New Dx

Hello,

My cat Stinky was diagnosed with Diabetes today (age 13). I was quite surprised and upset that I don't even remember everything my vet told me. Stinky
will be at the vet/hospital for five days while they attempt to stabilize him and determine the type/dose of medication he will be receiving. I am determined to
learn as much as I can before I take him home at week's end. Can anyone point me to a link in this forum that deals with beginners and what I should be doing/learning/preparing? Thank you all. This seems like complicated business and I am scared...

Thank you,
Sara

 

hi there

welcome to the FDMB.
You are actually in the right forum.

You'll probably want to add a bit more info, as others will ask.
What insulin are you considering or Stinky is currently receiving? Dose?
Will you be home testing?
History of ketones?
Diet?

Is he at the vets for ketones? Unfortunately if it's to regulate him, it's next to impossible to do it in a week.

The quickest I've seen here is 13 days on insulin, a diet change from dry to low carb wet food..this kitty I'm talking about is currently on day 10 of a off the juice trial here on the board.

Diet plays a big part in managing feline diabetes. Insulin treatment as well...and for even better results, home testing to see how insulin is working on your kitty.

Others will be by to offer more feedback so do check back ok?
You can do this - Feline Diabetes is treatable and manageable.

 

Thank you Ronnie & Luna -

Stinky just recovered successfully from pancreatitis (or so I thought) but the last few weeks he's been drinking A LOT of water. Then his back legs started to fail him a few times a day - so I brought him in today with concern and the definite Dx is Diabetes according to some on-the-spot urine tests. What I understand is that these next five days he will be monitored by the vet's staff so that they can figure out how to dose him correctly. I will call in the morning to find out the blood tests which were administered a few hours ago, and will ask lots of questions which I'm acquiring through research tonight.

This is so brand-new to me I'm not sure where to start...

As far as the insulin question - hopefully the vet will have advice on what kind/how much in the next few days. As far as ketones and other bloodwork, I assume he will test for that (and other things) with the blood that was drawn earlier today. I wish I knew what questions to ask at the time.

But I'm doing as much research as I can and I am really glad to have quickly found this place, which seems filled with caring and knowledgable people.

If anyone has some great advice on what to ask my vet tomorrow, or what I should be doing - feel free to let me know. Thank you.

 

You are in the right place .My cat Trey was dx in may/10 come to this place .Did a lot of reading and taking advice from the Angels here and guess Trey is insulin free 21 days. This is the place....Welcome and in no time your Stinky will be on the road to a speedy recovery.....Kath

 

Welcome Sara,

You have great instincts - the very best think you can do is to read and learn and ask lots of questions. Start with the Frequently Asked Questions page: http://binkyspage.tripod.com/faq.html and this beginning page: http://www.felinediabetes.com/newdiag.htm Dr. Lisa has a great site that explains the importance of diet: http://www.catinfo.org

We advocate wet lo carb food, insulin and hometesting - the same course of action we would take with our human children. Here are two sites for hometesting info: http://www.sugarcats.net/sites/harry/bgtest.htm http://www.youtube.com/watch?v=_zE12-4fVn8

When we first started (and please believe me when I say that everyone here started scared and overwhelmed) we read and printed off every page we thought we might need later. Then we reread and asked questions.

Hope that gets you started. Come back often with questions and concerns. You can do this - we'll help!

 

Hi Sara and welcome. Sorry you have to be here but you found the right place to learn everything you can about feline diabetes. This board saved my Sweety. There's lots of caring, smart, people to answer any question you have, and there are NO dumb questions - we've all been there and know how overwhelmiong it is at first.

Read everything you can on the health links. What I did was copied and pasted it all into word documents so I could absorb it all later. There was no way I was going to just remember it all.

You can do this!

First - breathe...it will be ok, really.

 

Thanks for all of the quick replies. I had assumed that Stinky would be tied to two insulin injections a day for the rest of his life... it sounds like that's not necessarily the case? I now see that low-carb, high-protein diet is the way to go. Stinky has always been overweight (18 lbs) but has always been on a portioned-controlled diet - no more than one cup of food per day - he still kept the weight on though...

He dropped 3 pounds when he was dx'ed 3 months ago with pancreatitis.... a few weeks of antibiotics seemed to o the trick with that... then all the water-drinking and back-leg malfunctions started a few weeks ago resulting in today's diagnosis of diabetes... do you guys think I caught this "early?" - and is that a good thing to try to bring him into "remission" some day? Is there even such a thing as "remission?" Is this potentially curable?

I should mention that all of his other behaviors have been normal - loving, seemingly happy, good appetite, good stool, etc.

Also, how often should I be thinking about doing his at-home blood-testing? Is that an every day thing? Every week?

Fortunately I have the resources and the love for Stinky to deal with this. Unfortunately, I travel quite a bit for my job. I guess I will need to start looking for a nurse or specialist to hire to stay in my apt. when I have to travel...

 

You have caught it fairly quickly, and there is always the chance that a diet change and short course of insulin (allowing the pancreas to rest and heal) will allow Stinky to become "Diet Controlled"

Be aware that the dose that the vet comes up with may be too much in the calm and comforting environment of your home -- the risk of having a dose decided in a stressful environment.

Also, most vets are not up to date with the current ideas on FOOD. You do not need Prescription food. You do need low carb high protein canned or raw food.

 

Remission is definitely possible. No guarantees with any individual kitty, but we see remission all the time. When that happens, the cat is still diabetic and needs to be fed accordingly, but no more insulin shots - maybe none for years, or maybe none for just a few months. You also keep testing blood glucose levels, so if the diabetic numbers do come back, you will catch it very early (which may allow you to achieve another remission).

Speaking of testing, while a kitty is receiving insulin, the testing happens *at a minimum* before each shot, which means twice a day. You also try to get one or two "in between" tests to see how the insulin is working. Periodically, when you have a day off, you test every few hours to get what we call a curve, showing how the insulin is working all day long. (No, kitties don't mind all that testing, once they get used to it. A lot of them purr through it and even seem to look forward to the undivided attention they get then.)

Kitties in remission are tested much less often. At first once a day, then once every few days, then once a week, then once a month ...(depending on how solid the remission appears to be).

I gather since you say that you are feeding a cup of food, that must be dry food? If you change to canned or raw, your kitty will do much better and probably will lose that extra weight readily. It sounds like portion control will still be wise, but the extra weight will come off without much hassle, making Stinky a much healthier cat!

 

We will all urge you to change to a wet lo carb diet, Sara, BUT DO NOT CHANGE UNTIL YOU ARE HOMETESTING. When we changed Oliver over from dry to wet, his blood glucose levels went down 100 points overnight. If we hadn't been hometesting, we would have risked overdosing him on insulin.

Yes, lots of cats here go into remission. Oliver was overweight (16 pound Maine Coon) when we started insulin and the wet lo carb diet. His weight got down to a normal 12 pounds. After 6 months of insulin - gradually reducing the amount as we tested him and got blood glucose levels daily - he went off insulin after 6 months. He was in remission for a year, before dying at 16 of heart disease. Doesn't happen for every kitty, but it happens often.

 

All of you have comforted me with your kindness and serious intelligence on this issue! Sue and Oliver - thank you for the hint on gradually introducing the new diet. I have to be honest with all of you in that I don't completely trust my vet: while he has always warned me that Stinky's weight made him a candidate someday for diabetes - why did he tell me to feed him Hill's Prescription Dry Food?? Why was I never advised before to get Stinky on a high-potien/low carb regimen? Perhaps I could've gotten his weight down and avoided this.

Stinky gets 1/2 cup of that per day plus one 3-oz can of Weruva which seems like excellent wet food... can anyone advise me as to a timeline on changing the diet, and what brand of food to buy.

I am going to guess that this community probably knows more than a lot of vets on this issue.

A thousand thank you's to you all...

Best,
Sara

 

Hi what a great thing you are doing .Taking control of your kitty`s health is the first step to a speedy recovery..My vet also gave me bad advice but did give me the name of this wonderful site. She was not too happy with me for a bit but in the end Trey won out cause he is doing great 22 days without insulin...Took about 5 days for him to come off the dry food and onto can only.He gets FF and Friskies. I also have 3 others and now they all get can food. His BG was 468 to start and now he is purrrrfect. Stick with this place and read read and if you have a question just put ADVICE in your subject line help will come.....Angels and beautiful green healing light coming to help you .... :mrgreen: Kath

 

What kind of relationship do yoth your vet? I ask because 5 days is a long time, is expensive and isn't going to regulate him. You are much better doing this at home, scary as this sounds..

 

Here are Janet and Binky's food charts: http://www.felinediabetes.com/diabetic-cat-diets.htm Janet has done a lot of research and calculated the carb content of lots of food We try to stay between 8-10% carbs without feeding too much seafood. (I don't know if your food is on her charts or not. If not, check the ingredients. You don't want gravy or any type of grain included.) As far as a timeline, if you are hometesting, you can change over as fast as Stinky's tummy will alllow. Since you are already feeding partly wet, you should be able to switch him over pretty fast.

Now that we haven't scared you off and it is beginning to look like we do know what we are talking about.....(We try not to scare newbies at first because we all remember how tricky it is to take advice from people over the internet instead of our vets.) I do agree with Jen. Leaving your kitty at the vet is expensive and unnecessary -unless there is an underlying condition like ketones or DKA. In those cases, he would need specialized care. If he is otherwise healthy, leaving him one day is okay if the vet insists - just to make sure he doesn't have a reaction to the insulin.

The problem is that cats usually suffer from vet stress - it is noisy at the vet and it smells strange and the food and sleeping arrangements are different than home and there are lots of people who are "not the mommy". In most cats, these things cause stress and stress raises blood glucose levels. So if the vet bases a dosage on the numbers he gets in his practice, the dose may be too high when you get him back home and he relaxes into his old routines. That is why we hometest. We figure our numbers are more accurate than the numbers the vet gets, and are based on the actual conditions the kitty lives with.

If I were you, I would call your vet. Get some more details. Does Stinky have DKA or ketones? Why is he staying a week? Tell him you have been doing research and are planning to hometest Stinky. (You do not need the vet's permission to hometest.) If you decide he is not a vet you can work with, put your city and state on this forum. Maybe someone lives nearby and has a vet who is more up to date on feline diabetes.

 

I can't believe I was lucky enough to find a group of rockstars like you guys. THANK YOU!!! Here's what I know after this morning's phone call:

1- Baseline BG at intake was 569 last night
2- Negative for ketones and a whole battery of kindey tests (hooray)
3- Waiting the results for an IPL test which tests pancreatic issues of some sort. Stinky tested positive for pancreatitis 3 months ago and then responded well to antibiotics.
4- Dr. says they're keeping him inpatient to determine the curves. I will approach this logic with the doc when I visit Stinky at 3 pm
5- Dr. believes in home testing! Apparently I will be given the equipment at 'checkout'. He also wants Stinky to go on a Hills Prescription Diet Wet D/M diet. DO YOU GUYS RECOMMEND THIS BRAND? Dr. says it is less than 10% carbs.... my online research says EVO wet is a great choice...
6 - Dr. says Stinky will only need to be fed 2x a day... I am reading that others say 4 smaller meals a day is better. THOUGHTS?

Also, Dr. Lisa offers phone consults so as soon as I get copies of Stinky's chart and blood results, I will fax them to her and book an appointment.

I'm trying to get ahead of this and would not be able to do so without the support and knowledge you all have offered me in the past 24 hours...

THANK YOU!!

-Sara

 

The thing is, it doesn't make sense to curve in the beginning because it takes time for the body to adjust to insulin. So its useless to pay for the vet to do it. Plus the fact that vet stress can skew results. REally, the best thing is to start at a low dose at home and test prior to shots and do spot checks, and then in a week or whatever do a curve yourself.

Second, DM canned is 'ok' but the ingredients really aren't great...it isn't just about the numbers, its also about the quality. If your cat likes it , well, it won't hurt, but there are better foods. Google HIlls Prescription DIets and look up the ingredients...

Jen

 

Fantastic that your vet agrees with hometesting. Not understanding why he thinks his readings will be valid with vet stress.....You have every right to say that you want him home, that you want to test at home. You can send in your results daily via fax and have your vet check your dosage amounts. Your curves at home will be more accurate - or as you can argue, just as accurate. Why have him at the vet? You can always say you just can't afford it!

It may be that your vet will want you to get the Alpha meter made just for animals. There is much debate about this on the site. Some people feel it is more accurate than the human meters, most feel they are all in the ball park and the important thing is that you are dealing with the patterns your meter gives you. (We aren't talking about huge differences, just a few points...) The big consideration is cost. The meter costs more and the strips cost more and are usually only available through the vet (which can be a big problem if you run out on a Sunday...). Human glucometers are cheap (sometimes free) and most of us buy our strips through ebay or Hocks in bulk. I'd say 98% of the posters here use human meters. The important thing is that you get one that sips and takes a tiny amount of blood. Lots of people like the ReliOn from Walmart as it is the least expensive as are the strips.

If you get a meter ahead of time, you can always take it to the vet and compare it to his meter. And he can show you how to take the sample on your meter.

We started on Hills. Oliver soon tired of the taste (lots of cats do) and we went to Fancy Feast. Too much money for a "prescription diet" which has no prescription ingredients. Yes, just like human diabetics, several small meals seem to keep the bg levels lower and more evened out. Again, you can feed the way you want to - you just don't have to share your methods with the vet.

 

You can feed more than twice per day -- the key is that the kitty needs to eat at shot time -- if he/she is always willing to eat, then more meals are ok.

small meals are easier on the pancreas than big ones. If you're hoping for remission, small, frequent meals can help.

 

Awesome, thank you!!! Should I buy this one?

http://www.walmart.com/ip/ReliOn-Ultima ... or/3555238

 

That one or the ReliOnMicro will be fine. Get some extra strips also. You will need lancets to poke with - most people start with the medium grade - not real thin but not thick. I think 30 gauge is right. (Someone will correct me if not.) Try the meter out on yourself first so you are confident about using it.

Make up a rice sack to warm his ear. (uncooked rice inside a thinnish sock that you can warm in the microwave.) It helps the ear to bleed.

Find a lo carb treat that he loves. You can just cook a chicken breast without any spices and cut it up into small pieces. Freeze dried meat/chicken treats from the pet store are great also. You want to treat every time you poke, successful or not.

If your vet is willing to show you how, that would be great. Just hope he pokes the ear. Some vets use syringes and poke a vein. We find the little capillaries that run off the vein that runs down the ear and poke there. (You can see with a flashlight behind his ear where to poke.)

I saw your post above. Hope you can find someone who will help you out the first few times - especially with hometesting. Every few of us got it the first time; it takes a while to get confident. You will be surprised how easy it is to give the shots. We always gave them when Oliver's nose was deep into his food and he never noticed.

You are doing great, Sara. Really jumping into this and being a wonderful advocate for your kitty!

 

For gauge of lancets, most people find 28 or so to be easiest at the start. That's thin enough not to hurt the kitty but thick enough to get a good blood drop without much difficulty. 30 is a little thinner (the higher the number, the thinner the sharp part) and might make getting a blood drop hard at first. Testing is hard at first anyway; no point in setting yourself up for frustration with too fine a lancet.

After a while you may wish to change to 30 or even higher, but to start, I would recommend a bit lower (about 28).

 

Oh boy... quite a lot to absorb here... can I buy lancets at the drugstore? Do they nee to be brand-specific to the meter? Arghhhh...

You guys do rock, however!

 

Steep learning curve, huh? You are doing fine. Yes, you buy lancets at the drugstore. Any brand is okay. They are cheap. They usually come with a pen or lancet device. You put the lancet (a little like a push pin) into the device and clip and it pokes. Some people like the device (I did); others would rather free hand. You will just have to see what works best for you.

 

What needs to match: Lancets need to be "compatible" with whatever lancet device you are using. In a few cases, that means the brand of the lancets needs to match the brand of the device. In most cases, though, there are a number of brands of lancets that will fit a particular device (the box of lancets and/or box containing the device will tell you).

The lancet/lancet device and meter need not match at all. The lancet and lancet device are only the means for getting a blood drop. Getting the drop onto a strip in a meter is a completely separate operation.

As Sue (and Oliver) said, the lancet device is not required. Some people find them helpful (I do, too), but others "freehand" the lancet without a device and find that method easier. It's entirely personal preference. My recommendation: Just pick something and try. Lancets and lancet devices are not expensive, so if you don't like your first choice, you can change.

 

Well, I am not too happy. Vet yelled at me for daring to suggest that I take Stinky home before he says so. Here's what
I'm looking at - last night - baseline - 569. Today - 3 units 'regular insulin.' 8 am - 600; 11 am - 166; 1 pm 51;
They will test again and dose in one hour; then Stinky is alone until 8 am.

They said they are switching to 2 units Lantus tonight. I suppested the PZI, and was shot down saying it's too hard to find.

Also when I asked how the dosing would be different at home - due to vet stress- I was seriously told that makes little difference.

I am really sad and don't know what to do. This doesn't feel right, and I held stinky for more than an hour today
And he is sooooo miserable - and drinking so much water - never seen anything like this.

I need to find someone else in nyc asap

 

:shock:

i'm going to stick my neck out and suggest you call them and insist they not give him a shot tonight, with nobody there to monitor. ask them to explain the 51 reading at five hrs after the shot, and what they did when they saw that reading. i'd be surprised if they didn't do anything. and if they did anything, ask what will happen tonight at 5 hrs after the PM shot when he goes that low and nobody's there. ask what is the worst case scenario if he continues to drop lower and there's no intervention.

i'd pick him up before they close, if i were you. and he has no right to yell at you. your cat, your money.

 

Me too. I know it's hard to think your vet may not be the expert, but those numbers are scary. (It seems like the insulin is hitting him really hard, going from the 600s to 50s.) If he were my kitty, I would go pick him up. They aren't going to be able to monitor him overnight, so you have every right to insist that he come home with you so you can monitor him.

They can't keep him without your permission.

 

We have some exccellent people in NYC who can help!

Your vet used humulin R which in my mind is completely inappropriate as it is short acting. Second, veterinary articles support hometesting over clinic testing. Third, I would bring him home asap

I am so sorry. If you haven't gotten a good referral by the time I am on the computer tonight I will contact some people

Jen

 

Hi Sara,

I see you have already been in touch with Dr. Lisa. I am in Brooklyn, ex-Manhattanite. Finding you a vet will depend in part on where you live. I have sent you a private message with my phone number. Please call and we can start to sort things out.

 

Did they do a fructosamine test? What's the scale on that 569?
The vet stress can raise the BG's and make it appear they are diabetic. The fructosamine is the average over the last couple of weeks. When Sweety's came back after I asked for the test, it was around 487 with 500 being considered diabetic.
I declined insulin, changed her food from dry to wet (getting the lowest carb food on Janet & Binky's list), got the meter, urine glucose & ketone test strips and in two weeks, she was no longer borderline diabetic. I didn't want to put us both thru it if I didn't have to, and I was terrified of shooting insulin and coming home to a hypo'd cat...nine hours later from work. So this trial of the diet change worked for us - and others that have been here.

It's great that your vet is onboard with hometesting - you can do it!

Good luck, and welcome.

 

Ditto what everyone said about bringing Stinky home tonight. Have no clue why vet used R unless he really wanted to get those numbers down quickly. He took a risk, IMHO. Also, next time you are at a pharmacy buy some Keto-Diastix (tests the urine for glucose and ketones) or better yet, just buy some Ketostix (they test the urine for ketones). Forget the AlphaTrak meter too as others have said. Not worth the major expense.....Reli-On is a good, cheap meter. Please let us know if you were able to get Stinky home tonight.

 

Angels please watch over little Sticky tonight I pray his momma gets him home .This is so scary...Prayers & Beautiful green healing light coming his way. Please keep him safe !!!!! Kath

 

What an amazing community you are. I am so grateful to have found all this good info from all you good people.

Well, I spoke to the amazing Dr. Lisa Pierson who is going to help guide me through the tough beginnings of this process. I have a whole heck of a lot to wrap my head around, but I feel confident that I will eventually "get it" like you guys all have.

I do actually feel OK now about many of the decisions my nyc vet made after I my consult with Dr. Pierson. Some elements of Stinky's curresnt scenario are not ideal, but we can live with it for the next few days, and I'm shooting for Thursday to get him out one way or another.

I feel like I can get my education and help with Dr. P and with you kind souls and get Stinky back to being a healthy happy cat.

I also am going to ask them to test for fructosamine - thank you for that tip!

Thanks again,
Sara

 

Dr lisa and Gia are great resources. Let us know how things go!

 

Stinky's coming home tomorrow. I will go in the a.m. for the amps and shot, will return to the vet every three hours for blood draws, them pmps + shot - hopefully by the end of the day I'll have it down pat, and I'll have him home in the evening. Wish us luck!