Newbie on Vetsulin

Hi, my cat was just diagnosed with diabetes and was put on Vetsulin. She's also on the diabetic food, though she's not very enthusiastic about it. I used to work in a vet clinic and have administered Prozinc so I have basic knowledge of the whole process, but how my current vet and my previous bosses monitor diabetes is very different. My current vet wants me to monitor her water intake, which wouldn't be a problem except I have 2 other cats and a dog. The only way I can think of is to keep her locked up in the spare room all the time. That to me is incredibly cruel to her and is only going to make her stressed out. She's a super cuddlebug (as I'm typing this she's curled up next to me) so her being separated all the time is just not going to work. I was wondering if anyone else has been in this situation and can give me some ideas on how to do this without my cat feeling like she's being punished. Thanks for any help.

 

Wow, that does sound really tough on your kitty, keeping her locked up so you can monitor her water intake.

Most of us get a human glucometer and use that for home glucose testing.

Which diabetic food did your vet put your kitty on?

 

That was what I was thinking but I wasn't sure if it'd work for cats. She's on the Science Diet food for diabetics. I think it's M/D which I worry won't help too much right now because she's underweight. Her long hair is devious and hid how much she's lost because I moved 6 months ago and put everyone on a diet because all of them were super fat and ironically I was trying to avoid them ending up with diabetes. She's also 9 years old just in case you were wondering.

 

Yes, human glucometers can be used for BG (blood glucose) testing our extra sweet kitties. Member @BJM has a link in her signature to the reference ranges. Let me find that for you. Here it is Glucometer Notes.

Is that the dry or canned Hill's M/D?

What is your name?

What is your kitties name?

 

It's dry. He wants me to give her 5/8th cup once a day which fits fine with her current feeding schedule and I give her 3u once a day for insulin. Her name is Tora and mine is Courtney. Owning a diabetic kitty and helping others take care of them are two very different things as I'm learning the hard way. Thank you for answering my question. My vet kind of just shrugged at me and told me if I don't figure out some way to monitor her water intake I'll never get a handle of the disease, which just made me very frustrated and annoyed.

 

Hi Courtney and extra sweet Tora. Thanks for introducing yourselves.

Many of us in the USA get the Wal-mart Relion Confirm or Relion Micro glucometer. They are inexpensive, take a small 3 microliter blood drop (think head of a pin size) and test strips are a reasonable price too. You'll need lancets,for poking. The ones labeled "for alternate site testing" have a bigger pin for poking, 26-28 gauge.

Would you like some BG testing tips?

The M/d dry is a bit higher in carbs (18%) than we like to recommend for our diabetic kitties. We try to stay <10% carbs, feeding the lowest carb content our kitties will eat, per the AAHA Diabetes Management Guidelines for Dogs and Cats.

Does Tora like to eat wet food?

Does she have access to the other cats food or the dogs food?

Insulins don't last for 24 hours in our diabetic kitties. You might want to think about splitting that high dose of 3U into two doses and give them 12 hours apart.

 

For cats I'm guessing poking a pad would be the easiest so there's no hair in the way. She loves her old food. It's the duck and green pea diet from Natural Balance and she has access to it and I put a little bit in with the new food to make her more interested in the diabetic food. I originally put her on a restricted ingredient diet because she has a sensitive stomach and vomits a lot on other foods (I tried 4 different kinds from 3 different brands). Fiber is 4% in her original food with 30% protein, according to the website anyway. I would much rather keep her on her original food because it's what everyone eats and more affordable. Other than the weight loss and vigorous hunger, I had no idea she wasn't feeling well. I also thought it was weird that it was only once a day, but her glucose was also at 200 which isn't too far out of the normal range. I just assumed that was why. I only gave her 2u today because she's been on the diabetic food for a few days and I didn't want to overdo it for the first injection.

 

I would strongly encourage you to split the dose in half and dose every 12 hours. You run the risk of too much insulin with the dose you've been told to give.

In fact, you should check her now, to see how low she is going and look for signs of hypoglycemia. Here are instructions on Handling A Hypo.

 

She's laying right next to me and she's bright and alert, stable on her feet, and acting normally. I kept a close eye on her after I gave it because I worried it was a lot at once and that it was so long after she ate, but he was adamant to start it right away. I plan on getting her seen at another clinic as soon as I can to get a second opinion on how to handle her diabetes. It especially bothered me that he didn't want to even initially do a glucose curve on her to make sure the dose would work for her. I didn't even know she was that badly sick to the point she was ketoacidotic because she was actually perfectly like herself, just losing weight on me so evaluating only water intake seems kind of risky.

 

Water intake, urination, hunger, fecal output, dehydration checks, urine ketone and glucose monitoring are much less precise, although useful, adjuncts to blood glucose monitoring in evaluating the condition of your cat. They and others are listed in my signature link Secondary Monitoring Tools. A much older protocol uses water drunk and periodic tests at the vet to manage diabetes.

Because your cat has had ketones, it is important to monitor for them, either in urine or in blood.

 

Hunger, dehydration checks, and urination are much easier for me to keep tabs on. She only uses one of the litterboxes I have and she lets me know quite annoyingly when she's hungry. He believed she was ketoacidotic because her mucus membranes were very pale. That one will be harder for me to monitor because she does not like her mouth being messed with unless a vet does it. Her nickname is princess for a reason.

 

Hi Courtney and (Princess) Tora,
Welcome to FDMB

Are you testing Tora's pee for ketones at home? Sounds like that would be an important thing to monitor at the moment. You can do so with Ketodiastix test strips (or equivalent) available from most pharmacies. The test is done by dipping the end of the strip into fresh pee (Oooh, what we do for our kittehs...)

There are some good tips on this site about catching your pee sample, and using Ketodiastix:
http://www.sugarpet.net/urine.html

I agree with Deb and BJ that you'd get better coverage from the insulin if you split the dose; and you'd also be less likely to risk hypoglycemia.

Vetsulin/Caninsulin usually has a fairly short duration in cats. And in some cats it can be out of the system in around 10 hours after the shot. For cats that are given shots twice daily that means that they'd have no insulin in their system for several hours every day. But for a cat on only one shot that could mean no insulin for maybe 14 hours... If your vet thinks your cat may be ketoacidotic it is essential that she has insulin in her system for as much time as possible.

Did the vet actually test for ketones/ketoacidosis?
Did the vet say that your kitty needs additional treatment...?

Eliz

 

Nope, he did not actually test for it. He just said he thought she was ketoacidotic because of her discolored mucus membranes. There's a lot of things he didn't do and I think it's because I came in on a day he wanted to be closed but normally open. When he himself originally scheduled my appointment, he didn't ask me what was wrong or if she'd been seen for the issue anywhere. Then he had his receptionist call a few days later to change the appointment to another day which is difficult for me because I'm in school all day and work 3 workday nights and every other weekend. After like 10 minutes of back and forth and me telling them I'm not available for another 2 weeks, they just made my original appointment earlier. Because of that, I think he doesn't really like me and just rushed me through everything to get rid of me. I had to find someone to cover my shift yesterday because he didn't give me any option about when to pick up the insulin and when he called to verify the appointment on Monday, I told him I still didn't know because my coworker hadn't gotten back to me about covering my shift and he tried to make me feel guilty about not being certain. I told him I worked as a vet tech for years and I'm a vet student and still wanted to do an insulin demo with Tora, which I did not bring her and stress her out so he could show me how to do something I already knew how to do. Sorry, it's been a very frustrating situation with him but thank you for letting me know how to check for ketones. I never knew pharmacies carried stuff like that. She's doing well this morning and was super cuddly last night like always. I think she might've even put on some weight, or I'm imagining it because I don't like to see her sick. One of the two.

 

UPDATE: Tora has indeed put on weight and is now at an ideal weight. I took her to a different doctor and redid her blood glucose to see where she was. I didn't give her any insulin for 3-4 days and only fed her the special diet. Turns out the food is enough to keep her diabetes in check so I'm no longer giving her insulin. I'm glad I took her somewhere else and thank all of you for your support. It helped me get through all of this.

 

Hi Courtney,

That's great news about 'Princess' Tora!

When you say "the food is enough to keep her diabetes in check" do you mean that she is in a normal blood glucose range now without insulin? If she's done that for 14 days then we'd say that she is definitely in remission.

If she's at the higher end of the normal range, or 'borderline', then you may well find that a lower carb food will encourage her blood glucose to inch down a wee bitty.

And do watch out for any sign of infections (dental, UTI etc) as these are notorious for knocking kitties out of remission.
Testing her blood glucose periodically could alert you to potential problems and enable you to 'nip those in the bud'.

Well done, Courtney. And good luck!

Eliz