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Sunni's Mom

Sunni's Mom

Member Since 2016
I am a RN with a ton of experience caring for diabetic humans but having a diabetic cat is new territory for me. My cat's name is Sunni. I adopted him from a shelter in 2010. he is a sweet, docile orange tabby. we're not really sure how old he is but probably around 8 yrs. old. I'm starting him on insulin tomorrow. I'm not at all nervous about giving the injections but very nervous about what his reaction may be to the insulin. I could use some hand holding.
 
Welcome Sunni and Sunnis mom. Since you're a nurse, you know the importance of testing glucose before you give the injection. It's the same with our kitties. We test before shots and try to get at least one or two tests in during the cycle. By doing this you don't need to be so nervous about Sunnis reaction because you will know if he goes too low and be able to steer him back up. It will also tell you how well the insulin is working so you'll know if he needs an increase or decrease in dose. Ask all the questions you need to, we are here to hold your hand whenever you need us!
 
Welcome to the message board, the best place you never wanted to be.

There are 4 things you'll need to manage your kitty's diabetes:
- You - without your commitment, the following won't work.
- Home blood glucose monitoring with an inexpensive human glucometer such as the WalMart Relion Confirm or Target Up and Up (the pet ones will break your budget!). This saves you the cost of going to the vet for curves and done regularly, removes the need for a fructosamine test. All of our insulin guidelines use human glucometer numbers for reference. We have a grid set up for recording test and doses which is automatically color-coded here.
- Low carb over the counter canned or raw diet, such as many Friskies pates. See Cat Info for more info. If already on insulin, you must be home testing before changing the diet. Food changes should be gradual to avoid GI upsets - 20-25% different food each day until switched. Here are 2 low carb, dry, over the counter foods in the US - Evo Cat and Kitten dry found at pet specialty stores and Young Again 0 found online.
- A long-lasting insulin such as ProZinc, Lantus, BCP PZI, or Levemir. No insulin lasts 24 hours in the cat, so giving it every 12 hours is optimal for control.
 
Welcome Sunni and Sunni's Mom! Don't despair! Just approach this like you do your patients and you will be just fine. I am a retired R.N. and I am embarrassed to say my hand shook so bad the first few time I tested/injected my cat, I really thought I wasn't going to be able to handle it. Once I calmed down, so did my sugar baby. Our kitties do not feel the lancet pricks like we humans do in our fingers. There are very few nerve endings in their pinnae. It's really a matter of getting into a routine so you can quickly accomplish the testing because it's the playing with their ears or restraining them they don't like.

Just holler if you have questions/concerns 'cause the folks here have lots of tips and tricks to help and you'll soon realize testing isn't hard at all. :D
 
Sunni's Mom said:
Yes, I do but I have no idea how to do it in a cat. can you clue me in? thanks.
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Sharon14 said:
Here's a link with some great videos and explanations. Check it out and if you have any questions, come over to the health forum and ask. There are more people there to answer your questions.
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
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Great, thanks so much to everyone. Big help. His vet started him on PZI, which I'm not very familiar with. That's the other thing I'll need to learn. I'm very familiar with onset, peak & duration in a human adult but no idea what it would be in a cat. I suspect that it's shorter. I have a glucometer but I need to buy the lancets, etc to make use of it. Thanks again. I will be keeping in very close touch for awhile.
 
There is a great deal to learn about FD at first, but you will get the hang of it as you and your kitty start establishing some routines that work for you. You will have many many questions, as we all did in the beginning. But there are many here who have years of experience and will do whatever they can to help you help your kitty. So now take a deep breath, start thinking of your questions and head on over to the Main Health Forum to get abundant assistance.
 
Sharon14 said:
Glad you will be home testing. Diet is also very important. A low carb wet food is the best. There are many grocery store brands that are as good or better than anything your vet can sell you. Many of us use Fancy Feast Classic, Friskies Pate and Wellness Grain Free. Here's a list of other choices
http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf
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thanks again for the food information. Sunni's vet is big on moist food. unfortunately, Sunni is not. He is a dry food man but he does seem to like FF flaked chicken & tuna & his vet is OK with that. His appetite has been fairly low & he has lost almost 1 lb. Hopefully, as he stables off, his appetite will improve & I will be able to get more moist food into him. I just gave him his first 2 U of insulin so I'm watching him closely. So far, so good. I spoke with his vet's office twice today. She is dead set against home BS monitoring because she thinks that it causes more stress in the cat which raises his BS more so than usual. I was wondering why she didn't say anything about it when I was there on Friday for instruction. But she is one of the few cat experts in this area (Exclusively Cats) & she has been right on so far. So I guess the bottom line is we will see!
 
Jan Radar said:
There is a great deal to learn about FD at first, but you will get the hang of it as you and your kitty start establishing some routines that work for you. You will have many many questions, as we all did in the beginning. But there are many here who have years of experience and will do whatever they can to help you help your kitty. So now take a deep breath, start thinking of your questions and head on over to the Main Health Forum to get abundant assistance.
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Thanks so much. I so appreciate everyone's help.
 
Sunni's Mom said:
thanks again for the food information. Sunni's vet is big on moist food. unfortunately, Sunni is not. He is a dry food man but he does seem to like FF flaked chicken & tuna & his vet is OK with that. His appetite has been fairly low & he has lost almost 1 lb. Hopefully, as he stables off, his appetite will improve & I will be able to get more moist food into him. I just gave him his first 2 U of insulin so I'm watching him closely. So far, so good. I spoke with his vet's office twice today. She is dead set against home BS monitoring because she thinks that it causes more stress in the cat which raises his BS more so than usual. I was wondering why she didn't say anything about it when I was there on Friday for instruction. But she is one of the few cat experts in this area (Exclusively Cats) & she has been right on so far. So I guess the bottom line is we will see!
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My vet told me at first to just do home BG monitoring every two weeks and report the results to him for dosing decisions. I certainly didn't know then what I know now.... I would never give a drop of insulin now without first checking the BG level. I disagree with your vet about the home testing causing more stress for the cat. My cat doesn't mind the testing at all and I'm certain that I've saved his life a few times because I knew exactly what the insulin was doing inside him and was able to intervene. At our house, the humans were the ones who were completely stressed out by the thought of poking the kitty's ear for a drop of blood, let alone actually doing it. :nailbiting::nailbiting: When we calmed down the whole process was a lot simpler and now I can even do it in my sleep or when Radar is mostly asleep. Don't worry. It gets much easier. really.
 
Sunni's Mom said:
She is dead set against home BS monitoring because she thinks that it causes more stress in the cat which raises his BS more so than usual. I was wondering why she didn't say anything about it when I was there on Friday for instruction. But she is one of the few cat experts in this area
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As right as your vet may be with most things, testing at home causing stress is one I would strongly disagree with. Even the most fractious cat is not going to have their BG raise nearly so much at home as it does during a vet visit Your vet made a diagnosis and prescribed what she perceives to be an appropriate dose of insulin based on an stress elevated BG taken at her office. That elevation can be 100 points or more. Not to criticize your vet, but I think her logic is a bit flawed. Would she dose any child with insulin without testing to make sure it was safe to do so? I think not. SO why would she suggest to her pet parents that it will have a negative impact on a cat. To me, a negative impact is having to deal with a cat whose BG has gone too low because insulin was given when it was unsafe to do so or the cat was given too much insulin. Just my humble opinion.
 
My cat runs to me to be tested as soon as I sit in our designated testing chair, and he purrs through the whole thing. I wouldn't call that stressed. I do agree that testing at the vet is stressful for them though. Being a nurse you know that BGs fluctuate throughout the day. If you don't test before you shoot how will you know if Sunni is even high enough to shoot?
 
Sharon14 said:
My cat runs to me to be tested as soon as I sit in our designated testing chair, and he purrs through the whole thing. I wouldn't call that stressed. I do agree that testing at the vet is stressful for them though. Being a nurse you know that BGs fluctuate throughout the day. If you don't test before you shoot how will you know if Sunni is even high enough to shoot?
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My point exactly!
 
I need to think about this a bit. unfortunately, the accuchek I have is outdated & so I can't replace the strips. Wal-Mart has a $15 monitor with free strips so maybe I'll go get it & see how we both do.:nailbiting::cat:
 
Just remember what you do at home is entirely up to you. You hold the needle and are caring for Sunni 24/7.

Many folks here are using one the ReliOn meters from Walmart and quite like them. I would suggest getting either the Confirm or Micro rather than the Prime because of the smaller sample size required but the Prime is also being used by members here and does have cheaper strips.
 
MrWorfMen's Mom said:
Just remember what you do at home is entirely up to you. You hold the needle and are caring for Sunni 24/7.

Many folks here are using one the ReliOn meters from Walmart and quite like them. I would suggest getting either the Confirm or Micro rather than the Prime because of the smaller sample size required but the Prime is also being used by members here and does have cheaper strips.
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OK, thanks.
 
Hi Sunny, and mom ;) Welcome.
Hope you can home test as soon as possible because like other already told you, that is a really important thing to do (as you might know yourself being a nurse)
You will get great help, advise and tips here!
 
Sunni's Mom said:
thanks again for the food information. Sunni's vet is big on moist food. unfortunately, Sunni is not. He is a dry food man but he does seem to like FF flaked chicken & tuna & his vet is OK with that. His appetite has been fairly low & he has lost almost 1 lb. Hopefully, as he stables off, his appetite will improve & I will be able to get more moist food into him. I just gave him his first 2 U of insulin so I'm watching him closely. So far, so good. I spoke with his vet's office twice today. She is dead set against home BS monitoring because she thinks that it causes more stress in the cat which raises his BS more so than usual. I was wondering why she didn't say anything about it when I was there on Friday for instruction. But she is one of the few cat experts in this area (Exclusively Cats) & she has been right on so far. So I guess the bottom line is we will see!
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I would print this document out to share with your vet: https://www.aaha.org/professional/resources/diabetes_management.aspx. They are the American Animal Hospital Association guidelines for diabetic dogs and cats.

Note in the cat section where is says under "Initiating Insulin Therapy" "Precautions and Details":
  • Home monitoring of BG is ideal and strongly encouraged to obtain the most accurate interpretation of glucose relative to clinical signs.34 Most owners are able to learn to do this with a little encouragement, and interpretation of glucose results is much easier for the clinician. See Table 2 for web links to client educational materials.
and

  • In-clinic blood glucose curves (BGCs) are more likely to be affected by stress hyperglycemia than BGCs generated at home. Veterinarians should be cautious of high glucose results and subsequent overzealous increases in dose.
I think she may be misunderstanding how stress hyperglycemia works in cats. Bandit has gone up as much as 300 points before from vet stress at the emergency vet, and they tried to convince me that he needed insulin immediately because his numbers were in the 400s. I had just tested him at home a few days prior so I knew he was still in remission, so I told them I wanted to wait a few days and see what numbers he was giving me at home. The Emergency vet scoffed and called my regular vet to tell her that she was seriously concerned for my cat because I was refusing to treat his diabetes! Sure enough, when we got home his numbers dropped back to normal and he did not need to start insulin again. If I had listened to the emergency vet I could have killed my cat with an insulin overdose. Needless to say, we do not see that vet anymore. Bandit's current vet is an internal medicine specialist at Cornell, and he strongly advocates home testing over office testing for all of their feline diabetics.
 
I also wanted to add, that my Mom was a nurse for almost 40 years (now retired), and she is the only one I really trust to come over take care of Bandit when he's been on insulin and/or other meds when I've had to travel for periods of time. I barely had to show her how to do Bandit's tests and shots, she was really adept at it! With your experience, I think you'll be more than fine once you get over this initial learning curve. :)
 
Julia & Bandit said:
I would print this document out to share with your vet: https://www.aaha.org/professional/resources/diabetes_management.aspx. They are the American Animal Hospital Association guidelines for diabetic dogs and cats.

Note in the cat section where is says under "Initiating Insulin Therapy" "Precautions and Details":
  • Home monitoring of BG is ideal and strongly encouraged to obtain the most accurate interpretation of glucose relative to clinical signs.34 Most owners are able to learn to do this with a little encouragement, and interpretation of glucose results is much easier for the clinician. See Table 2 for web links to client educational materials.
and

  • In-clinic blood glucose curves (BGCs) are more likely to be affected by stress hyperglycemia than BGCs generated at home. Veterinarians should be cautious of high glucose results and subsequent overzealous increases in dose.
I think she may be misunderstanding how stress hyperglycemia works in cats. Bandit has gone up as much as 300 points before from vet stress at the emergency vet, and they tried to convince me that he needed insulin immediately because his numbers were in the 400s. I had just tested him at home a few days prior so I knew he was still in remission, so I told them I wanted to wait a few days and see what numbers he was giving me at home. The Emergency vet scoffed and called my regular vet to tell her that she was seriously concerned for my cat because I was refusing to treat his diabetes! Sure enough, when we got home his numbers dropped back to normal and he did not need to start insulin again. If I had listened to the emergency vet I could have killed my cat with an insulin overdose. Needless to say, we do not see that vet anymore. Bandit's current vet is an internal medicine specialist at Cornell, and he strongly advocates home testing over office testing for all of their feline diabetics.
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OK, thanks.
 
Sunni's Mom said:
OK, thanks.
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I do believe this vet graduated from Cornell. Every time we have needed to put one of my cats down, she makes a contribution to Cornell in that cats name. One thing I do have to be careful with is her strong tendency to become defensive. I don't know why because she's very smart & knowledgeable. I can ask a million questions to understand but if I start challenging/doubting, she becomes defensive. She actually almost kicked me out of her practice once because I objected to a price she was charging. I hate leaving her because she is convenient to home but also because I have a very good relationship now with her & her staff & also because she is so knowledgeable & now has a long track record with Sunni. He is very complicated with multiple conditions, including asthma from heartworm infection, IBS/chronic pancreatitis, hyperthyroidism & now diabetes. She always seems to be right & the office goes out of their way to accommodate us. So far, so good with Sunni. Yesterday was his first day with insulin & not only did he make it through without incident but he actually ate well, better than he has for awhile. However, I'm still taking this all in and completely appreciate all your words of wisdom & am still considering testing him myself. Thanks so much.
 
While you consider home blood glucose testing, see my signature link Secondary Monitoring Tools. These are some less invasive (and less specific) means of monitoring a cat's health.
In particular, checking for urine ketones and glucose, dehydration, and food and water intake and output are the most sensitive to diabetic health.
 
Sunni's Mom said:
I do believe this vet graduated from Cornell. Every time we have needed to put one of my cats down, she makes a contribution to Cornell in that cats name. One thing I do have to be careful with is her strong tendency to become defensive. I don't know why because she's very smart & knowledgeable. I can ask a million questions to understand but if I start challenging/doubting, she becomes defensive. She actually almost kicked me out of her practice once because I objected to a price she was charging. I hate leaving her because she is convenient to home but also because I have a very good relationship now with her & her staff & also because she is so knowledgeable & now has a long track record with Sunni. He is very complicated with multiple conditions, including asthma from heartworm infection, IBS/chronic pancreatitis, hyperthyroidism & now diabetes. She always seems to be right & the office goes out of their way to accommodate us. So far, so good with Sunni. Yesterday was his first day with insulin & not only did he make it through without incident but he actually ate well, better than he has for awhile. However, I'm still taking this all in and completely appreciate all your words of wisdom & am still considering testing him myself. Thanks so much.
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Sunni's Mom - Given that he has all those complications, perhaps your vet is right that the testing may be too stressful to handle...at least right now. Praying Sunni continues to improve!
 
Connie & Max said:
Sunni's Mom - Given that he has all those complications, perhaps your vet is right that the testing may be too stressful to handle...at least right now. Praying Sunni continues to improve!
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While some cats don't like to be tested in the beginning, they all come around and accept it relatively quickly if you give a treat after every test. Cats have fewer nerve endings in their ears than people do in their fingers, so the pokes don't hurt them at all. They just don't like that you're doing something new and strange to them, and usually the owner is stressed out and nervous trying it and they can sense that. If you approach them with the right attitude (less "poor kitty" and more "we're doing this!") and work it into their routine, they're not stressed at all. Bandit fought me tooth and claw the first week of testing (because I was nervous and using the wrong lancets), but now he comes running when he hears the meter beep on, sits patiently in front of me and purrs while I do the poke.

I'm saying this because it's way more stressful for the cat to go to the vet for testing than it is to do it at home, so if avoiding stress is the goal, then home testing is a must.

Sunni's Mom said:
One thing I do have to be careful with is her strong tendency to become defensive. I don't know why because she's very smart & knowledgeable. I can ask a million questions to understand but if I start challenging/doubting, she becomes defensive. She actually almost kicked me out of her practice once because I objected to a price she was charging.
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It's hard when your vet choices are limited, and if you're scared to challenge your vet and you don't want to lose her, you can just do what you want in regards to testing and just not tell her. It's your cat, and you don't need the vet's approval to home test her. However, I would maybe bring her the AAHA guidelines and ask her about them in a non-confrontational way. Tell her that you found them after following Cornell's searching recommendations. It's possible she just doesn't know all the current treatment recommendations--which many vets don't. Your vet really needs to work with you and not make you feel scared or threatened to talk to her, because the health and safety of your cat is more important than her ego.
 
You don't need permission from the vet to home test, I just did it - and they were quite impressed and told me I was in the minority, I have set my spreadsheet to share with them so they have the option of remote monitoring and review of home curves - very helpful when I go to see them. Put it this way - we recommend all our human patients on insulin to test, and with good reason. It is no different for cats and once you get into the routine of doing it, and approach it with a firm attitude then it just becomes part of the overall treatment plan and routine.
 
Thanks to all again. We have an appointment on Monday for BS & Fructosamine follow-up. I'll talk to her to see what her objection may be. One of my thoughts with this little guy is related to the fact that I already do so much to him; he gets insulin in the morning + 3 pills shoved down his throat throughout the day + Methimazole rubbed on his ear every day. He's so good & patient with me but it will just add one more reason to contain & poke him. Like I said, I may just start testing him myself but he has done so well thus far that I wonder if I need to add one more thing. We'll see. I'll let you all know on Monday the results of our discussion.
 
You indicated Sunni is a dry food man but will eat some wet. If your intention is to switch him over to an entirely wet low carb diet, please consider testing at least while you are making the transition because the switch to a wet diet can often lower BG levels substantially. Some cats even go into remission when kibble is removed from their diet so not testing during the transition would increase the possibility of hypoglycemia unless the BG is monitored and the dose of insulin adjusted accordingly.

What insulin are you giving? You've indicated you give him insulin in the morning. Are you dosing only once per day? A cat's metabolism is much faster than humans and while there may be the odd cat that can be regulated on one shot per day, it is definitely very very rare.
 
MrWorfMen's Mom said:
You indicated Sunni is a dry food man but will eat some wet. If your intention is to switch him over to an entirely wet low carb diet, please consider testing at least while you are making the transition because the switch to a wet diet can often lower BG levels substantially. Some cats even go into remission when kibble is removed from their diet so not testing during the transition would increase the possibility of hypoglycemia unless the BG is monitored and the dose of insulin adjusted accordingly.

What insulin are you giving? You've indicated you give him insulin in the morning. Are you dosing only once per day? A cat's metabolism is much faster than humans and while there may be the odd cat that can be regulated on one shot per day, it is definitely very very rare.
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I'm giving PZI, which I'm not personally familiar with but it looks like it's just like NPH in the human world. For now, he gets insulin once a day but I know she's being conservative. We'll see what his numbers are on Monday but she's already warned me that we will probably go to twice a day. I think switching him over to all wet food is just wishful thinking. We've always had trouble keeping weight on him so I tend to give him whichever one he wants just to get him to eat. I'm use to having fat cats. A cat under 12 lbs. is also a new experience for me.
 
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