Sick Kitty, Scared Mom! HELP!

[sarahlfiles]

This could be long, so I'll shorten all I can.
About Toonces: She is my husbands 13yo female Norwegian Forest. Until a year ago (5 years into living in the same house together) I was unable to approach or pet Toonces. To this day, no one except for the two of us can come close. A vet visit requires sedatives simply to get her into the crate and more sedatives/gas upon arrival to keep her under. In Feb 2012 she began filling litter box w/urine and was diagnosed diabetic. Given PZI insulin (3units AM/3 units PM), a flyer titled "Feline Diabetes and You" and recommendation D/M food. Was told to come back in one month for fructosamine test and, upon inquiring about the benefits of a raw diet, was told that "diet didn't really matter, just get her on the insulin and her pancreas could start functioning again and we would be in the clear." I skipped on the food and, after some research, bought EVO with the intention of transitioning her to raw. We decided to put off the insulin until we could do some research into controlling her glucose with diet. However, after speaking with the vet upon a dog-visit in early March, he said we could be missing the critical window of kick-starting her pancreas. We started that day with the recommended dosage of insulin.
Last night we got home from shopping to find her unconscious and seizing/foaming on the floor. I checked her sugar for the first time ever (she will not allow that to happen otherwise) and it was 59. I gave her some Karo and then we rushed her to hospital. Her sugar was actually 32 and they set her up on an IV drip and kept her until this evening. They had to sedate her to remove the catheter and IV so she is not yet back to her normal self. They told us not to give her insulin and to go to take her to the vet on Monday.
This leaves me so distraught and full of questions! I could really use some help and advice. Anything at this point would be a light in this darkness.
-How do we home-test a cat who will not allow us to prick her?
-How can we know if she needs to be back on insulin?
-Should we risk her health with continued sedatives to get her to and from vet visits?
-Is there a Feline-Diabetes specialist in the Houston are? (possibly one who supports a raw diet)
-Is relying on urine test strips more effective than not testing at all?
-Would it be more cruel and inhumane to allow her to suffer through this disease with us guessing all the time OR to de-claw her (something I am COMPLETELY against!) so that we can test her blood glucose regularly without permanent damage? Even the thought of doing this makes me sick to my stomach.
-Do cats who have recovered enough to no longer require insulin still urinate excessively?
How can I calm myself and not stress so much over this?!?!? I am so heart broken that we sent her into that hypo-shock.

That's all I can think of for now. I thank you in advance for any help you can offer.

Sarah & Stephen (And Toonces too!)

 

[MJ+Donovan]

I was about to log off since it's ~2 am where I am, but I wanted to try to reassure you that there are many people here who can help you. There are alternative ways of determining glucose levels in cats who are difficult to test the traditional way. I believe there are indicators that can be added to the litterbox, for example. Blood testing is ideal, but until when/if you find a way to do that without harm, you do the best you can. I am not familiar with PZI myself, so I will try to find someone who is. But yes, diet is extremely important for diabetic cats. There may be someone online now who can better answer your questions, but it's likely you will get more advice in the morning. Please hang in there.

MJ

 

[Jenn & Baxter]

Hi there I am Jenn & my big brown cat is Baxter. Baxter was DX in November 2011 almost 6 months ago. I was so heart broken & very depressed. We are PZI users & belong to the PZI family, over in the insulin support board. We live in a suburb outside of Houston.
Maybe we can help.
First off I want to say take a deep breathe & exhale. :YMHUG: Everything is going to be ok. You are going to get so much help. All you have to do is ask.

Diet is extremely important in FD. Just like diet is important in human diabetes. Low carb, high protein diet is the best way. No more dry food. It is high carb & It lacks moisture which is hard in the kidneys.
Canned food is the best. Although, some canned food is still high carb. Please take a look at food chart on the front of the forum. I would post a like, but my iPad doesn't ever do it right. Fancy Feast is a very low carb food. Many members feed fancy feast.

Insuline dosage. 3 units of PZI is a lot. Most PZI memebers will start at .50 or 1 unit. My vet started Baxter at 1 unit.

You stated that the vet said no more insulin until Monday. I think this is good advice. Between now & then. Go purchase some Fancy Feast etc & start feeding. No more dry food. It is easy to do a diet change without insulin. When you do a diet change with insulin as you can see you run the risk of hypo.

Home testing. Some of the most difficult cats are able to be home tested. It does take time. Please keep in mind home testing is extremly important. For many reasons. It will help you know how the cats body is responding to the insulin. It will help prevent hypos. There are lots of YouTube videos that can help you with hometesting. There is even when with a complicated cat.

FD is a manageable disease. Cats can live a very long happy life with FD. So there is no need to entertain the thought of giving up. You have already taken a big step in getting your furry friend better...you join FD message board. Truly the best place to be to help your friend.

Here are my questions...
At what BG was Toonces DX?
What area of Htown do you live in?

Breathe!
Jenn & Baxter cat_pet_icon

 

[Doug N Libby]

Sarah -

I do hope my note will be coherent; I just got up for Hershey's 3am test and was doing a quick scroll through the forum before returning to bed.

I am so sorry to read of the scary experience you have gone through. Take a deep breath and try to calm yourself. Since you're not currently giving insulin, it gives you time to read and arm yourself with knowledge!

I see you have already met Jenn and Baxter - SUPER - they are very active on the PZI board. Whenever you're ready, I would invite you to join us on the PZI board. We are a much smaller group and you will be able to ask questions there of people who are familiar with your insulin, as all insulins work a little differently. I still post sometimes on HEALTH, too, if it's a general HEALTH question.

Jenn has given you some excellent advice. I would suggest you spend as much time as you can, reading on this site. There is a chart that allows you to compare canned foods, so you can find something you can afford that is lower carb. We use Wellness and find it is much more affordable buying the larger cans online. Less money + delivered to my door? I'll take it! There are several good options available, including Fancy Feast, which seems to be pretty popular here.

Let me try to address your questions -

-How do we home-test a cat who will not allow us to prick her?

You work up to it. Every cat is different, but I've not read of a cat, yet, who didn't get used to it. Start by picking a spot to test. We use a rocker beside our table lamp. Always follow testing (even unsuccessful attempts) with treats. She will start to associate the testing with getting TREATS! (You'll need to purchase some lo carb/no carb treats. We buy freeze-dried turkey and freeze-dried chicken, but there are other options for that, too.) Some have started by clicking the lancet pen (without actually trying to test) so the kitty can get used to the sound. Also, if you use a little vaseline, it'll help the blood bead up, so it's easier to draw up into the strip.

Home testing is very important. My Hershey has gone low on me a few times, with no symptoms, so I wouldn't have known if I hadn't been testing. Just keep reminding yourself that you're doing this to keep Toonces safe. We recommend testing before giving a shot and at least one other time during each cycle. It is important to test before giving insulin - once, Hershey was at (31) when it was time to give his shot. I wouldn't have known that if I hadn't been testing. Scary thought that I would've injected insulin into BG that low.

-Should we risk her health with continued sedatives to get her to and from vet visits?

There are not many things related to FD that you can't manage at home, without a lot of visits to your vet. Because you're home testing, you can do curves at home, too. Many here just send their results to their vet and only go in for routine check-ups. Hershey has not been back to the vet since he was diagnosed in Nov, 2011. (He began ProZinc in Jan, 2012.)

-Is relying on urine test strips more effective than not testing at all?

Others will come along with more experience than I have, but I can tell you there is no substitute for home testing. This is something you CAN do. You need to be calm and confident so Toonces will be calm, too. There are other tips, but, my brain isn't firing on all cylinders right now.

-Would it be more cruel and inhumane to allow her to suffer through this disease with us guessing all the time OR to de-claw her (something I am COMPLETELY against!) so that we can test her blood glucose regularly without permanent damage?

Hershey was declawed as a kitten, but I'd guess there are cats on here who still have their claws. I don't think it's an absolute that you have to choose 'allowing her to suffer through this disease' or 'de-clawing her.'

I can not even tell you how heart-broken I was when Hershey was diagnosed. I cried...and cried...and cried...I didn't even know cats could GET diabetes! During the weeks between diagnosis and starting insulin, I found this place and it was a God-send! I met wonderful people here who have been/are going through the same thing. They understood how I felt. I went from KNOWING I could NEVER test and give a shot, to feeling pretty comfortable with it now. Hershey is so used to testing, that when we click on the lamp, he comes to be tested.

So, take comfort, you are no longer alone! Spend some time reading...I have found great benefit in skimming other threads and asking questions. Ask LOTS of questions! I ask questions almost every day

Again, WELCOME!!

Libby (and Hershey, too!)

 

[BJM]

{{hugs}}
Breathe!
There are numerous, albeit indirect, methods for monitoring. Please see the link in my signature for a set of secondary monitoring tools.

Now, one thing that may help you out is to begin some behavior shaping. What is something Toonces really likes? A toy? A treat? Catnip? You want to identify things which are positive rewards for her.

The next step is to identify 1 thing you would like to improve in her behavior, and to identify all the tiny steps which lead closer and closer to doing that behavior. This is going to be a process, not an event, ie it is going to take some time. Each step along the way, you will reward her with a low carb treat or toy afterwards.

For example, perhaps you want to help her be more comfortable with travel. A logical first step is to help her be more comfortable with the crate. Leave a nice clean crate with the door off or tied open in a pleasant, slightly off the main path area, but in view of the higher activity areas. Placing it up a few feet may help, as cats like to climb up and look down. Put a plush towel in there. Pick up some feliway spray and give the towel a light misting daily. Let her decide if and when she wants to go in it, but put one of her rewards in it a couple of times daily - catnip, food treat, toy, etc.

If she likes to engage in any play, aim for 15-20 minute play sessions before feeding; try different toys (Da Bird gets some good reviews). This will help elicit the hunt, catch, kill, eat, eliminate, groom, sleep cycle which is normal behavior for cats. It also may improve the bond between you and reduce some of her stress. You may be able to slowly move play sessions near to where the crate is, too, until she becomes more confident in being around and in it.

Once she becomes comfortable in hanging around or in the crate, put the door back on it. This step involves shutting the door for a few minutes, then opening it. The intent is to slowly build up the amount of time she will tolerate the door being shut.

After that, you move on to lifting the crate with her in it, starting with a minute or two, then putting it down and opening it, and gradually increasing the time in movement. Slowly add in taking a step or two more until you can carry her to the car and back.

Next, you'll add in turning on the car, turning it off, and going back inside. Then moving the car a bit and returning, and so on.

 

[Sue and Oliver (GA)]

You have gotten great advice on food and starting to hometest. I agree with Libby - working up to testing gradually is a good idea. I would also start playing with her ears, while offering treats. If that goes well, start warming her ears with a rice sack (thin sock filled with raw rice warmed in microwave till very warm, not hot.)

A kitty burrito is also a possibility. We started with Oliver in a burrito and were able to discontinue it when he learned it only took a second, and he got treats. You put the kitty down on a towel and wrap her up with only her head showing.

There are other testing methods. They will give you a picture of what is happening hours after the insulin is given. Some people have to use them, but I would urge you to try to test with the meter first. It is the only method that gives you a blood glucose number the minute you shoot, so you can be sure the amount you are going to give is safe.

Since you are taking a break from the insulin, you have time to gradually work up to testing and try the wet low carb food. Once you can test, you can see exactly how she is doing with the diet, and whether insulin is needed. Starting on a low dose is so much safer. You can always add insulin if needed, but as you know, a hypo is very scary.

You might start a new thread asking for a vet in Houston. If a member lives nearby, they might also be able to help with the testing.

 

[Catannc]

Hi Sarah,

I know you're really overwhelmed. I had a similar experience at first, put on dry w/d and Prozinc by vet and told no home testing, cat hypo'd after the 2nd shot. I got rid of the vet, switched to raw food, dropped the dose of insulin down, and my cat went into remission within 8 weeks of initial diagnosis. It's great to find a supportive vet, but many on here just use the vet for insulin and dignostic tests and use the board for the diabetes.

I will say whatever diet you're going to use for your kitty, get it going now and if you're truely unable to get a blood test I wouldn't start insulin for a few days to let the food take effect. If you've been feeding high carb food your numbers could drop over 100 points easy just from the diet change, and people have to test carefully if they're giving insulin to make sure the dose doesn't become too high. So don't let the vet give the cat insulin yet.

Norwegian kitty....I own a Maine Coon, non diabetic, so I can only imagine the fun it must be to wrangle something that size that is not particularly fond of being held by the sounds of things. If this is a cat who snuggles at all, I would try to test her in place and see how that works. My kitty was best at first if I just tested her where she was sleeping. If that doesn't work, try the burrito wrap. With a cat of that size and power, you're gonna need a large sheet folded in half or a big beach towel. You just throw the towel over the cat, tuck one end under and start wrapping tightly, making sure no paws make it out the neck hole. It'll take two people probably.

There are other ways of testing, but they are not ideal because a urine sample is at best going to show the average of BG levels over the last couple of hours, it won't give you a solid number at any point.

Come on over to the PZI forum under the Insulin Support Group sub-board when you get some time.

Cathy

 

[troublelaurak]

Hi there - you have indeed gotten a lot of good advice. You can monitor glucose in the urine - either by putting an indicator in the litter box or by using testing strips. This is not the best way to go about it since it just tells you if at some point over the last few hours the glucose levels were high enough to be eliminated in the urine. But, it is at least a way to get a better idea of what is going on. Pricking the ear is more accurate in that you get an immediate snapshot of what the glucose level is at that particular moment.

There have been others on this board over the years who have had cats that, like yours, would not be easily approached for testing. One way to get around this might be the use of what one member referred to as the "kitty burrito" which involved immobilizing the cat by wrapping her in a blanket. I don't know if that will be a possibility for you.

Something that should give you hope: your vet is aware that there is a window of opportunity to get her pancreas back into the game. This, to me, means that your vet has some good knowledge about feline diabetes. True story- my cat, Trouble, got his pancreas jump started after only 10 days of lantus, home testing, and a diet change, all carefully home monitored. He lived a happy kitty life until cancer claimed him at the ripe old age of 17. I encourage you to keep posting to us - the PZI support group could be very helpful to you as you work to help your kitty.

And yes, please breathe - it will get better with time. We are here to support you and provide information to help you. I'm not here so much anymore, but I know the regular posters here are a great group. Laura

 

[sarahlfiles]

Toonces is doing better this morning. Tough she still cannot walk properly and has peed herself, she is eating and drinking normally. She is in good spirits and very loving today. I am going to try to respond to each of you, but I am new at this message board thing, so if I don't get the abbreviations correct or if this looks like a copy-and-paste nightmare when I am done, please bear with me!!


MJ+Donovan: Thank you for taking the time to post before you headed off to bed.


Jenn & Baxter: Thank you for all this great advice. I will be checking out the PZI board very soon.

We live in a suburb outside of Houston.
Maybe we can help.
First off I want to say take a deep breathe & exhale. Everything is going to be ok. You are going to get so much help. All you have to do is ask.

Thank you!!!!

Diet is extremely important in FD. Just like diet is important in human diabetes. Low carb, high protein diet is the best way. No more dry food. It is high carb & It lacks moisture which is hard in the kidneys.
Canned food is the best. Although, some canned food is still high carb. Please take a look at food chart on the front of the forum. I would post a like, but my iPad doesn't ever do it right. Fancy Feast is a very low carb food. Many members feed fancy feast.

Toonces is current;y eating 50/50 FF/RAW. I failed to mention that in my first post. We are slowing transitioning to the same no carb/raw meat diet that our two dogs have eaten for a long time now.

Home testing. Some of the most difficult cats are able to be home tested. It does take time.

After the advice I received from this post, I am confident we can successfully home test over time!

Here are my questions...
At what BG was Toonces DX?
What area of Htown do you live in?

She was DX (which I assume means diagnosed) at 372. We currently leave in Pasadena, southeast Houston.


Doug N Libby: So kind of you to take this time to help me in the middle of the night! :smile:

Whenever you're ready, I would invite you to join us on the PZI board. We are a much smaller group and you will be able to ask questions there of people who are familiar with your insulin, as all insulins work a little differently. I still post sometimes on HEALTH, too, if it's a general HEALTH question.

I will check these out today.

here is a chart that allows you to compare canned foods, so you can find something you can afford that is lower carb.

I used this chart to determine which were the lowest carb varieties of FF to use in Toon's transition to raw!

You work up to it. Every cat is different, but I've not read of a cat, yet, who didn't get used to it. Start by picking a spot to test. We use a rocker beside our table lamp. Always follow testing (even unsuccessful attempts) with treats. She will start to associate the testing with getting TREATS! (You'll need to purchase some lo carb/no carb treats. We buy freeze-dried turkey and freeze-dried chicken, but there are other options for that, too.) Some have started by clicking the lancet pen (without actually trying to test) so the kitty can get used to the sound. Also, if you use a little vaseline, it'll help the blood bead up, so it's easier to draw up into the strip.

Excellent advice. It seems so simple, I don't know why I didn't think of this myself. After all, this is how I trained my dogs. I suppose I have always seen Toonces as more of a stubborn toddler who will do whatever she wants regardless of my actions. (Guess it a good thing I don't have human kids... they'd run the house!)

It is important to test before giving insulin - once, Hershey was at (31) when it was time to give his shot. I wouldn't have known that if I hadn't been testing. Scary thought that I would've injected insulin into BG that low.

This is precisely what we did to Toonces. I now understand the importance of home testing.

So, take comfort, you are no longer alone! Spend some time reading...I have found great benefit in skimming other threads and asking questions. Ask LOTS of questions! I ask questions almost every day

THANK YOU THANK YOU THANK YOU!




BJM: Wow- what great advice! I know that by using this method, I'll be home testing within a week or so. Thank you so much for your help!!


Sue and Oliver: Thanks for your reply! :smile:


Cathy:

I had a similar experience at first, put on dry w/d and Prozinc by vet and told no home testing, cat hypo'd after the 2nd shot. I got rid of the vet, switched to raw food, dropped the dose of insulin down, and my cat went into remission within 8 weeks of initial diagnosis. It's great to find a supportive vet, but many on here just use the vet for insulin and dignostic tests and use the board for the diabetes.

It's nice to know I'm not the only one going through all of this. This support is wonderful.

I will say whatever diet you're going to use for your kitty, get it going now...

She is transitioned to 50/50 FF Canned/raw, continuing to cut down on the FF as we go. No more carbs!

Norwegian kitty....I own a Maine Coon, non diabetic, so I can only imagine the fun it must be to wrangle something that size that is not particularly fond of being held by the sounds of things. If this is a cat who snuggles at all, I would try to test her in place and see how that works. My kitty was best at first if I just tested her where she was sleeping. If that doesn't work, try the burrito wrap. With a cat of that size and power, you're gonna need a large sheet folded in half or a big beach towel. You just throw the towel over the cat, tuck one end under and start wrapping tightly, making sure no paws make it out the neck hole. It'll take two people probably.

Toonces is quite large, though she is not as large as the breed gets. The sleeping method was a double-failure because not only was she mad, she was startled too which made for extra aggression! I am going to start working up pricking and testing slowly, I think this will work best for her.


Again, I cannot thank you all enough! I will begin today by slowly familiarizing Toonces with a warm rice bag and over-handling her ears. We will work up to teaching her how to use the lancet-pricker thing and get the drop of blood onto the strip. Oh wait, she doesn't have thumbs (one of the many reasons she resents humans.) :lol: ;-)

 

[sarahlfiles]

Hi there - you have indeed gotten a lot of good advice.
We are here to support you and provide information to help you. I'm not here so much anymore, but I know the regular posters here are a great group.

Thank you, Laura! After all this great advice, I am full of hope and promise that Toonces will live to fight many more daya!

 

[nwnews]

HI Sarah, one thing not mentioned on other posts is that some of us free hand the lancet instead of using a pen. I just get the lancet, uncap it, spread Sitka's ear on a index card and poke. That way she isn't startled by the clicking of the pen plus I had a hard time getting the poke in the right spot with the pen. However, she now knows its coming anyway (she's been dx'ed 4 months) and she tries to move her head when my hand is coming down LOL. Fortunately I've never stuck her in the wrong place. Glad your kitty is doing better and you'll feel more confident once you get the home testing going. Jan

 

[BJM]

A dab of Neosporin ointment (not cream) with pain relief on the ear a few minutes before testing helps reduce the annoyance of pricking. It helps the blood bead up. Wipe off before the test. As mentioned above, free hand may work easiest for you. Also, make sure the lancets are 27-28 gauge when starting. the higher the number, the thinner the lancet ... the more difficult it may be to get blood.

Wash your hands before testing so you don't contaminate the results.

If you absolutely can't get blood on the first 2 tries, aim for the vein and be prepared to blot quickly as it can bleed profusely (why we don't usually use it). Save a droplet on your fingernail if Toonces is struggling a lot, as you can test it from there.

 

[Jenn & Baxter]

Sarah....I hope this will give you some comfort....I am not far from you. I live in Pearland. Baxter's vet is located in Pasadena. So I know exactly where you are. PM me your current vet.

I will say that being DX at BG 372 3 units of PZI is way to much. You need to take into consideration that 372 probably has vet stress in that. Stress will rise BG levels. For your vet to advise you to give 3 units I question there experience & knowledge of FD. Baxter was DX at 468 our vet started us out at 1 unit. Over time & with collected BG data we did rise Baxters dose, but it didn't do anything for him.

If Toonces was my cat I wouldnt give any more insulin until I knew how to hometest. You have already had one hypo episode which I am sure was very costly. If anything just test before the shot thats better then not testing at all. Test, feed, shot.

Right now one of the best things you can do is read & read everything about FD. Its going to be your ammo. Knowleadge is the one of the keys to FD.
You are going to make it threw this. Promise!
Jenn & Baxter cat_pet_icon