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Discussion in 'Feline Health - (Welcome & Main Forum)' started by C.W. Gortner, Nov 13, 2016.

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  1. C.W. Gortner

    C.W. Gortner Member

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    Nov 13, 2016
    Hi, I'm new to the board. I have two former feral rescue cats, Mommy and Boy, whom I fed for years in a local park where I used to walk with my late corgi. After several years, I brought them home and they've lived with us for six years now. Recently, Mommy appeared to be losing weight; she was getting that "bony" look some older cats can get. I'm not sure of her age - her son, Boy, who also lives with us is at least 7 so she must be close to 11 or maybe 12. Anyway, they're very sweet, affectionate cats whom we adore and they did adapt extraordinary well to being indoors only. However, as formal ferals, they are very stranger adverse; whenever we travel, we hire an in-home cat sitter, a good trusted friend of mine, who says they eat, poo and pee while we're away, but she rarely actually sees them and she can never touch them. Mommy, especially, is very wary and only comes out of her room at nightfall, though we can always spend time with her in her Princess Suite. Boy is more gregarious. I'm an author who works at home, so he comes down a lot to be with me when I write.

    I decided to take Mommy to my regular vet a week ago, as it had been six years since she'd seen one, their last visit being to the SPCA feral cat vet who gave both cats a cursory check-up before I brought them home - and I was advised not to bring them home, as "they'd never adapt"). Well they did adapt, but getting her to the vet this time was a major ordeal. Took three tries - and two cancelled appointments - before we managed to get her into the carrier. She was, as you can imagine, very freaked out once we got there. So freaked out, she was panting, in danger of hyper-ventilating, so they kept her for a few hours to calm her down before they could sedate her and do her blood-work, check her weight, etc. She's 9 lbs, which the vet felt was okay for her size; she's always been a lean, small cat. All of her tests came back normal, except her blood glucose level, which was 325. There was also glucose in her urine. They told me that cats can get very elevated glucose levels from stress, so they suggested a fructosamine test. That result came in at the cut-off high end of normal: 400. So, they think she might be diabetic, but are unsure and want another urine sample, which I'll try to obtain with the black litter they gave me yesterday. My vet says, if there's glucose in her urine, she's diabetic. Of course, now I'm the one who's freaked out.

    She has no obvious clinical signs of diabetes besides this one borderline fructosamine test result, but she clearly suffers from stress-induced hyperglycemia at the vet. She's always been a nervous cat, with keen survival instincts from years of surviving in a public park. She does pee about 4 to 5 times a day, in the box, which is pretty standard for her. Some days, it's less. Some days, more. Never outside the box. Their diet, as I've discovered since reading up on all this, isn't ideal. They ate Meow Mix and Purina One dry in the park for years , but when we brought them home, we switched them gradually over to Dr Fosters and Smith Dry Adult Cat Food (which has higher carbs than I'd prefer but far less than Meow Mix) and Whiskas Seafood Medley wet food in pouches. They loved this diet and have been on it for 4 years. I recently started introducing them to Hound & Gatos canned - trout and lamb+chicken - to phase out the Whiskas, as it's all fish and not good for them. Live and learn. Some days, the new food is a hit. Other days, they turn their noses up at it. Mommy tends to like it more than Boy, especially if I hand-feed it to her. Finicky cats, but aren't they all? Her water intake isn't exorbitant. Her water dish upstairs holds three measuring cups of water and it's never dry after 24 hours. I'd say she drinks about a cup at most in a 24-hour period. Her appetite is good, not ravenous. She never overeats. As she is a senior, she tends to nap a lot, but that's always been her style. She's more active at night, when she and Boy go downstairs to party while we're asleep.

    Does any of this sound like diabetes? I will do my best to get another urine sample. and of course, do whatever I can to care for her. Being a writer, I'm home so I can do it. My main concern is our travel schedule - we go away twice a year for about 10-14 days - as my cat sitter couldn't give her insulin and boarding her would freak them both out. Not to mention, the expense to board a semi-feral cat who needs insulin and goes into a state of shock at any change in her routine. I think I can do the in-home blood glucose testing if need be, once I get the hang of it, as she's okay with applying Advantage - Boy is not and getting topical flea treatment on him is a test of endurance - but she can't be taken to the vet consistently without sedation, which seems to me a rather cruel situation for her. Likewise, this last vet visit cost me $628. I'll spend what I must, but really? San Francisco has become so expensive, it astounds me.

    Any advice is very appreciated and I apologize for this long post.
     
    Last edited: Nov 13, 2016
  2. Sootyca

    Sootyca Member

    Joined:
    Oct 3, 2016
    Sky didn't have any symptoms of diabetes other than hind leg neuropathy. She wasn't eating excessively or drinking but she was losing weight - not a massive amount and not enough to cause concern as she did need to.

    I'd get the urine retested but if possible is there any way to borrow a blood testing kit to be able to do some bloods at home to get a better idea? They both sound like real characters!
     
  3. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    Good luck getting the urine sample.
    I was just thinking about the large puppy play pen I bought recently to travel with my cats. Maybe if you got her used to having something like this in the house, that you could keep her in one when your pet sitter is there and she could then be accessible for testing and shots. It is very big, 56" in diameter so plenty of room for a food area, bed, litter box, and toys. It has two big doors, and I could practically lay down in sleep in it. Just a thought for the future. I always took my diabetic kitty with me on vacations, but it sounds like Mommy would be happier staying at home.
     
  4. C.W. Gortner

    C.W. Gortner Member

    Joined:
    Nov 13, 2016
    Thanks for the replies. Much appreciated. I will try to get the urine sample tomorrow, and I actually have an Acucheck One BG monitor here, from a friend who's diabetic and gave it to me. It's her old monitor, so I just need to get new batteries for it and then see if I can possibly test Mommy. My friend also gave me test strips and the lancet; the questions is, will Mommy let me do it? She's unpredictable that way. I never quite know what might set her fleeing under the bed. She may tolerate it, if the moment is right, so I can at least try it.

    They're wonderful cats, but yes, quite the characters. And very set in their ways. As for travel, we go abroad so no way we can take her with us. My mom lives in Spain, and I can barely get Mommy to the vet office 2o minutes away! We'll see about the rest. I'm far more concerned at the moment about how to treat her if she is in fact diabetic, and determine the best course of action. We'd need to home-test her BG levels and that's one hurdle we'd have to conquer upfront.
     
    Last edited: Nov 13, 2016
  5. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    Hi and welcome. I've had a few ferals myself so I know how difficult it can be to treat them and make any changes to their routine. Are you still feeding the dry? If so, I would stop that and feed only a low carb wet food. If you must feed dry, Young Again is a good choice. It's only available online. https://www.youngagainpetfood.com/index.html
    I would also try the home testing. That's the best way to know if Mommy is truly diabetic http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/ It will help to desensitize her to the process before you actually attempt the test. Choose a spot to be the testing spot. Take Mommy there several times a day, pet her, rub her ears, give a low carb treat, then let her go. You want her to associate the place and ear rubs with the treats. When you're both comfortable, try the prick. Be sure her ear is warm and always give a treat after. If you have problems with the process, ask. We have lots of suggestions!
     
  6. Callie & Patches

    Callie & Patches Well-Known Member

    Joined:
    Jun 18, 2016
    It could be that just changing to low car food will keep her BG low enough that she won't need insulin. We have seen several food controlled kitties here. It's worth a try.
     
  7. Amy N

    Amy N New Member

    Joined:
    Nov 17, 2016
    I'm new to this board as well. Here is where I stand with my kitty and looking for advice:
    So we finally got my diabetic cat's glucose numbers to be in the low 200s upper 100s after giving 4 units of insulin twice a day. That's all good but her other behavior is not improving at all. She still lays around, can't walk well, pees a lot and has not started going out of the box (not all the time, just occasionally and I clean the box every morning and when I get home from work). My vet has her on Hills Science M/D but after I've been doing a lot of research it appears even that is no good, and I could switch to canned Fancy Feast or Friskies, but if I do switch her to a canned food diet her insulin should change. So, last night I gave her a can of Fancy Feast (she ate it!!! has never before eaten canned food). This morning her glucose was 243. I gave her a can again this morning before leaving for work but didn't give her any insulin. Thought I'd check her number when I get home tonight and see what it is. If it stays in the 200s while feeding her the canned food with no insulin shots, can I stop giving her those? I plan to call the vet today and talk about changing her diet but if what I've read about the diet is accurate, it perturbs me the vet would put her on that food in the first place!
     
  8. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    Amy, it would be better to start a new topic in the Health forum
    http://www.felinediabetes.com/FDMB/forums/feline-health-the-main-forum.28/
    You are on the right track change food to FF if the M?D was dry. Cann M/D is not that bad all all but is expensive and not necessary.
    It was OK to shot no insulin when changing to FF or at least a reduced dose. 4 units may be too high. You did not say when the low 200s upper 100s were recorded with respect to giving insulin?
    What insulin are you using?

     
  9. C.W. Gortner

    C.W. Gortner Member

    Joined:
    Nov 13, 2016
    Hi, I know I've been absent for a while. This isn't an easy post for me to write but I'm hoping for some advice and forgiveness for my ignorance.

    Per my last post, because everyone, my idiot ex-vet included, seemed unsure as to whether our Mommy Cat was diabetic or not, we made the preventive measure of switching her to a low carb wet food exclusively last year (Friskies Classic Pate). She did fine on it, and continued acting normally. She never had the excessive urination or drinking often associated with diabetes, as I kept a close eye on that. Nor was her appetite more increased than usual.

    Last month, however, we went on an extended vacation (two and 1/2 weeks) and employed our usual cat sitter. No issues with the sitter, as my former ferals don't let anyone but us near them, yet once we returned home, we noticed Mommy was looking very frail and underweight - as in, extremely bony around her hips and spine, a marked shift in her. I thought maybe she'd been eating less due to our absence, so I upped her feeding to four times daily, as I'm a novelist and work at home, so that's easy to do. She responded, but still gained no weight. She also gradually became more lethargic, which was hard to quantify at first as she's always been a sedate cat who sleeps a lot during the day. Last week, however, her lethargy turned pronounced and her appetite waned considerably, so I called the vet. I became furious when the vet again requested that I home-test her urine for glucose "to be sure", because really, at this point, based on her initial blood-work numbers and her current state, it's pretty clear to me that she must be diabetic and uncontrolled, at that. I searched for another vet in a panic and found one that only treats cats; we go in today at 3:30 pm. Getting ASAP appointments at vets in San Francisco is a nightmare, they're all booked out weeks in advance. I also enticed her appetite with tuna; she ate this way for a while, off and on, but yesterday only a little and today not at all. She's still joining us in bed at night and comes when we call her, she purrs and wants affection, but she's obviously not feeling well at all. And she's so very thin, even her fur looks depleted.

    In any event, I've been reading this forum diligently, all the stickies and info I can absorb. I know that with some practice and patience, I can home-test her glucose levels and do the insulin shots, as well as any needed curves. My questions are: If she's been an untreated diabetic for nearly two years, as now seems to be the case, is there any hope we can get her stabilized? I don't expect remission at this point, I'm aware that window may well be closed, but I'd like to try to save her and give her a few more years of quality life. She's a senior cat, but not yet in her mid-teens, maybe 12 or 13 at the most. Most likely, she's 11 or 12, based on when I first found / trapped her in the park, had her spayed, and the length of time she's lived at home with us and her son, Boy, which is 7 years now.

    Also, is Lentus the preferred insulin to start? I realize it all depends on the cat and their response, but from all my reading, Lentus appears to be the least "harsh" initiation insulin. She may well require hospitalization today, I'm worried she might have ketatones, and I'm trying to take this one step at a time. I broke down yesterday, crying like a child. I adore my cats, I rescued them, and I should never have heeded my ex-vet's "wait and see" approach. I feel guilty that my ignorance and lack of incentive aggravated her condition, though I also realize other pet owners must face this dilemma. It all felt so overwhelming at first that I seized on the diet change as the one thing I could control. Which was stupid of me, in hindsight.

    I hope we might be able to save her.
     
    Last edited: Dec 2, 2017
    Reason for edit: More info
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  10. Tanya and Ducia

    Tanya and Ducia Well-Known Member

    Joined:
    Feb 25, 2017
    Hi there,
    welcome back (if it is appropriate under the circumstance!).
    Lantus is indeed very good choice for cats - good remission rates were reported by its users. Lantus works best if a dose is given consistently 12 hours apart. The we food diet - Low carbs, low Phosphorous (P) - as could be found in THIS FOOD Chart - is the best option.
    I'll post more in the minute.
     
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  11. Tanya and Ducia

    Tanya and Ducia Well-Known Member

    Joined:
    Feb 25, 2017
    The only way to get a good grip on the insulin needs and to keep Mommy safe from Hypoglycemia is to home test.
    I have no words in my vocabulary (.v novelist's) to convince you that it is very easy on you , a non medic, and it is not painful at all for your cat girl, I just ask you to believe me blindly..
    Let me know if you 'll need a list of home testing supplies ( no need at all for a pet specific glycometer, really).
    There are many details that we may ask you before offering good advise - please do answer them all - we are not pesting you, we need to asses careful where we are at dose- and food-wise, that's all.

    You might need to start urine testing, sorry - but it is no way as hideous as it sounds...
    There are very few on this Board who can claim that they employ good vet, most of them, the vets, to put it mildly, are "clueless"... very sad..
    After I read that you called Mommy "senior" I thought I should introduce you to Squallie @Squalliesmom who is much more senior (although you'd never say it if you get a look at him) or to talk Dickson @Noah & me whose cats lived happily beyond 20 years old?.. I hope they'll pop in...

    Speaking more practically :
    what is the current dose of Lantus?
    what does she eat, the brand and how much/ how often?
    are you willing to test at home (we can help to start)? Please...
    are you willing to maintain the spreadsheet w/ tests results?

    I hope you 'll answer "yes" to all of the above - she has such a strong chance for a long happy years ahead! Looking forward to see/ to hear from you soon!
     
    Last edited: Dec 2, 2017
    Reason for edit: typo
  12. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    @C.W. Gortner My name is Dickson and along with some incredibly bad luck I've had cats for almost 40 years now, some of which have eaten the worst food, no big pet stores back then, fallen out of 3rd floor windows and stayed out all night on a tree farm I used to rent a house on. Without any holistic food or dietary supplements two brothers lived to 17 and 23. And I've had incredible luck with vets like my current one who urges testing at home and for you to do your own research. I use PetMD. Whatever is going on with Mommy she can bounce back. Never assume anything. It's true that ferals are at a disadvantage from the start; poor nutrition, mites and viruses everywhere. Sorry, I've been very sick for 48 hours so I can't soak up all the details. I feel for you having to crate a feral and all that goes with it. Ferals face danger every minute of the day and now we want them to sit still while we poke and prod them.
    Whatever the case if there is no serious organ damage she can come back to you. I'll tag @JeffJ for you who has had extensive experience with both diabetes and taking in ferals. Be realistic but be thankful you don't live here. We're feeding a feral that's beginning to trust me but soon it will be 40 below and every time a new house goes up 3 trees come down.
    Again, sorry for getting off track and not offering much but hope. I have some neurological mumbo jumbo going on and it's getting worse. I do know how you feel, really.
     
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  13. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    I've dealt with 3 ferals. None were diabetic. We tamed 2 of them into lovebugs (it's true, see picture of Little Dude).

    For any diabetic cat, home testing is key to success. Why? If you don't test before a dose, the cat may already have low glucose that day, and the insulin will cause hypoglycemia (please read about hypos).

    Lantus or Levemir are both good 12 hour insulins for cats. I get Levemir off the grey market to save costs. Look in subforum "Supply Closet". I get mine from Alan Hamman - for about 1.5 years now.
     
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  14. C.W. Gortner

    C.W. Gortner Member

    Joined:
    Nov 13, 2016

    Mommy is an ex-feral. She's been an indoor-only cat with us for seven years now, and she's very loving and affectionate, just averse to strangers. The issue with her is that she only trusts us, which isn't unexpected in a former feral who survived for years in a public park before I rescued her.

    The internist called me today, the one who'll be doing her ultrasound and is basically King S#$& at this hospital. All the attending docs who rotated on shifts in the last two days and tended to Mommy were great, very personable and caring, both of Mommy and of my concerns. But it seems that no matter where I end up with vets, I eventually always get Dr-Talks-Down-to-You. Mommy ate on her own today - yeah! - and her BC is now 192, so he's switching her to 12-hour Lantus injection, taking her off the insulin pump. Her renal values are stabilizing. But, when we talked about her care coming home, he said a few things that struck me as odd:

    1) He doesn't think home BG monitoring is "useful" in the first few weeks. According to him, her numbers will be "all over the place" and he's prescribing a low initial 2x daily dose of Lantus. When I countered that her BG might still go too low, and how would I know if I'm not testing her before every shot at the very least, he said it was "highly unlikely hypo would occur during this induction phase." Fine, I replied. If she does go hypo and I end up back at the hospital with her, are YOU going to cover the cost? He didn't like that, so he proceeded to deliver an arid clinical lecture about how home testing can interfere with bonding with the cat, as if I'd scooped Mommy off the street last week. It's also the complete opposite of what people here report about home testing their cat's BG, that, in fact, it can become a mutual bonding experience that cats even look forward to. What he said was that if I approach her twice or thrice daily to "poke her ear" then I'm going to make her mistrustful, even wary of me. What I inferred from this bull, though he didn't actually say as much, is that HE doesn't want me gathering and recording BG values, as if I might fly into a panic if she goes too high, though I know she'll indeed be all over the place to start and one or four high BGs is not the concern, that what I need to focus on is her overall trend to eventually adjust/reach the right dosage and avoid shooting her below the threshold. Naturally, at this stage I'd never adjust her dosage without prior vet consultation and he seemed to infer that I might, or he was trying to head me off at that pass. All I would do if she went borderline low was delay shooting, monitor and re-test in a few hours after feeding to see where she's at.

    2) He also doesn't think I should return to my regular new vet for a while, and let the hospital (him) continue her follow-up for the first few months. Which is fine, no problem. Except that he's an asshole and I need an internist who'll be my partner in this journey, not my daddy.

    I've already ordered a home glucometer and downloaded the FDMB spreadsheet. I'll add her details to my signature as soon as I know her daily insulin dose. She's still in the hospital until this evening.
     
    Last edited: Dec 4, 2017
  15. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Well, all I can say is that this King S#$& internist is full of BS. This is a big ego speaking and it's plain wrong! You'd feel so much better working collaboratively with a vet instead of one who's going to be challenging at every turn. If there's any way you can avoid working with this guy after Mommy's crisis is past I'd go for it. FD is stressful enough without having the added burden of "sneaking" behind the vet's back to do what you need to do to keep her safe and enduring lectures from on high at every vet appointment.

    My two cents ...
     
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  16. C.W. Gortner

    C.W. Gortner Member

    Joined:
    Nov 13, 2016
    Right? I was just flummoxed. Not home test her BG? How the hell am I supposed to know if she's doing well on the prescribed dose or not? It's never one-size-fits-all in FD, as he, Mr King-**** Dr, should know. I simply couldn't believe what I was hearing. He's allegedly one of the best veterinary internists in the city and his practice certainly promulgates it: his hospital (he's the founder) occupies a city block and his prices are commensurate with the Coco Chanel Suite in the Paris Ritz. Screw him. I'm home testing Mommy's BG and he can bite me. I'm not shooting my cat without knowing her daily values. That's insane.
     
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  17. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Hurray for you! You're doing the right thing. :smuggrin:
     
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  18. Tanya and Ducia

    Tanya and Ducia Well-Known Member

    Joined:
    Feb 25, 2017
    He, he, he... Kinda explains the charge rate, does it not? ;) Some one has to pay for that sq. footage after all.:joyful:
    :bighug:
    my very very best wishes to both of you!
    Should I've listened to vets my Ducia would be dead twice over - only this Forum's greatest, the kindest and the very knowledgeable ppl who saved her are the reason she is still with us.
     
  19. Sandi&Maxine&Whispy(GA)

    Sandi&Maxine&Whispy(GA) Well-Known Member

    Joined:
    Oct 2, 2015
    I "scooped" Whispy up from a rescue org where he had been living for years, put him in my car, immediately poked his ear (literally in the parking lot) to test his BG, and then drove 6 hours back to our home.

    That's a fine how-do-you-do, right??? What the heck, new mama?

    Whispy and I bonded as fast, if not faster, than any kitten I've ever adopted.

    I call total BS. What an arrogant jerk.
     
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  20. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    Sounds like you have a good plan for Mommy. As for the Dxxkhead internist, I would drop him like a stone. He is missing the bond between patient and doctor - which is an important bond to retain if he wants to get paid.
     
  21. Noah & me (GA)

    Noah & me (GA) Well-Known Member

    Joined:
    Dec 3, 2016
    King S#$& the internist! That sounds pretty bad.
    Nurses love this. When you're speaking to a doctor and he says "It's 'Doctor' Actually" ask him if that's some kind of Slavic name. Like Pompous Ass? What is it with doctors. When a plumber saves me on Sunday I don't call him Your Highness. Sheesh!
     
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