New User Here

Hello everyone!

I have 2 male cats, both from the same litter and 8.5 years old. One of them was diagnosed today with diabetes.

Fortunately for him, his human has double diabetes (both type 1 and type 2) and is very knowledgeable about human diabetes. Some of that knowledge can transfer and some of it can't. I'm hoping to get some support from this group with the things that cannot transfer.

 

Welcome to FDMB.

Some of the same things you do for yourself, you'll need to help your cats to do.
- gradually switch, 20-25% per day or two, to a low carb, canned or raw diet, per Dr Pierson who writes Cat Info.
- home glucose monitoring, using an inexpensive human glucometer such as the WalMart ReliOn Confirm or Confirm Micro, or the Target Up and UP, matching test strips, and alternate site testing lancets (26-28 gauge, probably bigger than the ones you use.) and comparing them to cat-specific reference numbers in your insulin protocol.
- use a long-acting insulin such as Lantus, Levemir, ProZinc, or BCP PZI which last about 12 hours in the cat.

 

Food - My vet has had them on C/D for quite awhile because he was blocked a couple times. I tried switching off once and he got blocked again, so I don't see changing food as an option for that reason.
Meter - No problems with that. Good tip on the lancets - I'll see what I can get because I'm having trouble getting enough blood at this point. The vet wasn't at all concerned about regular testing, but I am.
Insulin - I got a vial of pet insulin from the vet. It is U-40 insulin, and he says to give it to him 2 times daily (12 hours apart).
The vet wants to see him in another week or so.

I must say that my other challenge is the commitment this entails. It always used to be that I could leave all day or 2 days and no problems. Now, the cat misses insulin if I do that. It is more than I had expected. I love the cat and plan to keep him, but if I didn't have a connection to him already, I would not have taken him.

 

Had you tried Friskies Special Diet pates? It was developed for cats who have issues with crystals and stones.

Is the insulin ProZinc, BCP PZI, or Vetsulin/Caninsulin? The first 2 work well for many cats. Vetsulin, aka Caninsulin, was developed for dogs initially, and tends not to last more than about 10 hours in cats (their metabolism is faster than dogs).

The vet may want to run a curve, ie serial blood tests from pre-shot to pre-shot. The thing is, most cats get stressed at the vet and this may raise the glucose from 100-180 mg/dL. If you do it at home, you will get more valid numbers.

I hear you about the schedule constraints. It is why I have Gracie on ProZinc, not Lantus or Levemir. It is more forgiving of schedule imperfections.

 

No, I haven't looked at that food, but I use dry food now with an automated feeder. It was always so much more convenient, but if I must be home to give insulin anyway...
And the insulin he gave me was Vetsulin. It's a small town and I'm pretty sure that is all he had. I'll ask the vet about it when I see him next. I'm sure he can order something else. The cat's BG was over 500, so we didn't really want to wait for insulin.

 

Its what you have for now. If it turns out to last less than 12 hours, an option is shooting every 8 hours, although that is more inconvenient than shooting every 12. Might check for students - high school or college- interested in veterinary studies, to see if you might hire and train a couple to provide you with some respite periodically. Or, a vet tech needing to earn some extra money, might be willing to provide occasional respite care so you can get out.

 

Hi and welcome to the forum

You might like to look at this page on the dr Pierson's website where she talks about urinary issues
http://www.catinfo.org/?link=urinarytracthealth

With regards the dry food, wet food can be left out for 12 hours at a time with no problems. There are also ways around making the dry last for longer. You could freeze small amounts of it and then allow it to defrost slowly in the feeder and hence stay fresh.

Low carb wet food -less then 10% calories from carbs-is the ideal diet but whatever diet you end up with please make any changes (if you do) happen slowly and when you are testing his blood glucose.

 

I took a look at some wet food, particularly with low carbs. It looks like the Hills m/d would be a good option but it would run around $250/month. I can't justify spending that much on food.

 

Also, it doesn't help that I live in a rural area. My vet handles cats and dogs for some of us, but probably spends most of his time dealing with cows and hogs. I'm not saying he doesn't know anything about cats, but that isn't his expertise.

 

I have one cat with diabetes, and the other with urinary issues (used to be on C/D). They get the same food now. Choose a low carb and low phosphorus wet or raw food and add plenty of water to the food. The food chart here gives you some off the shelf options in addition to the Friskies Special Diet. You don't need special veterinary food. Yikes on the price of m/d! I spend a lot less than that on high end raw food for two. I also add glucosamine to his food - it's supposed to help strengthen the bladder walls. The other one gets it too for her arthritis. But, do not change the food until you are home testing his blood glucose, as changing food can lower insulin needs sharply. Try switching to C/D wet food first - that's lower carbs than the dry, but still pretty much like eating donuts. You can also feed wet with automated feeders which is what people do who are away all day.

My vet started Neko on Caninsulin too - they have more dog focused than cat focused. We've had a couple of diabetic people here share their Lantus or Levemir with their cats.

 

Thanks, I'll study the food list later.

Since I need to be home to give insulin anyway, wet food really shouldn't be a problem. That is if I can find something lower cost and low carb and safe for his bladder issues.

I've been able to successfully take BG using hot water in a pull bottle to warm up his ear first. Yesterday morning, 4 hours after insulin, it was 410. Then it was over 500 in the evening (machine goes to 500, then says HI). I gave him 3 units instead of 2. This morning it was HI still. I gave him 4 units. I don't want to increase too much too fast and cause a low, but I'll keep trying to increase until he comes down. At that point, I know I'll need to back off.

I don't use a basal insulin myself. I use a bolus insulin in a pump, which delivers small quantities every few minutes to mimic basal insulin. But I know Wal-Mart sells some cheap insulin OTC. Is all human insulin safe for cats?

 

I agree I wouldn't increase too fast or in too step jumps especially if you might change to a low carb wet food.

Ideally you would discuss with your vet about switching over up a longer lasting insulin such as lantus. This builds up little deposits under the skin that allow longer control over blood glucose.

You will get more purple looking at your thread if you post over in the main health forum and j would recommend you do so with regards insulin dosing and even perhaps start a thread in finding a low carb wet food for cats with urinary issues. No doubt others have already researched this issue.

 

Hello and welcome.

Saoirse was treated with Caninsulin at first (same as Vetsulin, but different brand name). I was advised by the vets that it takes a few days for a dose to 'settle'. If you increase the dose too quickly, it may drive numbers higher. Vetsulin is quite a harsh insulin for cats. It can drop the blood glucose hard and fast.

 

If the acting time is 10-12 hours, I don't understand why it would take several days to see a response. Regardless, I've been steadily increasing his dose and finally today got a reading below 400 at 6 hours after his morning injection. It was back up in the 400's by dinner time, but that seems like it is a good sign that this dose may just be enough to do more than just sustain him. And I need him to drop... no more 400's and 500's. I would like to get him in the low 200's and upper 100's in the near future with peak BG no more than 300 (within the next month).

After changing food to fewer carbs, and perhaps even getting a more stable insulin (something with a higher basal %), I hope to get him consistently at or below 200. That's more of a medium-range plan (6-9 months).

 

I can't describe why it works like that but it does but I am glad you are monitoring him.

It is good that you have both short term and long term aims, we say treatment is a marathon not a sprint. When you go back to the vet you might like to show him this treatment guidelines
http://www.felinediabetes.com/AAHADiabetesGuidelines.pdf

 

Hi, and welcome to FDMB

There do seem to be different schools of thought on the 'dose settling' issue.
My vet also said, at the time of my cat's diagnosis, that doses of insulin needed to settle in order to see the full effect. And I can see that there are some good reasons for keeping a dose the same for while:

In a cat that is newly diagnosed it can be helpful to keep at a given dose because it’s impossible to predict how the cat will respond to the insulin, and that response may be quite erratic initially (possibly due to factors such as glucose toxicity, as many diabetic cats will have been hyperglycemic for a long time prior to diagnosis).
A dose of one unit may seem to do nothing or very little on day 1 or 2, but may suddenly seem to have an effect on day 3 (for example). Or, the blood glucose numbers may be very ‘up and down’ with little consistency when the cat is first on insulin. Every cat is different. But it is helpful to try to see what the pattern is on a given dose before changing it. (Although an exception would be if the cat’s blood glucose was dropping too low, in which case it should be reduced immediately).

Insulin type matters too: Folks here have found that the long-lasting 'depot' insulins like Lantus and Levemir do need time to show what any given dose, or dose increase/decrease, will do. (It can take a few days for the 'depot' of insulin to establish in the cat's body).

Once experience has been gained about how a given dose of insulin works, it becomes easier to make dose adjustments. And in fact some cats, like mine, do best on sliding scale dosage, where the dose is adjusted according to the blood glucose level immediately prior to the shot. So, he can get a slightly different dose each time I give the shot (in which case that dose has no time to settle at all! But that seems to work best for him .)

Some folks here have also commented about their cat having slightly odd blood glucose numbers immediately following a dose change. I’ve not experienced it with my own cat but the phenomenon is so familiar here that it has been given a name: ‘New Dose Wonkiness’…. I don't think the term will ever appear in a scientific journal, but if you do a search of the forum you'll find many references to it here...

Eliz

 

My Norwegian Forest cat Beowulf, was diagnosed with diabetes in Dec 2014. I have been home BG testing with the AlphaTrak II glucometer and settled into some BG stability with 4 units Lantus 2X daily. However, there were still spikes in mid 300's in AM before feeding... both my vet & I were scratching head.

Before finding this forum, but researching ingredients (not on labels, BTW), I discovered how pet food giants "lie" with labels; the wet food, Royal Canin Urinary SO prescription he has been on for 3 years due to UTI chrystal problem... was on the "approved" list for diabetic cats that the vet provided... good, right? I now find that the 4% (by weight) that they publish, paints a picture that is not accurate. I contact Royal Canin and they cannot tell me percentage of caloric content (take away the 74% water!). One site had an online Digestible Carb Estimator would accurately estimate carbohydrates, given 1) %Protein, 2) %Fiber, 3)%Fat, and 4) %Ash.

Royal Canin SO has a WHOPPING 32.5% carbohydrates!!

After reading more information on the best source of ZERO carb cat food, feline diabetes, fluctuating/spiking BG levels, and UTI... I find the most probable culprit is carbohydrates "hidden" in the very foods that were to prevent this condition!! Young Again website is a great place to start, and you can talk to their specialists about your very cat issue.

I am making the switch to Young Again Zero Carb cat food, and have decided that, based upon the results of others, and the latency in Lantus, I would like to "test, then dose" as you mentioned. My delemna is a table of BG and Lantus dosage.... can you help in directing me to a resource??
Many thanks from Beowulf and my family!!

 

How do carbs spike BG before they are even consumed?

 

The body produces its own glucose to provide energy to sustain cell metabolism between meals (either released from glycogen stores or from metabolism of other nutrients). Incoming dietary carbs stimulate the pancreas to pulse insulin. Lack of food can actually cause fasting spikes in some cats if they do not have enough basal insulin in their system between meals, or if they are somewhat insulin resistant.

Saoirse is an example of such a cat. If she fasts for more than 2 hours or so her blood glucose level starts to rise. She's diet-controlled now, but was the same way at the end of cycles when she was receiving insulin. If she eats food with her particular 'goldilocks' carb level, her BG often drops within 2 hours of eating.

 

This is why you use basal insulin.