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angie and dinkus

angie and dinkus

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Hello all. My 12 year old cat, Dinkus, was just diagnosed with diabetes about a month ago. His initial blood sugar was 436 and was drinking and urintating a lot. About a week after finding out we had his teeth cleaned just to make sure he was in good health. From then on we started him on Lantus insulin 3 units 2x a day. We also checked his blood sugar 2x a day. With in 2 days his blood sugars were in the 150's. We did a glucose curve about a week after starting the Lantus and he had gotten so low that it didnt read on the meter. So we have been giving him 1.5 units 2x a day. He now runs from 40-110.

When we found out he had diabetes, we immediately starting researching about the feline disease online. I'm a nurse, so I know about diabetes, but not in cats. We were feeding him HALO dry and Fancy Feast wet food. After looking into it, we stopped the HALO since it has fruit in it. Our vet highly reccommends the prescription Purina DM dry food. After reading all the different websites they all seem to say that you should not feed your cat that brand, nor strictly feed your cat dry food unless you absolutely have to. So we started to feed him Wellness Core, grain free and Fancy Feast Classic. He doesnt get much of the dry food, but just a little to give his wet food texture, since thats what hes use to. He seems to chow it all down just fine.

I received a voicemail from my vet today saying that they still highly reccommend the prescription food ($31.00 per bag) and that they also have DM wet food that costs $1.69 per can. "the DM wet food is about the same price as the Fancy Feast youre buying". Hmmm Fancy Feast is 54 cents per can, not that its a major deal, but just stating a point. She went on to say that I should bring him in so we can change him to a different insulin since he will most likely never go into remission with the poor diet we are feeding him. At this point I am just speechless...... Oh and this is the 3rd voicemail reguarding this

What do you diabetic kitty parents think?

Sincerely, Thinkingaboutchangingvets
 
hi there and welcome to fdmb

first, i want to start with letting you know that my old vet (old being that she got out of practice, not that i didn't like her 'cause i did :-) ) holds the patent on the wet version of dm. she herself has been known to say many times over the years that the quality of the ingredients the company has chosen to put in that food is not the best and if it comes down to finances, that there were plenty of other brands, including fancy feast by the way, that was as good or better than the dm. she even sold fancy feast in her clinic when she owned it and the vet that bought the clinic still does, along with wellness and a couple other brands.

second, the idea of changing insulins based on the type of food fed seems preposterous to me. especially given the numbers you are getting. those are awesome numbers. and what one would they switch you to? lantus is the preferred insulin for cats as a matter of fact, for a few years now, so at this point in time, i don't know why changing should be discussed even.

third, are you hometesting kitty's glucose at home? if not, i highly recommend it. it's not that hard once you work out a routine and you just use the same glucose meter humans use. if you're not doing it already and want to, speak up and we'll show you how :-)

fourth, given that those numbers you are getting are awesome normal numbers, you may even want to talk to peeps in the lantus forum here and see if they think you should see if kitty is in remission or near remission already.

hope that helps. :-)
 
Hi,
I think you should set up your phone to block all incoming calls from the vet... :smile:

He's wrong about the food. The numbers you are getting for BG are non-diabetic normal BG range numbers. And the insulin you are using is very good (obviously from the numbers you just told us about).
What exactly does your vet want? You've been treating kitty for a month and he's got those sort of numbers?

You are home testing.... do you ever check his BG in betwen shots? With Lantus, the most important number is when he's at the lowest point in his cycle (or should be), at nadir. If you are dosing 12 hours apart, it should be around six hours after his shot. If those numbers are also in the "normal" BG range, then that's perfect, and remission is a pretty good possibility.

I guess I just don't understand what the vet expects? There are dozens of people that post here daily who would be thrilled to trade places with you. :-D
Given his numbers, the diet you are giving him is working really well. My cat Bob went into remission eating only fancy feast classics. Lots of people feed that brand here. It would be best to eliminate the dry, if possible. If you were to do so, you might see his insulin requirements go down. Plus, dry food just isn't the best thing for any cat to eat. Here's a link, if you haven't already seen it, that is full of information about why dry food is bad, and lots of tips on how to eliminate dry food completely.
http://catinfo.org/?link=felinediabetes

I am sure lots of Lantus users will drop in shortly to give you some help (I used PZI, so can't help much with lantus advice.)

Welcome to the board!
Carl in SC
 
Well I'm a proud owner of two Sugarcats (diabetics) and my Maxwell who I adopted as a diabetic was 485 when he was diagnoised...he was started on 1u of Lantus b.i.d. and had his diet changed from dry food to Friskies pate because I also had at the time 11 other non-diabetic cats and not a single one of them would touch the prescription stuff, but loved their Friskies wet...2 weeks later after the diet change Maxwell was completely off insulin and has remained diet controlled now for over a year and shows no signs of heading back on insulin.

He is an absolutely stunning boy now, he went from the 10.5lbs that he was when I adopted him to a lean muscular 17lbs (he's a big guy, likely a Maine Coon Mix) in fact he is doing so well that my vet now calls me to help with their diabetic patiences and have requested the food lists that we use here to pick our cat food for our diabetics so they can hand it out not only to their new diabetics but to ALL their new cat owners.

Ask your vet this one....What makes their prescription food so special? If you look at the ingredient list it is no better than the cheapest wet food out there, there is far better stuff on the commercial market ingredients wise than the prescriptions stuff. And after field testing it here with my small furry herd and having every last one of them turn their noses up at it...How good can it be for a cat if they won't touch it?

And as far as dry being better for their teeth...not so, Maxwell and Musette who were both fed dry all their lives have lousy teeth in fact tomorrow they go in for pre-dental exams so we can get their teeth cleaned and the bad ones pulled. However, I have a guy here that will celebrate his 17th birthday that since his last dental when I adopted him seven years ago and has always been spoiled rotten on a canned diet still has beautiful teeth and needs nothing done to them. I simply give them a few raw chicken wings and gizzards a couple times a month to gnaw on and they all have lovely teeth. Dry food for dental health is about the same as us humans eating cookies and potato chips for our dental health.

Personally I would be vet shopping.

Mel, Maxwell, Musette & The Fur Gang
 
Welcome to FDMB. You will get LOTS of great info here, from people who are living the sugar dance every day!

Here's something to think about: Many vet school nutrition seminars are sponsored by pet food companies...so guess what they learn! That's right, that they need to prescribe special diets (which the sponsoring company just happens to produce, of course) for many conditions that don't require them if they do the research!

In a nutshell: cats are obligate carnivores. Because of this, they don't drink much water, because when they eat exclusively prey they kill,they get enough water. Dry cat foods can lead to all kinds of problems, not just diabetes. Most of us don't feed any dry at all, not even a few nuggets. That's sort of like a human diabetic having just a few M&M's- it's going to affect the numbers, even just a few pieces. So if I were in your shoes (and I was; we all were! That's why this board is awesome!) I would lose the dry altogether. But if you do, make sure you are monitoring the numbers closely at home. You can use a human meter, and home testing is VERY important, probably the single best thing you can do for your cat!

This is a great resource on feline nutrition: http://catinfo.org/?link=felinediabetes The link is to the diabetes section, but the rest is worth reading, and sharing with your vet.

Here's a link to a couple of the charts many of us use when choosing cat foods: http://binkyspage.tripod.com/canfood.html It lists the dry weight (as fed) percent of calories from carbs in many foods. Purina DM dry is 13% carbs...nearly double the highest recommended amount. The DM wet is 7%; not bad, but you can find lower carb foods for less...like the FF pates!

Many of us use Lantus (many others use Prozinc or Levemir) and Lantus has a very high remission rate if you follow the tight regulation protocol. However, that requires home testing. Even if you are using a more relaxed protocol, testing is very important at shot time. 2 units is a pretty high starting dose for Lantus, most cats start at .5 or 1U. Too much insulin can contribute to high BG numbers as well as too little!

So, my recommendation would be to buy a meter (many of us use the Relion from Walmart as it has the cheapest strips) and to ditch all dry food. But don't ditch the dry until you are testing consistently, or you could have a hypo that isn't caught before symptoms show.
 
Everyone has given such great advice on the food, so I don't even need to post really, but your situation irks me.

Here's my take - the vet is giving you a sales pitch. I can't really blame them 'cause like everyone else they are probably hurting in this economy. I understand they need to make money too, but it seems a little over the top to call you 3 times and even try bribing you with "You need to switch insulins if you won't switch foods 'cause he'll never go in to remission on that food." He has the best chance on Lantus, so don't buy in to that argument, please.

I don't know if you've set up a spreadsheet yet or not, but an awesome way to handle this situation might be to make a chart of the BG numbers you get at home for the next couple weeks, then take it to the vet. I suspect your kitty has a good chance of going in to remission, not despite of the food, but because of it! We frequently see new members come here, switch their cats diet and even after a few weeks on insulin, they have normal blood glucose again.

This could very easily become a case of the client teaching the vet. Just be patient and understanding, but in the end you can't be required to feed the food they are pushing at you, especially if you see the food you are feeding making a difference for Dinkus. Love the name, BTW!

And kudos to you for doing your homework about the food first!
 
HOLY BUCKETS!!! I didnt expect so many responses :) Especially this soon. Thank you all for the information! Im glad im not completely crazy.... I do have 3 cats and 2 foster, so maybe im a little "cat" crazy. Anyways to answer some questions:

We check his blood sugar with a glucometer every morning before giving the Lantus and every evening before giving his Lantus. We also make sure he eats first. We have kept a log of all of his sugars, so I will look to see if there is a way I can make a spreadsheet on my computer. I have randomly checked his sugars inbetween meals and are usually around 50-ish. I give him 3 pieces of freeze dried chicken, forget the name brand, but its 100% chicken. I had planned on doing a curve (which we do ourselves) this Saturday, since we can keep him our main focus.

(When we did our first curve he was still on the 3 units and it was only about a week or less into the insulin. Thats when he read "lo" on the glucometer and had a few "20"s readings. The vet still wanted me to give 3 units. I didnt feel that was right, so I went to 1.5 and then they eventually agree'd).

What would you consider "normal" remission readings for a cat to be off insulin?
 
We're a little "cat crazy" around here too it seems! :lol: But really this is one of the best message boards online for helping people and their kitties.

We have templates for doing spreadsheets on Google documents in the tech support section:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=50130

Click on a few spreadsheet links people put in their signatures to see some customizations. I didn't like the bold and limited colors for BG ranges, so I did them manually. But it's helpful for everyone if there's a basic standard, so when other members look at your SS, they can see at a glance how the kitty's doing. We have found that the spreadsheet format makes patterns easier to pick out.
 
I can answer that one really easily...normal for a non-diabetic cat is between 40-120 on a human meter and between 70- 150 on a pet only meter.

My Maxwell has been in remission for over a year now and he normally tests in the 50-70ish range, you can take a look at his spreadsheet there is a link in my signature at the bottom of my post.

Mel, Maxwell, Musette & The Fur Gang
 
angdue414 said:
Thats when he read "lo" on the glucometer and had a few "20"s readings. The vet still wanted me to give 3 units.
Click to expand...

This seems absolutely crazy. Just totally wacko. Those readings are dangerous hypo land and you vet wanted you to stay at the same dose? I would have loved to hear the vets rationalization for this, it just seems wacko to me. So glad you were testing and that you reduced the dose. I also don't understand why your vet would suggest changing insulin based on you not wanting the prescription food. That's downright confusing.

Here's a great paper on lantus with a dosing protocol (pdf is available through link):

http://jfm.sagepub.com/content/11/8/668.abstract

The protocol in the above article is a pretty aggressive one, similar to the tight regulation protocol you'll find in the lantus forum here, and they both call for reductions in the dose when you get readings below 50 for newly diagnosed cats. Since you've said he's running from 40-110 now with random tests during the cycles, you're probably overdue for another decrease in the dose right now. Your upcoming curve will say more but with random check ins in the 40's he might still be dropping frighteningly low and I'd be inclined to very strongly consider a lower dose.
 
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