Mimi the cat :)

Hi there!

My name is Bella and my beloved cat Mimi is about 14 and was diagnosed with diabetes at the end of July this year. She hadn't been herself for a while but vets had always put it down to her age, and in April we went for a blood check up and unfortunately the diabetes was in its early stages and her high blood sugar was missed and she ended up being misdiagnosed with early stage kidney failures, as her then symptoms could be interpreted as such. We then changed her diet to treat the supposed kidney failure which I think made the diabetes worse as it is the opposite of the suitable diet for diabetes: rich in carbs. By July she started looking more and more tired and was drinking all the time. She started coughing (she's got asthma too) so we took her to the vet who still missed her diabetes symptoms and thought she had an infections gave her antibiotics. This is when everything got really bad: I live away quite a lot of the time and Mimi stays with my mum, who is older and struggles to give her medication. Because Mimi isn't easily tricked, the only way to give her the medication that worked was to give it to her in a wee dollop of jam and other sweets... After a couple of days Mimi's state got worse and worse until I got back and completely panicked took her to the vet. A different doctor saw her and finally she was diagnosed with diabetes and treated overnight. We slowly changed her diet and started her on prozinc. At first, it seemed to be working really well and we felt really lucky that her first dose was the right dose as after a month on it her blood sugar looked great, between 0.8 and 1.5. However, a month later when we took her for another reading she had gone up, and this went on for a few weeks. We switched to home testing and slowly increased the prozinc dosage (from 1 to 1.5 to 2 to 2.5). She started responding at 2, but not enough so we went up however I was always sure that 2.5 was too much, which it was. For a few weeks she was on 2.25 which seemed great and slowly she started responding too much and her blood sugar was too low.. So we started lowering the insulin 0.25 at a time and testing every 10 days. This seemed to work, and the vet thought she might be lucky enough to not need insulin anymore. However, after lowering from. 1.5 to 1.25 her blood sugar started going mad again, like when we couldn't figure out the right dosage and was showing levels as high as 6 throughout the day. Because her blood sugar has been so extreme with prozinc for 5 months the vet decided to change her to lantus. Today was her first day, she received 1 unit this morning at 7am however her blood sugar was still at 6 and above. The vet recommended to give her another unit at noon and her blood sugar was still at the same level and now she has just received another unit at 7pm. I'm not currently home, I have just been talking to my mum throughout the day and am really worried as I've been reading on this forum that lantus acts differently than proving (even though I still don't understand in what way and trying to read all the information made my head so sore...) so I don't know if giving her that unit at 12 was a good idea? I definitely need your advice and expertise! I struggle to trust this vet, we had a really good one for a while but he injured his knee and is unfortunately still on medical leave...

 

Welcome Bella and Mimi! Lantus should be dosed consistently and at 12 hour intervals. It’s great that you are home testing! If you can set up our Spreadsheet and plug in whatever numbers you have we can help you help Mimi. Here are the instructions, but if you need help setting it up, just ask and someone will do it for you.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
Also come to either the Main health forum, or the Lantus forum and tell us more about Mimi, such as what you’re feeding, any other meds she may be on, etc.

 

Thank you Sharon!! I've just had a wander around the spreadsheet and the instructions and it looks great! I rang my mum and explained to her how Lantus work and to be honest just reading through everything I feel better already. It's such a stress for me because I'm away at the moment and Mimi will be moving with my parents permanently so I want to make sure she is well taken care of . I also got an update and Mimi's blood sugar has lowered after her night-time injection which is great. It's still above what we'd like (she said around 4) but its not 6 anymore so I feel better!! I will be home in a week though and show her how to use the spreadsheet and I will be posting it on the health forum. It's hard right now because I'm away and I'm so worried, especially when the updates are vague like "around 6", etc, but I believe it's all going to get better for my wee Mimi!

When I do post an actual post in the health forum I'll give more details, but she gets fed Royal Canin special diabetic diet three times a day and has just gone off dry food progressively the last few months. She was never a fan to be honest but we always gave it to her for dental care. I know about fancy feasts however my parents live in France and are moving to an island in the Indian Ocean and Fancy feast isn't available there so we have to stick to RC . Mimi is a fusspot though so honestly I'd be surprised she tolerates anything other than RC as it was already difficult to get her to like it... Mimi also takes Semintra as a preventive measure for kidney failure, since the misdiagnosis of last April. She had started taking it as the vet believed she was at risk due to her age and had mistaken the early diabetes symptoms with early kidney failure symptoms but even after we found out about the diabetes, the vet decided to continue giving it to her as she had originally shown a slightly off creatinine which then returned to normal after starting to take Semintra.

 

I’m glad you’re feeling a bit better about things. We can definitely help you, your parents and sweet Mimi. The RC glycobalance food is a bit higher in carbs than we like to feed, but if that’s what she’ll eat and you can get it easy, then I’d stick with it for now. You can always try some other foods once she gets settled in her new home. Hope to see you on Health forum soon!

 

Hi Bella and Mimi welcome!

I have no dosing advice – cannot read any measurements but the US – but your post reminded me of another member of the Board who also lived in an island (Spain, Atlantic) and she had huge problem obtaining diabetes friendly cat food (limited supply channels from the mainland). IMHO, Mimi's current food isn't the best for diabetes. As you know level of carbs in the daily foods is crucial for glucose control so I thought I should mention an easy and healthy way to feed diabetic cat (especially in a situation where commercial good options are not available) – have you ever thought of making your own food? I spent about an hour in the kitchen to make 2 weeks supply which I then freeze in 2-4 Tablespoon portions and use as needed.

I buy the meat from supermarket (not private butcher shops where it’s freshest) which might be risky in terms of bacteria so instead of 100% raw I bake poultry breast or tights (skin and bone in) to kill the surface bacteria. After 15-20 min in the preheated to 200C – 220C oven the meat comes out 50% - 75% baked, then I remove all of the skin (need to lose weight) and discard the bones (Phosphorous and antibiotic containers, no need for those) and grind the meat (I bought my meat grinder on Ebay for $20), add some water and (very IMPORTANT) add this ready premix which contains essential nutrients. Without this premix the home made diet is incomplete and can lead to health complications (for instance no taurine = blind cat).

The link I included for the premix is for the US - but perhaps they ship internationally too? The company is extremely helpful and will spent time over the phone with you to help. We have several EU based members here but I cannot recall all of the names now except @Stephanie & Quintus , maybe Stephanie can point you to the EU equivalent of the US premix which your mom can buy in advance before she moves?

Warning: raw/ semi raw is zero carbs and the glucose levels should be monitored carefully to avoid Hypo – too low levels.

Bonus: (at least for the US) – feeding this way significantly reduces cat food bill. Plus you’ll know exactly what your cat eats.

I hope it does not sound too daunting – it’s really easy if you can obtain the proper premix. The time you spent preparing is minimal. Of course the place your parents are moving to maybe better supplied than the one I mentioned above but “ hope for the best and plan for the worse”, right?

Here is the blog by renowned cat nutritionist Dr. Lisa Pierson – really worth your time reading. She explains in great details how she cooks for her gang of cats and why is it beneficial for them. I use ready premix because it is easy to get in the US, otherwise I’d do exactly as she does. And I add double amount of water per semi raw portion for extra hydration – it’s good for kidneys.

no it was not good idea at all. Lantus works best 12/12 h schedule. Giving another mid cycle shot means that your mom needs to check the glucose more often throughout the day and if BG falls low give some high carbs foods or honey/ maple syrup/ sugar in water directly onto the gums to raise it up. I would also be very vigilant testing BG at night as some cats go lower at night v. day and adding another dose will add to the momentum. It looks that the vet is more familiar with short acting insulin types- and it's not like Lantus works, no wonders you are struggling to trust him.

I hope this will help a little. Post in the Lantus Forum for dosing. Please us posted about how that 2nd shot worked.

Very best wishes for Mimi and your parents relocation!

@BellalovesMimi

 

Quick answer because I'm falling asleep! In France you can order vit'i5 to supplement home-made food https://cuisine-a-crocs.com/en/ (you can even order recipes tailored to your can and its illnesses if necessary -- the nutritionist vet who is behind the site knows her stuff). Which island? Would help to know to get an idea what facilities will be there.
I'm in Switzerland, so not Europe strictly speaking. And I've spent a lot of time in India, meaning I understand what veterinary care can look like (or simply getting cat food) outside Europe and the US

 

Hi! My parents are moving to the Reunion Island, a French island below Mauritius in the Indian Ocean. Thanks for the tips, but I'm not sure how I feel about raw food? I'd heard about it before but I read studies that explained house cats have evolved the same way humans have and they are not meant to be eating raw meat (Because of bacteria, germs, etc, all those things they have not developed the right immune system to fight) and I feel it might be possible for a young cat or a kitten but because Mimi is older she wouldn't be able to adapt?