longish term diabetic showing signs of neuropathy

Hi all,

Just looking for some advice on what to do with my cat. I've searched the internet & found a few different articles regarding neuropathy etc but I can't find one that directly relates to my cat.

My cat (Spazz) is 12 1/2 years old & was diagnosed diabetic in September last year. She has been on insulin shots & diet since the beginning of November. Her initial dose of insulin was 3 units twice a day, but that was reduced almost immediately to 2 units twice a day (because she had lost her appetite completely on 3 units). In the beginning of April I took her back to the vet for a check up & he increased her dose to 4 units twice a day because her blood sugar was still too high. This was going well & no real problems that I could see, until very recently. I noticed her having a bit of a harder time jumping onto our bed and the couch in about the last two weeks or so. But this weekend I noticed that she was sitting differently, and her feet were sliding out from under her once in a while. She also can't walk very far without having to lie down, and she also lies with her back legs to the side. Today I've been investigating what this could be & I see that it is most likely neuropathy.

What I'm not sure of is the fact that her insulin/blood sugar has been regulated in some way for 8 months, and this is suddenly happening now. There has been no change in her diet, or her water consumption. Any ideas on why this may be affecting her now & what I can do to help her? She is on Lantus (glargine) insulin & her current bottle is almost empty - could it be that her insulin isn't potent anymore? I see that the form of vitaminB12 is suggested, but I'm unsure of where to get the capsules/how to get her to take them (she's awful with pills). I'm also somewhat hesitant to take her back to the vet for another appointment, as she gets very stressed now & vomits (and also poops) on her way to the vet. I also have a husband that doesn't see the "point" in spending a lot more money on a cat that is sick.

Thanks in advance for any advice & suggestions.

 

Hi,

I am also wondering about my cat as well, also 12 years old, but has had diabetes for 4 years.

Here is a link someone had also sent me. I had googled B12 (mehyl...) and a few places did come up as having it. I think the creator of the website below also provides places to order. It also seems relatively cheap $15 for the spray.

http://laurieulrich.com/jasper/

Good luck!
Dianne

 

Hi there

Hope you're prepared to read a lot! Welcome to the FDMB, I'm adding some links for you to give you more info.

A few questions,

- how old is your lantus? Meaning when did you open it? How are you storing it?
Proper Handling & Storage of Lantus/Levemir
Note: manufacturer's recommend tossing your insulin after 28 days. That is their recommendation. Many of us who have used Lantus and/or currently on, find we can get a bit more days out of it.

- Are you home testing at home? Or just at the vets?
- Is the vet testing through the day and night to make sure her numbers are stable?
It sounds like she is being tested at the vets - which will can also further increases her BG numbers due to vet stress. Sounds very traumatic for her. Plus more expense for you in the long run.

Please have a look thru the home testing links.
Home Testing Links

- How has your vet determined your kitty's insulin dosage? As I mentioned above, vet stress can spike numbers up.

- Has your vet tested/checked for ketones? Easily done at home by purchasing a Ketostix box from any pharmacy.
Ketones

This link I found very useful for me when I was looking into neuropathy.
Diabetic Neuropathy

- What are you feeding? If it's dry prescription food, that also is higher in carbs and can raise and keep numbers up. Have a look thru Dr Lisa's Feline Nutrition link for lots of good info.
Dr Lisa's Feline Nutrition

If you could answer some of these questions, it will help others offer their feedback, ok?

 

I also should add info for you on Hypo.

Without home testing or the vets taking tests thru any given cycle, there is no way to know if your kitty is experiencing a hypo situation. I don't mean to scare you - this is why home testing is very important. Do keep an eye out for any of these signs:

How To Treat Hypo
Jojo's Hypo Tool Kit

 

My best guess is that she's not as well regulated as you may think. I would suggest starting to home test her and get a better idea of what her daily glucose levels are really like.

 

Here is the methyl B12 I used and recommend:

http://www.vitacost.com/NSI-Vitamin-B-1 ... cobalamin/

I emptied one capsule, mixed into wet food daily.

 

Welcome Amy & Spazz,

I completely agree with Deanie. Unless you are hometesting blood glucose and know how low an insulin dose is taking the glucose level, you cannot be sure of anything. Fructosamine tests give a raw average and within that can be a huge range from lows to highs. Extreme or fast lows can bring on Somogyi Rebound, so BG goes up as their liver releases stored glucose to protect them from hypoglycemia.

You asked about the efficacy of the insulin - how long has it been since you began using the current vial? If it's more than 3 months old, then possibly the Lantus is past its effective point. So that is worth investigating as well, just get a new vial, but are you aware Lantus can be purchased in pen form, usually 5 packs to a box? It is cheaper over time that way than a vial.

Any sign of neuropathy in a cat receiving insulin should be cause for concern. When I began my Feline Diabetes journey with Gandalf he received up to 6U of PZI type insulin once a day and had developed neuropathy in his hind legs. Once better regulated on 1.5U of PZI twice a day the neuropathy cleared up. Yes, you an supplement with the Methyl-B12, but the real cure for neuropathy is regulation.

The best help you can give Spazz is to begin home testing and start a fresh vial or pen of Lantus. Unless the diabetes is caused by Acromegaly, 4U is a pretty high dose for Lantus. Not unheard of, but with the neuropathy signs, dose and freshness of the insulin should be the first areas of investigation.

We determine dose by hometesting, NOT by random blood glucose curves or fructosamines at a vet clinic where stress affects the results and may cause the determined dose to be too high. It has now become the recommended method for monitoring and controlling feline diabetes by the American Animal Hospital Association.
http://www.aahanet.org/PublicDocuments/ ... elines.pdf

If you would like to learn how to home test, we can talk you through it and we may even have a current member near your area who would be able to do an in home demonstration. Bless you for being concerned about Spazz and looking for alternative help! That's what we're here for.

 

Amy,

Wanted to add a word encouraging you to start hometesting. My kitty was on insulin for four months without hometesting, and in retrospect, I think he could have had a hypo, and I would have missed it. once we started hometesting, we adjusted Kitty's dose, and eventually got him regulated. He had neuropathy too, but with regulation, it improved.

The end result: Kitty went into remission after 15 months on insulin. We would NEVER have gotten there without hometesting.

You'll get great peace of mind knowing how Spazz is reacting to each shot. There are lots of people here to give you the support and information you need to get the hang of it.

Good luck!

 

Hi everyone,

Thanks for all of the advice and words of encouragement. The encouragement & support is really needed some days (as I'm sure you all know) and it's greatly appreciated.

Spazz's Lantus is stored in the fridge but was opened in April. I bought a new vial yesterday & will try that. I spoke to my vet (to get the prescription) and explained to him what was happening. He advised me to increase her dosage to 5U twice a day, and may possibly go up to 6U. That seems like a lot to me. I have been considering doing home testing, but unfortunately I don't have a lot of income to do as much as I would like for her. Does anyone have any suggestion on how to proceed with home testing on a budget? I live in Winnipeg, Canada so if there is anyone in the area that can provide me with info on where to go & what to do that would be fantastic.

The vet had checked for Ketones at her last checkup, and everything was fine in that regard. When she was first diagnosed he did a BG curve over a few days, but since then he does fructosamine tests when I take her in.

Does anyone also have suggestions on the best wet food to feed? My vet had initially had her on Hill's diabetic, but at her last check up he informed me that the carbs in the food were actually quite high, and provided me with a link to wet foods with lower carb content. Unfortunately in my area the only kind that I could find with low carb was Friskies (which I know isn't the greatest quality of food). Since I live in Canada we don't have as much variety of brands to choose from - any other Canadians with suggestions? He also has her on 1/5 cup of Purina DM dry/day. I've noticed links to other websites suggesting that dry food should be eliminated completely from the diet. Is that recommended?

Did anyone else experience a lot of vocalization with their cat once they were diagnosed? Spazz has always been quite vocal, but now she has become quite a bit more so. At the beginning she was fed at 5 pm and around 6:30 am, but in the last couple of months she demands to be fed at 5am. She meows quite a bit during the night - starting at about 3 am, and increasing at 5am when she is fed (I no longer need an alarm clock to know when it is 5 in the morning - her knowledge of what time it is is kind of impressive to me). I wish that she could actually talk because besides her feeding time I never know what is bothering her, and I just want to help her with whatever it is.

Sorry for going on & on. I'm just relieved to find a group of people that understand what I am going through. Everyone else I know thinks I'm crazy for doing all this for my cat.

Thanks again everyone,

Amy

 

Amy,

I cross posted your location into our Communtiy forum.

From what you wrote above, home testing is essential. Go to your local pharmacy and pick up a test kit.
Here is a guideline for recommended meters:
Consumer Reports Meter Reviews
Note: The Relion meter from Walmart, is not available in Canada, but there are plenty of good other meters to choose from.

The vet visits (Fructosamine) is only going to add up your expenses.

Please read thru the links provided, especially on nutrition...this one too Janet & Binky's food charts.
Janet & Binky's Food Charts
The grocery store brands such as Fancy Feast and Friskies are good choices for low carb wet food.
Check your local pet stores, you should be able to find other brands from the list too, like Wellness for example.

Keep in mind: Very important: you need to be home testing before you switch from dry to wet food
Transition From Dry to Wet Food Please read

 

Hi Amy,

The initial cost for the meter and strips will be far less expensive than one fruitosamine test from the vet. You can often get the meter free; it's the strips that are expensive, but you can buy them on ebay for 50% of the store price. (I don't think the usual favorite, ReliOn, is available in Canada.) The lancets are cheap.

I agree with everyone that you don't really know what is going on with Spazz until you test at home. The vocalization could be that he is going low at night and feels badly.

Yes, it would be best if you completely eliminated dry. BUT DON'T DO THAT UNTIL YOU ARE HOMETESTING. A completely wet, lo carb diet can drastically reduce the amount of insulin needed and if you are not on top of the numbers that day, you could easily give too much. Many of us feed Fancy Feast, but other higher quality foods are low carb also - like Wellness. Check out this chart: http://www.felinediabetes.com/diabetic-cat-diets.htm You want a food that is under 10% carbs.

Here is the video for hometesting: http://www.youtube.com/watch?v=_zE12-4fVn8

If I were you, before I would increase his insulin, I would start hometesting and then change the food.

 

Hi Amy!

I'm originally from Brandon, went to University in Wpg and now am in Alberta

Honestly, your vet has you going about this wrong. Testing will SAVE you money in the long run, and it makes no sense to be increasing that dose without testing at home. Human diabetics test at home and so should you. Your best bet is to see if Cindy has a free meter and strips or if someone here in Canada has got one kicking around. Or you can get a free meter if you buy strips (the strips are the expensive part). That dose may be too high (depending on food, other conditions etc.) and you aren't doing your girl any good by increasing so much. This is NOT a criticism of you though!

Let us know how we can help

Jen

 

Hey there Jen! Always nice to see another Canuck!

Welcome & good job getting here- this is definitely the place to be to get your cat well. I've only been here a month, and these wonderful people have helped my family so much.
-
Just a few tips; buy your first bottle of strips at the pharmacy to get your free glucometre (the strips will probably cost around $80/100 strips), and buy subsequent strips online or by ebay for way less. Home testing is really the only way to go. Look around and see how many of these great people have their pets OTJ (off the juice/insulin free)- that's because of a strict wet food only diet, and frequent testing.

I was reticent about switching to wet food too- it seems soo expensive! However, if you get the food on sale, it ends up costing the same or less than prescription or higher end dry food. Many people here use Fancy Feast (check this page to see which are low carb, you'll want to keep the % of carbs below 10%, but most people try to keep it under 5%) which you can get pretty cheap, or Friskies. If you'd prefer a higher end wet food, you can get some great deals (I just bought a bunch of By Nature food for less that half the store price) through pet food direct.

If you'd like to see the difference a switch to wet food can make, take a look at Max's SS!

Keep up the good work, things are going to be fine.

Holly

 

Hi again Jen!

Just one more comment- about the Friskies/Fancy Feast thing. I didn't want to feed my cats that stuff and was making a big fuss (we eat mostly vegan & local, almost no processed foods, etc -yeah, we're yuppies, what do you expect in Vancouver? ;-) ) until my husband made a very good point.

You see, my downfall is a good hot dog. Oh my gosh, it's 8am and my mouth is watering! The thing is, if you'll feed yourself a hotdog, then there is no reason why you shouldn't feed your cat a budget brand food. It's all made out of the same stuff.

My cats like Fancy Feast, and it comes in a very convenient size for early in the morning feedings. Friskies they will eat too, and it is soo cheap. I figure I'll feed them the good stuff while I can afford it, and if money gets tight (like with the addition of a *gulp* baby perhaps) we'll go with the budget stuff.

Hope my rambling has helped, or at the very least, has not hindered.

Holly

 

Holly, Amy is the OP (original poster), not me

 

EEEP! I linked to this post through the Lantus group and just assumed...

Well, welcome Amy too! Hopefully I've posted something useful, and now I'm just going to go away...

 

getting the names mixed up doesn't invalidate your ideas!

 

I'll be quick about what I have to say.

Do NOT raise the dose until you are home testing. A dose of 5units is kind of high and if your cat is needing that dose, you should be looking into reasons why. Most cats don't need that high of a dose, so that's why you need to be testing to find out what's up.

Go to the pharmacy and pick up a BG meter; ask about a OneTouch or Aviva or any other that they have. You may be able to get the meter free when you buy the test strips.
Any meter is going to better than NO meter.

If you are changing foods, OFTEN the insulin needs go down, so that's another reason to hold whatever dose you are giving. Switch to something like Friskies or Fancy feast; they are fine but be sure to get low carb - ones without the gravies. Get the pate ones. You do NOT need to be paying an arm and a leg for all that fancy expensive rx food from the vet. it's a waste of money and got lousy ingredients anyways. And why a vet would say to feed a diabetic dry food that is full of carbs just tells me this vet does not know much about feline diabetes.
Cut the dry foods.

About the dry foods. I have one cat who eats only dry, but not diabetic. She would starve rather than switch but that's another story. My Shadoe, if she gets even just a small mouthful of say 6 pieces of dry food, her BG goes through the roof! So yes, dry makes a BIG difference. Be very careful that you are testing before you cut out that kitty krack from the diet.

You MUST be testing before giving any shots. Ask any human diabetic and they would be shocked if you said 'just shoot, never mind about checking your BG first.' So why do that to your beloved cat?

For all you know, you are giving too much insulin and causing problems!

I must sound like 'the sky is falling!' but it's very important to test. If your vet says it's not important, disregard that stupid vet comment. Just smile and nod and say ok ... then go home and TEST!

I am from Winnipeg, grew up there, lived near Logan and McPhillips, so I am a Prairie girl. I still have most family there too.

The other guys all gave you great links but in particular, study those HYPO links. Look at the signs and know them. Have a hypo tool kit put together so if you find out when you test that the numbers ARE too low, you will be able to do something about it.

Once you get the meter, if you have any problems at all in testing, just post and lots of people can help you out with tips and sites with pictures. there are even youtube's that can show you how to test the cat's ear.

When the vet says let's do a fructo test, laugh. Why pay money to tell you what you know already from your own home testing? The only thing that test is good for would be BEFORE you are giving any insulin - you can find out the average, how your cat's BG has been over the last couple months or something. And what good is that? It's going to say oh your cat is not regulated! Wow, big surprise there! Total waste of money.

When the vet says bring the cat in and we will do a curve, laugh. Why pay money for something you are doing by home testing?

Testing for ketones can be done by YOU. Pick up a bottle of KETOSTIX from the pharmacy and test the urine yourself. When you are testing and you find that the BG numbers are high, you should be testing for ketones frequently, every day if you can. No big deal, not hard at all, something you can do ... easy peasy.

Use your vet for things like blood draws for tests, Xrays, ultrasounds, dental cleaning and fixing, stuff you can't do for yourself.

OK that's enough of my meanderings.

Welcome to the site, you are in the very best place now for help for your cat.

 

Thanks everyone for all of your advice. I'm starting to feel better about this already. Lately I've been feeling like I've been fighting a losing battle!

Her current diet is 1/2 can morning & night of Friskies (so a full can a day), and the 1/5 cup of dry food/day. Would it be safe to take her off the dry food altogether? She has always been a grazer (I never really had her feedings at twice a day before all this happened) and I'm sure that she would be quite unimpressed with not having her food throughout the day. Does anyone have any suggestions for a treat that I could give her after her shot that won't raise her BG too much? I feel like I should be giving her something for putting up with getting poked twice a day, but don't want to contradict her insulin shots with treats. I suppose I've always sort of spoiled her, and that's most likely the reason that we're in this situation now.

Jen - you had mentioned to see if Cindy has a free meter/strips. This may be a stupid question....but who's Cindy?

 

Amy

do not take the dry food away until you are testing; otherwise it could have the intended effect of lowering her insulin needs...which is not good if you aren't testing and catch it.

Cindy posts free meters sometimes in this forum but I see it is in the supply closet - viewtopic.php?f=15&t=304. just note that meters bought in the us have different measurements but you can convert.

For feeding, simply give her more that 2 meals a day...you can use a timed feeder during the day or feed at breakfast, when you get home, and at bed time. You do not need to leave dry down so once you are testing you can take it away. Treats are absolutely fine; preferably ones that are mostly protein, like bonito flakes or chicken or shrimp....

Jen

 

I leave canned food out 24 hours in my home for grazers. My cats are indoor only, and since the AC is on most of the time, it doesn't get too hot, and no insects can get on the food.

 

I don't think Cindy is doing the meter/strip kit thing, but maybe Lori is or will be?

About a snack, Oliver likes just pieces of raw chicken; he is such an animal LOL.
Shadoe likes steamed chicken. I usually get chicken for myself and just steam it then dice it into little cubes. Shadoe likes them. You can also look around at pet places or WalMart and pick up some PureBites - they are freeze dried 100% chicken pieces. Get them in the dog section for the bigger and more economical bags. Chicken is chicken so why charge more for cutesy little bags for the kitties?

Many people use timed auto feeders. It is better to spread out the food through the day, and if you have a kitty who gobbles it all down in the morn, then you are away at work all day, they go hungry till you get home. It's better for their BG to give more frequent smaller meals.
I use the PetSafe 5-section autofeeder - here's what I have:
http://www.petsmart.com/product/index.j ... Id=2751315

It rations out the food and better stabilizes the kitty's BG.

Treats after testing? Well, that would mean I would have to wake my cats up first!
Seriously, most times, my cat's sleep through the testing.
Also, for 2 of the tests, you are giving the shot and the meal right after so no need for a snack!
Others will surely have some good ideas for snacks.

Before cutting out that dry, get a meter and start testing. Get some idea of her numbers first, and we can help you get set up with a spreadsheet and a profile.
Click on the links in my signature for the spreadsheets and profiles for my two and you can see how we track the numbers.
You want to be sure that you don't cause the numbers to go down by taking away the dry food and leaving the dose where you are now.
If your numbers are already not too bad, it may be an idea to lower the dose as well as remove the dry. The others can let you know about the best way to do that safely.

Spoil her? :lol: I think that's a given. Sadly we all have in the past spoiled them in unhealthy ways, but that's ok. We will fix that now. There are lots of healthy ways to spoil the kitties. When I wave a strip of raw chicken under Oliver's nose, if he were a dog, his tail would be wagging like crazy!

When I get home, I can send you the conversion sheet I use for our Canadian BG numbers and the ones that others here put on the spreadsheets. When you look at Oliver and Shadoe's sheets, you will see that I put a couple values into each field. I put the Canadian ones because every time I go to the vet, I take a copy of the spreadsheet to let her know how well my cats are doing with home testing. She does not ever question me know; she knows my way is the good way!

 

Amy -- You have far more experienced people posting here. You can trust their experience. They have seen many, many cats.

I really want to share my experience with you, because it sounds like your vet may be going down the same bad road my vet did.

When my kitty didn't get regulated at 2 units, the vet kept raising and raising and raising. Amy, he had me giving 5, and then 6, and then 10, yes TEN units a day without testing. I know now that my kitty was being damaged by that treatment.

If a cat is getting TOO MUCH insulin, he won't get regulated any more than a cat getting too little. My vet was misreading the results, and I nearly lost my baby.

When I finally found FDMB, and another vet, we started over at 2 units twice daily, and worked our way up by half units, TESTING all the way.

You can not know what this insulin you're giving the cat is DOING until you start testing.

Consider this financially: Your kitty could get regulated, and get off insulin. How much money would THAT save?

You have the best support system in the world here. People will help you find the right meter at the best price. You'r in the right place now.

Hugs.

Kathy