UPDATE: Looking to air concerns and receive advice!

Hi everyone,

As I had mentioned in my intro I am expecting my 13 year old cat (Mowgli), recently diagnosed with diabetes to join me and my 7 year old cat (Nyx) in our house so that I can take over the care of him. I had also aired some concerns about my new situation in the intro section that MrWorfMen's Mom suggested that I post here for a more thorough round of advice from the community.

My main concerns are listed below:

1. Introducing Mowgli to my 7 year old female, anti-social, and anxious cat Nyx. Nyx is overly nervous of new situations and has never lived with another animal, when exposed to other animals in the past she has completely flipped, and remained stressed for a few days after.
   • Any advice on introducing a new cat into poor Nyxie's territory?
2. I know that wet food is best but Mowgli really hates wet food. I am willing to try and switch him over to wet food but my job keeps me away from the house 10hrs/day which will make it tough to stick to, and the vet has assured me that the dry food they prescribed for him is effective (PVD Feline DM)
   • If I do start feeding Mowgli wet food successfully, I'm a little nervous about adjusting the insulin even with the spreadsheet that is provided, especially since it seems that the BG can drop so suddenly with a change in diet.
   • Do you think I should continue on with the diet that the vet has recommended until he stabilizes?
3. My vet has set Mowgli up on 5 units of Caninsulin 2x/day... this seems high, although his initial BG test at the vet was 28.7mmol/L. The vet has said that he is responding very favorably to this dosage.
4. Kind of nervous about injecting insulin into anything let alone a cat I care about.
5. Wondering how people plan for vacations with a diabetic cat... who do you trust to take care of your cat when you're away?

I'm a little nervous but I am maintaining a positive attitude that I can get Mowg on the path towards remission... with a little help

 

Welcome!

1) Introducing cats can be a slow process, especially ones that haven't had to deal with other kitties in a long time. Keeping them separated at first and slowly introducing them in supervised situations helps. Swap out some towels or blankets each uses so the other can get used to the smell. Don't try to rush the process, but cats can learn to get along, even ones that have been alone for most of their lives.

2) Wet food is a lot better than dry food, even prescription dry food and will do a lot to help regulate Mowgli. There's some good advice here https://catinfo.org/docs/TipsForTransitioning1-14-11.pdf about stubborn cats learning to eat wet food. You can keep on dry food for a little bit, but the sooner you can make the transition the better.

3) I'll let people who know more about Caninsulin speak to the dosage directly, but that does seem quite high and you might want to start lower. I'd wait for their advice though. The initial BG test at the vet could have been artificially high because stress at the vet can increase BG, so it's important to home test and see where Mowgli is both at shot time and throughout the day. If you can't test in the middle of the day because of your 10 hour days, you can try to wake up briefly in the middle of the night for night tests and get more day tests on your days off.

4) Injecting with insulin seems scary at first, but it's really quite easy! The needles are very thin and you're not injecting into muscle but rather into the space between the skin and muscle so the cats barely feel it. Many cats will eventually not even look up as you give the little poke.

5) You can ask at your vet if any of the technicians or anyone they know does pet sitting that can do insulin shots. They may have some recommendations. You can also try to train family members or friends, since it's not too hard to do once you get used to it.

If you set up a signature, then once you get settled in, people can help you with dosing advice. You can find more information about the spreadsheet here: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/ and setting up your signature here: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

 

Hi and welcome.
5 units is a lot of insulin to start with. I am unfamiliar with caninsulin so I will tag some people who can help with it.
@Elizabeth and Bertie @Kris & Teasel @MrWorfMen's Mom
Good luck with it all.

 

Hi again!

As far as introductions between Nyx and Mowgli, there are lots of ideas available on the web and I know there are folks around here that have introduced new adult kitties to one another who may have some helpful suggestions. I'm out of practice on this one but I am a fan of Jackson Galaxy's methods so you could try these helpful tips out for starters.
https://www.jacksongalaxy.com/blog/cat-introductions-part-1-before-the-introduction/
https://www.jacksongalaxy.com/blog/cat-introductions-part-2

Diet seems to often be one of the toughest parts of this journey. My girl was a diehard kibble addict too and it took me forever to get her to switch but eventually she did. You never know......you might find something Mowgli really takes to and be surprised. In the meantime, the DM dry so called prescription diet is FAR too high in carbs for Mowgli and the ingredients are not great. There are a few lower carb high protein kibbles available here (not as low as we'd like but better than DM) that you could switch to. They include Nature's Variety Ultimate Protein, Instinct Original Chicken and Petcurean Go Fit and Trim. These are all around 14 or 15% carbs (Ultimate may be 12%).
Any food changes is going to have to be done slowly to prevent GI upset and keep kitty safe but with monitoring there should be no problem.
Wet food can be left out during the day. Many folks use automatic pet feeders to dole out food while they are at work etc. I freeze some cat food in ice cube trays and leave it out to thaw over time so my crew can nibble as they see fit.
5 units of Caninsulin is an extraordinarily high dose for a cat diagnosed 2 weeks ago. As mentioned before vet stress elevates BG and often leads to this overdosing problem. We see this happen time and again which is why we are advocates of home testing. A dose of 1u would be a good place to start and I would strongly suggest you reduce Mowgli's dose ASAP. There is some reading material HERE that explains more about the Caninsulin and how to use it.

Many of us give our kitties their shots while they have their heads buried in a food bowl and they couldn't care less. With Caninsulin, it's important to make sure kitty has sufficient food on board and wait 20 to 30 minutes before giving insulin so you might want to hold back a tsp or 2 of food to offer when the shot is being given.

I had a friend who offered to learn how to test and give insulin. I also have a vet tech at my vet who is available and there are pet sitters who will look after diabetic cats. Assuming you already have a pet sitter, probably worth asking them if they would be willing to learn how to care for Mowgli since Nyx would already be used to that individual. If you do get your current sitter or a friend wanting to learn, start well in advance of any planned trips so everyone, kitties included, are Ok with the process.

This all seems complicated and overwhelming but just take it one step at a time. It would be a good idea to make sure you have the meter when Mowgli arrives. Most of us use human glucometers here (pet meter is NOT needed and horribly expensive to use). There are usually some meters you can get for free if you buy the strips. You will need a meter that takes the tiniest sample of blood (nothing over 0.5 microliters). The second consideration is the cost of the test strips. There are a number of us using the Freestyle Lite meter and I believe there is a coupon for a free meter available for it now. Just don't say the meter is for a cat.

 

Thanks for the speedy replies! I’m setting up my basement now for Mowgli so I don’t put Nyx into shock. I will take your guys’ advice and use the slow and steady method.

I’m actually a huge Jackson Galaxy Fan, and I can’t believe that I didn’t know he posted to a blog! Who knew!? You’re right, he gives a lot of valuable information.

I picked up a blood glucose monitor at Shoppers today. I did end up choosing the Freestyle Lite because it seemed to have been the cheapest option and I ended up getting the monitor for free since I bought 100 strips (awesome)... no one even asked who the supplies were for... maybe I look diabetic these days

I thought that 5 units 2x a day seemed high but I don’t really have the confidence or expertise to press Mowglis vet on it... especially since I live across the country. I have been boarding Mowgli at the vet until he can fly out with my sister since my parents aren’t able to provide diabetic care for him so I just figured he may have gotten over his stress by now, by all accounts there he’s doing very well. He won’t be arriving to my house until Wednesday so I will get to work right when he gets here.

I feed Nyx “GO chicken turkey and duck” dry food. Do you guys think I should use this food for Mowgli instead of PVD Feline DM to slowly switch him to wet? I will attach the nutritional info to this thread. I had asked the vet technician and she was wary of this idea... I think because Mowg’s insulin dosage would be so linked to the food he’s eating.

Thanks for providing some expert feedback on Caninsulin as well. I spent some time reviewing the forum for that product today as well. I’m sure once Mowgli arrives that everything will settle in with a little experience and I will hit my stride.

Thanks again!!

 

Hi Amanda, just adding briefly to what others have said - 5u Caninsulin is a very high starting dose and I'm a little wary of the vet's reports saying it's all going well. I understand you saying that you don't have the confidence (yet!) to press the vet about dosage, but if you communicate with them in a way that makes you seem a responsible owner, they may tell you more... ask how they settled on that starting dose (weight? Fructosamine result?) and if they are running regular curves to see exactly how the dose is working. If they have curve data, ask for details. Don't let the vet intimidate you - just say that you've been doing a lot of research and that you understood that starting doses of insulin are usually lower. Remember, the bottom line is that Mowgli is your cat and you have every right to ask for confirmation that he is being correctly treated.

Good luck and let us know how it all goes.

 

I agree with everything Diana has said.

 

Agree with Diana as well. Adding my anecdotal story. My cat had a starting number of 571 which I think converts to 31.72 mmol/L. He is also 13 years old. His starting weight was 14 lbs (which was a little underweight for his frame). My vet prescribed 3 units of Vetsulin/catsulin twice a day. That was too much! They did not take into account his diet change would also lower his numbers. I changed his dose at home to 1 unit and he responded well to it. 1 unit is the recommended starting dose. You can increase or decrease after you see how his numbers react with home testing. I have slowly lowered his dose as his numbers continued to improve. He gets between .25/.125 unit. Some days he is too low to even give a dose. If you give too much they will drop low and fast, their bodies will freak out and dump glucose into their blood to prevent hypo and then their numbers go sky high (bouncing). I brought him in a few weeks later armed with the numbers I got at home and they didn't push back at all.

 

@BBelshan Thanks for the anecdotal story, it definitely makes me more comfortable to hear that you had a very similar situation with Beast... insanely similar actually. Mowgli is having his final glucose curve done today before he flies out to join our family. Hopefully they will have lowered his dosage but if not I will take your advice and change his dose to one unit of Caninsulin 2x/ day and begin the spreadsheet so that everyone can help me get this straightened out.

Does anyone have advice on flying with feline diabetic supplies in their carry-on? Should we get a note from the vet?

I was wondering what do people do with their lancets and discarded testing supplies? do you keep bio-hazard sharps containers? if so... where do you get them?

#questionsfordays

 

Oh forgot to mention, if you do need to increase, you should increase by .25 units at a time not whole units. I find the plunger of the syringe is about .25u thickness. That helps me eyeball the dosage. As for discarding, hopefully someone from Canada can help. In the US, it varies by state. My state only requires that you put them in a sealed plastic container and it can go with the regular garbage. Some states require you put them in a sharps container and bring them to facilities that handle medical waste. You can usually buy the containers from the same company you buy the syringes. Not sure if they deliver to Canada, but I got my syringes at https://www.adwdiabetes.com/ for pretty cheap.

 

I take it Mowgli will be flying in the cabin with your sister. If the Caninsulin has a prescription label on it with Mowgli's name that's likely all you need but it certainly wouldn't hurt to have a note from the vet. Better to be over prepared. A quick call to the airlines would be able to confirm their requirements both for taking Mowgli on the plane and for clearing security with the medicinal supplies. They can differ between airlines.

As for discarding lancets and syringes, looks like it depends on the municipality. Attached is a document I found from Alberta Health Services. If you need as sharps container, they should be available at your local pharmacy. Usually, at least here in Ontario, you buy one and when you turn it in when full, they replace it at no cost.

Going forward @BBelshan is correct that changing doses by 0.25u being ideal and for that you need either U40 syringes with half unit markings or U100 syringes with half unit markings (even finer dosing options) that can be used with a conversion chart. HERE is a link to U40 syringes with half unit markings available at a pet pharmacy here in Ontario. The U100 syringes are available OTC at any pharmacy. ADW does not ship to Canada unfortunately.

 

Love your avatar!

 

Thank's @MrWorfMen's Mom,

Mowgli is in the cabin, I called the vet today and they are preparing documentation that says he can fly and that he needs his diabetic supplies. They sent along some of his results so I will be updating his sheet with the information that they provided... without passing on too much judgement to them... I think I can see that there isn't a lot of consistency in their data collection. I think I will be more consistent and hopefully be able to rely on this community to get Mowgli back on track.

RE: my avatar... the only thing better than cats, are cats with laser eyes... imo

 

You're right, there isn't a lot of consistency in the vet's data collection, or dosing either. This is not the ideal way to embark upon treatment for a diabetic cat. There's no way of analysing how the dose is working and it looks as if different doses are being given at random. I'd be quite concerned at the amount of insulin being given at only moderately high numbers. Hopefully you can turn this round!

 

Right!?

I have continued my quest for information and Support on the Caninsulin page... I really hope that I will do an awesome job getting poor Mowgli regulated... I'm so excited for him to arrive tonight

 

I thought it would be nice to show everyone an update on How Nyx and Mowgli are getting along... I didn't think I would live to see the day!!

 

Looks like you've managed to get Nyx and Mowgli to live in harmony without all the drama! Congratulations!

 

Thanks! Nyx still has her moments, but she's a total diva and I already knew that about her

 

good to see you've switched to Lantus - as far as the Vetinsulin goes, my Catcat was initially diagnosed at 511 on the vet's meter, so prescribed 2 units 2x day; I immediately switched to low carb wet food and went along with her protocol; just had her run a curve, a week after diagnosis, and his +4 bg was 52 on her meter so we've now switched him to 1 unit 2x day ... he's eating enthusiastically, drinking very little other than the water I add to his wet food, making it a slurry so it's easier for him to eat with his congenital tongue problem, it won't curl, he laps like a dog), slowly gaining weight back, purely hates the ear sticks

 

That's so great to hear! It's really amazing to see what progress some of the cats around here make simply with diet change, you are what you eat I guess! Mowgli didn't really do so great with Vetsulin, I was too worried he would have a hypo event when I was at work so I'm so glad that the board recommended lantus as an option, Mowgli's new vet supported it as well. So far I have been really happy with his results.

My cats like water added to their wet food too! I've even been getting my dry food addict Nyx to eat some when a little water is added! You should add a pic of CatCat so we can see him! or a video of his dog lapping capabilities

 

LOL -- will get a pic of Catcat as soon as I find my digital camera and the patch cord to hook it to computer -- particularly funny is when he drinks water, he splashes the water forward against the inside of the bowl, winds up with droplets all over his face -- for awhile we were dubbing him "ChieF Rain in the Face"

 

LOL!! OMG!