Newly diagnosed, vet visit #2

So thankful to have found this site. My 8 year old baby was diagnosed with diabetes last Monday. Have learned so much from reading the forums (and articles). I'm overwhelmed, but want to do what's best for him and have a few questions about our second vet visit tomorrow. The vet called with the results of his bloodwork - glucose was 455. She directed us to give him 1 unit of insulin (Novolin N), twice a day. That has been hit or miss. He gets the medicine, but sometimes they're painless and he doesn't know its happened and sometimes he does feel it - not pain, just knows we're doing something.. We've been practicing on a piece of fruit, so I'm sure we'll get better. Have two questions in particular (at least to start!) -

My boy is a formal feral, in the house for 3 years and is extremely skittish with everyone except for me and my husband - hides/runs from everyone. We've been taking him to a vet practice (Mount Laurel, NJ) that has a mobile team, in fact most of the vets are out making house calls daily. That leaves one vet at the office on any given day. Don't want them to come to house unless it's an emergency (want to keep his safe place, safe), so that means we go to the office whenever he needs to. He's been there 3 times total and has seen a different vet each time. You can request to see a particular vet, but you never know when she (he doesn't like males) is scheduled in the office or is out making house calls. And in the case of excessive water drinking and eating, we didn't want to wait for one in particular. My question -- should I change practices? I'm thinking that with his new diagnosis, it would be important for him to have one doctor that knows him and his history. Also, on that phone call, she directed us to their youtube website and said to watch the video on how to give the needle and if we were comfortable, then to go ahead and start giving them. If we were uncomfortable, call back and we could meet with a tech for instructions. Of course, the video didn't help without seeing directly how it's done for the first time. When I called back, there were no vets or techs to meet with us for two days, but since she want him started on insulin, she arranged for a surgery tech to meet with us the same day. The surgery tech was helpful with the injections, but not with all of our questions. The surgery tech even suggested that we didn't need to test his blood at home, which I now know the opposite is true. BTW, that was the surgery tech, the doctor on the phone mentioned giving us the AlphaTrak. I'm assuming that's not the way this is typically handled, but I just don't know.

Since we need to have his blood checked again, we're scheduled to go back tomorrow. We'll see yet another vet (this is the 4th different one). I'm planning on bringing my own glucose meter, but in addition to blood work and instructions on the meter, can anyone tell me what to expect? I have a list of questions, but I want to be sure that I don't miss anything.

Sorry for the long post, but any advice would be greatly appreciated.

 

no advice really, just sending support and encouragement -- you are on the right track, doing the right things, the learning curve is steep, and every one of us has been confused, worried, eager to do the right thing, and balancing what the vet(s) said with what is said here -- remember, very few vets have had experience in day to day management of our sugarcats -- they are going on what pharmaceutical reps and old style textbooks have to say -- TRUST these members here, they KNOW what it is like ..

former feral -- I can relate, I have two barn cats at the moment, one will probably always be feral, one is warming up to me, allowing me to pet him -- so testing him will be a delicate balance of what you NEED to do and what he will put up with -- special snacks are the answer -- you get to condition him to let the tests happen, because that's really the only way you can manage diabetes successfully

be sure to read the forum for Caninsulin/Vetsulin/Novolin -- and be aware that they all "hit hard" and often "don't last the course" -- many of us have transitioned to other forms of insulin but you will hear it often ... ECID -- every cat is different --

also be sure to read the INFO post on this forum, lots of us need the details, the numbers, the info in your "signature" and spreadsheet once you start testing, to give you valid advice ...

welcome to the site you never wanted to inhabit ...

@JanetNJ -- any advice on the vet?

 

Hello and welcome!

I don't know if I can answer your questions, but here's some information that might be relevant:

In general, it is better to test glucose at home than in the vet's office. Stress can raise numbers by as much as 100pts, so (especially for a former feral), going to the vet might mean an inaccurate picture. Plus, single spot-checks aren't the best for judging the progress of the disease and how well a dose is working for your cat.

That said, it will take some time to ease into testing with a former feral. Most cats put up with the testing (involves ear pricks for blood) quite well, especially if there are treats involved, but you'll likely have to go slow and in stages with your guy. Designate a spot in your home the "testing spot", and just start with calling him over, giving a treat and letting him go, then build to playing with his ears a bit, etc. etc. It'll take time, but in the end, you'll feel much more in control of the diabetes care (and likely save money and aggravation from vet visits, too!).

Meters: vets tend to like AlphaTraks, and they are indeed very good meters, but the test strips are quite pricey. For that reason, most of us here use human meters and strips. Much cheaper, easier to get supplies in an emergency, and gets the job done even if the numbers aren't totally comparable to the AT.

Insulin: Novolin-N is a fairly "harsh" insulin in cats. It does work, but can be harder to manage-- if you stick with that insulin, I would definitely make home testing a priority. Other insulins that are gentler and easier to use in cats include Lantus, Levemir, and ProZinc. They tend to be more expensive, but if your vet is willing to switch we can give tips for saving money on the L+L insulins (not sure about the ProZinc, others might be able to chime in here).

Hope this helps!

 

Welcome to FDMB. It can be very overwhelming at first, I remember so well! But, step by step, you are going to be able to learn about feline diabetes and how best to treat your cat.

First, testing his blood sugar at home is very important, especially since you are using Novolin. We recommend testing before very shot, and then as you can during the 12 hours between shots.

You can get a ReliOn Prime meter and strips at Walmart, about $10 for the meter, and about $10 more for 50 strips. The AlphaTrak2 is a good pet meter, but it's more expensive and the strips are about a $1 apiece, plus you have to order online and wait for delivery. When you are learning to test, you will be using more strips until you become more proficient. A box of lancets, 26 or 28 gauge is just a few more dollars. We have videos and tips about testing at home, and many members will pitch in with what worked for them if you create another thread asking for more info/assistance.

As CandyH said, most members who began treatment with Novolin have transitioned to other insulins, because they are gentler, longer lasting and more effective. We can help you explore the different insulins and how they work, and cost factors.

Diet is one of the three basic components of diabetic treatment, just like for humans. We recommend a wet diet (canned or home prepared) with carb levels below 10%. But, and it's a big but, it's very important to be testing consistently before any changes are made because transitioning to a low carb diet can lower blood sugar significantly and you will want to make it gradually, and to track it. We want to keep kitty safe from a hypoglycemic event (very low blood sugar).

We have a lot of information here on the board, and it can be difficult to track individual issues or concerns by yourself at first. Ask the specific question and we can provide information and/or links to help you out.

Please take a few minutes and create a signature so that kitty's information is available when you post:

Setting up your signature (light grey text under a post). Here's how:
click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what (s)he eats/any other meds or health issues (s)he has. You can add your name, and a geographic location (sometimes the country/time zone matters) Be sure to SAVE when you are finished.

You can always edit that information as you go forward and if anything changes.

Take heart and a deep breath, feline diabetes is treatable and manageable. It's just a matter of learning how and why, and we will help all we can. As far as your question of changing vet practices, I can't advise on that. My suggestion is to get yourself educated and then present your views on course of treatment, and see if this vet practice will work with you.

 

You already have some great advice here, so I will just reiterate the importance of proper diet and home testing. I had a VERY difficult to test cat but with a lot of patience, treats, and tips from this site, I am now able to test her multiple times a day!

As far as vets go, I was in a similar position. I went to a teaching hospital so it could be very hard to see the same vet; sometimes the vet I preferred to see would be gone for weeks at a time. It is definitely beneficial to have a vet that knows your particular cat, but that being said, the reality is that a lot of vets (maybe even most) simply do not know much at all about treating feline diabetes. I spent a lot of time and even more money following vet advice and trying to manage my girl that way, and it just did not work at all and ended up being very dangerous for her. She did not get better until I started following the advice of this forum and testing her at home myself. I really do not talk to her vets about diabetes related things at all anymore. So I guess my point with saying all that is that even if you DO choose to switch vets, it still may be frustrating dealing with them

 

You already have received great advice so I won't repeat it. There is also one other long acting insulin not mentioned. It is BCP PZI. Your vet can order a free vial for you to try from BCP. https://bcpvetpharm.com/request-your-free-samples/

 

@hummys

My cat has been diabetic for 5 years and has only been on Novolin N. It is not the greatest insulin as others have said but if finances are an issue with you as they are with me, it is workable. Read all the stickies but print this one out and keep it handy along with a hypo kit. Not to scare you or anything, but it is vital to read and understand. Most of us have been through at least one hypo event. Should that happen, you can post and use the 911 label and someone will be here to help you through it.

 

Well I do live in nj but not near mount laurel so can't help with that. Novolin is kind of a short acting insulin. It's cheap but for a good reason. I'd ask about switching to ProZinc or lantus. ProZinc is $106 through chewy.com and will last you about 4 months. Lantus is expensive in the US but through Canada is about $170 for a years worth.

As far as testing goes.... I use an Alphatrak... I like having the same numbers as my vet. Many here use a human meter... It's up to you. To make the Alphatrak less expensive I usually use freestyle insulinx strips with it and have found them to work just as well.

I have a video in my signature showing how I test my cat CC at home.

 

Thank you all so much for the advice and links. I called the vet's office today and found out an AlphaTrak will cost $115 if purchased from them tomorrow. I went to our local CVS and purchased a FreeStyle Freedom Lite. The strips were expensive from them, but I looked online and I can get them way cheaper. I'm a little scared to use it, but I'll get instructions from the vet and watch a few videos and see how it goes. Will definitely discuss insulin brands tomorrow. Whatever the cost, we want to do what's best for him. It really is so overwhelming, thank you for your caring and support.

 

Free next day delivery. $49

AlphaTRAK 2 Veterinary Blood Glucose Monitoring Meter Kit https://www.amazon.com/dp/B079Y62RS6/ref=cm_sw_r_cp_api_i_nnbsDbR7DZBEY

 

Back from our visit to the vet. Think it went ok. Liked this vet the most and we're going to do our best to schedule all of our appointments with her moving forward. Had a lot of questions and she took her time and didn't make us feel rushed. Some we kind of knew the answer from this site, but wanted to see if she would give the same information. And for what we asked, she did. No contradictions.

Asked her about switching the insulin and she said that she was glad that we brought it up, because she wouldn't have prescribed Novolin. She would have prescribed Lantus instead. She wouldn't have brought it up unless we did (she said), so thank you for the insulin information. She switched him to Lantus. Told us to skip the Novolin tonight and start the Lantus tomorrow morning. Wants to see us back again next week and in the meantime wants us to email her all of his glucose readings. Told us to please call with questions and that even is she's not in the office, she could be reached.

His glucose went from 455 last Monday to 317 today. Is that a normal progression?

On another note, I gave him his first injection alone! My husband and I were both off from work last week, so we were doing it together. Today, I was on my own. Pit in my stomach, but it wasn't too bad. He knew I was there sticking him, but I think he was more uncomfortable with me following him around trying to give it to him.

Next challenge... learning to use the glucose meter. Going to watch some videos, hopefully it's as easy as it looked in the vets office. I have some questions about food, but I'll start another thread for that. Can't tell you what a relief it is to have found this site. Thank you all again.

 

Great update! You're doing wonderful. I'm glad you found a vet you like.

 

So glad to hear it went well! Definitely be sure to check out the lantus forum, as lantus works very differently from novolin. They also have tips for getting it much cheaper!