it would be hard to feed strictly canned to 13 cats, but there are a few people with big herds that do it (Mel comes to mind). She found a food everyone could tolerate (Friskies pate) and uses a combination of auto-feeders in separate rooms, I believe. Friskies in the big cans are super cheap, about a dollar for 13oz of food. Special Kitty from Walmart is around the same price. These foods are okay, a bit high in byproducts, certainly not premium quality, but better than any dry food out there. I think they may be higher in phosphorous so if you have any kitties with kidney/renal issues. Pretty much anything in a big 13oz can is going to be the most economical for you. Sometimes local stores will give you a nice discount if you buy an entire case of something like Wellness, Merricks, etc. so maybe you could call around and get some prices.

I *personally* feed a mix of Special Kitty Select (Walmart's FF equivalent) and Whiskas recloseable trays. They are both .50 each, the FF being 3oz and the Whiskas about 3.5oz. They are both middle of the road foods, muscle meat first ingredient, nice low carb no corn/wheat/rice/potatoes and come in many varieties. The Whiskas trays might be nice because then you don't need a bowl, but I'm not sure you'd want to open and dump out 40 tins of FF a day. :lol:
 
Ry & Scooter said:
Unfortunately the Lantus pens were discontinued in the USA so you can't get the pen cartridges any more.


In the US you can still buy the Lantus SoloStar pens as well as the 10 ml bottles. The Lantus OptiClick pen cartridges have been discontinued in the US.


rozie99 said:
1- We use Lantus but it's pricey- $125 is the cheapest I've found per vial in our area (Iowa). The bottle says you can only use it 30 days after you start using it?!?! Is this true or do you folks keep using it longer?

The 28 day thing is for Human diabetics. For a cat you can use the 10 ml bottle much longer, though sometimes it does poop out after a month. Here is the sticky on how to handle and store Lantus: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=151

Buy the box of Lantus SoloStar pens next time. There are five pens in the box which is at least a 5 month supply you have on hand. The initial cost is more (maybe 225 for the box?) but break down the cost per pen and it comes out to be much less than a 10 ml bottle. Some pharmacies may sell a single SoloStar pen.

You don't need the pen needles like a Human diabetic would use with the SoloStar. Just stick the insulin syringe needle into the rubber stopper at the end of the uncapped pen and draw up a dose just like you would with a bottle. Do not inject air or extra insulin back into the pen.

Here is a $25 coupon you can use for your next purchase of Lantus SoloStar pens: http://felinediabetes.com/FDMB/viewtopic.php?f=15&t=36964


2- I've read what AlphaTRAK says about human/ canine/ feline glucose and it makes sense. I'd much rather use a cheaper human meter- but don't know how to even start picking. Help?


Here is a meter comparision guide: http://forecast.diabetes.org/files/images/v65n01_BG_Meters_0.pdf

Buy a meter that uses a 0.3 ul drop of blood. Some meters have fancy extras like graphing and meal tracking but you do not need these for a cat. Any of the big name meters are good: AccuChek, OneTouch, Bayer, etc. Wal Mart's Relion brand of meters are good, too, if you have a store nearby. The test strips are what costs the most so what most people do is use a meter that has inexpensive test strips. Test strips for most brands can be purchased online at places like AmericanDiabeteswholesale.com and even Amazon.com and Ebay.

Do not use meters that have "True" in the name (TrueTrack, etc). These are way inaccurate, as much as 100 points off. I've heard that the FreeStyle brand isn't very accurate either.


rozie99 said:
We switched to low carb, grain free wet food. He's sharing a room with my grandma's other cat, who is semi-feral and will take time to come around to my herd of 11 other cats (giving me a total of 13).The other cats are free feed dry Royal Canin Intestinal HE formula to accomodate our youngest's IBS and another's struvite crystals.

3- Food and feeding! I feel bad NOT feeding this skinny guy. He's large enough that I searched out what type of litter boxes Maine Coon Cats use to get him one he won't pee/ poop out of, because he's so long. I can feel every knob on his spine. But he is a bit of a grazer. So in theory- two main meals at insulin time, and a third before bed to reduce any temptation to eat the dry and try to put some weight back on him. Last weigh in, he was up to 10.8 lbs, so that's good. The grain free is a bit expensive, but he likes that and a Merrick brand from Petco noting a low glycemic index. We give the other half of each can to my 18 yr old, who's just thinning down a bit due to age, I think (and he thinks it's an awesome idea!). What do y'all feed them, how do you deal with multiple cats with different diet needs, etc??[/qote]


I think you may be able to feed low carb canned food to all the cats. Special food isn't necessary for urinary problems. The key is to get more water into the cat and you can do that by feeding any canned food, maye even adding some water to the food to ensure good water intake. This web site may have more info about what to feed the IBS cats as well as good general info about proper nutriton for cats: http://www.catinfo.org
 
Oh you are such a good person for taking this kitty in and getting him to a healthy place again. So many people would give up on him, especially because of his age. Others have answered a lot of what you need so I'll just put in my $.02.

1. Like the others said, that's for human use. If you refrigerate and don't shake the bottle, it should last about 6 months. I'd also call around to pharmacies on the price. Just call and ask if they have a moment to give you a non insurance price on a prescription, tell them what it is, and they can give you a dollar amount. I'm in Omaha and the price didn't vary too much from the $118 I paid with my Walgreens Rx Saver club. I don't think I called Costco though, if there's one near you, sometimes they are pretty cheap on prescriptions and you don't need a membership to buy from the pharmacy there, though you do need one for various payment types, though I forget which.

2. A lot of people have the ReliOns from Walmart. I'm the ONE person who had a problem with it. LOL I have a Bayer Contour USB which can hook up directly to your computer to download numbers. I like that sort of thing. The strips are what really get you though. The ReliOns are cheap and easy to come by if you have a Walmart near by. If you go with a more "name brand" meter, buy strips off of eBay, they are much, much cheaper that way.

3. I only have one cat, but I know others with multiple cats with special diets try to feed them separately. If you're free feeding dry, this is harder because you can't keep them separated all day. My cat went from free feeding dry to mostly timed wet food feedings fairly easily. What I did was put down his food at meal time and gave him 20 - 30 minutes to eat. And then picked it up. He went hungry for a couple of meal times but it didn't take him long to learn, and he's 13 so an old cat an learn new tricks! As for what I feed him, Hobbs also has CKD and is technically "on" a kidney diet. The vet prescribed him the Royal Canin Renal LP food, which he doesn't like. And Hobbs is not a picky eater, never has been. He's only ever turned his nose up at diet food before (and really, who can blame him??? LOL) so it really bothered me that he wouldn't eat this food that the vet was insisting he be on. CKD cats can starve to death before their kidneys give out. Anyway, I tried making homemade chicken broth to mix with it, which kind of worked, but I've recently decided to just mix his kidney food with other low carb, low phosphorous food 50/50 (Some Merrick's and some EVO 95% Chicken & Turkey). That he will eat, happily. The vet can suck it, I'm not going to starve my cat. (Not to mention, Rx food is hella expensive even more so than most ultra premium foods)
 
In the US you can still buy the Lantus SoloStar pens as well as the 10 ml bottles. The Lantus OptiClick pen cartridges have been discontinued in the US.

Ah, good to know, thanks :) But you still can't buy the cartridges any more? That's what I meant to say.
 
The others are more knowledgeable about the insulin, so I will leave that to them.

Home testing- I can't stress it enough. Get the Relion meter at Wal~Mart.

We have a multi-cat household-6. Withe 2 diabetics and all of them used to free feeding on dry it was a challenge. It requires some effort but what worked for us was 2 methods. First we switched everyone to Friskies classic Pate as suggested. We fed 3 times per day. We have a fixed income, my hubby is retired. So it got expensive and although I didn't want to, we let the other 4 go back on dry food. We still follow the same schedule of 3 times a day though. We put each diabtetic in a bathroom with their dish of canned food. Then the dry comes out in the laundry room for the other 4 cats. It usually takes about a half hour for everyone to finish. The diabetics are let out of the bathroom and the dry food put away till the next feeding time.

It works for us and everyone gets enough to eat. My diabetics came off the insulin once we switched to canned only food and home testing.
 
Thank you so much to everyone that replied!
It's all very helpful in what's still a pretty gray world for me. I know with diabetic cats, there is no black or white- which is a struggle for me because I'm not a fan of gray. But I'll learn and adapt, just need to do it on the fast track since Cricket came in kinda rough shape.

One last question for home testing- looks like Relion is a dependable accurate brand, although I do like the Bayer concept of uploading all the info. Here's what it said on the alphaTRAK site about blood glucose content for humans vs canine vs feline:
Humans, dogs, and cats all have different makeups of blood, specifically the difference in the ratios of glucose in plasma and red blood cells. While dogs have 87.5% of glucose in plasma and cats have 93%, humans only have 58%. This is significantly lower. If you use a human meter on a dog or cat, it assumes human glucose distribution in blood to calculate glucose levels, which may result in underestimation of blood glucose concentrations and inaccurate readings.

So when home testing with a human meter, do you need to account for that? And if so- how?
 
All that really means is the Alphatrak reads a bit higher than normal human meters.

Probably 99% of us here use human meters. The dosing protocols for Lantus are measured using a human meter. The variance is already accounted for. When someone tells you "hypo is below 50" they mean on a human meter. Hypo on an AT or iPet is about 80. When someone tells you "ideally you want to be between 50 and 140 for regulation" or something similar, they mean on a human meter. You also have to keep in mind that, by law, meters are allowed by law to have a max of 20% variance on any reading. That means a 100 could actually be anywhere between 80-120. But the specifics don't matter as much as ranges and patterns do.

I use a Bayer Contour USB personally, because the Contour is the meter DCIN (Diabetic Cats in Need) chooses to send supplies for in the assistance program. I ignore the USB function because as a computer/tech-orientated person, it is annoying and full of unnecessary functions. Google Docs works much better. If I hadn't gotten two of them for free, I wouldn't have bought it. It is a nice meter, though.

Others use Walmart's Relion Confirm and Micro, some use the Accucheck Aviva, some use the One Touch Ultra... just stay away with anything with "True" in the name ie. TruRead, TruTrack, and also avoid the Freestyle Lite with the butterfly strips. Those meters DO read significantly lower than they should.
 
You've gotten lots of great responses. One quickie on the insulin - as the others have said keep it refrigerated, don't shake it, and don't push excess back into it. I've successfully used a bottle of Lantus for 4 months before replacing. I keep it in the box it comes in along with keeping it in the covered butter/egg area of the refrig. In the box its much less likely to tip over and in the covered area its protected. You will know when its time to replace it when you start seeing wonky high numbers for no reason. At the 4 month mark Sitka started throwing 300's regularly so thats when I replaced it with a new bottle. It is more cost effective to buy the pens because the vials are much smaller but the initial outlay is higher. However many people buy lantus online using Canadian Pharmacies. There is a sticky at the top of the page on which ones DCIN uses. Jan
 
Do store Lantus on a shelf in the refrigerator.

Do NOT store it in the door - that will shake it every time the door is opened, and may cause it to deteriorate more quickly.
 
Ry & Scooter said:
Ah, good to know, thanks :) But you still can't buy the cartridges any more? That's what I meant to say.


I think US people may still be able to buy the OptiClick cartridges from online Canadian pharmacies. Canadian brick-and-mortar pharmacies, and maybe pharmacies in other countries, may still have the cartridges.

BJM said:
Do store Lantus on a shelf in the refrigerator.

Do NOT store it in the door - that will shake it every time the door is opened, and may cause it to deteriorate more quickly.

Wrap something cushiony around the outside of the 10 ml bottle to prevent breakage if you accidentally drop it. You can buy insulin bottle protectors from the pharmacy or make your own. I know some people have wrapped a piece of bubble wrap around the bottle or a piece of paper towel. The SoloStar pens don't really need to be wrapped but if you're worried you can.
 
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