Jett - Newly diagnosed

My rambunctious, troublemaking terror - Jett - was an outdoor kitty until New Year's Day of this year, when she wandered into our house during a cold snap as I was going out to feed her and basically announced she was going to live here now (much to the chagrin of our three resident cats). She wasn't fixed, didn't know how to interact with humans (except biting them) or cats (except chasing/biting them), and had an insane appetite that we thought was caused by years of being out on the "mean streets." She knew how to use the litter box (boy, did she ever!) and knew to scratch at a scratching post, so at some point, she was around humans, but our vet felt she had been outside for a year or more before we brought her in - we had seen her in the neighborhood for over a year, so we think he's correct on that one. She was fixed in March (vet wanted to wait until we were between heat cycles, but apparently she was never between heat cycles, so we finally just had to do the surgery), and her numbers were a little high then but (they thought) due to the stress of the situation.

While Jett has always been an "enthusiastic eater", we noticed over the last month or two that she was willing to stop at nothing to get her paws on food. She'd steal off of plates under the guise of "Oh, I'm so cute, pet me" (and then grab the food with her paw while folks were distracted), eat chunks of food that fell out of the pan off the oven after it cooled and before we'd cleaned, eat the other cats' food (even just after eating her own), and even chewed through bags to get to donuts, bread, buns, and other food we'd had sitting on the counter. Then, we came home from a weekend trip to find mold in her litter box - a quick google search suggested it might be diabetes, and I started to watch her a little more carefully. Sure enough, she was spending longer and longer at the water fountain and flooding out her litter box. I called the vet and had an appt. last Saturday, where we got the official diagnosis. The vet had just sold his last box of insulin, so we had to wait til he got a new shipment in to do her glucose curve (yesterday), but we changed her over to a low-carb wet food diet immediately (she used to get low-carb wet food twice a day and free-range dry food), and she seems to be drinking less because of the liquid in the wet food. Yesterday, we started her on insulin, and she's gone from lazing about the house to terrorizing the other cats again (they're back in hiding), so I'd say she's perked up a bit. The vet has her on 1.5 units of PZI twice a day (along with medicine for the UTI she'd developed, which she tolerates because chicken), but has discouraged us from doing home testing at this point while we get her adjusted - they have another curve appt. set for two weeks from now. My husband did her first shot last night, and I thought it was something I could handle...this morning, she jumped away right before I put the needle in, and I had a panic attack and had to get my husband to do it (my hands wouldn't have been steady enough at that point to not hurt the poor thing!). I hope I'm able to get past my overwhelming fear of needles and do this to help my sweet terror of a cat.

The only thing I haven't been able to get an answer on is how much she should be eating? She's youngish (3) and only about 9.5lbs. I asked the vet on Saturday, and he said because she wasn't absorbing it well to give her "as much as she'll eat" which resulted in her getting what I'm sure is waaaay too much food. How much should she be eating a day? We can't really do the "small often" meals, because with work I'm out of the house 12-14 hours a day, and my husband is gone for about 10 hours - she gets a breakfast meal from me (and, since the vet said however much she wanted, she's been begging a second breakfast from hubster before he leaves for work), and then dinner after we're both home from work. If she had her way, she'd probably gobble down well over a pound of wet food a day, plus chicken for treats, but there's no way that's healthy. Will her appetite decrease as the insulin starts to get her regulated? When we tell her it's not time to eat yet, she acts like we just kicked her! LOL

Thanks for letting me share my story! I hope to learn a lot about this and manage Jetter's condition as well as we can!

 

I would encourage you to work with your vet regarding the home testing. A glucose curve conducted in a clinic is not always accurate given the stress of being in a clinic all day. Clinics are noisy places - barking dogs, strange voices, cages doors banging, etc. All of this is a stressor to Jett.

Can you distract Jett with some food while you inject her? If she is focused on something else she more than likely will not even notice you are injecting her.

Hope this helps.

 

We definitely will work with him on it, probably after this next curve. They showed me the area they had her in, and it's a quiet room away from everything else (it's where they've offered to board her if we need to leave town, etc), so while the smells and such are different, she's not in with or near other animals or hearing chaos. She love love loves "her" vet techs and the vet, and they went in quite frequently between checks to snuggle her and love on her. I know it's not ideal, but I'm willing to give my vet the benefit of the doubt for the first few weeks because of how high her sugar was (at no point yesterday during the curve did it get below ~275).

We are distracting her with food when we inject her (the only way to this cat's heart is through her tummy) - hubster had great success with it last night and again this morning after I failed miserably.

 

Welcome to FDMB, the best place you never wanted to be.

There are 4 things you'll need to manage your kitty's diabetes:
- You - without your commitment, the following won't work.
- Home blood glucose monitoring with an inexpensive human glucometer such as the WalMart Relion Confirm or Target Up and Up (the pet ones will break your budget!). This saves you the cost of going to the vet for curves and done regularly, removes the need for a fructosamine test.
- Low carb over the counter canned or raw diet, such as many Friskies pates. See Cat Info for more info. If already on insulin, you must be home testing before changing the diet. Food changes should be gradual to avoid GI upsets - 20-25% different food each day until switched. There are 2 low carb, dry, over the counter foods in the US - Evo Cat and Kitten dry found at pet specialty stores and Young Again 0 Carb found online.
- A long-lasting insulin such as ProZinc, Lantus, BCP PZI, or Levemir. No insulin lasts 24 hours in the cat, so giving it every 12 hours is optimal for control.

 

Hi Scooter and Jett. Welcome! I have a black cat boy named Jet! Bless you for taking in this girl (she has the look of mischief about her!) and taking such good care of her. She sounds like a wonderful, crazy, fuzzy, wild-ish handful!

I hear you on the working all day -- me, too! I just ordered an automatic feeder - they have good reviews and might help your situation being away all day. You can see the feeder here. They do work with wet food! I hope it can work with your other 3 cats in the household. Head over to the supporters section of the website if you do order one (plus there are great sites for ordering other supplies, which you don't necessarily have to get from your vet).

Welcome again - you have come to the right place!

 

Hi Scooter and Jett. I really enjoyed reading her story. (You're a very entertaining and vivid writer.) She sounds like a real character.

Here's a link to one of our forum stickies to help you with home testing, and another one to help you set up one of our spreadsheets so that you can record Jett's test results and share them here when you need help. (Be sure to ask the vet for her curve numbers, too, so that they can be included as well).

With regard to food, because Jett's insulin levels have been low it means that glucose can't pass into her cells to give them energy to do their jobs. Jett may be eating plenty but, in a very real sense, at cellular level her body is actually starving because it can't properly utilise the nutrients she's consuming. That she's already more active on her insulin is a good sign that her body's using nutrients better. It's handy to get a reasonably-priced digital baby scales to monitor Jett's weight at home. You can assess her progress using a body condition chart. Her appetite will normalise as her blood sugar levels become better regulated.

Welcome to the Sugar Dance.


Mogs
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We have put together a protocol for ProZinc. It is in blue in my signature.

 

Thanks everyone! She was tolerating the shots (and the meds for the UTI) fairly well until last night, when all of a sudden she decided she's over it. While trying to do her shot (when she was nearly done eating, as we have been doing), she scooted all over the place around her plate to avoid hubster's hands and the needle. I finally had to hold her so he could do the shot. This morning was no easier for me, though I finally managed to do it alone, much to her dismay. She's onto us, and she is none too happy. I can't even give her pets without getting bitten or swatted at (with her claws out) - a full step back from where we've been for months now with regards to her behavior towards us. I'm not really sure what to do to make it easier for her (or us).

I know she has to be feeling better - she's drinking so much less, her litter box doesn't look like wet, sweet, sticky cement anymore, and she's definitely packed on a little weight since we started insulin (though she's as ravenous as ever) - but it sucks that she isn't cooperative anymore and currently hates my (and hubster's) guts.

 

Visions of Scooter with a speech bubble saying: "Enough with the pointy things!!"

Saoirse got crankier when she started feeling better, if it's any comfort.


Mogs
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Jett is DEFINITELY saying "Enough with the pointy things!" - and so am I! Unfortunately, it's not likely to be in the cards (our vet tech told us with her age and weight, it's incredibly unlikely that she'll ever go into remission. While remission isn't our goal - a good life for our kitty is - it's still disappointing to hear).

I'll take cranky to lethargic and ridiculously thirsty, I just hope she stops trying to jerk around while we're doing the injection - I'm terrified of hurting her badly.

 

Dang! Got kitty's name wrong. Mea culpa, mea culpa ...



Does Jett like being brushed/stroked/groomed. If you make injection time a fuss fest, it can help to relax things. Saoirse did fairly OK with that approach in the early days. As time went on, we moved to drive-by dosing ... I never got over the worry of snagging Saoirse with the needle, but we got through it.

If 9.5lbs is Jett's ideal weight, depending on her level of activity, c. 150-230kcals is a rough guestimate. Logging food amounts and weighing will help you home in on the right amount to feed. Calorie requirements may vary over the seasons. My two tend to need more food in the winter (to keep themselves warm, presumably).

Did your vet tech share the basis for that assertion?



Mogs
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It's okay - both of us are quite sick of pointy things!

We started petting/brushing/fussing with her from the start of the injections, along with doing it while feeding her - the vet thought it would be the best way to keep her calm. He told us it wouldn't be more noticeable to her than a mosquito bite, but she certainly doesn't seem to agree. At this point, when we come near her, it's a slug-fest....so petting and brushing are at a minimum. She just won't let us (now she's associated petting and brushing with shots, I fear).

The vet tech said she was basing the "almost no chance of remission" assertion on her age (3) and how tiny she is (only 9.5lbs). She said if it was an older cat developing diabetes later on, or if she was overweight, there would be a chance she could go into remission, but because she's so young and tiny, it was unlikely (the vet himself told us that he gave us maybe a 40% chance at most of getting to remission - odds I like better than "almost no chance")

Right now, Jett has a 5.5oz feed in the morning (along with some chicken as a reward for taking her UTI meds), and gets another 3.5oz feed at night once we're both home (again, along with some chicken for the UTI meds). I have no idea exactly how much chicken she's consuming - her chicken container drains at a pace that tells me she's harassing my husband for treats after I leave for work and after I go to sleep - but 3 of my 4 cats prefer chicken as their "treat of choice" (one won't eat anything that isn't cat food, period) so I know it's not just her making the dent in it. The vet tech took down the names of the foods we're using and promised to call us with amounts as well as a quote for what they'll charge for us to board Jett last Thursday, but I haven't heard from her yet.

 

Interesting. It's not something I've seen mentioned or discussed before. @BJM, @Chris & China, @Meya14 - have you ever come across any cases/research where such a prognosis might be given?

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Here's a link to the forum sticky that tells you how to calculate carbs and kilocalories in foods.

You can get a rough idea of the nutrition profile of human foods like cooked chicken here.


Mogs
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There was some literature I read about remission that described populations with the greatest success rate, but I can't really remember what the specifics were. In my opinion, all cats have the potential for remission, but how likely it is, is another matter. Solving comorbidities and diet issues seem to increase the change. Never say never.

As far as the trouble you're having with the shots, I do have some advice. I spent months playing "chase the kitty" AND I have a cat that has seizures when you touch him wrong, so I'm all about the stealth shots.

First things first, I think PZI is neutral pH (can anyone confirm?) so it shouldn't sting. Other types of insulin can sting.

Needle size: Get the BD ultrafine 3/10ml, 1/2" or 6mm, 30G needle. These are the smallest, finest needle you can get, and the BD brand is well made for very smooth insertion. Max would hiss at the 29G generic needles, but never even noticed the BD ultrafine. They cost a small fortune as far as needles go, but are well worth it. Insert with the bevel side up, which is easier and smoother.

Injection location: Scruff is where most vets show you. You can also inject into the flank. In a small cat, the location with the most fat is usually the least sensitive. Try out different locations. Don't go too deep with the needle, because if you hit muscle it's more sensitive.

Food: If the cat is busy scarfing, he won't notice you ninja-ing behind him with a syringe. At first, because max was so hungry all the time, food and shot went together. He learned to associate the two. When we started to relax with this routine is when I ended up chasing him all over, and eventually it became a fun game we did twice a day. Not too fun for me. He had a blast.

Cuddles: If he's motivated by this you might be able to get him to settle down.
Feliway: You can buy at the pet store to calm anxious cats.

Condition yourself: The biggest barrier sometimes is fear. Cats can sense fear and hesitation. Get comfortable with holding the needles, practice giving water shots to oranges, even try poking your own belly with a clean needle and the syringe empty and see how it feels. Condition yourself to relax, and it will help him relax.

 

Oh, most cats need anywhere from 200-300 calories a day. Really depends on the cat, the activity level, the weight, and health. You kinda gotta play around with the food so their weight is stable, however it's normal to gain a little when insulin is first started. I think "as much as he'll eat" is fine advice for now, unless "scarf and barf" is an issue. He's not able to use all the calories he eats.