Newly diagnosed - wiating for regulation

Our 9 year old Maine Coon male Robbie was diagnosed with diabetes about 6-7 weeks ago. He's had asthma since he was about 3 and has been on prednisone pills off and on when needed for the last 5-6 years - we tried inhaler and it didn't seem to work well, plus he got very nasty about having the mask put on and the inhaler administered. His asthma is very unusual in that it's more bronchial than lungs and also seems to be either allergy or sinus issue related. We've been working with our vet as best as our budget allows to figure out what is going on. So far no luck. He was also about 4 lbs over weight - as a Maine Coon he is a very big cat and should weigh about 19-20 lbs - he was weighing about 23-24lbs a year or so ago and we've been working very hard to get him to lose weight. This April after several bouts with constipation and several vet visits we got that all regulated and when he went in for his annual visit to the vet he had lost 1.5 lbs since the year before and was in good shape except his asthma sounded pretty rough. The vet did a full blood work up (since one hadn't been done in about 2 years) and gave him a steroid shot to try and quiet down the breathing.
The steroid shot seems to have been a bad move. He was jittery for a long time, ate like a nut and started drinking tons of water. Checked in with the vet who felt all this could be explained by the steroid shot and advised us to watch him carefully for a couple of weeks. He seemed to settle down and except for the drinking - which continued unabated.
After about a month to 5 weeks of this he started acting very lethargic and didn't eat as much - the minute this happened we took him back to the vet. Much to our dismay he had lost 4 lbs in 5 weeks and was weighing in at 17.5lbs. The vet checked him out and felt it was either thyroid or diabetes and because of some indicators in his blood workup from 5 weeks previous he was leaning towards thyroid. The test came back fine - so the diabetes test was next - his numbers were very high - I do not have the papers in front of me but I know his shorter test (not the test that is more expensive) his numbers were 380+. He was started out at 3 units of the humalin insulin 2x a day. We are now up to 8units and both tests show that his numbers have moved VERY little. We did not originally change his food as x-rays show he has mega colon and tends to have bowel problems esp. around food changes. However, now we have just started moving him over to a prescription (Royal Canin) food for diabetic cats (both wet and dry). On day two of 8 units 2x per day I think he has started to drink less water - we monitor it carefully and unless our cleaning person did something stupid he is down about 16-22 ozs a day from where he was. He has seemed a bit better (perkier, more active) since the first insulin shot - but our vet is not happy with his progress.
He is discussing a few things with me -
a pig based insulin which he says is expensive but might work better
switching the food over and waiting to see if the 8 units works - or going up to 9 units with the food change and seeing how it works.
I am planning on talking to him about Mellit - also about feeding him small meals several times a day instead of the 2 meals he has now.

I would appreciate any input - obviously we can't put him back on the prednisone pills so we have to go back to the inhaler - but right now his breathing is totally fine so we have not started that just yet - hoping to get him settled in a bit with the new life he has.

thank you all - glad to have found this group.

 

Hi,

you've had a rough ride but sounds like a vet that is trying to be proactive.

Cats can get diabetes induced by steroid shots.
aven't any experience of pred.

Humulin is not a particularly good insulin.
Lantus, Levemir have had fanatastic results and prozinc (released back end of last year) seems to be gaining favour. Don't know of any research on it though.

Lan/Lev there has been (have a look in the Lan isg and read the stickies and link to the research)

Although seemingly more expensive, if you buy the 5 3ml vials it works out cheaper.
8u BID is a high dose, but because of his asthma can't say that isn't needed.
Dry food is no good, (but if you come off this, would more than likely need to reduce the dose)
Wet food is much lower in carbs.Janet and Binky's food charts give you all the % carbs in various foods.

Might be worth starting another thread (linking this one) and asking for advice for using pred whilst treating diabetes.

Keep reading and ask lots of questions.

Good luck :mrgreen:

 

Kate gave you lots of good info, especially cutting out ALL dry foods and switching to LO CARB wet foods only.
Here are some food links; you can consult binky's list for foods with lower carbs than what you are currently feeding and try them out. People who remove dry and switch to wet foods, sometimes see great improvement with some even not needing insulin at all.
Binky’s Food Lists
Feeding Your Cat: Know The Basics of Feline Nutrition

If you look at the cost of Lantus or Levemir, the cartridges are really not bad considering the length of time it takes to use each cartridge.
I pay about $130 or something for the 5-pack, each cartridge is 3ml. Now you divide that cost over months, it's not so bad at all! You will have better luck with one of these two longer lasting insulins, I am sure.

About high doses, I have 2 high dose kitties, and there are tests you can have done if you still see high numbers with food changes to all wet or raw, even though the dose keeps rising or staying high.
Here are the links to the acro and IAA tests I had done:
IAA Test
IGF-1 (Acro) Test


I can't comment on asthma as one of mine may have only mild case so nothing in treatment is needed yet, but I know that dental issues can affect BG as my Shadoe had a great improvement after her first dental ever with one canine needing to be extracted.

I hope you can get Robbie nice and regulated and he feels better soon.

 

Yes, please get rid of every morsel of dry food. My cat is a living testament that a dry-food diet led to his obesity and diabetes. You can also see from his chart that he is a great candidate for remission after just a few weeks of following the protocol explained on this board. Ask your vet to switch you to Lantus insulin, which apparently has very good effects when also following the diet and hometesting advice here. Our other bonuses for switching to a low-carb wet diet: 1) increased energy - likes to play more often. 2) Awful, lifelong dandruff is all but gone... 3) Pancreatic healing and subsequent improvement in BG levels - IN LESS THAN TWO WEEKS.

 

Thank you for the feed back - we are going to work him off the dry food - his intestinal issues are making us do this all very slowly - Vet had hoped initially that he'd respond well to the shots and we could move him over to different food very, very slowly. This whole roller coaster seemed to start when we decided (for weight and general health issues) to move both cats over to higher protein, low carb diets about 9 months ago. This was long before the diabetes was an issue. We did it gradually and both cats (we also have an 11 year old Maine Coon female who is the picture of perfect health 99% of the time and who our vet says has the health of a 2 year old) became very constipated - Robbie to such an extent that it became critical. We went back to the Wellness dry with a little bit of nutro max hairball remedy mixed in and fancy feast wet (thankfully one of the favorite flavors is on the list of low carb/gluten flavors).
From what I have read on the asthma forums and been told by my vet (during the time we were using it) prednisone use, which is a steroid, can push cats towards diabetes - we were aware of this all along and used it very sparingly. However, Vet and I agree that the steroid shot pushed him over and it was probably too high a dose at a bad time. With so much going on with this cat I realize the vet had several decisions to make and when his breathing sounded so bad he felt that issue was primary. I know now he feels bad about this but he is a wonderful vet and has many cats with diabetes he is currently treating successfully.
the Vet did mention the other insulins - I have emailed him the info from this forum on humulin and will be calling him Monday - we just bought our second bottle of it... but I don't care. Any other info or pointing in directions of other info on the "better" insulins would be helpful.
Any comments on where the shot is administered? I was instructed in the scruff of the neck as they don't feel it as much and Robbie is perfectly fine with this - doesn't even look up some times. Now I'm reading this also isn't the best situation - although 2 other patients of our Vet have talked to me about their diabetic cats and do the same thing and after a couple of months cats regulated and are now fine - all with same protocol as we are using. I know all cats are different but thoughts on where we admin. the shot would be helpful.
Thank you again - forums like this are a god send I know the asthma one helped me tremendously. This big boy is my baby - just a very special guy and I want to have him comfortable as soon as possible.

 

It sounds like your boy has lots of issues and you are working to stay on top of them. Great job!

As far as other insulins, take a trip over to the Insulin support group pages. viewforum.php?f=5 Three are quite active - Lantus, Levemir and PZI. The stickies on the top of the page will give you information on how the insulins works. If you read through some of the posts, you can get a feel for how people are doing with them. They are all slow acting, milder insulins that make it easier to regulate kitties.

You do want to be careful making a switch to all wet lo carb until you are testing at home. Oliver's blood glucose levels went down 100 points overnight when we made the change. If we hadn't been hometesting, we would have given him the usual dose and caused a hypo.

 

Hi again,

Shooting in the scruff of the neck is fine. There have been arguments that insulin is taken up slower here than on the flank but if you move to a longer lasting insulin it's slow release anyway!
There is no real proof basically that scruff over flank of vice versa is best. It's what works for you. Lucky would have my hand off if I'd tried to shoot anywhere but scruff.

As I said and echoed by Sue,removing dry you will need to reducethe dose.
Lucky was 454 on dry. 1 week later (no insulin at this point) and she was 257-both included vet stress.That means a lot less insulin.

Hometesting really is the best way to manage FD and prevent kitty having a hypo.
Lots of advice and help on that here too.

I'd agree on the steroid thing-you have to treat the most life threatening symptom at the time.
Get the info on the insulins and let us know what your vet says. :mrgreen:

 

Here's a food story for you.

Not too long ago, a person joined this site and had a kitty that was getting 20units of insulin. Yes, 20. The food being offered was some wet and I think mostly dry.
The person as advised the same thing: home test to know the BG before shots, and toss ALL the DRY out the window!

It did not take long but that kitty dropped like a stone and was at 1unit of insulin, in days. Yes, 1.

I know each case is different, but it's been proven over and over, time and time again, even the dry that is 'claimed' to be healthy, is contributing to the high numbers.

It could well be that much of the 8unit shots is needed because of the dry food.

 

thank you thank you again - we have cut basically in half with the dry since this diagnosis - continuing in that direction being careful because of the intestinal issues (the hairball dry has lots of fiber in it) - we have started giving our boy metimucil to compensate and he seems to be going along just fine in terms of being regular in his litter box - of course he's peeing like there's no tomorrow but I've noticed in the last week that even that has lessened as his water intake has also - I can only hope we are in the right direction. Lots to go over with our vet on Monday - and I will read the suggested pages etc. - just finished the very long and fascinating site about cats being carnivores - very good. I can tell Robbie has lost more weight - so am thankful in some odd way that he needed to lose a few but doing it this fast is no good. So I give him a bit more wet now than he used to get - so far he shows NO signs of hypo at any time - but I sure would love to lower his dose my Vet doesn't really want to increase it.
I have to talk to my vet about the home testing and read more here - to be honest it freaks me out a bit - ironically I am a diabetic (type II) also (weight issues) but changed my diet and take herbal supplements and am now on a very low dose pill and am doing fine - so I test myself daily - but I just don't know about the cat - so more info on that is needed for sure. This gentle giant of a cat will let me do just about anything to him so perhaps this won't be so bad - but on top of the inhaler for the asthma, the insulin and the 3x a week doses of laxatone - he's bound to start running when he sees me coming.

thanks again.

 

You'd be surprised at the impact of treats :mrgreen:

Hometesting really isn't as bad as it sounds.I think we are all worrying for you because of the dose and I certainly would feel a lot better knowing what effect the dose has on his bg's.

Lots of beans will help with the hometesting and quite often there are others in your area that are willing to come and show you how it's done. Alternatively some good videos of it on youtube. :mrgreen: