911 need to respond to vet today!! diagnosed yesterday

Hi to all,

I am a newbie and I am sure I am doing this wrong, but I didn't have a chance to thoroughly read your FAQ''s and process it well. My husband took our 7 yr male cat to vet yesterday. He is skin and bones - I thought it was hyperthyroidism but vet (young - newly out of vet school - if that makes a difference regarding experience or should he be better and more up to date on issues??) said hypoglycemic. Hubby was stressed out and didn't retain much info re: Huey's weight or glycemic level. He thinks vet said in the 500's. Vet said diet change was not important and your site says ABSOLUTELY IS!!

He is calling later today to set up hospitalization for about 3 days to moniter his glucose levels and the cost to us will be about $600-700. We just spent over $500 yesterday for the diagnosis. Can't afford this unless it means life or death for Huey. What do I need to ask him to get what we need to get Huey started on "home care". Can we you tube how to give him the shots? Do we get the insulin from the vet? I tried to get to the page "what to ask your vet" but my computer couldn't get to that link.

Sorry to ask for info that I know is plentiful here, I just don't have the time before he calls. Huey thanks all who help his dummy mommy!!

Deborah

 

Hello Deborah, I can't answer all your questions but I can tell you that diet is very important. My cat's glucose dropped 200 points after taking him off of DM dry food. Others here have also reported significant drops when switching to a low carb, high protein wet diet.

 

Hi Deborah ~ I know how upset and overwhelmed you are right now. Yes, diet is very important , we recommend a low carb wet diet with the carbs under 10% I am giving you a link to look up food by the brand. Dry tends to be way to high so if Huey is a dry food addict, you will want to transition.
foodchart

The insulin we recommend are the human Lantus and Levemir and the pet insulins ProZinc and BCP PZI. For those two human insulin it is best to get the 5 pack of 3 ml disposable pens via a 10 ml vial. Although per ml the vial is less expensive most cats will not use up a 10 ml vial before the insulin goes bad/becomes ineffective.

Here, we all home test. It is mandatory to understand how your kitty is reacting to the insulin and the dose. You will want to test before each shot and some additional test in between the 12 hour cycle. Another reason to home test is to keep your kitty safe. Find a place in your home where you will always perform the test and give lots of hugs before and after testing. There are many videos showing you how to test. Here is a picture of where you test on your kitty. http://s106.photobucket.com/user/chupie_2006/media/testingear/sweetspot.jpg.html

Here is another good link on Home Testing:http://www.felinediabetes.com/bg-home-test.htm

There are many meters. There is a pet meter called the Alpha Trak2 and human meters. Some use the pet meter because it is what the vets use so the numbers will match up. The meter and strips are expensive though. Most use human meters that can be purchased at any pharmacy. It typically reads a little lower than the pet meter but we have ways of compensating it. Many use Walmart's brand, Relion Micro or Relion Prime, because it only needs a tiny drop of blood. The Prime testing strips are ½ the price of the Micro.

These are used to poke the ear to get blood. There are many different sizes (gauges). It is recommended when you are first starting out to use a 26-28 gauge. Also, it would be a good idea to pick up Neosporin WITH pain reliever to apply on the edge of the ears and don't forget to alternate ears.

Once you learn to home test you can do your own curves without the high cost of a vet bill and keep in mind that while your cat is at the vets, he is going to be very stressed out resulting in much higher numbers. The vet is going to base the dose on those high numbers. We recommend to start at 1 unit to give your cat a cat to adjust to the dose.

This is a lot of information for you to absorb but, will get you started off. Don't let the vet talk you into a RX diet that you have to buy from them. There is nothing special about it, they are expensive and usually a lot higher in carbs that you want the cat have. Many of us are feeding our cats Fancy Feast CLASSICS, 9-lives PATES, and Wellness NO GRAIN. I bolded the classics, pates and no grain so you would make sure you get the correct ones with in the brand.

If you are so inclined to get a meter test strips and lancets and learn to test, you can do the curve yourself and save yourself 6-700 dollars. Please let us know if we can help you furthere.

 

First of all, when your vet calls, tell him that you are going to learn how to home test and will be happy to provide him with the numbers when you get them, but you can't really afford another $600-$700

If he pushes it, you may have to tell him that you understand that he's the "professional", but this is the way you want to try first. Ask him if he's familiar with the Roomp/Rand Tight Regulation Protocol that uses Lantus and encourages home testing.

As for his "diet doesn't matter" statement....fine!! If he doesn't care what you feed, then you're free to feed a low carb canned diet like the ones we recommend!

It's actually safer to go ahead and transition to the low carb food before you start giving insulin anyway (IF the cat has no history of ketones)

Has he indicated what insulin he's planning on using? Just want you to be prepared because Lantus and Levemir are both quite expensive. We've found a great pharmacy in Canada called Marks Marine Pharmacy where a lot of us are buying since it's 1/3rd the cost it is here in the US.

If he's using Lantus/Levemir, you should ask for a written script so you can shop around for the best price (you can email or fax the script to Marks if you choose to use them....their price is $99.99 for the vial and $144.99 for the 5 pack of pens which will last until the expiration date on the box..usually about 2 years)

In the US, a vial of Lantus is around $250 (which contains 1000 units)...the Lantus Solostar Pens are around $450 (but you get 1500 units in 5 "pens" that each contain 300 units per pen and you can use every drop). With the vials, you end up throwing a lot of it away when it loses it's efficacy at 4-6 months. (pharmacists may tell you it's only good for 28 days, but if cared for properly, it'll last you much longer)

ProZinc (if that's what he plans on using) is about $90 but because it's a U40 insulin, that only buys 400 units so the price is comparable with Lantus...and it's ONLY available through your vet or a veterinary pharmacy

If you can get the script for the insulin (or the ProZinc from the vet if that's the insulin he chooses to use) we can help you learn everything else you need to know!

 

Welcome Deborah and Huey. Can I ask where you're located? There may be someone on here that's close to you and can help or at the very least recommend a good vet.

 

Hi Deborah, I agree with what everyone has said. The only thing I'll add is something that Chris touched on and that is to make sure Huey is negative for ketones. The vet should have checked, and you can get testing strips at any pharmacy. Please keep us posted.

 

Here's a "Getting Started Shopping List"

1. Blood glucose meter. The Walmart Relion Confirm or Micro. (about $15) These are the best choice until the ears "learn to bleed"...then the Relion Prime is the cheapest one for replacement strips. The Confirm and Micro take the smallest sample size...the Prime take a bigger sample and some people have complained about higher error rates

If you are in Canada, and can get to a WalMart regularly (or have friends/family that can ship you supplies if you need them), the Relion meters are great. I think the Bayer Contour or One Touch are other favorites of the Canadians in the group

2. Matching strips (about $19 for 50, $36 for 100) Prime strips are $9 for 50. Will vary depending on what meter you end up using. Using the Contour or One Touch, check Amazon/Ebay for better prices

3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool. (about $8 for lancets, $5 for lancing tool ...not required if you can freehand poke)

4. Cotton balls/cosmetic pads to stem the blood

5. Neosporin or Polysporin ointment with pain relief to heal the wound (ointment ONLY...no cream)

6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against

7. Ketone urine test strips..ketostix (urine only) or ketodiastix (test urine and blood but more expensive and unnecessary if you're already testing BG) - Important to check ketones when blood is high (about $8)

8. Sharps container - to dispose of wasted syringes and lancets. (Optional)

9. Treats for the cat - like freeze dried chicken or any low carb treat your cat likes

10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast

11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast

12. Syringes (If using a U100 insulin like Lantus or Levemir or willing to use a conversion chart with U40 insulin like ProZinc) WalMart's Relion U100 syringes are $12.58 per 100....other syringes vary in price)

IMPORTANT that you get syringes with half unit markings! 30 or 31 gauge, 3/10cc insulin syringes....All the WalMart Relion 3/10cc syringes have half unit markings

 

Hi Deborah, welcome to FDMB. First of all, take a few deep breaths!

Ask you vet to tell you in as much detail as possible exactly what is is that he wants to hospitalize your kitty for. (Have a notepad handy and write down all the information he gives you.) If it is to run glucoses, as Chris & China said you can do that at home, and save yourself the money. I am concerned about the weight loss; has your kitty been eating well at home? Diabetic cats do lose weight, because their bodies can't properly utilize the nutrients they take in. If he seems dehydrated, the vet may want to administer fluids. Sharon14 and Chris & China are absolutely right about checking to make sure that Huey is negative for ketones; ask your vet if he did this, although I'm sure he must have.

Yes, diet makes a huge difference in a diabetic cat! Huey needs to eat canned food that is 10% carbs or lower. The link Bobbie and Bubba gave you is a good resource for information on cat foods.

I don't know if cost is an issue for you or not, but there is another insulin some vets Rx called Vetsulin, and it is much cheaper. It's not the ideal insulin for cats, and most members here don't recommend it, and neither do I if cost is not a problem, but I use it and am making it work, so if it's your only option don't be too scared of it. But if you can manage it, definitely go with one of the others (Lantus, Levemir, Pro Zinc), that are very good, and easier to work with

Other than the above, I can't really add much to the excellent information the others have already given you. Please update us on Huey's situation after you talk to your vet!

 

The Relion meters are NOT available in Canada however both Bayer and Abbott usually have a meter available free with the purchase of strips if you check their websites. The strips rather than the meter make up the biggest cost and the least expensive meter/strips available in Canada is only available online at this site. This of course means that you will have to order strips well in advance of running low as you can't just dash to the nearest drug store for more. If you happen to be in a border town and can get to a US Walmart relatively easily, then the Relion meter might be an option.

 

We are in Oley/ Reading, Pennsylvania zip code 19547 - We go to the Oley Valley Animal Clinic. Thanks!! This group is fabulous - such prompt and detailed info!!

 

@Bobbie And Bubba , Are you anywhere near Reading?

 

I am an hour away outside of Doylestown. I could help but I am pretty stuck here with my 88 year old mom but, if Deborah would want to travel to me.......

 

I was hoping maybe you could point her in the direction of a vet somewhere close to her who is a little more experienced in treating diabetic kitties.

 

I don't know that area and the vets. Actually I am trying to find a vet well versed in feline diabetes myself. I am sorry I can't help in that department.

 

Thanks . Hope you find a good vet, too!

 

I've said this before but I really believe it - feline only vets are very well versed in feline diabetes. If you go to the website of the American Association of Feline Practitioners (http://www.catvets.com) you can plug in your zip code and find nearby vets that specialize in feline medicine - I just checked and there are several near zip 19547

 

Bobbie - there's a cat only practice about 15 miles from you

 

Really ? Do you have the name?

 

go to www.catvets.com and plug in your zip code - (I'm not really sure what it is) I used 18901 and there is a cat only practice and several cat friendly practice - if possible, I'd try the cat only practice - It's easy - just go to the website

 

Thanks, Carol! That's good to know! Maybe you could see if one of the administrators could make that a Sticky in Health Links / FAQ's about Feline Diabetes, that could be very useful to a whole lot of folks!

 

Not necessarily....our vet is a member of the AAFP and still pretty much quotes the "company line"...Rx foods, increases/decreases in whole units, etc., but it is nice not to have to deal with a bunch of dogs in the waiting room and they have Feliway defusers in all the exam rooms and play "cat-friendly" music. They also practice "stress free" cat handling....they'll sedate instead of trying to force an uncooperative cat into putting up with exams, tests, etc.

 

I've only been to cat-only practices since 1996 (except when I lived in Cambodia) and recently had to go to a general practice vet and the difference is night and day - I guess being a member of AAFP is different from working in a cat-only practice, but at least it's a marker that they are interested in feline medicine

 

Oh yeah...I'm much happier with this vet just because she is a member of the AAFP...at least she knows her cats!! That's different from knowing anything about feline diabetes though.

The best way I've found of finding a good vet is to call around and ask to have the vet call you back (usually it'll be after hours) and discuss how they treat their feline diabetics...what kind of food they recommend, what kind of insulin they like to use, what kind of success rate they have treating,do they approve of home testing (and with a human meter?) etc....If they are pushing the old lines about prescription only foods, only use ONE kind of insulin (not all cats respond to insulins the same....just because they "like" to use one kind doesn't mean they shouldn't be open to using something else if the cat doesn't do well on it), insist on curves being done in the office or that you can ONLY use the AlphaTrak (or other pet meter).... that can tell you a lot about how willing they are to work WITH you instead of dictate TO you

It's hard finding a vet that knows as much about FD as the people here do...it's understandable since vets don't really have the time to stay up to date on the latest treatments for all the diseases they see (even if they do just concentrate on cats)

 

That's exactly what I did to find my new vet, and he's wonderful. I'm so glad I found him!

 

Unfortunately with feline diabetes now at 1% of cats and rising it seems, diabetes is getting more attention in feline vet literature and from what i've seen, feline veterinary conferences as well. It seems the nutrition issue is a tough nut to crack, but every feline vet I've talked to has told me that wet food is one of the main therapeutic modalities for diabetes. In any case, the best of all worlds would be a feline only internal medicine vet, but barring that, I would still opt for a cat only practice if possible. I am in awe of vets, having to know about dogs, cats, hamsters, birds, snakes, ferrets, horses, cows, etc. so I don't want to take anything away from them at all. You are right - you need to find someone who is not a dictator

 

Welcome to FDMB.
In my signature are a couple of links you may find helpful, beginning with the Secondary Monitoring Tools and the reference materials on glucometer values. Notes to Share has links to a few other websites which cover common issues here.

 

I hope you were able to get enough information so you didn't need to "hospitalize" your cat at such a high cost for such a long time. It really is useless because the cat is so stressed doing that that it in no way tells you what is going to happen on that dose of insulin once you take the cat back home and he isn't stressed out and starts eating normally again. FD can be managed very well at home with a glucometer, a good insulin and good food.

This is interesting. The first one listed in our area IS the cat-daddy of vets. Has his senior cat tattooed on his bicep. We all love him. But as far as I know he only works in the e-clinic, he doesn't have a regular practice let alone a feline-only practice and the address given isn't a clinic. The second one I've never heard of and the address given isn't of a vet clinic that I can tell either.