need help--to treat or not to treat...NEWBIE in MI

Hello,

My apologies, this is going to be long...

My cat Max (8yo last October) was diagnosed Friday with diabetes. It's possible something else is wrong, but without treating the diabetes first, the vet can't run any other tests reliably. He's always been a "pukey" cat--he'll throw up fairly easily if he overeats, but last fall the vomiting gradually increased. He saw the vet in October, she recommended changing his food to Science Diet Light/Hairball (both cats had been on it before, but I'd switched due to cost). I did switch it back, and it didn't help. I switched both cats back to Iams Indoor/Hairball Light, and that at least brought the vomiting down to just water, or mostly water--no solid or undigested food. In December the vomiting became downright unbearable--throwing up at least once a week, but closer to twice a week. I finally got him in to the vet at New Year's, and she thought it might be IBD, so we tried some low-allergen Rx food for two weeks. That improved it, but didn't eliminate it. At New Year's, he'd lost about 1.5lbs since his visit in October. For a 16lb cat, that was only slightly concerning, and we figured most likely due to all the vomiting.

After the Rx food didn't change things, we switched back to the Iams, and put him on prednisone for a month (2 weeks daily, 2 weeks every other day). During that time, he lost more weight, but the vomiting nearly stopped. He only threw up twice during that time. I made an appointment to have his weight checked tho because he was definitely skinny and feeling bony. I'd been through tryign to nurse a cat back (unsuccessfully) from liver failure, and knew was major weight loss felt like. So...on Friday he was 4.5lbs lighter than at New Year's. Definitely a bad sign, and the vet ran a variety of tests and came up with diabetes (BG was 500-something).

So here's my dilemma: 1) I'm a bit scarred by the experience of feeding a cat with a syringe and giving him pills every day for 2 months only to lose him in the end anyhow to liver failure. 2) I have a 2.5 year old daughter and a 5 month old son. I work 8-5, and have a 40-minute commute each way. I love my cat, I've had him longer than I've had my husband, but I barely have enough time to take care of my kids. I'm really not sure if I can handle the daily drill of caring for a diabetic cat, let alone the costs. Really, our son came a year earlier than planned--finances with two in daycare are TIGHT. And I also have another cat and a dog. Both of them seem relatively healthy, but given my current track record with cats (liver failure, diabetes), I'm not so sure. ;-)

Anyone have experience with a diabetic cat under these sort of home circumstances? And we do travel--half my family lives in CA, and I'm in MI. I don't really believe we have anyone we can rely on to care for him when we're gone...and don't even know if there is a place we can board him while we're gone. He's a bit of a high-stress animal as it is, particularly if he's not with ME. We live in a very small town, access to a lot of things is somewhat limited. Anyone have any advice? I feel awful for considering to put him down, but I'm having a hard time seeing another choice. I don't know yet what the costs are going to be--the vet is going to get back to me early this week (appt on Friday was just before closing, she stayed late to run the tests and called after hours to give me the news) with treatment options.

 

Newbie in MICHIGAN

Hi from Michigan - where are you? we have at least 7 FDMB members in Michigan - one is even in the UP. I live in the Novi area (NW metro Detroit)

Has your kitty been tested for Hyperthyroid? I have a HyperT cat and a diabetic cat, and my HyperT cat pukes MUCH more often - nearly every day right now - HyperT causes upset stomach and the medication, Tapazole also causes stomach upset.

My diabetic cat, Tiggy, --- I don't think I've ever seen him puke - we adopted him a year ago.

It is very possible that with a diet change to High Protein, Low Carbohydrate canned food, your kitty may become diet-controlled and not need insulin. Many diabetic cats need insulin for a little while to let their pancreas rest and recover.

You could definitely try diet change FIRST before starting insulin, and see how much the blood sugar improves.

Janet & Binky's Food Charts contain protein, fat and carbohydrate content of many foods. I don't have the link handy, but someone will post it soon.

Home testing blood glucose will save you on vet costs too. Also cats are usually stressed out at the vet, which gives extra high blood sugar readings from stress.

Other illnesses (infections) or poor teeth/gums can also cause temporary diabetes (transient).

Please post your city -- maybe one of us in Michigan can show you how to test blood sugar at home, and even maybe pet-sit when you travel - or at least take care of your diabetic kitty so reduce your worries when travelling.

I'm at work now, so I need to sign off. Will check back later this evening.

We can help you learn to treat diabetes on a tight budget. (((((((hugs))))))))

Edited to add:
Not treating diabetes results in a constantly starving kitty - eating like crazy and losing weight. The excess sugar causes damage to organs which can lead to organ failure.

Diabetes is very treatable, and sometimes a food change is enough -- dry food is not good for cats -- avoid grains and vegetables and gravies. The ideal food for cats is mice and birds. High Protein with some bones for calcium and organs for taurine. (plain meat is not a complete diet)

phoebe

 

Re: need help--to treat or not to treat...

I'm near Dundee, MI

Pretty much ditto what Phoebe said...

Woody had IBD but not diabetes. I found the chicken or turkey pate canned foods were easier on his system...he ate Friskies, so not high end. With the pred and S/D light, you may very well have a temporary diabetic...SOME cats can be thrown into diabetes from pred--*I* have used it without that happening but it Has happened to others...especially cats eating science diet weight management dry foods.

Perhaps try feeding him some boiled boneless skinless chicken breast mixed in with his food.

I used to work 8-5 with a one hour commute the entire time I treated Bunny. Diabetes is not time consuming. My biggest concern here is that something else may be going on. What was his blood glucose (bg) reading at the vet????

My Asp pukes all the time, but I think it's from eating too fast. He's not losing weight though...

As far as having somebody to care for your cat when you are away...depending on where you live, many of us help each other out. Annie, our second diabetic, traveled with us. She LOVED it.

 

Re: need help--to treat or not to treat...

I am from MI as well, but more in the thumb area. I believe dundee is about a 2 1/2-3 hour trip for me. Isn't it near the OH border? I could be wrong, only been there once I believe. I don't really have any advice for you, but listen to what others say on this board. So much experience on one site! It's amazing, these guys seem to know it all, and they will help in whatever way they can. A great bunch of folks here!

 

Re: need help--to treat or not to treat...

ok this message board is eating my posts!

Hi and welcome from another working mom with young kids and multiple pets!

I think that you've had poor vet care which has landed you guys in this situation. The vomitting issue needs to be resolved; it could be IBD or it could be pancreatitis..has your vet tested for pancreatitis? The dry food and the steroids may have been what induced diabetes, so another mark against the treatment you guys got. Steroids shouldn't really be given unless all other options have been ruled out, and pancreatitis looks like a possible culprit to me.

I think that this is all doable, but it will require an intensive amount of time at first; you need to learn about feline diabetes and the role that insulin and food play; you need to start your cat on a low dose of insulin twice a day and monitor blood glucose levels at home so you can make informed choices (cheaper this way too); you need to find the root cause of the vomitting and get it under control; you need to feed a better food that is more appropriate for cats and healther; and you need the help of your hubby to get you through all of this

What do you think?

 

Re: need help--to treat or not to treat...

I understand your hesitance about treating because of your previous experience, really I do, but diabetes is not bad once you get your cat off the low quality so-called 'prescription' junk from the vet and off the dry food that caused all this to begin with. And I entirely agree with Jen that you have had bad vet care, I'm just not as polite as she is.

My story has been repeated here hundreds of times--when I put my Quirk on insulin he got a bit better. When I changed his diet he was off insulin in 10 days. Total elapsed time from start to finish was 32 days, so I hope you'll decide to at least give treatment a try, the results can be dramatic. Oh, and back then there were no special diets, we just fed the best canned food we could afford and some additional turkey or chicken with every meal and for snacks.

The most important reading you can do is at www.catinfo.org , the feline nutrition site compiled by DVM Lisa Pierson. It's worth its weight in gold.

We're here to help, so you have a support system when you decide to try treatment. I don't think you'll regret it.

Gia & Quirk (GA)

Guilt trips are a detour from life

 

Re: need help--to treat or not to treat...

Hi and welcome! My cat Boomer got diabetes most likely from pred too. He has IBD and pred worked very well except that now he's got diabetes. He's now on budesonide for IBD which is a different type of steriod; it doesn't absorb to same way and somehow doesn't cause diabetes. Not sure why she didn't give me that first instead of pred; but it seems that pred can be used successfully for a lot of ailments. Boomer's been a diabetic for 4 months and getting better and better. His dose went from 2 units to one drop (2x a day) i am big fan of Lantus. Diabetes is a little more work, but it's doable. I work all day and have a 45 minute commute and i can do it. Granted, I don't have little kids. I think it's worth giving this a try! It's definitely manageable and we can help you!

 

Thank you all sooooo much for your kind words. We live in Grant, which is northwest of Grand Rapids. I guess I'll need to start doing some food research--naturally if we can control it with that, it would be awesome. From the reading I did yesterday, I did have to wonder if the pred caused this to happen. He's still acting normal, other than peeing on rugs and guzzling water. The pred did work for stopping the vomiting--he's been off the pred for a week and no vomit. I'm still waiting on the vet to get back to us with food/med options and costs. I'll have to call them today. She was testing for pancreatitis and thyroid on Friday--diabetes was never mentioned as a possible cause of his issues, and it did seem as tho the weight loss sped up while he was on it. My fault for not taking him back in sooner. Of course, I had no idea that dry food was so bad for cats either.

We don't have internet at home, so I can only do limited research while I'm at work. I certainly don't want to have to put him down if I don't have to...just definitely feeling overwhelmed with the extra care this condition may need. The vet we've been working with is young, and seems to not have much experience with dealing with this...thus why it didn't come up in any discussion as a possible cause for his problems. While this practice does see a large number of small animals, it was primarily set up as a large animal practice. We live in a farming area--not many vets or pet care options, and I get the impression that a lot of pet owners in my area can't or won't put up the $$ for treating special needs. I really, really miss the vet we worked with for the cat with liver failure. We lived in a different city then, she was older, and she was AWESOME. She also had a diabetic kitty at home--it was the first thing she tested for with Potter's liver failure.

 

Hardly anyone knew about the dangers of dry food. Between the advertising and the nice little profit center the manufacturers give the vets the idea of educating vets fell through the cracks. It's a mission for almost everyone here to educate people in the aisles of the pet food and grocery stores, welcome to that, too!

The two things, other than some high protein Nine Lives, Friskies, Fancy Feast or whatever, are ketostix, which are behind the counter at your local pharmacy, and insulin. Since you live in the US you will need a prescription for the insulin and it's safe to assume, from the information you have given us, that your vet knows very little about the choices available.

The two newest insulins, Levemir and Lantus, are proving to be the most effective for cats. Have your vet write the prescription for pens or cartridges rather than a 10 ml vial. Doses for cats are so low that the vial goes bad, the cartridges/pens hold 3 ml each, that's about a month's supply for most cats. The Insulin Support Groups fora for these insulins have basic information for you and yor vet.

Whatever you do, refuse the 'prescription' junk. It's made from poor ingredients and marked up so vets can make a profit selling it. To call it 'prescription' is an outright lie, since there isn't a single pharmaceutical ingredient in it, Stick to commercial foods, Janet's charts will help you choose wisely.

 

Sarah & Velcro may be closest then - she is in Lansing area.

 

My cats have eaten canned food before. At some point in the past, a vet said to try getting them onto at least 50% canned food to get Max's weight down. I did it for months, no weight change, and then they gradually decreased the amount of canned they were eating, so I stopped (stupidly) feeding it to them.

Because I think they'll eat it without a problem, is it safe to just make an abrupt switch to canned food? Or do I need to make it gradual? I'm going out on my lunch hour to buy some canned food to at least start the switch tonight.

And thank you, Gia, for the info on the insulin pens. Definitely good to know, and I'll be sure to mention it when I talk to her.

 

Some cats tolerate an abrupt change, others have more sensitive tummies...so you can transition over a few days if you think thats best.

 

The insulin pen cartridges come in a 5-pack. The least expensive that I have found is ordering from Canada

www.canadadrugsonline.com

 

I changed my four cats abruptly to all canned and they haven't suffered any ill affects. They have lost a little weight but that is because they don't always have dry food available to eat all day.
My one diabetic cat is also under control without having to take insulin so it is worth it for me to feed canned food if that will regulate him. I have also noticed that all of my cats are getting better coats since I have gone to canned.

 

Alright, I now have a variety of Friskie's cans and pouches in the trunk of my car that have a carb content of 11% or less, and the protein % is higher than the fat %. We'll see how the boys like the different flavors and go from there. There were a variety of other foods listed on Janet & Binky's list that were low carb, but the fat content was higher, sometimes twice as high, as the protein content...since we might be dealing with pancreatitis as well, I figured we'd aim for the lower fat level for now.

Does anyone know of a high-protein "treat" that I can give them? Or are a few "regular" treats okay? I always give all the boys some treats or a bone (for the dog) before I leave for work in the morning, and they follow me around all dejected looking if I don't. The ones we've been using lately are Temptations, but I can buy others if they're better.

Still haven't heard from the vet, but need to check the machine at home.

Thank you all again for all your help and input. It's nice to know I'm not alone!

 

For treats, some people just boil up a chicken breast and cut it into small pieces. At PetSmart you can also get Kitty Kaviar (fish flakes) and freezed dried fish and meat. All are lo carb. Temptations are unfortunately higher carb.

 

There are bonito flakes (available from some pet stores and I think from asian groceries), also chicken, shrimp, beef, etc.

 

i've developed a theory :smile: that cats brought from the streets for whatever reason handle food switches much easier than kitties who have been inside and coddled since day one or close to it. figure the strays/ferals have a bit stronger tummies from eating god knows what is what i think.

as far as treats go, i think the best is anything that's 100% freeze dried meat or regular meat. i buy some freeze dried cod & salmon at petsmart (bottom shelf, white tub, in cat treats section). i've also boiled up some chicken breast and chunked it too.

 

Oh, and is it okay to give him catnip? I know he loves it--usually rolls around in it and growls at the other pets to stay away while he's doing it, but he does eat some of it too.

 

definitely. catnip is still ok

 

Still playing phone tag with the vet about insulin...

In the meantime, tho, the cats both are devouring the canned/pouched Friskies with no issue. Whatever I put out is gone within 5 minutes of setting down the plate. I think we're done with the dry food forever.

And I found a coupon online to get a free glucose meter at the pharmacy, so at least I won't have that expense. :smile:

 

The test strips can be expensive -

I like the Maxima AST - only available online though - I order from www.hocks.com. If you use the link above, FDMB gets 8% for your order.

Maxima AST test strips run $16.49 per 50ct -- and if you buy 6 at a time (300 strips), the price is reduced to $15 per 50 ct.

The meter only requires 0.5 microliter, so one of the lesser amounts of blood. (harder to get big drops of blood)

 

We ended up with a free meter also. Yes, the strips are more expensive. But we really brought down that cost by buying in bulk on ebay. Just be sure that the expiration date will work for you, and that they are the exact strips for your meter.

 

Thanks, Phoebe. I'm ordering the Maxima today. It definitely costs less than the two meters I found for "free" yesterday, even with buying the meter.

 

Just talked with the vet. She recommended using "Glargine" insulin, 2 units, 2x's a day--and she recommended it because this particular insulin has a chance for turning diabetic cats back to being non-diabetic. She said if it worked, it would happen in the first few weeks. She also was going to refer me to Janet & Binky's website for food, so she was excited I'd already found it, and had switched the food.

She did recommend testing his BG at home, and gave me a website link with videos on how to do it. I haven't been there yet, but it's www.veterinarypartner.com for anyone who is interested. And then she also wanted me to bring him in for the day-long glucose testing two weeks after starting the insulin to see how he does with it over a day.

Here's a question--do I need to check his urine glucose if I'm able to check his blood glucose? She told me about some strips to use in the event he wouldn't tolerate the BG testing.

Oh, and as for the possibility of him having pancreatitis, she said he pancreas levels were NOT elevated, for what that's worth.

 

Good stuff! A few comments though

1. lantus/glargine should be started at 1 unit twice a day
2. you do not need to test urine glucose if testing blood glucose but testing for ketones is still important
3. a curve at the clinic is not a good idea if you are testing at home, as vet stress MAY skew results

 

This is the best place/link to go to for hometesting info. FDMB was way ahead of the vets on hometesting.
viewtopic.php?f=14&t=287

 

I agree with Jen's three points, I want to add that urine testing for ketones should still be done. I did it whenever Quirk was "off", if he had lost his appetite or if I thought an infection was brewing. Ketones lead to Diabetic Ketoacidosis, which can be fatal, so you need to know how to test and how to read the test. You may never have a problem,, most of us don't, but there are no garantees, so get the ketostix and practice in case you do need to know.

I also want to add that your vet does not know as much about Lantus as the folks at the Lantus forum. Go over there are read the stickies, introduce yourself and, especially for the first week or so, make a commitment to check in with them every day. This is another safety precaution.

 

I don't have any advice to give you, but wanted to let you know it does get easier and less overwhelming in a week or two. I wanted to encourage you not to give up yet; this could turn out to be much more manageable than it seems now. My Max was off insulin and just diet-controlled within ten days, and lots of people here have stories like that. And even if you end up doing shots every day, over time it just becomes part of the routine, like brushing your teeth. You can do this :smile:

 

Phoebe--I tried to order Lantus from the Canadian website you posted, but they're saying I need an Rx for it. Are they going to send it anyway, or do I need to get an Rx from the vet? The vet said I didn't need one.

 

The vet is wrong - Lantus and Levemir require prescriptions both in the US and if ordering in the US from Canada (the latter just went into affect Jan 1, 2010).

Humulin N and Humulin R are human insulins that do NOT require a prescription - so your vet may be assuming the ALL human insulin does not require prescription.

Request a prescription written for the 5 pack of 3ml cartridges. Many pharmacies will have to special order it.

A 5-pack should last you 5 to 6 months for Lantus or over a year for Levemir. (Lantus is fragile and will go bad after a while. I've been using Levemir, which is more stable -- and can use the 3ml cartridge completely -- no waste)

If I had a spare right now, I'd send it to you, but I'm on my last one right now - have to buy another 5 pack. If you are interested in trying Levemir (acts very similarly to Lantus), I could buy my 5 pack early and sell you one cartridge. Could you do a road trip and meet in, say, Lansing or ????? halfway?

phoebe

 

If you are going to use Levemir, note that In the USA cartridges are not available. You can the the five pack of disposable pens (recommended) or 10 ml vial.

 

Re: need help--to treat or not to treat...

I was thinking Panceatitis too, espcecially since it goes hand in hand with diabetic cats. That's hard to diagnose but it sure is what causes Pearl to puke. It is widely thought now that cats with an underlying pancreas problem like pancreatitis, are very prone to get pushed in to diabetes by steroids. Seriously should be explored. Certainly take this time to get him off dry and learn to hometest. Diabetes is treatable and your schedule isn't that different from many here.