New and feeling frustrated

Hello, my Cat Rumpy was diagnosed with diabetes about a month ago. He was hospitalized twice for DKA and only put on insulin two weeks ago. I feel like I cannot depend on my vets to help me and have distrust in them. I am having trouble finding the right food for him as well, he is having terrible diarrhea. Rumpy is very picky about texture and does not like pate options. He was on a dry food from Earthborn up until his diagnosis and I have been trying out several different we food options. The only one he enjoys is Tiki Cat Succulent Chicken, but I believe this is causing his diarrhea. Any suggestions of a good shredded chicken canned food would be appreciated.

The vets advised against me doing home testing, but I see that it is actually beneficial and would like to start doing that. I am unsure of where to buy a glucometer from and which is the best brand to get.

I am also having trouble with finding the correct syringes due to needle length. I noticed the shorter needle makes him wince more than the longer one. I asked my vet, but have not gotten an answer. my pharmacy did not carry them and I don't know where else to look.

I am overwhelmed and scared.

 

I also used all of my savings to put him in the hospital and worried about being able to care for him in the way he needs. If there are any ways to save money on food, insulin, supplies, or anything else please let me know! He is my baby and I want to help him the best that I can. I was so happy to stumble across this board.

 

Hello and welcome back to the board. I just reviewed your first post when you responded to a new member in the Intro forum. I remembered your post because I thought the name "MrRumps" was so cute.

Ok, first, we do recommend home testing and you can learn to do that. Here is a link to some tips and videos.
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

It's going to depend on where you are in the world regarding what glucometer to recommend and where to get one. We have members all over the world and some meter kits are not available world wide. Ditto on the syringe and food questions.
Edit: I do see that you are in Dallas, TX so that makes it easier to make recommendations.
Walmart ReliOn Prime meter and strips are very cost effective and available. I see that you have located the Food Chart and are reviewing that. Most of the food we initially recommend is pate (Fancy Feast and Friskies classics), but I believe Weruva has textured low carb varieties. Possibly Tiki Cat After Dark, I will do some research on that.

Please create a signature for MrRumps so that we can see his information with each of your posts.
Setting up your signature (light grey text under a post). Here's how:
click on your name in the upper right corner of this page
click on "signature" in the menu that drops down
type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using and dosage amount /glucose meter you're using/what (s)he eats/any other meds or health issues (s)he has. You can add your name, and a geographic location (sometimes the time zone matters) Be sure to SAVE when you are finished.
Then another thing that will help us help you when you've started BG testing at home is to set up a spreadsheet like the one we use here. You will see how the trends and patterns emerge, and members can review his/her progress before offering suggestions or advice:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

We will do all we can to help you with the home testing, finding the syringes you need and the food that MrRumps needs and hopefully resolve the diarrhea issues.

It's all a learning process that we all have gone through, or are currently navigating. I'm very glad you returned to the board and are seeking education, and want to learn to take care of your fur kid to the best of your ability.

 

Tell us why he was in the hospital, when, and what was the treatment please.

 

I will update the signature with dates and the other information I don't have when I get home this evening.

Rumpy first went to the vet on 2/22/19 for vomiting and appetite loss. The vet did a urine analysis and found high sugar and told me he may be diabetic and to try changing his food first. We slowly switched over to Royal Canin Glycobalance and a probiotic. This helped for a couple of weeks and then he began to stop eating completely. I took him back into the vet on 3/18 and had a fructosamine test done and the vet gave me a price estimate that I had to have a day to figure out what to do financially. on 3/22 Rumpy was in bad shape so I took him back in to the vet. His anal sac ruptured and he stopped eating again. The vet checked for ketones and said he was in DKA and needed to be hospitalized. I took him to a different vet ER and they took him in for only one night as the said his ketones levels dropped fast. He came home to me on 3/24 and during my discharge from the ER I was not told anything about a glucometer or given insulin. The vets said he was being playful and eating well for them, but as soon as I took him home he wasn't eating again. I took him back into the vet and then to ER on 3/25 because he was back in DKA. This time he was in there for 2 days and was put on insulin. He was taking antibiotics for the wound and appetite stimulants. I still have Cerenia left, my vet told me to give that to him for a few days and see if that settles his stomach and stops the diarrhea. However, I have not done that because I don't trust their guidance.

 

Ok, DKA is a whole different situation and Rumpy needs to be cared for carefully. You need to make sure he eats, and right now, it's not as important what he eats, within reason, as that he's eating. You need to test his urine for ketones, as DKA can develop very quickly and you need to know if the ketones are above a trace on the dipstick. Ketostix are available at about any pharmacy for approximately $12.00.
Here is a link with information about Diabetic Keto Acidosis:
http://www.felinediabetes.com/FDMB/...oacidosis-dka-and-blood-ketone-meters.135952/
I am going to tag some more experienced members to help us out here.
@Bobbie And Bubba @Kris & Teasel @Chris & China (GA) @Wendy&Neko @MrWorfMen's Mom @Bron and Sheba

 

I will pick up the glucometer and ketone tests tonight. I am concerned about his diarrhea because I think there may have been a small drop off blood in it, but it was hard to tell. He is still eating his food, although last night and this morning he seemed to not want it at first, but I think that is because his stomach is upset.

 

Please keep in touch here so that the wiser people here can help you. We do not want Rumpy back in the ER

 

What insulin? What dosage?
I went back through a thread by a member with recent DKA and am providing responses from an experienced member, some may not apply, but read through:
Here are the basics of recovery treatment at home:
kitty needs calories - up to 50% more than normal - to prevent ketone formation from metabolic breakdown of body fat and muscle (you might have to syringe feed)
during recovery wet food should be high enough in carbs to support a large enough insulin dose to prevent ketone formation - maybe mid range carbs (10 - 15%?)
insulin in a large enough dose and do not skip a dose - ask for help in deciding on a lower dose if PS is lower
hydration is very important - add extra water to all wet food meals and/or give subQ fluids in amounts appropriate for the kitty (be careful if there are cardiac issues - ask the vet)
use meds as needed: 1. antinausea/vomiting (Cerenia or ondansetron); 2. appetite stimulant (mirtazapine or cyproheptadine) if anti nausea meds alone aren't enough; 3. diarrhea meds if that's an issue (metronidazole or tylosin)
test urine for ketones at least once a day for the first week home or so
Know that recovery can be slow and it could be weeks before your kitty is back to normal.
I think the dry DM is about 14% carbs. Don't worry about carb level right now. Getting her eating consistently is far more important so whatever that takes, do it. She also needs to be well hydrated. Adding extra water to wet food meals (if she'll tolerate it) is an easy way to do this. When Teasel was very ill a year ago I added 4 Tbsp of water to every meal and he was fed 4 meals a day, so 16 Tbsp daily. That's equivalent to 240 mL or close to 1 cup of water extra per day. I also gave him subQ fluids a couple of times but the water added to food was my main approach.
It's critical that you have an at home pharmacy of meds when she comes home. Antinausea meds top the list. Cerenia is good for vomiting and somewhat for nausea. Ondansetron is better for nausea. Treat for nausea first. If that doesn't get her eating, add in the appetite stimulant. Mirtazapine is usually the vet's first choice but I gave Teasel cyproheptadine - less likely to cause side effects like agitation, yowling, etc.

 

Ouch, you've been having a rough time. Wiser heads than mine should address most of your questions, but I can offer a couple tidbits.

Here is the only U-100 syringe I have found with a 1/2" needle and the half-unit markings we like for fine dosage control.

You might try Weruva's Chicken Frick 'A Zee. Shredded chicken, low carb.

Many of us get Lantus through Mark's Marine Pharmacy, at a much lower price than you'll find anywhere else.

 

Friskies Shreds, Meaty Bits and Prime Fillets are in the mid carb foods that Kris & Teasel recommended, the 10 to 15 % range. So, just add some water to the food, no need to rinse. You can pry find them at Walmart too.

 

So glad you will be home testing, very important! You poor momma! Sounds like you have been through the ringer. And I am so glad that after the second DKA he was put on insulin! I don't understand that. Here is the recipe for a cat going into DKA: not enough insulin + in appetence + a systemic stress or infection ( likely the anal gland infection) = DKA


I am glad you found this site as it has a wealth of information and experience here.

Syringes: I use Walmart's brand Relion, 31 gauge, 3/10, 6 mm length. They are only about 13.88 for a box of 100 and have the 1/2 unit markings.

Question about his previous food Earthborn: What protein was it? Chicken? There reason I ask that diarrhea can be a symptom of a protein sensitivity and if you are feeding him a different protein than he was used to, it could be consideration . Also, just with a new food change, kitties can get diarrhea, so maybe that is all there is to it.

Idjit's Mom gave you some good advice regarding a kitty with a recent DKA. Keeping them eating and hydrated are very important.

Could you set up a Spread Sheet and attach it to your signature. That will help us to help you with dosing advice. The instructions are Here .

Keep asking questions as that is how we all learned.


ETA: Oh, and Welcome to the best place you never wanted to be. We can all relate to being overwhelmed and scared. Let us know how we can help you.

 

I picked up the different canned food of friskies, glucometer, and ketone strips. I appreciate all of yalls advice. I think Rumpy may have another abscess and that is why he is not eating. I will look into the link for how to use the glucometer and post any questions I have.

 

I think the Earthborn protein was seafood medley. I will start the spreadsheet tomorrow! I picked up the glucometer and strips this evening.

 

I just want to say, my girl just had a terrifying DKA 3 night hospital stay last weekend. I feel for you and your baby.

I am following the same advice @Idjit's mom shared with you about food and schedule and it has helped. There is a lot of monitoring but it's going to be okay, you can learn to do all of it.

I've been using some of the meaty bits gravy chicken friskies type stuff for my Alice, that is 14%. I also have a 2% (fancy feast) and a 4% (friskies pate). I add 2-3 tablespoons water to each meal/snack to increase water intake, and try to stir it around.

If she is feeling weak, I stir it in front of her face and hold it for her. Cats are motivated to eat in part by smell. (I learned this when my herpes positive cat stopped eating before I knew she had it--it causes respiratory congestion.) Your cat really does need to be hydrated. Every time Alice is better hydrated she perks up, and I see that.

Also, the blood sugar tests will get easier. It will all get easier with practice and learning and you're doing that right now!

Given that you're in Dallas, maybe I know some cat people in another group of mine that might have some randomly useful supplies to share. You're welcome to message me and I can look into it. With Alice's increased urination (polyuria), for example, she goes through 40 lbs of litter or more in a week at times. Maybe I can find someone to help with *anything*. I understand finances can be hard with this. :\

I'm glad you've found us though I wish you didn't have to be here.