Uncontrolled Diabetic Kitty

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Nicole and Simba

Member Since 2017
Hi everyone!

On April 25th, 2017, our orange kitty, Simba, pictured was very lethargic. We immediately got him to our vet to figure out what was going on. After 3 days of tests, hospitalization, and worry, we found out that our young 4 year old boy has diabetes. We brought him home and began insulin therapy (vetsulin, 2 units, 1x per day). He perked up and was back to his normal loving self within a week. After that visit, the vet bills totaled ~$1200. On 6/26/2017 we came home from work at 8:30pm EST to find our baby, Simba, behaving very similarly to the scary episode in April, but this time it was accompanied by vomiting and he was so weak he was off balance when he tried to walk. Our standard vet office was closed, so we took him right away to the nearest emergency clinic. He was diagnosed with Diabetic Ketoacidosis. He was hospitalized for 4 days (another $3600) to get him back on his paws. We brought him home and we were told to change his insulin to PZI (glargine is not an affordable option for us) 1 unit 2x per day. We had a follow up with our regular vet yesterday. Simba's urine output increased over the few days preceding the vet follow up for his blood glucose curve, but his appetite was great and behavior normal otherwise. When we picked him up from the vet yesterday, he seemed very tired and drained. The vet said it was likely due to the stress of the vet appointment. We were instructed to increase his insulin to 2 units 2x per day. When feeding time came, I couldn't get him to eat his food (we feed the classic fancy feast per lurking on this forum). As I couldn't get him to eat his food, I had to withhold his insulin. This morning, he also refused to eat. I called the vet and he said he doesn't think he is acidotic because he checked his bloodwork yesterday, but suggested when we get off of work to try to force feed him (which I can't even begin to think of how to do). I am nervous because we've literally drained our meager savings trying to get this under control and I am so scared to think what may happen. I want to get this under control, but how can I when he won't even eat?

**At the emergency vet appointment on 6/26, they did an ultra sound/xray and nothing was discovered. They have no idea what is causing his diabetes.
 

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Hi Nicole!

Are you home testing? If not, would you be willing to learn? This is really the best way to both keep Simba safe and get his BG under control. Vet curves are not as accurate as home testing, and it's very difficult to get a cat regulated if you're not testing daily. Also, home testing is much, much cheaper than vet curves, and it seems that money is a factor in his treatment.

It's really important that cats with DKA (diabetic ketoacidosis) get their blood sugar under control as quickly as possible, and the absolute best way to do that is to make dose adjustments via daily home testing.

PZI is not a bad insulin choice, but if you're not having good results with it over time (once you start home testing you'll have a better picture of how it's working in your cat), Lantus (glargine) is very affordable if you order it from Canada with a script from your vet, and possibly cheaper in the long run than the PZI. A box of 5 pens is about $170, and they'll last you at least a year (sometimes more). That works out to be about $15 a month. Lantus usually gives a bit better control than PZI, but many cats do well on PZI, so it's certainly worth trying that out first. Just something to keep in mind if you do decide if you're not getting good results within a month or so.
 
I agree with Julia... The best (really only) way to really get the BG under control is to test at home. we are happy to give you a shopping list and instructions if that's something you are willing to do. It's not as difficult as you think, and once you know what you're doing a test takes all of a minute to do. It's also a lot cheaper then going to the vet for curves, and will keep your cat much safer, esp. since he's prone to DKA.

Getting him to eat, try: warming the food, sprinkling cheese, adding some tuna on top, hand feeding. If all else fails you need to force feed. Not eating and high BG is a recipe for DKA again!!! To force feed water down pate food and syringe a few ml of food every couple of hours into his mouth. It will get messy but really important that he eat to avoid ketones and fatty liver.
 
Hello everyone,

Just tested at home right now and kitty is very lethargic. His blood sugar was 585. I administered the 2 units of the PZI as the vet instructed after force feeding (and forcing some water too). How long after administering the PZI should I retest blood sugar?
 
Hello everyone,

Just tested at home right now and kitty is very lethargic. His blood sugar was 585. I administered the 2 units of the PZI as the vet instructed after force feeding (and forcing some water too). How long after administering the PZI should I retest blood sugar?
I would check at +4 (4 hours past the shot) if your awake then. I think pzi generally his is lowest around +6-7
 
Hello Janet,

This is actually my first time home testing. I just set up the spreadsheet and will recheck him at +4. Thank you so very much. I appreciate all of your help and will keep you all updated. Hoping he starts feeling better soon.
 
At +4, he is at 518. Should I test again at +6 or +8? How do you avoid hurting them while testing? I feel bad pricking the same spot on his ear :( He is still very sick at the moment. Hoping he perks up and maybe will eat on his own tomorrow morning.
 
Should I test again at +6 or +8?

If you happen to be up, it's great to get the data, but there's no reason to get up special...that's still really high

What I would suggest is that you start also testing for ketones....You can get urine ketone testing strips at any pharmacy with diabetic supplies. Here are some Urine Testing Tips too.....anything over "trace" is a medical emergency

How do you avoid hurting them while testing?

They really have few pain receptors in the edges of their ears, but a little Neosporin with pain relief ointment (not cream) can really help them heal up quickly

Where do you live? If it's in the US, you can do what the rest of us are doing to afford the Glargine (Lantus) and buy from Canada. It's 1/3rd the cost compared to the US. If it's helpful, here's the information on buying from Canada

Here's something I wrote up for others that needed help with testing...maybe it'll help you too!

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well.

When you're first starting, it's also important to use a lower gauge lancet, like 25-28 gauge. Most of the "lancet devices" come with 33 gauge lancets and they are just too tiny to start with. The bigger lancets (that are lower numbers) make a bigger "hole". As you poke more and more, the ears will grow new capillaries and will be easier and easier to get blood from...we call it "learning to bleed"

Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!
 
His AMPS was 375 and he was a little more alert this morning. Just force fed/hydrated and administered his insulin this morning. I will get those ketone testing strips today. What do you do if they come back positive?
 
His AMPS was 375 and he was a little more alert this morning. Just force fed/hydrated and administered his insulin this morning. I will get those ketone testing strips today. What do you do if they come back positive?
You want to see a negative result. If you see "trace" call your vet for advice. Anything more than trace is needs a vet's attention ASAP.

Be aware: you have to allow the strip colour to "develop" for a time (usually 15 seconds), view it in really good light and know that negative and trace colours are very close to each other.
 
Nicole,
You can actually poke anywhere between the marginal vein and outer ear. The "sweet spot" is just the place that bleeds easiest until Simba's ears learn to bleed better. :) Applying pressure, so squeezing the poked spot on the ear with your fingers, not nails :smuggrin:, for about 10 seconds or as long as he'll let you can help reduce bruising and promote healing too.
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Hi everyone. My simba passed away on Wednesday :( Thank you all for all of your help. I talked to the vet and they think there was some underlying issue they couldn't figure out. (He's had ultrasounds/x-rays/numerous blood tests, etc, but nothing abnormal showed outside of his blood sugar.) I am heartbroken and my home feels more empty than ever :(
 
So sorry to hear it was Simba's time to leave you Nicole :bighug::bighug::bighug::bighug::bighug:

Fly free sweet Simba and land softly....there are lots of friends at the bridge to welcome you and keep you company until the one you love most comes to be with you forever cat_wings>o
 
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