Looking for info and advice for my sugar kitty

Hi everyone! Our cat, Tigger, who is 15 years old, was diagnosed with diabetes August 2015. Prior to diagnosis, he was pretty bad off---eating and drinking excessively, major weight loss, neuropathy in the hind quarters, lethargic. Our vet put him on Vetsulin and Royal Canin glycobalance dry food. I have since stopped the RC dry food and he currently eats only wet food---usually Friskies, sometimes Fancy Feast. I try to stick to the pâté kinds, but sometimes he gets the bits or shreds version. His weight went from around 16lbs to around 7lbs -before diagnosis- so he is no longer overweight, but now underweight. I use a Precision Neo to test him for his blood sugar. He just went in for a recheck because he seemed to be going down hill a bit. Blood panels came back with him being uncontrolled again. So, his Vetsulin was increased from 2 units to 3 units, but after a home glucose curve, vet advised to lower just a bit to 2.75. He also had a Fructosamine check this week, and the vet said he is in the "fair control" group, which is an improvement over his last check. Also, I have seen his levels at a low of 40 (too low) and a high of over 400-500 (too high) since the dosage increase. He's has some great numbers and some borderline high numbers, but nothing really consistent yet. He does not have any of the other accompanying ailments of diabetes (CKD, thyroid problems, etc.) yet. He grooms himself well still and his fur is looking good right now. He currently gets one can of food in the morning & one can at dinner time, with 2.75 units of Vetsulin at each feeding, and a snack(about half a can of food) at around 11pm-midnight (no insulin at snack time).

I have questions I'm hoping you all can give me good advice on. They are:

1. Is Vetsulin a good insulin for him, or do you know of one with better results, longer lasting, etc?

2. He really needs to put on some weight---I would be happy if he was in the 10-12lb range, just a healthier weight. I know that is controlled somewhat by his insulin regulation, but what kind of feeding schedule is good/better? Only twice a day, four small meals a day, etc?

3. On the Precision Neo meter---since it is a human meter, is there a curve to the numbers I should be accounting for or is the readout I get when I test be accurate?

4. His bowel movements are very soft, sometimes loose, and goodness they smell! I'm am fairly certain this is because of the switch to wet food only and the insulin. I had him on a human probiotic for a while, and it helped, but I'd like to put him on one that is specifically for cats. Recommendations? I've heard of Fortiflora, but I know there are more out there.

Thank you all in advance! Our current veterinarian is closing their small animal practice, so we are looking for a new vet for Tigger. Any advice/information you give me will help when I go to the new vet and get his care established there.

 

Welcome Rachel and Tigger.
You have come to the right place for lots of excellent information about feline diabetes. There are many very experienced people here who are only too happy to help you.

In answer to your questions:
1. Vetsulin is not really a good insulin for cats. Lantus and Levimir and Prozinc are much better options and are not nearly as harsh as Vetsulin. Not sure where you live...if it is on the UK I think you might have to start out with Vetsulin and then graduate to one of the others when it can be shown that Vetsulin is not working.....which it is not for Tigger.
If you are in the US I don't think you would have trouble swapping.

2. If you are using Vetsulin you need to make sure Tigger has eaten well before giving the insulin as it drops the BSL quite quickly. With Lantus and Levemir it is a gentler insulin and the food can be spread over the day more easily. We often give two meals in the am and two in the evening. Others let their cat free feed. The only thing you need to do is lift the food for the two hours before the preshot so it is not influenced by food.
When they are not regulated, cats bodies do not absorb all the nutrients from the food, so they are always hungry and will lose weight. I would let Tigger eat what he wants while he is unregulated, making sure he has a good meal before insulin shots, especially using Vetsulin.

3. Most of us use the human meter. It reads slightly lower than the feline specific meter and you can adjust the numbers if you want to but most of us just use the human meter and stick with those numbers.

4. The soft bowel movements could be from the change in diet. You might like to try another canned food just in case he is allergic to the current ones. I use mashed pumpkin for Sheba and it is very good. She had chronic loose stools and no cause could be found. It turned out she was allergic to the canned food I was giving her. Mashed pumpkin is good for both constipation and diarrhoea. If you buy it canned, make sure it has no additives, just plain pumpkin. I cook my own pumpkin in water then mash and divide up and freeze. I give a small teaspoon to Sheba twice a day.

It looks like Tigger is bouncing from the increase in insulin if he is dropping to 40 and then going to 400-500. You definitely need a reduction in dose from the 3 units or whatever dose is giving him those numbers.

If you tell us where you live, there might be someone who can help you with a recommendation for a vet.
You will need to find a vet who has a good knowledge of feline diabetes, who is happy for you to home test and who you are comfortable with.

Keep asking questions....we are happy to answer them

 

Bron,

Thank you so much!

We live in the U. S., in the Pacific Northwest town of Graham, WA. Nearby cities are Tacoma, Puyallup, Parkland, and Lakewood. Our current veterinarian is fresh from college, and doesn't have a lot of experience with diabetes in cats yet. She was really insistent that he stay on the Royal Canin glycobalance dry food, and I actually lied to her and said he wouldn't eat it, and I was putting him on wet food only. Lol just made it easier without any discussion back and forth. She's been really good to Tigger, and has tried to help him as best she can, but I feel like I know more than she does about it at this point. We will be changing vets soon, as our vet office is about to close its doors to small animals. It's a small, rural veterinary office, and it's hard to get veterinarians to drive that far out and stay, I think. Which, is one of the reasons I am here, so I know what to ask for when I get to this new veterinarian.

Thanks for the Vetsulin tips! I had a gut feeling this wasn't the right insulin for him, and now I know I was right. I will start feeding first and then giving the shot after so maybe it's a bit easier on him for now. At least until I get him settled in at a new doctor. I'll also feed him more to keep his energy up. I hate seeing him so desperately hungry, when I know it could be fixed with the right insulin and dosage.

As far as the poop problem, I'm pretty certain it is diet-related. I didn't know about pumpkin. I will try that. Is it better than giving a probiotic? Would you recommend using the two together?

Thank you again!

 

Rachel, lots of us have said that our cat will not eat the prescription foods, especially the dry which is really bad for cats, so don't feel bad about that. Dry food is not only too high in carbs, it has only about 7% moisture compared to wet food which has about 78% moisture. Moisture is very important to cats who are generally not great drinkers....they can get dehydrated with high BSLs and extra fluids not only help combat that, it is much better for their kidneys.

Most of us find we know more about FD than our vets (my vet openly admits it). They have so many animals and diseases to get their heads around and FD is only one of them. We live with it 24/7. You need to find a vet who will work in partnership with you to help Tigger.

I think pumpkin and probiotics work in different ways. The pumpkin helps form normal poops and the probiotic adds good bacteria to the alimentary tract. I can't see why you can't use both. Pumpkin is only a food and there is nothing to say a probiotic can't be given with it as far as I know.

Re feeding before giving insulin. No matter what insulin we give, we all test first, then feed, then give insulin in that order. With Vetsulin it is even more important to do that.

To find out more about finding a vet where you live, I would write a post in the main forum...here http://www.felinediabetes.com/FDMB/forums/feline-health-the-main-forum.28/
And write in the subject line something like ......."looking for new vet in Graham WA"......then write the other towns that are nearby in the post.
You are doing a really good job looking for ways to help Tigger! That is great!

 

Here is a list of things to ask a new vet...from @BJM
https://docs.google.com/document/pub?id=1BqrojKe9oBVAoexL59pUWidEd7viNmxSqW5l2IBTWjY

 

Has Tigger been tested for pancreatitis? This could be another cause of the loose stinky poops and the failure to regain weight.

 

Hello Rachel and Tigger,

Welcome aboard. Finding a vet is one the hardest parts of FD. If you can find one who will work with you, advocates home testing and is willing to research and read up on it, is worth their weight in gold.

In October, I switched to Lantus insulin. My vet never heard of it. I had to show him how to use the pens with a syringe. Just this week I asked about possibly changing insulin and to think about it before our appt next week. Now he says Lantus is the best insulin for cats. However, he will look into the others I mentioned. He is willing to learn. He loves the spreadsheet we use. If he hasn't received it (by email) he is calling me for it.

My vet has two new doctors in his office, recent graduates. The female is unsure of herself and readily told me she has no knowledge of FD. I haven't met the other one yet. There is one other I see if it's emergency, she has some experience with FD but she lets the techs do any testing and I didn't like how they did it. I was not a happy mama and Smokey was becoming extremely agitated. So I made them stop.

You might have to go through a few to find one you like and one who doesn't mind if you question them. Good luck.

 

Other than an emergency situation, make 1 change at a time, food wise/supplement wise, so you can determine its effectiveness.

Also, take a look at the Secondary monitoring Tools in my signature link. Most of these are the kinds of things a vet will ask when you bring in an animal. Food and water intake and output, behavior changes, dehydration checks (explained), and urine ketone and glucose testing are some of the more useful ones for diabetic cats.

 

Alexi,
No, he has not as of yet. We will be getting a new vet soon, so I will be asking about this when we are there. I wondered if maybe it could be something else, but who knows at this point. Thank you for the response! Appreciate it!

 

Thank you for your response! I actually talked to my next door neighbor, who had a cat that was diabetic, and she said her vet is WELL versed on FD, so I think that's where I'm going to start for his new vet. Our clinic shipped our records over to a new vet that agreed to take on their patient load after closing, but I don't know if they know anything about FD or not. I'm just ready for my fella to feel better, and just have an overall better quality of life, you know? For whatever he has left of it =) I'll let you know what happens! =)

 

Thank you, Bron! All the info you've given me is great! I know Tigger is going to do better with all the information I'm getting here. =) I think I may have a lead on a vet that is experienced in FD from a neighbor who had a cat with FD herself. She said her vet has been in practice for over 30 years and knows a lot about them. So, I am very hopeful!