Newly diagnosed - doesn't seem to be improving.

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Lisa211, Apr 23, 2010.

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  1. Lisa211

    Lisa211 New Member

    Joined:
    Apr 19, 2010
    I'm so sad. My 13-year old cat Cujo was diagnosed as a diabetic last Saturday. We noticed weight loss starting about 6 months ago. We put off taking him to the vet because he is a TERROR at appointments. I am so angry with myself for waiting! I finally made an appointment at a Banfield hospital because of their extended hours. They ran lots of tests--his bg level was 620 and his weight had dropped to 7 pounds (from a normal 13). They also ran a check on his organs, which were thankfully normal.

    On Monday, I brought him to the vet I prefer to use. He reviewed the blood work and tests with me and suggested we start on 2 units of Vetsulin 2x a day. Because of his history of extreme stress during appointments, we agreed to take a wait and see approach, monitoring behavior rather than blood.

    Since Monday, I've seen no improvement. Add to that, I'm seeing increasing signs of neuropathy in his front and rear legs. He's barely eating. I've resorted to offering him chicken breast and various canned varieties to try to entice him. He'll take a few bites when offered, but that's it.

    When did you start seeing improvement in your cat? Did you have to deal with eating issues and if so, what worked? I'm at a loss. Am I being impatient? I don't want him to suffer, but don't want to give up too soon.

    ~Lisa
     
  2. squeem3

    squeem3 Well-Known Member

    Joined:
    Dec 28, 2009
    Welcome :)

    Insulin is not a miracle treatment. It takes time to work along with diet. Some cats who are diagnosed early can go into remission in as little as a few weeks. Other cats may take months to go into remission or at least have some good regulation of the blood glucose levels. Justbe patient and learn everything you can on how to manage your cat's diabetes. Even if your cat never goes off insulin, he can still live a healthy happy life.

    There is a FDA advisory against using Vetsulin insulin because of contaminated issues. Talk to your vet about other insulins you can use. Many people here use Lantus, Levemir, or ProZinc.

    Daily blood glucose testing at home is the best thing you can do to know if the insulin and dose if working for your cat or not. You use a Human diabetic blood glucose meter and take a tiny blood sample from your cat's ear or paw. It does not hurt or cause any damage. The numbers you get won't make much sense at first but if you keep track of the numbers and when they were gotten in relation to the insulin shot, you will see how your cat is responding to the treatment. Members here can help you, too. Just monitoring behavior doesn't tell you anything about how the insulin is working on the blood glucose levels.

    Diet is another important part of managing the diabetes. Low carb canned foods are best. Before you change the diet, read http://www.catinfo.org for basic info about proper nutrition. and learn how to test your cat's blood glucose levels at home. Changing the diet while the cat is on insulin can be tricky because the food change has a big impact on lowering blood glucose levels.
     
  3. Val and Sebastian

    Val and Sebastian Member

    Joined:
    Jan 23, 2010
    Gosh, two units of Vetsulin seems like a lot for a starting dose. Most people here start on one unit, then gradually increase. Maybe Cujo is getting too much insulin?

    We started on Vetsulin, too, about a year ago. We just recently switched to Prozinc because of the Vetsulin issues. I don't think it's very responsible for any vet to be starting people on it now, even if they still have vials in stock. Because it is no longer being distributed, you will have to switch eventually anyway.

    Sometimes it does take a while to start seeing signs of improvement. As a previous poster said, hometesting can really help you figure out what's going on with your kitty. I was totally against the idea when I first came here, but without it, we would have overdosed Sebastian many, many times.

    Read all you can here and ask lots of questions. This site is a valuable resource!
     
  4. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    Lethargy and not eating are classic signs diabetic acidosis. I would quickly go to a pharmacy and get urine test strips that test for ketones. If ketones are present than a vet visit, ER if necessary since it really can't weight ill Monday. I would also syringe feed to ensue that get some food in him.
     
  5. Lisa211

    Lisa211 New Member

    Joined:
    Apr 19, 2010
    Thank you everyone! We visited the vet this afternoon. His new symptoms just weren't sitting right with me, especially the neuropathy I was noticing and the fact that he actually layed down in his litter box this morning after I put him in. He was severely dehydrated and his kidney test was off the charts. The vet believes the anesthesia he received on Saturday may have put him in acute kidney failure. This vet do not believe in giving a cat of this age sedation for this very reason. So, they administered IV and subcutaneous fluids. He perked up almost immediately and ATE!! He said the next 24 hours are crucial. If the kidneys are able to start functioning, we'll be OK. If not, we're faced with irreversible damage and he will need to be put to sleep.

    Good news in all this was that his sugars are down to 75---if he recovers, we will be downgrading to 1 unit of Vetsulin.

    Please say a kitty prayer for Cujo tonight-I would appreciate your kind thoughts.
     
  6. pamela and tigger

    pamela and tigger Well-Known Member

    Joined:
    Dec 28, 2009
    "The vet believes the anesthesia he received on Saturday may have put him in acute kidney failure."

    Geez, that is too bad they felt they had to do that. :(

    Did you ask your vet about the vetsulin contamination problems? Maybe it won't be an issue for you.

    viewtopic.php?f=19&t=311

    So glad you took him in to see your vet today! I hope your boy recovers soon.

    Can you ask your vet about learning to hometest? Would you like to learn? There are lots of links available here.
     
  7. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    I'm glad Cujo is doing better. Kidney problems are one of the possible side effects of anesthesia mainly because anesthesia lowers the blood pressure and low blood pressure can cause kidney problems. Did the vet give any pain meds after the anesthesia and was Cojo on IV fluids during the anesthesia? Some pain meds like Metacam can contribute to kidney problems and IV fluids is relatively standard during anesthesia since it maintains blood volume and thus minimizes decrease in blood pressure.

    The Vetsulin site and the FDA Alert do not mention any problems with "contamination" of the Vetsulin. The Alert states:

    "The Food and Drug Administration’s (FDA) Center for Veterinary Medicine (CVM) and Intervet/Schering-Plough Animal Health are alerting veterinarians and pet owners that Vetsulin®, a porcine insulin zinc suspension used to treat diabetes in animals, may have varying amounts of crystalline zinc insulin in the formulation. Because this Intervet/Schering-Plough Animal Health product is out of specification it could cause a delay in insulin action and an overall longer duration of insulin activity. Products having significant problems with stability can affect the management of chronic diseases. Unstable insulin products can result in unpredictable fluctuations in the glucose levels of diabetic patients. Intervet/Schering-Plough Animal Health is unable to assure FDA that each batch of their product is stable. "

    There is a problem with Vetsulin but it is not contamination.

     
  8. pamela and tigger

    pamela and tigger Well-Known Member

    Joined:
    Dec 28, 2009
    Sorry, thank you for the correction Larry....got that from the post below.
     
  9. ceil99

    ceil99 Member

    Joined:
    Dec 29, 2009
    Welcome to our FDMB family and be patient with yourself. You sound like you really love your cats, so you have come to the perfect place. Get some chocolate, sit back and get ready to read. Also, remember Every Cat Is Different. (ECID) Also, remember opinions may vary sometimes on this board, so you may get different views. Unfortunately, that is human nature.
    Sorry this is very long, but there is a lot to say! Also, remember we were ALL newbies once and are feeling just like you are right now! :) OK……..breathe………. :RAHCAT

    You do not need any type of prescription food or “special” diabetic food. Use Janet & Binky’s chart for canned food at http://binkyspage.tripod.com/canfood.html. . Low carb is best for diabetics. I try to stay around 10% or under. I feed Whiskas, 9-Lives and mostly Friskies canned food. Diabetes is very treatable and does not cost as much as you would think. If you are giving a high dose of insulin and feeding dry, be careful with switching to canned food. You MUST reduce the insulin at the same time you switch to canned food.

    Please create a profile if you have not already done so (viewtopic.php?f=6&t=531). It will help us to help you. We need to know what kind of insulin you are on, what needles you are using (U-40 or U-100), what are you feeding, how much insulin you are giving and when, BG test results, etc. There are many people on this board from all over the world, so it will be helpful to know what area and time zone you are in. :coffee:

    Remember that your cat is YOUR cat, and YOU are paying your VET to help you take care of him; diabetes was probably a day or two worth of notes when the vet was in college; it is probably NOT a day-to-day existence with his own cat trying to maintain a quality of life. Sorry to say, but I would have overdosed my guys on insulin if I followed my vet's advice. Vets, unfortunately are not as knowledgeable as they should be on diabetes.

    Sometimes, as I did, you have to take a leap of faith and trust these people on this board who deal with diabetes day in and day out. Trust me. You will not be disappointed. OK………..breathe again……….get some chocolate…….. cat_pet_icon

    Also, please realize that it takes insulin about a week to settle. START LOW AND GO SLOW!! The usual starting dose from our experiences is 1u twice a day for at least a week. Insulin in cats is NOT and I repeat NOT based on weight. This is a misconception that a lot of us have gotten from our vets here. pc_work

    You have to be patient, as I also had to learn!! Do not adjust the dose upwards based on one test. Don’t freak out based on one test result. As long as the levels stay on the high side, keep the same dose twice a day for at least the initial week period and you should see improvements. When you have some time (hee hee), read my profile doc at http://docs.google.com/View?id=dfqss8sg_1cpgwhbd9 .


    If you are not hometesting already, you really need to start!! Hometesting is VERY important. Most of us here use any human meter. Think of it as a human diabetic does. *If it were you or a child of yours, you'd be testing blood glucose levels at home prior to each shot; you'd be working with your doctor to determine a proper dose based on those shot results, correct?* Some vets do not agree with hometesting and I cannot for the life of me understand why. Most vets, sadly are not knowledgeable enough in feline diabetes. Insulin is a VERY powerful drug and you NEED to hometest before giving a shot. This is very important. The vet would rather have you bring the cat to them, stress it out more, which may spike the levels anyway and then they can charge you $$. Hometesting saved me a lot of money and it is VERY important for you personally to know the cat’s levels and how it is reacting to the insulin before you shoot so you do not pass up your ideal dosage.

    Thanks to everyone's help here I learned to home test 2 cats and they both got off insulin within 3 weeks with diet change…but of course, they reacting both DIFFERENTLY with the process. If I can do it with 2 cats twice a day (and more on curve days), ANYONE can do it. It does NOT hurt them as much as you think it does. It just stings for a moment and then it is gone, you can try it on yourself. Also, put pressure on the ear after poking and it should minimize the nub. They won't mind it once they start feeling better. I use the True Track meter (CVS or Walgreens brand) which I love. And, the strips are also reasonable. Also, remember to give them a treat after the test. Here is a link to a member videos on hometesting:

    http://www.youtube.com/watch?v=_zE12-4fVn8
    http://www.youtube.com/watch?v=cZ6iXetR398

    I would not feed DRY food if at all possible. Of course, it is better than nothing – you MUST get them to eat if you are giving insulin, but if there is any chance, get them off the dry. I took my guys off dry and within a month they were off insulin. Again, remember that switching from dry to wet can cause a drop in blood sugars, so you MUST reduce insulin at the same time to make sure you are not giving too much insulin. I truly believe also that I saved some of my many others from developing diabetes. I also saved so, so much money changing them all to regular canned cat food.
    When Blackie and Jackie got diagnosed, I was afraid to start shots. The people on this board made me realize it was no big deal. (They went on PZI insulin around 3-25-06 and went off on 4-18-06! :) Please also realize that diet plays a BIG, BIG part in insulin needs. I switched my cats off dry food to all wet and I was never so happy. It was a challenge to try to regulate 2 cats at once.


    Welcome to the Sugar Dance. flip_cat
    Welcome to the Vampire Club.

    If I can do it, ANYONE can!!!
    It does get easier. Trust us.

    You need to test BEFORE you shoot. It usually goes: Test, Feed, Shoot



    There's a saying something like "better the sugar level is too high for a day than too low for a minute".
     
  10. Vicky & Gandalf (GA) & Murrlin

    Vicky & Gandalf (GA) & Murrlin Well-Known Member

    Joined:
    Dec 28, 2009
    Any updates? Please let us know when you can. We're praying for Cujo's recovery!
     
  11. Hope + (((Baby)))GA

    Hope + (((Baby)))GA Well-Known Member

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    Dec 28, 2009
    Lisa, I just read your post about Cujo...sending prayers that the kidney values improve and she will be okay. Please let us know how she is.
     
  12. Lisa211

    Lisa211 New Member

    Joined:
    Apr 19, 2010
    Hi everyone---
    WOW--what a nice place. ((Hugs)) to everyone. This is really one of the most difficult things I've had to deal with and I am SO thankful for this resource and support.

    Cujo is holding his own. After his fluids yesterday, he's eating a bit, drinking quite a bit and using the litter box (urine only)-which are all good signs. He's still not interested in walking, but I think he's pretty weak from all this. I had him back at the vet this morning for more subcutaneous fluid. They said he's still critical and we will know more by Monday. They are not certain his kidneys can come back from this--it will depend on how much damage they suffered. Monday morning will be our big decision day. I will not keep putting through this if his quality of life doesn't improve. It's just not fair to him. But, I'm also willing to wait as long as he needs me to so he can regain his strength. I just hope and pray I know if the time is right to let go.

    We've suspended all insulin at this point to deal with the kidney issue. If he stabilizes, we'll be starting back on the insulin Monday, down to 1 unit/2x day since his sugar levels dropped so much from his first blood work.

    I learned SUCH an important lesson through all this---even if your pet is tough to take to the vet, he/she needs to go. Cujo was SO agressive, taking him was virtually impossible. But I've been seeing signs of illness for over 6 months and hesitated. Also, I should have NEVER treated at Banfield--I went because it was easy and fit my schedule. I had a trusted vet that I chose not to see because it would have meant a day off work. How wrong!! I knew his feelings on sedation in older cats, but thought the vet at Banfield knew what he was doing. I feel so guilty.

    Thank you again for giving a newbie such welcome support--I will keep you updated and appreciate any advice you may have.
     
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