Cat Diagnosed . . BUT can This Change...?

Thanks for reading me! Anyway: 14 year old female got diagnosed with diabetes last week. Was brought in because of the usual increased water intake and urination. I won't go into the costs of everything involved because I'm sure everyone is aware of the upfront costs of all testing and new food, etc. It was humbling and stung quite a bit. But..on to the important part -

"Jet" would NOT eat the prescribed food. I immediately took her off her normal dry food (which she loved; she was a "grazer") and ONLY put down the prescription wet food. She did not touch it, and I did not leave it down for her to graze, as I am intent on changing that eating behavior. I of course did not administer her injection since she hadn't eaten. This went on for a few days. No eating, and no injections. I went back to her fave wet food (Fancy Feast, and oven roast turkey), but she refused. I of course was concerned, so I left out some food (wet) when I left for work; she did eat some, but not nearly enough. Other than the non-eating, she seemed fine.

Over this past weekend, I noticed changes - water consumption started to normalize and same with urination. Appetite came back and she ate well yesterday. However, I did not inject. Today...morning, ate well (all wet - tuna and home-prepared chicken - NO MORE dry food!), and did not inject. Urination is fine, water intake fine, appetite fine, attitude fine, everything good and VERY normal.

Here's the problem I am feeling - I tried to inject a couple times (3 units Lantus x 2/day), but her squirming and non-compliance just broke my heart (I know..I know..) and I backed off. I believe the reason I backed off is directly related to the fact that she seems good again. All the problems of the previous 2 weeks seem to have stopped. If she would have started to plummet, I would have brought her right back in, BUT she seems to be absolutely normal again and happy. Here's my question - COULD IT BE that my immediate changing of her diet (NO NO NO more dry food - all HIGH PROTEIN wet food! NO MORE GRAZING!) backed the diabetes off? I KNOW that can happen in humans, so I'm thinking ... maybe??

I'm also going to admit, I don't really trust vets. I've been drained dry by a vet in the past, and it somewhat disappointed me that this vet did prescribe the DM dry (as well as canned wet) even tho the dry is apparently garbage (from what I've read in the past week). Could it be she is mis-diagnosed? Can that apparent diabetes go into remission that quickly from an immediate diet change in cats?

She is going back in today for another look. I fully expect the vet to NOT appreciate my not administering the prescribed food and the shots. As you can all imagine and have experienced I'm sure, it's been a very frustrating, stressful, and confusing week.

Any thoughts on that idea of diet change = BG stabilization???

 

Yes, it can happen. Sometimes that quickly too.

Yes, cats can be misdiagnosed.

We understand. Those feelings are very common when our cats have been diagnosed with a serious but treatable illness.

Hyper-T ruled out? Kidney issues ruled out?
So you are saying your cat was never given an insulin shot? 3 Units of Lantus insulin to start is a VERY high dose. Based on what criteria and protocol?

p.s. You do not know what I said to myself when I read your vet had prescribed 3u of insulin to START with. Not polite words.

We are all laypeople here. Not vets. But we do know a fair amount about feline diabetes. Probably more than your vet had training about in school. Everything we talk about is based on our own experiences in helping our diabetic cats. Plus some vet journal information and scientifically based protocols.

 

Wanted to add that this is too soon for your vet to do a fructosamine test to see what the BG levels have been. You should probably wait at least 2-3 weeks from now for that test to be useful.

Or you could learn to home test, have less 'vet stress' skewed BG (blood glucose) readings and proceed from there.

p.s. Beautiful tortie.

 

Someone far more experienced than me will be in to respond shortly, but I will share what I do know to be true.

1. Yes, it is possible for diet change alone to send some cats into remission.
2. The only way to know what's going on is to test your cat's blood glucose at home.
3. 3 units of Lantus 2x a day is a very high dose (it's also what my vet tried to start my cat on last week; through home testing, I was able to avoid accidentally sending him into hypoglycemia with this very high dose which could've killed him.) That said - it's probably GOOD you've not been able to inject yet since it sounds like you are not home testing.
4. Most vets lack decent knowledge about diabetes in cats, so it's good that you are open to NOT following your vet's advice.

With the understanding that all of this might be SUPER overwhelming (trust me, I've cried my share of fearful tears), I'm going to offer some very helpful links from this site that I have saved in the last few days. My suggestion is to take a breath & take some time to read & get set up before injecting anything!:

1 - Home Testing Blood Glucose
You'll 100% want to start with learning to test blood glucose at home. This allows you to see if it's even safe to inject insulin; if a cat's number is too low, an injection could send it into hypoglycemia! This will require purchasing a blood glucose monitor, testing strips, lancet device & lancets, plus might I throw in the suggestion of nabbing some cotton balls... a lot of people here, myself included, use the ReliOn Premier monitor from Walmart - it's about $9, and then you can get 100 test strips for like $15...lancet, etc. was only a few bucks too. Here are all the helpful links & used to learn how to do it in the past few days:
Home Testing Links & Tips

2 - Home Testing Ketones
Along with beginning to home test blood, you will want to learn about testing for ketones at home. Here is a helpful link about ketones that includes links to pages helping with tips to capture urine for the test.
Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters

3 - Spreadsheet for Collecting Data
Once you begin collecting data, you will need a place to capture it all. These forums have you capture & save this information in a Google docs spreadsheet that we all link within our signature. This way, members can quickly pull up your spreadsheet to look at the numbers before offering advice.
Information on how to create the spreadsheet is located here:
How to Help Us Help You

4 - Hypoglycemia & Dosing Methods - Don't Inject Before This Prep!
Before you ever administer insulin, you'll want to learn both about hypoglycemia (what it looks like & how to treat it & make sure you have what you need on hand!!) as well as about the two methods used here for finding the right dose: they are called "Tight Regulation," which is more aggressive but also requires tight monitoring of your cat's blood glucose throughout the day or "Start Low Go Slow," which is more conservative but -- for me, at least -- felt safer -- but every cat (and human) is different!

Here's a link about these two methods:
Dosing Methods: TR and SLGS

And important links about hypoglycemia:
How to Treat Hypos
HYPO TOOL BOX
(In here, you'll find links to even more places -- my suggestion is read through, bookmark what you think you'll need to bookmark.)

5 - How the Forums Work
Understanding the forums & how they work - this can be a learning curve in and of itself First, here is a BIG LIST of FAQs that I totally bookmarked and refer to all the time lol. In particular, the Glossary.
Here's a nutshell of how it seems we use these forums for the most part:

~ You'll primarily be posting in the Lantus/Glargine Forum (your insulin type)

~ Each day, you'll start a new thread with the format of "Month/day Cat Name AMPS (that's AM pre-shot) and your cat's pre-shot glucose number; additional details throughout the day; additional details to call attention" (e.g., "2/11 Buzzy AMPS 90; STALLING - HELP!!" would indicate "my cat's pre-shot number today was low & I'm stalling on giving it to him; someone come help me figure out what to do!"). This is the thread you'll update throughout the day - we update the titles to show the numbers we are getting & most importantly we update our spreadsheet -- which should be linked in your signature. Take a look around the forum & you'll get a better understanding!


I think that's most of what I've learned & bookmarked myself so far since our diagnosis last week. Like I said I'm a newbie, so I'm not giving aaaaany dosing advice or anything like that, but I wanted to at least give you somewhere to start reading!

 

Hey Deb..thanks SO much for the reply! I love the advice.

Re: the 3 units - I THOUGHT that was high myself, and that was also a reason I was hesitant all week. The only reason I thought it was a high dose is thanks to all the reading I did in these wonderful posts over the last week. I have spent many hours looking through these posts and gathering info (some I unfortunately don't understand) and it's helped me. The dose I TRIED to give was 2 units, NOT 3. At this point, I am not fully committed to my vet's advice and am rapidly losing faith in him. I have this "Do what your heart thinks and deal with the consequences" attitude. Right now..my heart tells me the Diet Change could be the answer. And I have implemented that absolutely.

Insulin NEVER given. Eights days out since diagnosis.

"Hyper-T ruled out? Kidney issues ruled out?" - - - Hypertension wasn't mentioned at all. Even though I surmised it was a kidney problem, the vet didn't seem to agree. I don't know how he would know or not know on that. Maybe the tests rulled that out...I dunno?

Tests were Thyroid, Urine, Blood Count, x-rays (slightly enlarged liver). Apparently there is a bit of a urinary infection, but it wasn't serious enough to have her come in immediate. She is getting THAT medication today.

'We are all laypeople here. Not vets. But we do know a fair amount about feline diabetes. Probably more than your vet had training about in school. Everything we talk about is based on our own experiences in helping our diabetic cats. Plus some vet journal information and scientifically based protocols.' - - - That's what I've gotten through all the hours of reading here this week. I've read some really encouraging things and things that have made me go, "Is my vet right??" As mentioned, I already am not a "Vet Guy" so, there's already THAT prejudice. I truly believe that it's in the doctor's best interests to keep a patient "diabetic". Human or animal. It makes money. I get that. Probably not in any doctor's best interest for a patient to self-medicate and get better quickly.

But...I'm off to the appt. I am nervous as hell, and Jet HATES the carrier of course. She's a house cat and dislikes leaving her home. This kind of stuff upsets her and of course upsets me. As YOU already know through experience I'm sure!

I will let you know the results. Thank you again for the posts and the info. This stuff is so re-assuring and helpful. Thanks, Deb.

James

 

Thanks toomany . . I am quite overwhelmed by the wonderful advice and the time taken by forum members to reach out and help a stranger with advice and support. You people are quite something special. Many thanks in advance. I have to run to the vet now, but I want to respond to your post when I return. Thanks again to both of you!!

 

Please stay here in the Feline Health forum at first. At least until you have learned to home test the BG (blood glucose ). We don't like people to go directly to the ISG groups either. Stay in this same thread too for now. Change the thread title as needed. (Upper right hand corner, Thread tools drop down list, edit away and save the change.)

Hyper-t is shorthand for hyperthyroidism. Sorry for the misunderstanding on the abbreviation. I forget sometimes that not everyone understands the terms we use here.
Hyperthyroidism can also cause excessive drinking, peeing, weight loss. Many of the symptoms are similar to feline diabetes. Good thing your vet checked and ran some thyroid tests like the T4 test. Normal range on that????

Urinary infection can raise BG levels too. Vet stress can raise BG levels. Car rides and putting your cat in a carrier can raise BG levels.

Let us know what you find out at the vet. Don't let the vet chastise you. Although, he/she will consider you a bit of a "renegade" going against vet advice. Your vet will think you are "being non-compliant" and you are!

Give your vet some credit though. They know a LOT more than we do about so many diseases for so many different animals. Hard to keep up with it all and keep up the continuing education. Feline diabetes is not seen by many vets and they may never have had a cat before that they have treated. Or had a cat that had gone into remission (aka diet controlled). We have seen hundreds of cat in remission alone. My cat included. "Once a diabetic, always a diabetic."

Also, they are trying not to overwhelm you with information. So many owners choose to euthanize their cats upon learning the diabetes diagnosis. Totally treatable but they might not know that. There are still vets out there that "recommend" euthanization to their feline diabetes clients. It's a balancing act I'm saying.

Be well James and sugargirl Jet.
Let us know how the vet appointment went.

Two vet journal/site articles for you to share with your vet.
(2018) AAHA Diabetes Management Guidelines for Dogs and Cats
(2015) ISFM Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats

p.s. We've already overwhelmed you in this single post. Take a breather. Relax. Reread through this thread. Keep asking questions. Some people want the information given to them slowly. Others want to know "everything" in only a couple of days.

@Panters-mom from Norway was like that. A sponge for soaking up information.

p.p.s @toomanycats Well done on collecting the information you have gleaned in only a few days and passing it on to the next person. "Pay it Forward." Fantastic job!

 

To toomany - yes, I purchased a BG monitor a few days back (tests ketones too), but have admittedly had a hard time with it. Poked my cat's ears with it 5 times on day one and got nothing, except extreme howling and squirming. I gave up on that day. It was too much. BUT, when she was tested today at the vet, she took the poke like a champ and there it was. I've just going to have to suck it up and get better at the lancing. Funny..I can stick a needle in myself all day long, but the cat . .

I had read enough here about hypoglycemia that I was ready for for event (sweet syrup) if it happened, but certainly was dreading it. That must be extremely unnerving when it happens.

And thank you for all those links. You can bet that I'll be looking over them all over the next few days. But yes..Deb's right..a little overwhelmed right now. The next few days/week will give me time to read and absorb the knowledge you've sent over in those links.

Deb - yes, normal range on the thyroid. No issues apparently.

"Urinary infection can raise BG levels too. Vet stress can raise BG levels. Car rides and putting your cat in a carrier can raise BG levels." - - - Yes..had read that. Good to know. BUT, regarding that urinary infection...it was not enough to medicate (today's visit). When I inquired about it, the vet said that the urinary infection is minor enough that we can leave it alone at this time, because of the info I had given him about her situation evening out over the last couple days. He seemed impressed that I had taken it upon myself to totally revamp her diet and eating habits immediately upon news of the BG problems. He agreed with me that yes, the BG levels certainly could re-adjust with the diet change, and he also made mention that it could have been a small infection in the pancreas that has just let go. But her BG levels at today's visit were low, NOT REALLY high like last week. But apparently not low enough to cause problem. He agreed with me about relenting the insulin right now, and keep her on the diet I have now instituted. Repeat, he actually said drop the insulin for now. He said that the pancreas could have recovered from its "blip" (my words not his) and is trying to run normal again. So..we wait and see how that comes about, and I come back in 8 days for another look.

But I am still somewhat concerned that he re-iterated to me that 3 units was not a high dose to start. I'm not in agreement with that. I'm a 'low and slow' guy.

He did also mention that the number of people he sees that are not willing to change the cat's life habits is troubling. It seems a lot of people quickly consider euthanasia as soon as they get these BG issues (like you already mentioned). At least he somewhat commended me for stating that I had instituted a strict and immediate diet change. Honestly, I find that the easiest option. I'd rather not deal with insulin injections if I can avoid it. He didn't chastise me at all. I wouldn't have taken kindly to it.

So..the visit was better than expected. I have hope that I'm doing the right thing. And yes..she got a nice little treat (roast turkey) when she got home and out of the carrier. Let's see what the next few days bring. Hopefully, staying the course. Now all I have to do is get that lancet work in order and I'll feel a lot better. I do realize that I NEED to be able to home monitor that BG.

 

I still can't get over how helpful and wonderful you people are here. Wow. Pretty cool I have to say . . .

 

Some things that will help with home testing.

1) Relax. If you are stressed, your cat will pick up on it and become stressed also. If though you won't feel this way, appear confident like you know what you are doing. If that doesn't work, try singing to her. Sounds silly, but it is hard to be stressed when you are doing something silly.

2) Always reward her with a low carb treat even if you are not successful with testing him. Soon she will associate testing with getting her treat.

3) Help her get used to testing by rubbing and massaging her ears whenever you can.


Also we know there is a lot of information on this site and you will have lots of questions. Please don't be afraid to ask them. We have all been where you are now and will be glad to help you.

 

Thanks Lisa. Appreciate the good thought!