Starting Insulin Treatments and Holidays or waiting

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Steph M

Steph M

Member Since 2015
With the holidays coming up and traveling to see family originally scheduled, we have hesitation in starting Comet on insulin. This hesitation has caused significant delays in starting treatment.

I wanted to ask the forum what they have done in the past and would like to receive input on:
1. Using a caretaker (cost examples)
2. Traveling recommendation with DM and how to keep stress low for long driving trips
3. Helping extended family understand DM
4. When is best to cancel traveling plans (this is what I think our best option is)
5. Tips for handling day trips
6. Anything you think will help others plan for the upcoming holidays
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If you want to just give general advise, please skip the below. If you have time to read and give specific advise for Comet, details are below. Thank you!!
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Holiday situation for us:
1. When people come to the house, we have to tell people to ignore the cat. Thinking of him as a statue. If they try and pet him he goes after them. This is my husband's cat. It took me 3 years of dating/marriage to be able to touch him without appearing to be a threat. Our friends who have been coming over for 7+ years still get hissed at. A brave and dedicated caregiver would be required to come over. I don't think I can find the right one in time. *This makes me want to give up our holiday plans*

2. Extended family lives 5 and 8 hours away. Comet in the past has howled all 8 hours of the drive.
To me, it seems like he is stressed. I am concerned that this stress will through off his BG and the efforts of being on insulin for a month will be time wasted...am I wrong? Is there a Rx I should ask the vet to give us to take the edge off the traveling or an over the counter option? Is there too big of a risk to give a sedative?

3. What does stress do to DM cats? To my extended family, their animals come first and the cat is not a priority. The cat is a prima donna. How can I educate people I love that if we are to come spend time with them they have to adapt?
Extended family's home has additional stress: indoor dogs (5+) and bad memories. When Comet sees a dog, he puffs up and likes to start the fight. The dog could not careless for Comet, but once he hisses it is like Comet becomes a toy that squeaks and the dogs go crazy. Comet gets more stress. Typically, we keep him in a spare bedroom and every time we open the door he puffs back up.

4. Comet does not tend to do well outside of the house. Based on his past behavior, leaving him at a vet or boarding facility would spike his BG higher. I would guess his BG would be more maintained at home without insulin than with insulin at a facility. Is this bad reasoning?

5. We might be able to go somewhere an hour away, spend time with friends and drive back the same day. I believe this gives us a 12 hour window. How has the group handled one day trip?

The easy thing for us to do:
A. Keep our holiday plans and wait until the new year to start insulin. It also seems like there is a big risk if we put off giving insulin.
B. Take Comet with us and know the insulin will not have the same affect as it did at home.
C. Give up our plans and stay home to give Comet the best chance of going into remission sooner.​

Comet's Story:
Symptoms that initiated vet visit in October: excesses peeing and drinking, increase in kibble consumption.
Symptoms today: lethargic and decrease appetite. Not started insulin. Avg BG 300.

We had blood glucose done at a vets office and they read his glucose at 481 late October. We have done home testing that is attached in my signature that shows he has high BG at home to confirm there is issues with insulin. He is on wet food low carb and only eats kibbles once a week when he is refusing to eat.

We have a second vet coming on Monday to the house to get blood to run Fructosamine (get glucose levels for the last 2-3 weeks) and I have requested to test for his IGF-1 levels to confirm he does not have Acromegaly. They have to ship out the blood to run Fructosamine, might as well through in another test that has to shipped. I am very data driven and like baselines.

We are going to ask the vet for Rx on Monday and start Comet on Lantus. Timing is our concern.

My husband and I both work full-time (8am to 5pm), come home for lunch daily, can flex our lunch hour, but do struggle to get back to the house consistently.
 
First, lets check a few things.

Have you changed the food to low carb, over the counter canned food (ex Fancy Feast Classic pates, Friskies pates except mixed grill)? See Cat Info for more details from vet Dr Lisa Pierson. If you haven't started insulin, do this first. It may drop the glucose 100-200 mg/dL, and in at least 1 cat here, 300 mg/dL. If you are feeding prescription food, all of the dry versions are too high in carbohydrate, despite what your vet may say.

How high did he test at the vet? Vet stress may elevate the glucose 100-180 mg/dL.

Did he test positive for ketones? Ketones are a danger signal that diabetic ketoacidosis may be developing. It is a fatal complication of diabetes.
 
28Oct15 Reading at Vet 481. On high carb diet at the time. Very stressed.
29Oct15 Low carb wet diet. No Insulin.
15Nov15 Last reading at home 295. Avg reading on low carb 300.
23Nov15 Earliest to start insulin and be able to monitor Comet to establish BG curve and avoid emergency vet

Has tested negative for ketones.

Wet food: Fancy feast CLASSIC Chicken Feast and FF Classic Turkey and giblets.
 
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Wow. Okay, first of all, it does not sound like Comet is a good candidate for traveling, although there are things you can give to help ease the stress of travel. There are any number of calming agents (chews, snacks, sprays, etc) but never having used them myself for travel, I can't speak to the efficacy of any of them for an 8-hr drive. It also sounds like the extended family's home situation would be another nightmare for Comet, so I think any calm achieved on the trip will be undone at reaching your destination. Frankly, even without diabetes, this sounds like it would be terribly traumatic for Comet. A diabetic cat's BG level will rise if kitty is under stress; even a trip to the vet can raise BG 100 or more points. If Comet was my cat, we would be staying home with him. I think a day trip is, by far, your best bet, but that is only my personal opinion.

Understand that, even if you give up your holiday plans, Comet may not go into remission. Remission is indeed possible, but never guaranteed; every cat is different.

As far as getting back to your house consistently, is your concern here the ability to treat and monitor Comet? Once he is on insulin, he will need to be tested twice a day at a minimum, once before his AM shot and again before his PM shot. This is necessary to ensure the safety of the dosage you are administering and prevent hypoglycemia. It is also recommended, and very helpful, if you can test at another point(s) during the day, at least every few days. Ideally, once he starts insulin, you'd run a curve to try to find his nadir, to determine if he is receiving the correct dose. Insulin is administered every 12 hours.

I hope some of this has been helpful to you!
 
Squalliesmom said:
As far as getting back to your house consistently, is your concern here the ability to treat and monitor Comet? Once he is on insulin, he will need to be tested twice a day at a minimum, once before his AM shot and again before his PM shot. This is necessary to ensure the safety of the dosage you are administering and prevent hypoglycemia. It is also recommended, and very helpful, if you can test at another point(s) during the day, at least every few days. Ideally, once he starts insulin, you'd run a curve to try to find his nadir, to determine if he is receiving the correct dose. Insulin is administered every 12 hours.

I hope some of this has been helpful to you!
Click to expand...

Once we start him on insulin, our normal lives will make treatment easier and we can be consistent. With Thanksgiving and Christmas, his treatment would not be consistent especially if we traveled and he came with us.

When we told family about him having diabetes, they wanted to know the game plan for the holidays. Initial response is not coming to see family and staying home. We haven't seen our families since last Christmas...this would be the first Christmas not seeing them.

The question is do we wait to start treatment after Christmas when things are normal or is that too big of a risk?
 
Steph M said:
Once we start him on insulin, our normal lives will make treatment easier and we can be consistent. With Thanksgiving and Christmas, his treatment would not be consistent especially if we traveled and he came with us.

When we told family about him having diabetes, they wanted to know the game plan for the holidays. Initial response is not coming to see family and staying home. We haven't seen our families since last Christmas...this would be the first Christmas not seeing them.

The question is do we wait to start treatment after Christmas when things are normal or is that too big of a risk?
Click to expand...
If I was in the same situation, I would forgo the holiday trip and go ahead with starting the insulin. In my opinion the trip would be too much stress on both cat and owner!
 
Since Comet's numbers are still above renal threshold, waiting until after the holidays would not be the best option for Comet.
Is it possible, if you took Comet with, that you get a hotel room near your relatives to set him up in and you do not keep him or stay with relatives while you are there?
Otherwise it sounds like you would be better either making a quick trip and skipping a shot, staying home, or only one of you going at a time.
 
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