Overwhelmed Newbie

My 11-year old male cat was diagnosed this morning with diabetes.

I had noticed my previously affection-driven cat had become antisocial, and when his water intake and litter box output increased I got nervous. I had also noticed he stopped grooming. I took him to the vet and many costly tests later we have learned he has an elevated BG level, and has elevated calcium levels. The test results for the latter are pending, but my vet wants to put my cat on Hills d/m right away. I'm reading that this prescription food is NOT the way to go for this, especially Hills due to the high carb content.

He is currently on Nutro Natural Choice grain-free, but I can't seem to find anything that tells me the carb percentage for this dry food. What I'm reading thus far is wet food is absolutely the better choice (which he loves anyway) but I'm confused on which low-carb wet food to try. Does anyone have a link or trusted brand?

The vet tech taught me how to give an insulin injection, but now they want to bring me back in to show me how to do a BG level test as well as using the vet pen for insulin. I'm concerned about the "leave the vet pen needle inserted for at least seconds" part, because....hello...cat?! But I like the idea of less margin for human error for dosage. Does anyone have any experience with the pen?

My cats BG levels aren't extraordinarily high, but I want to focus on getting him the optimal food for now (aka I am going to the store in a few minutes) while we wait for an appointment with the vet, and to determine why he also has high calcium.

Thanks in advance, I'm completely overwhelmed but I'm eager to work to bring back my happy and snuggly cat.

 

Hi and welcome!

I'll try and give you a little information quickly so you can go and buy food without having to wait ages for a reply - and as and when you have other questions, you're in the right place to find people who can help you with them. You're right in thinking that the Hills food is not the best way to go for a diabetic cat (Hills have spent many years convincing vets otherwise which is why it's so often recommended). Many of us here use either Friskies or Fancy Feast Classic Pate varieties - they're low carb, high protein and switching to one of those foods can really help in bringing BG levels down. And they're way more affordable than the prescription foods as well as being better for your cat! However, if you're switching him to a low carb food, you will really want to be testing his BG at home as the food alone can bring his levels down and, combined with insulin, that could make him drop a long way fairly quickly.

There is a comparison list here http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf for wet food varieties - I'm not aware of one for dry food as it is generally too high in carbs for a cat. We aim to stay under 10% carbs as a percentage of calorie value.

Generally, when we use the insulin pens, we don't use the needle attachment for them as these can only dose whole units and a lot of cats need part-unit doses. You can use the pen like a mini-vial and use a syringe to draw up the dose instead. I think even with a syringe, if you can hold the needle in place for a few seconds, it will help to make sure your cat gets all of the dose - but as you say...we're talking about cats so you'll find that maybe sometimes you can do that and sometimes you can't.

 

There are very few low carb dry cat foods:
Evo Cat and Kitten at specialty pet stores and online.
Young Again 0 Carb online only
Stella and Chewy's freeze dried foods at specialty pet stores and online, not crunchy.

Wet food is preferred, per the feline nutrition guidelines at Cat Info

 

I literally got the email notification of your response while at the pet store, manxct419. Thank you SO MUCH for the links and info! For now I purchased some Fancy Feast wet food and I just mixed it in with his usual dry for now to transition him over. He's not yet on insulin as he was just diagnosed, so I'm curious to see what kind of impact this may have before we get him back in to see the vet. Since the BG levels are on the low end of the spectrum I think we want to wait for his hypercalcium test results so we can address everything at once. His BG was aok just 2 months ago its remarkable how fast this can happen!!

Today was our first foray into a scheduled feeding time, as my adorable old man has been free fed since I rescued him 3 years ago. If they don't finish their meal, do you all normally leave the food for them to return to later?

 

It's actually a good thing to be able to get the food change sorted out before starting insulin - some cats can manage with the food change alone, and for a cat already on insulin switching to low carb wet food can reduce their insulin need quickly. This way, you'll know what effect the new food is having before starting insulin which should help.

It happened really quickly for my Rosa too - she'd had blood work done for a dental last September and everything was looking great. She started losing weight quickly around Christmas and by January 12th, her BG was 680. However, knowing that he was fine just 2 months ago is actually a good thing - there is a higher chance of remission for cats who are regulated quickly so there definitely is a good side to the quick onset...and to you noticing it so quickly too.

I leave the food out for 12 hours at a time - I mix a little water into it to stop it drying out, but all the cats here have always been free fed and the only change I made was to take the food away 2 hours before Rosa's shot time while she was on insulin so that I knew her pre-shot BG wasn't food influenced. Free feeding can be easier on a cat's pancreas as it doesn't take the overload from a huge meal all at once.

 

Just what insulin/pen are you using? The Vetsulin pen dispenses in 1/2 unit increments
http://www.vetsulin.com/vet/AboutVetPen_Overview.aspx
The pens for the Human insulins Lantus and Levemir only dispenses in one-unit increments. Most cats requires finer increments like 1/4 or i/2 units.

Yes, you do have to leave the pen needle in the injection site for 5 seconds. I used the Levemir pen with my Murrfee. If yo take it out too quickly one or two drops of insulin will come out of the needle tip. At low doses that is a significant amount of insulin. My Murfee was on 18 units twoici dails so it was not a concern if I could not keep it in long enough.

You can use a disposable pen just like a vial of insulin and use a syringe to draw out the insulin and then use the syringe to inject the cat.
I used the pen for MurrFee since I got the pens and needles from Craig's list. Now I use a vial and syringe.

 

Hi Ellspeth and welcome to you and Godric.,

I've nothing to add to the great advice you've already received on this thread. I just wanted to say that I think Godric is a very beautiful cat.

 

Aww why thank you! I think so too, but I'm pretty biased.

I was wondering how quickly a change in diet can have an impact on BG levels? I started last night but I have noticed a decrease in water consumption and litter box. It may be random, but it was consistently high for over a week and now today, its much closer to normal. I was watching my little guy wake up and rush to the water bowl over and over and today? Its been twice. He's only used the litter box twice as well, which is also normal.

He also perked up at bird outside for the first time in weeks and came to me for attention this morning. Is it possible for 2 meals to make this big a difference?

 

I'm not using anything yet, we haven't put him on insulin just yet while we wait for one more test result.

 

Hi Ellspeth,

The change in diet can drop numbers very, very quickly hence the warning to caregivers of cats on insulin and dry food to be actively home testing before making the transition to keep their kitties safe.

The change in Godric's clinical signs sound typical of a cat returning to better numbers and sound very promising indeed. Definitely check with the vet about his BG on the wet food before starting insulin.

I look forward to seeing updates from you.

 

Food change may reduce the glucose from 100-200 mg/dL and may drop the insulin dose 1-2 units. This may happen in just a few days.
Vet stress may elevate the glucose from 100_180 mg/dL.

 

Wow it can reduce it that much? That's huge! My cat's BG levels based on a Fructosamine test was around 330, so lowering it by 100-200 would mean he would be back in normal ranges. I'm told the goal is >160. Its obvious since he is so close, BG monitoring is going to be a key factor here.

I'm going to the vet tomorrow for the vet pen (I've confirmed it can give .5 unit doses) and to make sure my BG monitor is calibrated. I'm bringing along my usual cat-sitter so he too can learn how to provide the best care when I'm not home.

I'm so grateful I found this forum. You guys are helping a furmom's frayed nerves and sad heart immensely. =^-^=

 

Recommended insulins are Levemir, ProZinc, Lantus, and BCP PZI as these all last about 12 hours or so. Cost wise, ordering Lantus and Levemir from Canada is much less expensive.

Vetsulin/Caninsulin tends not to last more than about 10 hours in the cat, leaving 2 hours uncontrolled, plus it can be pretty harsh.

The glucose, not the fructosamine, may drop 100-200 mg/dL, depending on what you have been feeding.

And you don't need to "calibrate" your meter to the vet's. You just need the feline-specific reference ranges, and these are in my signature link Glucometer Notes.

 

Thanks for all the helpful info, I have so much to learn! I misspoke about the fructosamine test, and meant the BG tests. My old Alphatrak has the settings so of course, calibrating isn't necessary.

I have ordered a blood glucose meter but since it won't arrive until tomorrow and I want to get my cat started on insulin asap, I've chosen to bring him in to the vet today for a curve. I was very concerned that his dosage would be based on his numbers before I changed his food, and now that it's been 3-4 days on FF I wanted to get a curve done before we start. I feel confident I can do BG monitoring at home after that.

My vet seems pretty attached to the Hill d/m food plan. Apparently one of his techs was supposed to send me the Rx for this, but never did. I called a couple times to check up on it, but when I didn't get anything I bought FF as it came highly recommended here and on several of the websites I researched. He insists its the only food that can treat both the diabetes AND his high calcium. Does anyone else have any experience with this?

On the plus side, Godric continues to improve JUST based off the food change. 3oz of water yesterday and he spent 3-4 hours snuggled up with me on the bed last night. First time in 3+ weeks he has done that. He even played a little!!

Edited to add: 1st BG test after eating breakfast was 247, 3 hours later 2nd test was 175. WITHOUT insulin. This could mean he won't need insulin right?

 

Well, I need to go buy a lottery ticket because I am the luckiest fur mom in the WORLD.

Godric spent the day at the vet, and after ONLY changing his diet he is now testing at 175. My vet and I spoke and he will not require insulin but I'll be monitoring his water intake and doing blood glucose testing at home.

My gratitude to all of you who replied and gave me links and suggestions is immeasurable. <3

 

See my signature link Secondary Monitoring Tools for additional assessments to help you monitor your cat.