What to expect from the vet (first appointment)

[ScyCat]

Hi, we were just told by the vet that my 14 (soon going on 15) year old female 11lbs cat has high blood sugar. The vet made an appointment for Monday to show us how to use the insulin needles and give us info etc. It's very overwhelming and a lot to take in so I'm thankful to find this forum.

Before we see the vet on Monday I really want to know what should we expect from a good vet? What brand of insulin, what their recommendations should be etc? And what to avoid? We are in the UK and are currently going to the Blue Cross.

Also, what is the daily routine for diabetic cats? And how do you give them blood checks etc comfortably? She has arthritis and is already slowing down a lot, we really don't want to push it too far for her to the point her life just becomes uncomfortable, full of fear (of the constant vet appointments and needles) and pain. Her heart is weak too so the stress won't be safe. For that reason I really don't think we would force her to go for any overnight appointments so I'm wondering how crucial they are?

I love her so so so much, I'm currently numb from a breakdown so sorry if none of this make sense. I only want her to be happy/comfortable, no matter what it takes, hopefully money won't be an issue. Thank you in advance.

 

[Sienne and Gabby (GA)]

The beginning of this process is completely overwhelming. I suspect that most of us were in shock; I know I was. We'll try to not add to your feeling overwhelmed by swamping you with information.

There are several basics that we recommend.

• Home testing: Some vets will tell you that your cat will hate you if you home test. I suspect that other members will stop by and tell you that their cats come running to their testing spot and purr the entire time. I was a "testaholic" and Gabby never seemed to be bothered by my testing. Of course, treats were involved which helps enormously! Home testing is also the only way to ensure your cat is safe.
• Insulin: for a very long time, Caninsulin was the insulin vets had to prescribe in the UK. It's not a great insulin for cats -- the name tells you it was developed for dogs and as we all know, cats are not small dogs! Either Lantus (glargine) or Prozinc are the two insulins that are best suited for cats. Other insulin has too short of a duration and doesn't last the needed 12 hours. Prozinc can now be prescribed for newly diagnosed cats in the UK.
• Food: Many vets will suggest prescription food. If you look at the ingredients, there is nothing "prescriptive" in these foods. In fact, many are very high in carbohydrates. Carbohydrates are a diabetic's worst friend. We recommend low carb food (i.e., less than 10% carbs) and most people use canned food that is around 5% carb. Kibble/dry food is typically very high in carbs. It is also low in moisture which is not good for kidney health and low in protein. Cats are obligate carnivores and can't effectively metabolize anything other than protein. (We do recommend that you keep some high carb food on hand if you need to bring blood glucose numbers up.)

This is a link to information on getting started for members in the UK. There's a great deal of information in this link.

My hope is that your vet is a partner in your care for your cat. Some vets will regard the information that you get here as coming from crazy internet cat ladies (and gentlemen). We're really not that! This site has been around for 25 years. We have a stockpile of information and a truly good track record for getting cats well regulated or into remission. Working with your vet should not result in a "my way or the highway" any more than you would accept that attitude from your own doctors.

I'm also tagging one of our experienced UK members. @Elizabeth and Bertie.

Please let us know what questions you have. The members here are very generous with their time and knowledge.

 

[Critter Mom]

Welcome to you and your little one, ScyCat.

What brand of insulin, what their recommendations should be etc? And what to avoid? We are in the UK and are currently going to the Blue Cross.

There are currently two insulins licensed for diabetes treatment in the UK - Prozinc and Caninsulin. Your vet is required to start initial treatment with one of them. Of the two, Prozinc is typically the better one for cats (longer duration of effect), as Sienne advises above.


Mogs
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[Critter Mom]

She has arthritis and is already slowing down a lot,

I'm not sure whether your cat is already on it, but there's a very recently approved new product for arthritis in cats called Solensia (frunevetmab). It's a monoclonal antibody treatment that helps block the pain receptors involved and reduce inflammation. My Lúnasa did well on it. Might be worth asking the vet about it. It's administered by injection once a month.


Mogs
.

 

[Elizabeth and Bertie]

Hi, we were just told by the vet that my 14 (soon going on 15) year old female 11lbs cat has high blood sugar. The vet made an appointment for Monday to show us how to use the insulin needles and give us info etc. It's very overwhelming and a lot to take in so I'm thankful to find this forum.

Hi ScyCat, first of all huge reassuring (((hugs))) to you.
We all understand how it can feel at first to have a cat diagnosed with diabetes. But diabetes is very treatable, and in a short while it's likely that it will just become part of your normal routine.
Please be patient with yourself, because there can seem to be a lot of info to take in initially. But just learn at your own pace. 'Baby steps' are fine. And 'remember to breathe'...

The vet should show you how to give the insulin shots. Please know that giving insulin shots is an easy thing to learn (even for those of us who don't like needles!). But it is a new thing to do and so, quite naturally, may feel a bit strange the first few times we do it. (I actually practised on a orange just so my hands could get the feel for the process). The insulin shots shouldn't hurt your cat. And many people find it easiest to give the shot while the cat is eating, as this serves as a really good distraction.

If your insulin is being prescribed by a Blue Cross vet it is 'likely' that Caninsulin will be prescribed. This usually seems to be the case, and I'm guessing that is because it costs less than the other insulin, Prozinc.
Please don't worry about this! Cats can do just fine on Caninsulin. But if it turns out that Caninsulin isn't working sufficiently well for your cat then you may well be able to switch to an alternative insulin at that point.

Also, what is the daily routine for diabetic cats? And how do you give them blood checks etc comfortably?

At its most basic the daily routine means giving insulin shots approximately every 12 hours.

In addition there are other things that can be done to help to manage the cat's diabetes. The most important of those is the home-testing of blood glucose. We strongly recommend that caregivers learn to do this. It may sound a bit strange at first. But it is really not that hard to learn. Honestly. And, just like the insulin shots, this shouldn't hurt your cat.
'Hometesting' is a very quick process that involves pricking the outer edge of a cat's ear to get a teensy weensy droplet of blood to test. Many of us use ordinary glucose meters made for human diabetics. In the UK at the moment the SD Codefree seems to be the most popular meter. It is also probably the cheapest one to use (the main cost of testing is the test strips). But other human meters are fine too.

Here are some reasons why it is well worth learning to hometest
It will help you to understand your cat's diabetes, and how the insulin is working in her body.
It will mean that your cat shouldn't need to go the vet for blood glucose tests or 'curves' (a series of tests over the course of a day) because these can be done at home.
The tests at home are usually more accurate than those at the vet because of the less stressful environment.
Hometesting helps us to get better control of the cat's blood glucose levels.
It helps protect against hypoglycemia.
It increases the chance of 'remission' (remission is when the diabetes can be controlled by diet alone).

She has arthritis and is already slowing down a lot

Do your cat's back legs seem weak? I'm just wondering if she may also have something called diabetic 'neuropathy'? This is quite common in diabetic cats who are in high blood glucose levels. Is she walking on her hocks, less able to jump, tiring easily...? It may be that she does just have arthritis, but if it looks like she has neuropathy as well then it can really help to give supplements of methyl B12 (details in the 'UK info' link in my signature).

Diet can also make a huge difference to managing diabetes.
@ScyCat, what are you feeding your cat at the moment..?

Eliz

 

[Elizabeth and Bertie]

We are in the UK

I know this is a long shot, but...any chance you live within travelling distance of the RVC in Herts....? They are currently accepting recently diagnosed cats into one of their research trials there...
It would require that you could take your kitty there a number of times. But the upshot is very good veterinary care, plus insulin, food, and other supplies...
Initially they were only taking on overweight/obese cats. But I know of a cat who's just been accepted into the trial despite being normal weight...
More details here:
https://www.rvc.ac.uk/research/rese.../projects/feline-diabetic-diet-research-trial

 

[ScyCat]

Thank you so so much everyone, sorry I'm struggling with replying individually at the moment so I'll just be brief ❤
@Critter Mom thank you soo much this honestly was a massive help, the vet was going to prescribe gabapentin which scared me so much (not only do I personally have very horrific experience with these type of drugs, but the side effects are similar to a hypo and it'd be difficult to differentiate). So I remembered your comment and asked for the Solensia, he said that's fine to do, I just gotta buy it myself but they'll do the injections. So thank you again!

If anyone in the UK has tried Solensia, do you know the best website to buy it from?

@Elizabeth and Bertie
Thank you so much ! So, the vet told us her right back leg is stiff and said there was inflammation, if i remember right (my mum was the one at that appointment), so far no one has suggested neuropathy, and her front paws are also effected so I assume it's just arthritis. But I will look into the methyl B12 thank you!
Her diet is 1 pouch in the morning and grazing on Go Cat (which I now know is high in carbs), the vet told us not to change her diet yet, he said to give her insulin for a month first before changing anything else, I assume it's to prevent a hypo? I personally wish we could have just started with a diet first but he said in her case, insulin is better.

Sadly we're very far from Herts, but thank you for the suggestion!

Also an update from the vet visit last night, her kidneys aren't doing great, we've taken her off her current pain meds as they weren't helping at all, she also has a urine infection (we're going to hand in a urine sample today). I feel sorry for her, I think she's suffering a lot right now and I feel completely helpless.

Also I was wondering if I could get some advice. With the Solensia, I had an idea to wait until her next vet appointment (early January) to give it to her so that way she's not making 2 trips in a short time (she is very stressy and her heart can be an issue), I also thought it would give her enough time to adjust being off the last pain med cos sometimes going straight onto a different one can be overwhelming. Is this a good idea?

Thank you again everyone, so sorry for not replying to everyone or everything but I've read and appreciated it all so so much, honestly I really thought it was over for Tinkabell until I found this site. You're all amazing ❤

 

[Elizabeth and Bertie]

If anyone in the UK has tried Solensia, do you know the best website to buy it from?

It looks like Mogs (@Critter Mom ) has used it for her own kitty. Further up this thread she says "It's a monoclonal antibody treatment that helps block the pain receptors involved and reduce inflammation. My Lúnasa did well on it."

It can be bought online in a couple of places with a prescription from your vet. Currently it's in stock at 'Viovet' and 'VetDispense'.

I just asked another UK lady who is not on FDMB (only on Facebook groups) about this. She uses Solensia for her kitty.
I understand it comes as a two month course (two injections).

Vets are entitled to charge a 'reasonable' fee for prescriptions. The average cost is around £15, give or take a few quid. But maybe your Blue Cross vet will waive this fee...?
...So, the cost for the Solensia could be the vet's prescription charge + the Solensia + postage costs. And the vet may also charge for injecting it..? ...It may be worth asking the vet about prescription costs and the cost of injecting prior to ordering, just so that you know the total cost involved?

With some meds it can work out cheaper if the vet will write the prescription for more than one item (some people buy insulin this way). And if Solensia works well for your kitty maybe that is something the vet would do...?
The lady I asked about this wrote; "I think I got three repeats on the prescription to make it worthwhile. They do say that if you don't see an improvement in the first two months then you're unlikely to so maybe worth them just getting one lot to start with. Probably best for them to chat to the vet about that bit."

Here's the link to Solensia on the Viovet page:
https://www.viovet.co.uk/Solensia-7-mgml-solution-for-injection-for-cats/c88595/

And here it is on the VetDispense page:
https://www.vetdispense.co.uk/solensia-for-cats/2613-solensia-for-cats-1ml-7mg-ml-pack-of-2.html

Eliz

 

[ScyCat]

Time senstive, I really need advice ASAP please

My cat has responded very well to her insulin dose, but my mum is insisting that she still needs to go to the all day vet appointment for all the tests. She says they won't prescribe any more insulin if we don't bring her in for the all day appointment (Blue Cross).
But my cat has a weak heart, is extremely anxious in general, especially when I'm not with her, and already has her other health issues like arthritis that gets worse with stress. I really don't want to put her through that unnecessarily when it could cause more damage.

Is there absolutely any way they can determine how she's doing with just a normal vet appointment and continue prescribing her the same insulin dose?

Thank you in advance. I thought my mum had already called and asked about this but today is the day of the appointment and she just told me she hasn't, so it's urgent to find out before the appointment today

 

[Wendy&Neko]

The thing about taking your cat into the vet for blood tests, is that many cats get stressed out at the vet and that stress increases their blood sugar numbers. That means the vet sees higher numbers and thinks a higher insulin dose is needed, when it might not be. If you can do home testing of blood sugars, you'll get a much more realistic set of numbers on how your cat is doing on the insulin dose. I used to take my numbers into the vet once a week (to start at least) and let them take a look at the spreadsheet, and not the cat.

Later I had a non diabetic cat very stressed at a vet clinic have blood sugar numbers over 11 (over 200) and when I got the blood test results I tested him at home at a nice normal 3.0. When the vet called to discuss possible diabetes treatment, I was able to say "no thanks".