newly diagnosed diabetic 14 yr old kitty

Hi from me and my Powder boy
What a shock it was to get this diagnosis for my tiny Chinchilla Persian. He has never been overweight, was always fed a high quality kitty food and when Wellness came out with Core that's all he has been fed. He was never fond of canned food until the last few months when I have been trying to get him to eat it after reading Dr Pierson's feeding info. I had found that he would eat a tablespoon of my dog's 95% meat products from EVO and Wellness but walk away from cat canned, same companies. He was a little thin but he has gone up and down in the past. I'm afraid I missed a lot of signs that he was ill but thought most were due to his age. He is not a lap kitty lately and walks away when I would go to pick him up. I am very tolerant of his moods because when I rescued him at 6 months no one could touch him. We had to lock him up in a room because I was afraid we might never find him! He eventually began to trust and would sleep with my son who went to live with his Dad when Powder was 3.(Dad said he couldn't bring Mr Powder as we affectionately call him. He was able to bond with me and became my little lap kitty and slept with me.He wouldn't let anyone pick him up and until recently hid when others were around. It became harder for him when I rescued a Belgian Malinois 4 years ago who is high energy and likes cats. Of course the cats think she is obnoxious but the last few months Powder isn't as bothered by her. She has calmed down a little.
That is a brief snapshot of 14 years and for two years he has been the only kitty in his domain, after losing our cat Lucky at over 16 years of age. They tolerated each other but there was no question at 12-15 lbs Lucky ruled! He came as a stray and the vet guessed he was at least 7 in 99. He became ill suddenly with a heart condition and there was nothing that could be done and I had to stop his suffering so I held him through the end and still cry over losing him. Maybe the trauma of Lucky kept me from seeing the truth about Powder. I was in denial. Until I went to give him his bath and he was so bony.

Off to the vet with fears of kidney disease because he was urinating so much(wasn't that just from his high protein diet)or diabetes maybe hyperthyroid(please let it be that)and when weighed had lost 4 lbs. Vet said the same thing but thought kidney disease the probable culprit. When all the tests were done his creatinine was 1.1 but his glucose was 350 so I dropped off a urine and that came back with high glucose, no ketones and normal specific gravity too. Couldn't it be due to an infection? He did have wbc's in his urine though no blood or protein. So a long acting antibiotic was given, he's to clever even for chewable pills. I had been testing him at home with my meter as I am diabetic (my dr is going to flip when she downloads my meter). The lowest reading was 299 all the others were from 325 to 450 I told this to the vet who now felt he was a diabetic and deep inside so did I. He said by today if he was elevated due to infection his BG would be normal again. Today it wasn't and I kept the appt I had made "just in case". I had been reading the fd info so I had a little knowledge I had him show me how to give the insulin though I had watched how tried to get a sliding scale and questioned why Humulin R. I wasn't sure about how recent the insulin info was so I bought it then realized after more reading that I was right it should be long acting insulin.

Now I have to challenge my vet again. He wanted me to feed Powder RC for diabetic cats. I almost choked at the garbage ingredients and had more carbs then what I was feeding. I had even called Wellness to discuss the diet after looking at the ingredients on Thursday knowing I could never feed my cat that. When I went today I was armed with info on the Core products and he still tried to get me to switch saying pet food companies aren't honest when they label their food however he said I could use it. I will do it for him because he needs me to advocate for him. Which brings me to my questions, I appreciate your patience.

What insulin is best to use for cats Lantus or Prozinc ? There is conflicting info on how long opened insulin is good for if refrigerated. Is it really 28 days or 2-6 months as I have read on other sites? My vet said the humulin R was good to expiration date hmmmm. Has anyone had any experience with the Easy Max meter? I need to get him his own meter my strips are outragiously expensive and it is a Freestyle. How do I make a chart like I've seen with the tests and insulin for othere's cats? The numbers posted still seem high for the treated cats is that typical for insulin treated cats? Humans are supposed to be under fairly tight control to prevent complications is it ditterent for cats? What are reasonable goals considering normal glucose values?

That's about all I can think of now! Its late here and I've been researching all day. Thank you for reading and I look forward to your comments and answers so I can help Powder recover his health.

 

Kathy, both B.K. and Chester use Lantus. My vet tells me that, if refrigerated, Lantus can be used well past 28-days (in fact, since switching to the pen, I've not had to throw out any Lantus). IMO, the best way to tell if the Lantus should be disposed of is by the cat's BG levels. If the BG starts to rise (and there hasn't been anything else going on that could have caused that), then it is time to toss the Lantus (and I tossed plenty of it when I purchased the vials instead of the pens).

I don't know about ProZinc, so I can't offer you an opinion. However, there are people here to do use it, so I'm sure someone will be along to answer any questions you may have about it.

 

IMO, Lantus. There are published studies out there done on cats that show that diabetic cats who start on Lantus right away along with a proper diet, can go into remission pretty quickly (something like 90% remission rate).

A 10 ml bottle of Lantus can last about a month, maybe a little longer, if kept refrigerated. The 28 day thing is for Human diabetics who can use up a bottle very quickly and drug companies aren't required to test the effectiveness of their drugs for more than 28 days.

Lantus is also available in a box containing five 3 ml pre-filled SoloStar pens and as a box of five 3 ml OptiClick pen cartridges. You can use either of these for a cat as well. There is a rubber stopper at the end of the pen and cartridge that you stick the insulin needle right into. A box of either is about $150 or so but you use one new pen or cartridge each month. So the box will last you about 5 months. That's a lot better than spending $110+ for a 10 ml bottle every single month.

The expiration date printed on a container of Lantus is how long it will last unopened.

No one here uses Humulin R as the main insulin. R is a very fast acting insulin. The only times one would use R in a cat is as a booster in addition to another insulin (like Lantus) for very high blood glucose levels and/or DKA and only with vet supervision.

Perhaps you mean Humulin N? That's a common insulin for cats but it tends to be too short acting. But it will last until the expiration date printed on the bottle.

Never heard of the Easy Max meter. Do you have a Wal Mart near you? Their ReliOn meters are inexpensive and work well. But you can't get test strips at any other pharmacy.

Shop around online for test strips. Hocks.com and eBay are two places where people buy test strips from.

See sticky on Tech board: viewtopic.php?f=6&t=18207

Also see Profile sticky: viewtopic.php?f=6&t=17766

You may have seen some newbie spreadsheets. If you take a look at some old timer's spreadsheets or even those who are in remission, you'll see how the bgs have gone from high to well regulated.

I think keeping bgs under 200 is considered regulated. This will take time to achieve with insulin and diet.

 

Hi Kathy,
We started out on ProZinc, and used it for 3 months before switching to Lantus about a month ago. They are both excellent insulins. ProZinc is more flexible, if you can't stick to a strict 12/12 schedule, ProZinc may be the better choice. Lantus is by far the most commonly used insulin by folks here, it give you a gentler curve but it does require a strict schedule. ProZinc is good until the expiration date on the bottle as long as you keep it refrigerated, it is stable and long lasting. Lantus is more fragile, but if you store it correctly you can get more than 28 days from a vial/pen/cartridge. If you go with Lantus, get a prescription for the pens or cartridges, not the vial...you will throw out too much insulin with the vial. Another recommended choice is Levemir...I don't know anything personally about it, but it seems to be similar to Lantus. You should look into Levemir also before making a choice.

That's just a quick snapshot of the insulins, please go to the insulin support groups (Lantus, Levemir and PZI) and read the stickies at the top to get more details about the insulins.

I'm not familiar with the meter you asked about, we use a Relion Confirm, Walmart's brand. It is an inexpensive meter to use, the test strips are $20 for 50 strips. We are very happy with it. If you click on the Hocks link at the top of the page, they have a Maxima meter that you can order that is also quite inexpensive to use, the strips are $16.50/50 strips. Some members use other meters and get their strips on eBay in order to cut costs.

For the spreadsheet, go to the Tech forum, there is a thread there with instructions to set up and link your SS to your signature.

As far as tight regulation, there is a clear protocol for Lantus and Levemir to help you with that. Unfortunately, for ProZinc, there really isn't a clear protocol, in part because the insulin is so new. Remission is possible with any of the insulins, Lantus has published study showing higher remission rates than other insulins, but it was a small study and ProZinc was not part of the study. We have seen kitties go into remission on ProZinc and other PZIs here.

 

I wanted to put in my .02 on Levemir. I love it. I find it much more stable than lantus for lasting. We get the pens and I leave it out and I have not had *any* problem with it losing effectiveness. Works pretty much like lantus. We use the WalMart Relion micro because the strips are 20.00 for 50 and I can get them in a pinch instead of having to use ebay (where you really can get most strips for around that same price no matter the meter.) If you are one who has the patience for ebay, you could use anything. No matter the insulin (Man, I don't know WHAT that vet was thinking using R though!!!!!) testing is the key to understanding your insulin and your cat.

 

powder and I say thanks for the info I appreciate it. I called my vet for a rx today and he never called back. His office is open on Sunday. I'm hoping he is checking into what I said to the tech about long acting insulin being the best option for good control.

 

Also, if you are asking for an Rx for Lantus, and depending on how much you cat needs, you may want to consider asking the Rx be for the pens rather than the vial. Both my boys get 2 units BID, and I've never had to throw away a pen that had insulin in it. When I purchased the vial, I had to toss approximately half. The vial is/was about $85.00, and a package of five pens is about $115 at Costco. So, for me, throwing away half a vial ended up costing more than getting the pens. BTW, if you get the pens, someone may try and tell you to purchase the needles that go with the pen. That isn't necessary. Your regular syringes will work just fine with the pen.

 

Just to top up what others have said.

Lantus is an excellent choice-lots of research on it (you can download and print off info from their stickys in the Lantus isg and take to your vet-can't argue so well with research :mrgreen: )

Definitley get the 5 3ml pack.Will last longer even though the outlay seems more. People have had as good as 9 weeks out of a Lantus vial. The best guide as has been mentioned is when numbers start to rise or you see floaties in it.

Humulin R-as stated-big 'no no'.Humulin N is also a very poor choice of insulin now there are ones such as Lantus/Lev and now Prozinc available.

I'm a fan off Lantus/Lev, but people speak positively of Prozinc as well.
Your numbers at present aren't too horrific, sooner you can get on a good insulin the better.

As for cat food companies-not sure about where you are, but they can't 'fudge' numbers ingredients other than using min/max amounts. These have been found to be a good enough guideline as to which ones to use. Janet and Binky's foodcharts give a whole host of good ones. Fancy Feast, evo seem popular choices.So you've done some good homework :mrgreen:

It's good to try and get/keep your vet on board, but not all are supportive of places like this (mine weren't so swapped to one eventually that tolerated it.'Well meaning' I think she called the people here :lol: but at the end of the day, this board saved my cat and gave me a lot more time with her)

Good luck :mrgreen:

 

It's been a week since I posted last and things are ok. Powder is so cute! He jumps up into his kitty cuddler on the chair for testing and insulin. Roast turkey has created a Pavlov's cat. He meows whenever he hears plastic bags, the refrigerator open and me taking out a syringe. Once he knows food's afoot he is a mighty pest and now he is always standing by hopefully turkey or any meat from dinner will come his way. He is now ignoring his dry food which he used to cry for. I don't know if this would help other cats but I knew from having a very scared, reactive rescue dog that food bribes go a long way. I would trim her nails and she would mouth me until I did one cut- one treat. Now she's great. So I thought if he had some payoff for the things I now had to do it might help him cooperate.
As I mentioned before he is extremely thin and needs to gain weight. Has anyone had the same scenario as this? If so, I have a few questions. He's eating Wellness canned chicken and turkey and would eat an entire can (12.5 oz) a day I've been giving him 3/4 of a can. Is there any harm in giving him as much as he wants since he has lost 4 lbs of his 8.5 lbs? Can he get pancreatitis from eating a can or more a day? I really want him to regain his weight not only for his health but it is very hard to give his insulin because he has no fat and therfore little "tenting" which makes it hard to do over rib area as I have read is reccommended. How did you handle this for your kitty?
Even though he is still getting regular insulin there has been improvement. Much less urinating and drinking. I was emptying his littermaid tray daily now it has been three days. My vet did give me a prescription for Lantus with the warning he wouldn't be responsible if anything went wrong because it's not approved for cats. I found a place online to order it that cost $96 for 5 pens so I'm waiting for it to arrive. The cost in my area was $200 and up. No pharmacy I called would split a box. So until then I am coming home to give him a shot durin the day. I plan to teach my daughter(21) because she comes home everyday at 12:30. The vet ordered one and a half units once a day but I read it should be twice a day. Are Lantus users giving twice a day?
I hope all your kitties are happy and healthy and look forward to any help or suggestions you can offer. "Meow" from Powder
and thanks from me.

 

Lantus users are very happy with it. Hope you will be too. Insulin is given twice daily, 12 hours apart, in the vast majority of cats. It won't last 24 hours, so it means a real roller coaster for the cat.

Have you read the stickies (topics on the top of the page) for Lantus? It explains how it is used: viewforum.php?f=9 The posters on that page can be a great support for you as you start the process.

 

Hi Kathy,

sounds like your doing realy well :mrgreen:
Food-A can a day is fine right now, more if he wants it. An unregulated kitty can't process all the food itgets, even if it seems a lot so as long as it's low carb wet-feed away :mrgreen:
You say roast turkey? Just be careful this isn't high carb. I used to give Lucky fresh boiled chicken. High protein (to gain weight) but negligible carbs.

Once you get into a routine and his insulin requirement stabilised his appetitie will naturally calm down (though hisdesire for treats may continue :lol: )

You are indeed right-regardless of the insulin, kitty's should be dosed twice daily (called BID here). Cats metabolise insulin far quicker than dogs (who only need one shot a day). Some cats can get more than 12 hours duration out of insulin but not 24 (Lantus has something called overlap which you will learn about in time, but still requires BID)

You can inject in the flank but it is ok to inject in the scruff too. Lucky would have had my hand off anywhere else! There has been discussion about absorption rates between the 2 areas but nothing conclusive and Lantus is slow acting insulin so why woud you want it to be absorbed faster! (some research says flank absorbs quicker)
We used Levemir but this has almost identical action to Lantus (we posted in Lantus group) and the protocol is the same for dosing, testing etc.
Great you've managed to get it half price.Hopefully you've got 5x 3ml vials? (just works out cheaper in the long run as countdown viability doesn't start until you open the vial.)
Some people have got as much as 9 weeks use out of a vial, the average is 42 days.In the stickies it explains what to look out for when nsulin no longer good (toast) Increasing bg's is one.


Is 12.30 twice a day going to work for you?
Lantus works best given as close as possible to every 12 hours. This is because of how it works in building a shed first then leftover gets to work on bg.s Again, all explained in the stickies. Best to read them then ask about anything that doesn't make sense.

BTW-No one knows what causes Pancreatitis, never heard of it being related to food and unfortnately there is no definitive cure, just good management of treating a flare that often works, again, guess what-it's in a sticky!!! :lol: Hope you don't get this as it isn't very nice. Good to know wat the signs are to catch early. Lucky had been beautiffully regulated for quite some time when diagnosed her as having it-no rhyme or reason, bt try not to worry about this (you can drive yourself mad with all the different complications that could happen, just focus on the FD for now)

Good luck and keep asking questions.
PS-Try and get a spreadsheet (ss) set up, then you can start posting daily in Lantus isg, always lots of people to help. :mrgreen:

 

I appreciate the input and will look for the stickies I'm a little technically challenged! I am anxious to get the Lantus so Powder can feel better. Today I found a site Tillie's Diabetes Site and read some great and hopeful info. I will have to be consistent and if my daughter will learn then it will be easier to do that when I have to work late.
The turkey is really just turkey my daughter Rachel says it's gross no salt! Thanks for the reassurance on overfeeding him and about pancreatitis Powder will be overjoyed! Mr. Powder and I hope we can someday help others.

 

Hi again.

This is the link to the Lantus group and the stickies I mentioned:
viewforum.php?f=9

Tilly's site is the protocol followed here in Lantus, albeit slightly modified here.German don't you know!
Fab site for info too.

Good luck and if you struggle to set up ss (me too! :roll: )just post in tech forum and ask for help.Some seriously clever tech bods around here :mrgreen:
viewforum.php?f=6