Miss Emmy is diabetic

Hello, I have a 14 year old cat with back issues. She was placed on prednisone for her back and has now developed diabetes. My vet is sure that the prednisone that she was on was the culprit and is hopeful that she will go into remission. We went in today for our first diabetic"tutorial" after being diagnosed. Emmy's blood sugar was approximately 250 at the vets office, which was down from her initial test. My vet debated on putting her on insulin, but knowing how picky an eater Em is, we weren't sure that it could be controlled with diet alone. (Emmy has dental issues and must eat a canned food, she also has a very touchy stomach and will often vomit her food if it doesn't agree with her) So because of her sensitivity issues, and the fact that we believe her diabetes was induced, we decided not to play around with her diet at this time and chose to go with a very low dose of vetsulin 2x a day. I am planning on getting my own testing meter, but do not have one just yet. In 2 weeks we will go in for our first curve test to see how she is doing on it.
Currently Emmy is eating a combination of regular Friskies mixed with Friskies Indoor Selects. It is a combination that has curbed her tendency to throw up her food for the past several years. (she went from throwing up 4-5 times a week to maybe once every other week) I am open to tweeking it, but I do need to make sure that she can keep anything we try down because IMO no diet is good if they can't/won't eat it.
Sorry if I'm rambling a bit, being new at all of this has me a tad rattled, plus it is hard seeing your baby hurt and since we had to pull her off the prednisone for her back, she has been in a good deal of pain. We are currently trying an alternative pain med and it does seem to be helping her out so I'm hoping I'll get my head on straight shortly and be able to think more clearly about what needs to be done.

 

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. All of our insulin guidelines use human glucometer numbers for reference.

- 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.


For the arthritis, discuss with your vet the use of Adequan injections to aid with this. Some folks find supplementing with a little fish oil and/or glucosamine may be helpful, too.

 

Emmy has started the Adequan injections. She is still on her initial 6 doses and will shortly begin getting them once a week. I also put glucosamine on her food daily. My vet has also switched her to metacam for pain. I know it has potential side effects, but without something to help with inflamation and pain now she doesn't really want to move at all.
Unfortunately, a dry food won't work for Em as she has a history of peridontal issues and has lost most of her teeth (it started as a kitten) so she is unable to chew anything dry. We think this is also why she has such a sensitive stomach.
I know that Em prefers, the food with juice/gravy on it, but I am seeing now that it is probably best to give her pates. She does eat pate varieties now, but we tend to give more of the gravy/juicy varieties. She is going to be a tad grumpy about the switch, but I think she can deal with it so long as it is a familiar flavor.
My vet recommended the Alpha Trac tester for her, and we did find it on Amazon for significantly less than they sell it for, but I've heard that it is possible to use human glucomiters. how do they differ from the one designed for dogs/cats?

 

There can be a significant difference between the carb levels of the canned pate foods and those with gravy on them so I would suggest you be testing Emmy before changing her diet to all pate when also starting insulin. Diet changes alone can sometimes have a major lowering effect on glucose levels.

Since you have stopped the prednisone which may, as the vet said, have been what brought on the diabetes, changing Emmy's diet to all pates along with the medication change could cause her glucose levels to drop dramatically on their own to the point where insulin is no longer needed.

Pet meters read higher than human meters so the reading of 250, assuming this was on a pet meter or from a lab, is just above a reading where we would even give insulin to a kitty just starting out when no data to know how they react to insulin is available. What dose of Vetsulin did your vet prescribe?

It's entirely up to you whether you get a pet meter or a human meter. Both are good choices. The reference ranges on this site are for use of human meters because that is what the majority of folks here use. There are however a number of folks who use pet meters and we can help no matter what you choose to use.

Please note though, if you decide to use a human meter, that your vet needs to be aware of this so that any home readings you discuss with your vet are not misunderstood/misinterpreted.

 

If she was 250 at the vet, it is likely she will be much lower at home. Stress raises blood glucose levels and most cats are very stressed at the vet. I am concerned about the starting dose. We suggest starting at one unit. Two units seems a high dose, especially for a cat who has low numbers to begin with.

 

Vetsulin is also considered a harsh insulin and could cause more tummy problems. There are not too many that use that insulin but what I have read, you need to make sure that your kitty has eaten and possibly waiting 20-30 minutes after eating before giving a shot. Here is some additional information on Vetsulin: http://www.felinediabetes.com/FDMB/threads/vetsulin-caninsulin-user-guide.302/