New Diagnosis - questions

Hi, I won't be too long, but had my 12+ year old cat diagnosed with diabetes today. All the signs where there for a few months now but like what I have read in other messages, it was attributed to him just getting older and it was slow changes in weight, increased thirst, etc... nothing sudden or abrupt. I took him to vet today after he showed signs of some distress on Saturday over weekend, but he improved significantly on Sunday and again this morning with appetite, alertness, etc...

After blood work the vet calls and says he has diabetes and recommended treatment begin immediately to stabilize him. Vet says it may take a week of hospitalization to stabilize, and informed me his (whatever they call it) number was like 500 which he said was way high. I authorized the treatment to begin tonight before I knew more about this and reading the cat info site about the low carb dietary route and now have some questions and would appreciate any guidance that can be given.

Since treatment just started and my cat likely only has had one or perhaps 2 doses of insulin, would it be advisable to stop the insulin treatment and try the low carb diet, and perhaps just have him frequently tested??

How quickly would the cats blood glucose levels come to a normal and safe level once the initial treatment is started? I presume initial treatment is just a low dose of insulin at time of feeding, then test, and repeat over and over until insulin dose size is determined, hence vet telling me it could take several days to stabilize the cat? Would a vet be giving a low carb diet at their facility?

I want to give the cat a chance, but am a realist and know he is older and has had a good life... the cost of hospitalization and then subsequent daily insulin is factor that has to be considered if it's not going to significantly improve the cats quality of life. Moving him to all can food diet would be easy as he has been on that mostly anyhow, but I now know it was higher in carbs, like 25+ based on the charts I looked at...

I have read the advice given on the cat info site, but I didn't see anything about the questions I have...

Any advice would be appreciated.

Thanks!

 

There's no reason to keep him overnight at the hospital unless the cat had ketones present causing ketoacidosis. It can take months, not days to regulate a at. Keeping him there is just going to stress him out. Unless it's dka, get a meter, bring him home and test at home. It's much more accurate that way as stress will raise the bg levels. I have a video in my signature showing how I test my cat CC at home.

Most of us feed fancy feast classic or Friskies pate foods. I mostly feed my diabetic ff and tikicat. Choose foods from the chart in my signature that are under 10 percent carb (under 7 is even better).

 

Nope..wet food is best. Friskies is just fine. He does not need to be in the hospital for a week. Ive never heard anything like that. Get yourself a meter, watch vids on how to test. Before shot am, half way through(nadir) and before shot pm..at the very least. Then you can adjuat dosage accordingly. There is a ton of info on here that will tell you exactly how to do it..but yes it takes a long time, patience and effort to regulate.

 

Thanks for the reply and I equally feel the stay at vet is very stressful for him.

I don't believe he was suffering from ketoacidosis because the vet made a point of saying that we were fortunate that we didn't have to deal with that first. I will be sure to get clarification when I call vet this morning because that needs to be addressed and monitored closely from what I have read.

I guess my next question is, with him having a 500 BG level when he was initially tested upon arrival at vet, what might I expect if he was picked up from vet today after only having perhaps 2 insulin shots at most and immediately put on a low carb wet food diet without any further insulin? I understand having his BG levels tested in near future will be a must and I intend to schedule a follow-up test with vet to do just that, but I suspect he has been dealing with higher BG levels for a couple months now as there was weight loss, increased thirst and urination during that time...

Any additional advice will be appreciated.

 

If it were me, with my cat,I would bring him home, switch to low carb wet food, learn how to test. Over the span of half a week to a week, I'd test, not do insulin, and set up one of our spreadsheets. At that point, you'll have a better indication of actual numbers and you could start insulin then.

The vet most likely isn't feeding him low carb wet, it's very likely high carb dry (diatetic formula, Rx food that isn't worth the bag it came in).

 

Thanks for that reply -

UPDATE - just talked with vet tech that does the testing/treatments and she confirmed my cat did not test positive for having the ketoacidosis and there had only been one insulin injection administered thus far. I requested no more be administered and conveyed my interest in going the low carb diet route exclusively, at least initially, and requested that the vet call me when he can to consult on the testing aspect of things, whether I administer it myself or bring back in for follow-up with vet. They said they would test for BG one more time to get a read on where he was at today and I asked that he be hydrated prior to collecting him to bring him back home.

I am glad I quickly researched this when I did and seen some of the info that's out there about the low carb diet... like many I suspect, I never gave it much thought as the cats have always pretty much been happy go lucky types...

Thanks to all that have replied - I am hoping this low carb diet thing will be the key to getting him back to being as healthy as he has always been...

 

Sounds like a good starting plan. Please consider coming back here for help with dosing if/when you start insulin. Many before you have thought it was time to give up if kitty wasn't doing well only to find that a turn around was possible with a structured testing/dosing regimen.

 

Ditto Kris! Also, please test at home. You shouldn't leave that up to an occasional (expensive!) vet visit. Testing before each shot and occasionally in between is crucial to knowing whether or not the insulin is working properly, and if you're giving too much which can cause hypoglycemia and death.

 

I would also pick up some ketostix from a pharmacy or Walmart and test for ketones if you are not going to give any insulin for several days. It’s just a urine test and you could test each day initially until you start insulin.

 

One of the things I am confused about is many of the replies indicate in some form that insulin is going to be administered or will be needed, as if starting the low carb diet immediately alone won't be enough to turn things around. I am hoping that will not become the case. I am thinking it would be good idea as was suggested to do the urine test because if I am understanding correctly that type of thing can give indication the ketoacidosis may be setting in - again, something I am hoping the diet exclusively will prevent.

What I don't want to get into is driving myself nuts with trying to maintain some optimum BG number by testing multiple times a day and being stressed because of that.

I've seen several posts about their cats being in remission after changing diet, have any of you had success in diet alone changing things for the better without doing insulin?

 

Hi there! So. Like you, I set some pretty high hopes on changing diet and that being enough to manage my kitty's diabetes. I had a diabetic kitty a couple of years ago that passed after a hypo event and, when my current baby was diagnosed, I didn't think I could bring myself to try insulin again. So, we tried diet. We went off of dry food entirely within about two weeks (there was some trial and error and vomiting, but we got there), and for the next two months, I just monitored blood sugar via home testing in the hopes that we might see some significant changes. We did not. Sherlock's BG didn't get any higher, but neither did it drop into normal ranges, either. He's sort of hovered in the 200-300 range, and I could probably owe that to the diet change. Without it, I imagine his numbers would've probably cranked up higher, and maybe we would've had to worry about ketoacidosis.

Sherlock's weight started to drop and the vet I was seeing at the time none-too-gently told me that by not giving him insulin, even with the diet change, I was essentially allowing him to starve to death. Now, I changed vets because harsh. But she wasn't wrong. Sherlock needed insulin, so we've started insulin. Each kitty is different, but I would probably cautiously say that your kitty will need some insulin to be healthy and happy.

On the up side, it's a lot easier to change diet before you get on the insulin routine. Then you don't have to worry so much about what the food switch will do to kitty's BG and if you might accidentally cause problems by changing too many things at once.

 

Yes, that's the case in most instances. Some kitties become diet controlled at the start of a low carb diet but they're the small minority. I understand your reluctance to even think about giving insulin right now. We've all been where you are.

Yes, testing urine ketones is easy and useful. If a low carb diet puts your kitty into normal range numbers that would reduce the risk of ketone development but not to zero. Once a diabetic, always a diabetic so some other health issue involving infection or inflammation or something that causes inappetence or vomiting and/or diarrhea can set the stage for ketone development.

This is exactly what I felt in the early days after my guy's diagnosis. I lurked here on FDMB, saw what people did with the spreadsheet, read a ton of posts and thought no way! - I'd drive myself nuts. I followed my vets lead for 8 months, got nowhere and finally decided to come here and try the "FDMB way". It taught me SO much about my kitty's responses, why my vet's way wasn't working and what I had to do. It was stressful at the start but very quickly became routine.

I suggest you take some time to do more reading here, ask some questions and let it all percolate for a while.

 

Welcome, and it looks as though you're getting lots of good advice here from the folks who know the most. I'm a newbie, and wanted to share that I was the least likely person in the world to do home testing and injections. We're about a month in on insulin, and it gets easier every day. What keeps me going during the challenging times (sometimes Sammy totally revolts at testing time) is knowing that I'm making him feel better each day, one day at a time. Good luck!