Cat Yoko, in AWFUL condition

Hi, my name is Erica. I am the mommy of a sweet kitty Yoko- a Russian blue and 8.5 years old. (I also have a miniature dapple dachshund, a 2 year old and a 3.5 year old).

Main issue and need for help: diabetic neuropathy & extremely bad. Cannot use any limbs fully, and totally doesn't use front paws AT ALL. Can pretty much only lay on one side. Losing weight fast! Went from a 12 pound kitty a few years back, down to a 10 pound kitty for a couple years (vet wasn't concerned) down to a 6 lb or less kitty within past few months). Diagnosed with Diabetes in August and was put on 1 unit 2x/day with Basalgar Kiwik Pen.

It is obviously not working and although we could slowly increase the dose and try and get her blood sugar down--at this point, WE DON'T HAVE ANY TIME TO WASTE. She can't use limbs, can't use litter, is getting to the point of needing to be spoon fed. And I have needy young children to care for, too. I will do anything for Yoko if I can, but I am worried about the length of time to give this to all work out given how serious her condition is. She is clearly in pain and so very sad.

One of my main concerns is staying with this type of insulin and using the pen-- wanting feedback on that.. and suggestions on how quickly we can increase her dose. She clearly needs MUCH MORE than what she has been getting. She has been on 2 units 2x/day for a little under a weak, but in the meantime, she is wasting away to nothing, miserable, and in pain...getting worse not better or even staying the same.

I'm also worried about making sure I have her on the right food to give her the best shot at getting her blood sugar in check. For the past week, she has been on purely fancy feast - one pack twice a day before/with insulin. and sometimes a little more. She needs weight! Is this enough? The Royal Canon Glycobalance upset her tummy A LOT and the prescription diabetic foods still seem to be way too high of carbs, but I am confused about what route to go. And again--WE JUST DON'T have time to mess around and figure this out because she is in such awful condtion.

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Back story for those who want to read more:

Yoko was diagnosed with feline diabetes in August of this year (2018). She had extremely high blood sugar, and was put on the Basalgar Kiwik Pen 1 uint;2x/day.

Her blood sugars were still very high at her 2 week check up, but I was worried that the pen wasn't working properly (because of misinformation from the tech), so the vet didn't want to try and increase the units, yet.

After that, nothing changed. There were stalls to getting her dose increased due to her having to be boarded and worried that the stress was part of her continued high sugar. I put her on 2 units, 2x/day on my own for about a week, but she had bad diarrhea and vomiting (which i think was due to her new glycobalance royal canine food, but the vet was worried that it was the insulin increase). Vet put her back to 1 units 2x/day.

A couple weeks ago, we switched her food back to Iams Indoor Weight Control (hard food) due to the stomach upset. She stopped eating that completely (she never loved this food, but was what i fed her all her life)- continued to lose weight - finally gave her canned tuna-- because she was RAVISHED and trying to eat all of our food -- and then got her onto fancy feast canned food (not the one with gravy).

She ate that great, but a few days later started walking with her butt high up in air and the rest of her body down low. She had clearly lost even more pounds, and within 24 hours wasn't using one of her front paws. After getting her under vet care (doubting how good this care is) last week on Wednesday or Thursday, they upped her insulin to 2 units 2 x/day, and they said they just need to give it time before they can do more, but in the mean time she has gotten even worse.


PLEASE HELP. I keep reading about diabetic neuropathy but it all references it being accute and rarely affecting front paws. So what when it gets to this point? Is this fair to put her through? Everything I read references them being able to potentially recover--but given that it is not too severe--and after possibly 1 year or more! I can't let her live like this. I cannot wait that long. And there are so many questions and lack of clear information on our specific an very intense case.

 

Welcome. Are you home testing? If so what are her numbers and if not are you willing to learn? It’s easy and really the only way to know what’s going on. As for food the purely Fancy Feast is low carb, but also very low calorie. You can get Fancy Feast or Friskies Pates and feed several meals/day to help with weight and energy levels. There’s a lot going on with your girl, but we can help. Come to the Main health forum and post so more will see it and respond. I’ll look for you there to give some more ideas.

 

Hi there, you have come to the right place.

Weight loss is most likely causes due to her not getting enough insulin, without insulin a diabetic kitty cannot absorb her nutrients from food. That is what caused the weight loss.

Firstly, If she will eat more, I would give her more fancy feast - maybe add an extra feeding or 2 if needed. I would let her eat as much of it as she will want until we get the glucose situation sorted out.

As Sharon suggested, the second step is to obtain a meter and start testing her blood sugar. You would also need to set up a spread sheet and enter her numbers so we can take a look and help you with suggestions about dose of insulin and how to interpret her sugars.

As for dosing, the best way to figure out what dosing is optimal is by testing, and following one of our protocols. If you go to the Lantus/Basalgar forum, you will find 2 protocols posted there - Tight Regulation (TR) and Start Low Go Slow (SLGS). I recommend reading through them to learn more about each one, and determine which one would fit your life/schedule better. Since you have a lot going on, you may want to consider SLGS - it involves less testing but also less frequent insulin adjustments. It does work, however, and kitties do well on it, but it might take a little longer to find an optimal dose. I would take your time to read through the stickies on that forum to learn more about our methods here.

I will also say that I recently read an update from a kitty owner who came here in a similar situation. After some time here and following the protocol, this kitty’s weight came and she was like a new cat. This person even posted pictures and the difference was striking. I cannot recall who it was, but it was really touching to see.

Best of luck, let us know what questions we can answer for you. ❤️

 

Erica!! Welcome to the board and I hope you find some great help here. I know how easy it is to feel helpless — I still feel this way most days. I don't feel qualified to give advice yet but there are so many people here who are rooting for you and Yoko!!

 

Thank you for your response. I agree that she needs to be eating more food--she wants to be eating more and needs it, as she is so very tiny. But I didn't know if this would mess with her blood sugars too much or counteract her increase in insulin.

Do you happen to have thoughts on whether I should try a different insulin at this point?

I am waiting for my feline glucometer to come in, and praying that it gets here soon. I agree that this will be the only possible way to truly figure this out.

I am going to get the classic fancy feast since it is still supposed to be only 3% carbs (chicken) but a little more than double the calories than the purely fancy feast--and she needs the calories.

I will look through those links you recommended, but I want to be able to increase her dose as quickly as I am able or I fear the neuropathy will never get better as it has already taken over her entire body.

Thank you!

 

Thank you so much for your reply. I totally agree with you on the food, and I am going to switch to the fancy feast classic chicken -- still only 3% carbs but more than double the amount of calories.

Do you know if feeding her throughout the day (inbetween AM and PM insulin doses) would wreak havoc on blood sugar too much though?

Also, I am very non-patiently waiting for her glucometer to come in --they ordered one at the vets office because i was insistent about it. Given her severe condition, I really should have insisted that they let me rent one from them over the weekend...since she seriously looks like she is on deaths bed, and just to start watching those sugar levels could really give us piece of mind as well as the info we need to move forward.

Lastly, what Main forum is it that I post on? Trying to figure this all out.

THank you so very much for your response!!
-Erica

 

I personally wouldn’t yet. First, we want to see what her levels are on this insulin and on her current dose.

As you will read in the stickies, although insulin is a great medication for diabetes, too much can cause sugar levels that are too low, and can be life threatening. That is why we don’t recommend increasing the doses “blindly” without knowing what her levels currently are.

If you feel like the Tight Regulation protocol is feasible for you, it will allow you to adjust dosage every 3 days. However, as you will see, we recommend increasing doses by 0.25 units since whole units are designed for humans and kitties are much smaller. this will help make sure that she isn’t getting too little or too much.

Hope that makes sense. Keep asking questions! Looking forward to seeing your spreadsheet (SS) as soon as the gluvometer arrives so we can help.

Also as a side note, some people here choose to use human meters for their kitties. Which pet meter did you purchase?

 

The vet was adamant that she wanted to order one specifically for cats, to take away one more potential variable of it not reading accurately. So I don't know what it is called, but it was ordered through the vet's office.

Unfortunately, they are going to have to do something so that I can increase by .25 units because my pen only allows you to increase by 1 unit at a time.

So you would recommend staying on the same type of insulin at this point, but getting a vial of it instead?

I am just so fearful due to how bad she has gotten that this insulin just doesn't work for her or that she needs a whole lot more than one unit. But my vet does want to stick to the same insulin and increase slowly as well. But she was thinking increase by 1 unit every week or 2 weeks.

 

You are getting lots of helpful advice.
I would also look into changing over to using syringes instead of a pen because you can increase the insulin in smaller doses. We increase in 1/4 unit (0.25 unit) increments as it is safer for the cat and you don’t go past the best dose. You can use the same ampoule you are currently using in the pen.
You need U/100 30 or 31 gauge, 6 mm 0.3 ml syringes..they are available from ADW online or at WalMart..brands available are Uticare, Monoject, Carepoint, SureComfort and B/D. Get the ones with 1/2 unit markings. Make sure you get the U/100 0.3 ml syringes as mentioned above as they go with the basaglar insulin...... basaglar is a good insulin for cats.
You can copy and paste your intro onto the Main forum page where there are many people who can help you get Yoko back to good health.
He is a photo of one of the syringes

 

Here is the link to the main forum
http://www.felinediabetes.com/FDMB/forums/feline-health-the-main-forum.28/

You do not need the cat specific meter. They are a lot more expensive to run because of the cost of the strips. You can pick up a human meter at Walmart or a pharmacy. Most of us use human meters. You could cancel the meter at the vet if you bought a human meter.

 

@Erica Ann we recommend using u-100 syringes and drawing out of the pen. I am not familiar with Basalgar pens since i used Lantus, but I got the syringes online that had 1/2 markings - they were specially made for pets. The top of the pen had a soft area where the needle would go. I punctured that area with the syringe needle and drew back the amount of insulin i wanted to give.

I think your kitty will respond to the insulin, we just have to find a correct dose. She may need 3 or 4. Or even just 2.5. I know it’s hard to be patient right now but what I would do in your shoes is this:

1. Feed her as much as she wants for now
2. Continue 2 units for now since 1 clearly wasn’t working
3. Ask your vet for a script for u-100 syringes and be sure to order those with 1/2 unit markings. I got mine from adw.com. You can email them or fax them the script from your vet.
4. While you are waiting for the meter to arrive, read through all the stickies on the Basalgar forum and familiarize yourself with the protocols
5. Once the meter arrives, start testing before shot times (12 hours apart) and recording her numbers in the spread sheet. Post a link in your signature so we can view your spread sheet.

Once you have that info and supplies, we can start viewing her glucose trends and adjusting the dose.

Hope this helps ❤️

 

@Erica Ann Has the vet checked to see Yoko is not dehydrated which would make her feel weak..
You can test yourself by checking her gums. Are they slippery or tacky? When you pull up the scruff of her neck does it spring back or go back slowly? Diabetic cats are often dehydrated especially in the beginning. If you think Yoko is dehydrated, take her to the vet and they will give her some SubQ fluids which will make her feel a lot better.
Something you can do to help with hydration at home is to add a teaspoon of warm water to each lot of the food to make it a bit soupy.
Also have you been testing for ketones in the urine? Cats that are diabetic and have high blood sugars can be prone to getting ketones which if not treated can lead to DKA which can be very dangerous. I don't want to alarm you......but this is something you can do to eliminate a possible issue. If I were you I would buy a bottle of KETOSTIX from a pharmacy or Walmart and test Yoko's urine. It is a simple test which you should be doing several times a week until the blood sugars are more under control.
Keep asking lots of questions