Dazed and confused, a just diagnosed cat-owner wanders in..

Hi all..

Just as the subject says, really... after a couple of weeks of being convinced that there's something wrong with our cat, we've just had the diagnosis that he's diabetic. Our cat Eric is 16, and already on various medications - 2kg dose of Metacam daily for a life-long limp on his front leg (which seems to keep the limp in check), and 10mg of vidalta as he's hyper-thyroid also. In addition to that, he's been on lactulose long term as he has regularly gets constipated. Recently he started drinking a lot more, losing weight, being lethargic etc. We thought perhaps his thyroid medication needed increasing, but it turns out he's diabetic. Now my wife and I are a bit shocked and struggling to work out how we are going to fit this new set of drugs into our routine in addition to everything else he needs already. We're seeing the vet on Monday to talk about our options.

The cost looks bad enough, and the fact that we can't board him at the same cattery anymore (they don't take diabetic cats) but the real issue is how we're going to adjust our lives to make sure we can give him his jab every 12 hours. I've read some of this (very helpful) website tonight, including the FAQ, and the section about trying to time the insulin. Does it have to be exactly 12 hours? How do people manage this? Are some types of insulin more flexible on time than others, or are they all the same? Has anyone come up with any ingenius ways of making this easier? How do you make sure you don't forget?

I really hope we can push through this and make it work, he's such a fantastic cat, a real character and very affectionate - but having read everything that's involved I understand how some people decide they can't go on with it and have to make some very tough decisions.

Too much thinking for one evening, i'm going to bed..

Thanks,

Adam

 

You do have your hands full. The diabetes may be the easier of his issues.....It really is not as difficult as many of the other issues he could have.

Some insulins are more flexible than others. If you go back to the Board Index, pick Insulin Support groups. Most people here use Lantus, Levemir or PZI. Of the three, I think PZI doesn't require as precise a time table. If you read the stickies at the top of each page, you can get a good picture of how the insulins work.

The cost isn't bad. We hometest and that eliminates a lot of vet visits. Many people here sent their spreadsheets into their vets and keep in touch that way. We strongly suggest wet lo carb food, but like regular cat food better than the prescription diets. (http://www.catinfo.org) Many of us feed Fancy Feast or Friskies. We also have a newbie kit that has all the testing supplies you need that Lori will send you: viewtopic.php?f=28&t=19541

Read a lot and ask a lot of questions. The more you know, the better you will feel about any decision you make. Welcome! We want to help.

 

Welcome to FDMB, Adam! You've come to the right place - we're here to help you help Eric.

You can absolutely manage Eric's diabetes and do so without it costing an arm and a leg. First, he needs to be on a low-carb wet diet. You can see Janet & Binky's food chart here http://www.felinediabetes.com/diabetic-cat-diets.htm, and you will notice there is low-carb food available that is also economical (i.e., Friskies, Fancy Feast, etc.)

As for the insulin, many of us use the more long-acting ones like Lantus and Levemir. My cats use Lantus, and I do understand how it appears to be over-the-top financially. My first script for Lantus was for the vial and, even though it lasts longer than the advertised 28-days and even with two cats getting 2 units BID each, I still ended up throwing out about 1/3 of the vial. I then started using Lantus SoloStar pens. The upfront cost is a bit more, but many of us can use an entire pen without throwing any insulin away. The pens are basically smaller vials, and we use our U100 syringes.

As for the timing of the shots, it is true that in a perfect world they would be 12-hours apart each and every day. But we don't live in a perfect world, and people have jobs and other responsibilities. Do the best you can, but know if you miss a shot by an hour or so, it isn't the end of the world. You asked how we remember...well, to tell you the truth, B.K. and Chester remember for me! They know that after their breakfast and dinner, they get a "sticker." They will sit and look at me until they get their sticker - it's just a habit we have all developed.

We have members here who have cats that are Hyper-T, and I'm sure they will be more than happy to discuss how they manage both. In the meantime, just know you can do this and we'll help you.

 

Yeahhh that DX does knock the wind out of ya doesnt it? But diabetes is NOT a death sentence.
I havent had a diabetic kitty since mine passed away (from heart problems) almost four years ago and look I'm still here! That is why I wanted to WELCOME you to the best site on the planet to help you, help your kitty. It's like a family here and I bet 100% of your questions can be answered right here.

Theres a wealth of information and experience here at your fingertips. All you have to do is ask.

Again Welcome,
jeanne

 

Welcome aboard.
I wondered too about the feeding and shot schedule. Right now, 8 am and pm seem to be best. My cat's on Lantus, by the way. I also give him smaller portions at noon, 4 pm and right before I hit the hay.

I switched him to nothing but Friskies canned food and add a bit of chicken broth to make a stew.

I had to add a bit of Miralax to handle the constipation.

Hope this helps.

 

Welcome Adam. You have come upon the best place to help you with your cat. This board is awesome.
I hope you will ask many questions, and continue to post, because this place is where you will get tons of information from people who have lived with diabetic cats for a long time and have a wealth of experience to share, lots of support and advise, and it's like a famliy here

 

I had a 16 year old cat who was hyper-t and was diagnosed with diabetes this time last year. He's since passed on from an unrelated issue, but with the help of the board he was in remission 6 weeks after diagnosis and never needed insulin again. There is no guarantee this will happen with your cat, but I just wanted to let you know there's a possibility of it happening. He was on lantus insulin. You do have to be very precise with the dosing, but we were already used to that since he was our second diabetic cat.

When our first cat was diagnosed several years ago it was daunting. I only wish we'd found this board when she was first diagnosed. Because we didn't know anything about home testing or about the disease we didn't have the tools to help her as well as we could have in the beginning.

I wish you the best of luck in learning to treat your cat. If you can believe it, even though this disease is awful, it can bring you even closer to your cat than you can imagine. It's a wonderful feeling watching the insulin do its job and watching your cat start to feel a little better each day with treatment.

 

All,

Just to say thanks for the warm welcome and words of encouragement. I feel more positive about the situation this morning, and will do some more reading today so I have plenty of questions to ask the vet. I'm in the UK, so I’m unfamiliar with some of the foods you guys mentioned - our local vet stocks Royal Canin diabetic cat food, and seems to favour Caninsulin as we've been given leaflets and information on their products, so I guess that's what we'll be prescribed. Hopefully this is OK to start with and we can adjust the food or insulin brand later if needs be.

Thanks again for your help, I’m sure you'll hear more from me!

Regards,

Adam

 

Hi again Adam,

We have lots of posters from the UK. They should be along. In the meantime, here is a older thread with food ideas: viewtopic.php?f=28&t=21713

 

Hi Adam
welcome, I am in the UK too and my cat fudge was diagnosed back in March. It is all a bit daunting but trust me, injecting insulin really does become just part of the routine after a while just like feeding. It is a bit stressful to start with but mainly for us not the cat. We have found our local 'paw pals' (google them to find your nearest) are happy to come and inject our cat when we go away which is great as we imagined never being able to go on holiday ever again when Fudge was first diagnosed. We are using caninsulin too, it seems to be the norm here.
kind regards
Ruth

 

Hi and welcome to FDMB :mrgreen:

The lik Sue and Oliver gave to a previous thread saves me a lot of typing!
Several posts from me about food, insulin and glucometers (Austin also possibly has neuropathy, something you don't sound as if you are dealing with-quite enough already!)

Always worth a try about mentioning Lantus/Levemir, there are a couple of vets in UK that have prescribed if. If it's a blunt 'no' I'd be inclined to push for Prozinc. Caninsulin just isn't a verygood insulin. Intermediate and 'peters' out around 10 hours after shot, leaving cat with high glucose numbers again.

Please try and get keto diastix
Wouldn't bother with the Royal Canin-expensive and plenty of good commercially available food, e,g Felix in jelly, as good as it looks, Whiskas in jelly. If you scrol back through health over the last few weeks there are a number of posts by UK newbies with loads of helpful info in.
Butchers classic is ood to (sainsburys) some have said but cats can be quite fussy about it so would suggest get a tin or a pouch of these and see what Eric likes.

Hometesting-think you've picked up how important that is!

Whatever insulin your vet starts on-try not to start above 1u twice a day. A lot of vets tend to prescribe a dose based on cats actual weight and it should be their ideal weight!
Then increase in small amounts so you keep cat safe and don't miss ideal dose.
Fructosamine tests gives a one off average glucose reading from the previous 1-3 weeks-not really very helpful cos could say 400 and actually cat could be 85 at one point and 600 at another! (maybe not this extreme but hope you get my drift)
Hence the hometesting! Don't need vets permission (nice of their on board with it) and don't need animal glucometer (expensive) standard human one is fine.See that thread and this for info.

Keep asking questions all will help as much as they can.

Good luck :mrgreen:

 

Hi Adam, I am in the Uk also. Everybody on here is so helpful and friendly.

Dont bother with the dx royal canin. Shop bought wet food is way better and cheaper.

I use Bozita which I get online from Zooplus (always have loads of offers on) but top up with whiskas/felix and waitrose own pouches.

If you get protamine zinc insulin (insuvet) you will only have to inject once a day (only available in uk, most pzi are twice a day. I am on cansinsulin and find it does not last long enough. (going to vet this week to get it changed). You and your cat will get used to injecting really quickly. (my cat now purrs when I inject him). I wish I knew about hometesting four years ago when my cat was diagnosed its way better than your cat going into the vets for a glucose curve (cost around £200 last time I had one done, complete waste of time because cat was so stressed it affected his bg levels). Also only found out on here I had been feeding cat incorrectly by giving him dry food as advised by my vet. I have completely lost faith in vets and only since being on here do I feel that I have some control over my cats diabetes and that I am actually helping him now rather than hindering him.

Good luck with the insulin injections. Hope Eric feels the benefit soon cat_pet_icon

 

Dear dbg,

Just so you know, there is no insulin that should only be given once a day. Even PZI only lasts 12 hours. Sometimes, at the very end of the process when the kitty is requiring very little insulin, you could maybe give it less than that, but not at first. Here is the info on PZI: viewtopic.php?f=24&t=1979

 

Hi Adam and welcome!

I'm just going to comment on the metacam....I'm very concerned that your cat is on a longterm maintenance dose of a drug that can be fatal to cats. Metacam has its uses, but I've not heard of a cat on it longterm (my dog is) and in a 16 year old cat I'd be worried about kidney damage. DOes your vet do at least annual blood work to see if there is any damage? There are many other pain meds out there that are safer....

As for insulins, caninsulin is workable but is better for dogs than for cats.

Jen

 

Thanks Sue.

I dont know if there is a different pzi in the UK but the one I first used when Nimbus was diagnosed I gave once a day. I dont trust vets but would they be misguided enough to tell me once a day if it should be given twice? I do remember reading the leaflet that came with it and it definitely said once a day. Maybe another UK poster could confirm this?? Going to vets this week so can be sure of what insulin it was and will post when I find out. Probably another reason why we couldnt get my poor cat regulated.

 

There are no insulins that are once a day in cats, but some of the leaflets do say once a day.

If you start testing blood glucose levels at home, you'll see for your self that your cat runs probably half the day without the benefit of insulin...not very helpful!

Jen

 

Have done a bit of googling to be sure I am remembering right and there is a once a day insulin for cats but at present it is only available in the UK. How effective it was I dont know. My cat is not on it any more and I did not know about home testing at the time. Nimbus did ok on it for nearly 4 years and that was with feeding dry food. Will try and find out more info and post in PZI forum.

 

Just a minute !

I have had three diabetic cats who were treated with Insuvet PZI(beef) on ONCE a day injections. That gives me about 10 years experience with it!

Most important is to give your cat good tinned food IN JELLY which has least carbs

Good luck
Mary, Hastings UK

 

Hi Mary, thanks for chiming in! Although I've 'known' you for years, I had no idea that you treated 3 cats with once a day injections. I was sure that insuvet was twice a day! Thanks for setting us straight on this, that it can be done. Here's the petdiabetes wiki article on Insuvet protamine zinc

http://petdiabetes.wikia.com/wiki/Insuv ... amine_Zinc

Jen

 

Wow, Mary. Never heard of it. I know that there was a poster from the UK really struggling with Insuvet PZI and I think giving it twice daily. They posted over on PZI (I think sweetcherrypie?) Anyway, how about a post over there explaining how it worked so that we can give good advice to PZI users in the UK.

 

Jen,

Thanks for the info. He has been having bloods to keep an eye on his kidney function while taking Metacam.. we've been decreased his dose down from 3.5kg to 2kg in the last month or so. To be honest, his limp hasn't come back to any great degree and I don't believe he's in any pain at all. So after reading the (quite scary) stuff about Metacam and cats on the internet, i'm going to speak to our vet again and see if we can drop it all together.

Thanks again,

Adam

 

Evening all..

Just thought i'd give you a quick Eric update

Monday morning he went to the vets to have his first dose of insulin and to be kept in for monitoring for the day. We picked him up in the evening and got our training on doing the injections, which seemed pretty straight forward. He's on 1 unit of Caninsulin twice a day at the moment. I did his injections last night and this morning, no problem at all thankfully - he's a good patient!

We can see the difference in him already, he's more alert and just seems more with it. Hopefully he'll start to put some weight back on, he's gotten pretty thin in the last few weeks :sad:

The other good news is that the vet is alright with us home testing him (but I think we'd still do it anyway, even if they weren't) once he's 'stabilised'. We've also been asked to monitor his water intake, which over the last 24hrs has been 200ml - which is apparently quite a lot !

The vet also said that as long as he's drinking enough water, it's OK for him to be on dry food - but after reading some more posts on this site I think it'd be good to get him back on wet food... so that's my next job.

Thanks all,

Adam

 

good news!

 

Stabilising Eric

Hi Adam,

Feel the need to throw my pennyworth in here.
Unless I've misunderstood, your vet has told you not to hometest until they have stabilised him? Which to me means you keep taking Eric in for Fructosamine/curves every so often.

If so, please ditch that idea. You need to start homtesting now. Caninsulin isn't going to be easy, even prozinc sounds better. Still can't understand how there can be an alert on vetsulin and not caninsulin when they are the same insulin!
In the main you will get high preshots because Caninsulin 'peters' out around +10 hrs after shot.

Your right to ditch the dry, regardless of vet (I already sense they are not as 'up' on FD as they could be)
Lucky was on 50-75ml water a day once regulated, but will depend on your cat. Your better monitoring how many balls are in litter tray.

Everything research wise now states that insulin should be given twice a day to cats as they metabolise it faster than dogs. In my view they would invent a once a day insulin for humans before they would for cats!

Glad to hear he's feeling better :mrgreen:

 

I'm pretty sure Metacam now [as of September 17th] has a Black Box warning see my post here:
http://felinediabetes.com/FDMB/viewtopi ... 99#p257199
Basically it should not be given to cats unless a one-time post-op scenario.

As to Insuvet PZI once per day:
Under normal circumstances PZI should be given every 12 hours. Some people use it in TID dosing [every 8 hours]. Rarely [usually in scenarios where with pancreas has started to kick back in - which is normally not the situation at first diagnosis] will a cat get along with once a day dosing. The every 12 hours helps break up the dosing so the BG swings are not so steep or large. Among other things, this helps the kitty feel better. And in the beginning at least twice a day dosing vs once a day dosing should help get the cat regulated faster. From my understanding, the duration of the various flavors of PZI vary little [but I'm certainly not right all the time]. Thus, I would not treat my own cat with once a day PZI [unless their delta - change from nadir to peak BG concentration - on once daily to twice daily varied little] - just for the simple reason of reducing kitty's BG roller coasters/swings. So if anyone has data showing that one can dose once a day with Insuvet PZI and that the difference in delta from twice a day dosing is 'insignificant,' [however you would chose to define "insignificant"] I would love to see it. And I encourage sharing that experience/data with the PZI group and how you have achieved it. Does anyone have the data showing that according to this website http://www.noahcompendium.co.uk/Pfizer_ ... 34413.html that the onset pf Insuvet PZI is is 2-5 hours and duration is 24-36 hours? Sorry I'm just a bit of a skeptic. :smile: Are there any beans out there that dose Insuvet PZI at twice per day and do they have any thoughts on this? There is a post in the PZI forum to that was just started about this which might be the best place for any followup:
http://felinediabetes.com/FDMB/viewtopi ... 24&t=25569

Adam,
You have come to the right place.

Cats should drink <20 ml/Kg/day on wet diet and <70 ml/Kg/day on a dry diet
Diabetes Mellitus: Update on Treatment and Monitoring
Endocrinology Lecture
by Ellen Behrend, VMD, PhD, DACVIM
Auburn University

You can also monitor how much a cat pees by weighing the litter box on a good scale that will weigh in grams out to about 8Kg. You weigh the litter box before then after then subtract [making sure to subtract any poop too]. Cats should pee <40 ml/Kg/day http://www.felinediabetes.com/urine.htm

None of these monitoring methods [PU/PD] should be using instead of home testing blood glucose. But I have used them in the past to indicate to a vet that did not believe in home testing that H was needing a change in dose.

 

Bushey Boy came to us on 2x2units Caninsulin daily which had no effect on his bgs which were in the region of 35(UK)

As I still had some of Katy's Insuvet PZI(beef) in the fridge, I took the executive decision to change him to that.

In two months his numbers were down to the twenties and he had put back 6lb of lost weight.

We continued with 2units once a day for three years but had to reduce when his heart disease took over. In his last week or two he was down to 1/2 a unit daily

He died of heart failure after 4 years of diabetes

Mary (Hastings UK)

 

Believe the Insuvet PZI available only in UK is the same as the Eli Lilly beef insulin that they discontinued years ago and forced those of us with diabetic cats to go to the Humulins that they also ended up discontinuing. I did b.i.d. dosing with that insulin and IMHO there truly is no insulin that works well in a cat that would be an s.i.d. insulin no matter what the literature says.