Recent Diagnosis

Hi! I just wanted to stop by and introduce myself. My name is Jen and I am the cat-mom to two beautiful rescue kitties. Both were found abandoned before weaning, so I have the extra special bond of having bottle fed my boys.

Unfortunately, my oldest at 7, Squeaks, was just diagnosed with diabetes yesterday. I knew something was wrong and had been for some time. I had even requested the vets re-screen his glucose level last year as it was slightly elevated at his comprehensive exam. He is overweight, though he hardly eats. And he has a passion for water and will even sit at the bathtub to lick drops off the faucet. There were so many symptoms I kept pointing out, including hindquarter pain, lethargy, crankiness, and loss of appetite without losing weight. I know a lot of people thought I was in denial about over-feeding my 'fat cat'- but my cat-mom instincts said otherwise!

I'm glad I found this website. Squeaks and Nemo are best friends, and even though they are not litter mates and are separated by almost two years, they do everything together... including eat. Just two meals into a Rx feeding diet and they are both beside themselves because the routine is so changed. Seeing the lists of "normal" food that will be completely ok for his brother, Nemo, to share with him makes me so much happier. And while I have researched cats and feeding, I never realized how bad dry food can be until finding this site. Many places recommend a canned diet only, but none of them ever flat out and said "You're essentially feeding your cat glazed donuts every day."

Because diagnosis was literally yesterday, only a Rx food plan was suggested while the vet and I research options for treatment and discuss. For better or worse, I grew up in a human diabetic household, so titration of insulin dosages, the effects of fast v. long acting, and so on are not new to me. (Maybe one of the reasons I could see the problem before anyone else did!)

I don't have any questions (Truthfully I have a TON... but I still have lots of reading to do!). I just wanted to drop in and say hello and maybe mingle a bit so when I do come across some questions I can't research answers for, maybe I won't be such a stranger.
Thank you for the wonderful research and support site!
Jennifer

 

Welcome.
Good insulin are the human Lantus and Levemir and the pet insulins ProZinc and BCP PZI. For those two human insulin it is best to get the 5 pack of 3 ml disposable pens via a 10 ml vial. Although per ml the vial is less expensive most cats will not use up a 10 ml vial before the insulin goes bad/becomes ineffective. The human insulin N/NPH is sometimes prescribed but only lasts 8-10 hours. Same for the pet insulin Vetsulin/Caninisulin.
Most of us here test or cats blood glucose at home using a human meter. We test before each shot and periodically between shots. We record our reading and other info in a spreadsheet. See:http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/
What are you feeding? A low-carb canned is best. No reason for a prescription food. Here is a list of commercial low-carb canned

http://www.felinediabetes.com/FDMB/threads/shortcut-shopping-list-all-8-or-less-updated.117688/

Here is a link to home testing blood sugarshttp://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

 

Welcome Jennifer, extra sweet Squeaks and Nemo! Looking forward to sharing your 'Sugar Dance'.

 

Welcome, Jennifer! It looks like you're off to a great start, and it's wonderful that you're doing your homework ahead of time.

You should have seen what Bandit looked like at 6 years old--I wasn't over feeding him, but the dry food made him blow up like a balloon and he was morbidly obese. You wouldn't believe the difference after switching him to canned only (with his diabetes diagnosis also at age 7). He dropped to a normal weight and we haven't had a problem keeping him at a healthy weight since (he's 14 now). I posted a couple pics of him in this thread if you want to see his before and after pictures.

I'm not sure what food lists you' ve discovered yet, but this one is the most useful for me: http://catinfo.org/docs/FoodChartPublic9-22-12.pdf
Anything under 10% carbs (but preferably under 8%) is great for both your diabetic and his brother. Given Squeak's weight, I'd also try and find something a little lower in fat, higher in protein to start him out losing a bit of weight (it's a little pricy, but Weruva is great for weight loss--and still less expensive than the rx food, I believe).

What rx food did your vet give you? The only one suitable for diabetics is Purina DM canned, all the others are still too high in carbs for diabetics.

Because cats' metabolisms are twice as fast as people's, the best insulins for them are Lantus and Levemir, followed by Prozinc. Vetsulin and NPH (Humulin-N) do not have a long enough duration of action in cats and should not be used. 80+% of cats on Lantus or Levemir go into remission if treatment is started with the right diet and dosing guidelines.

Lantus is pretty pricy in the U.S., so many of us get a script from our vet and order from a Canadian online pharmacy, where it's much more affordable! The 5 pack of pens are the most economical--it costs $170 after shipping, but because of the reduced waste (because of the tiny doses cats get, you'll use up all of the insulin in each pen before it goes bad, unlike the vial) they will last you nearly a year, maybe even more.

If your vet doesn't encourage home testing, you may have to go ahead and take the initiative yourself. Home testing is the only way to safely administer insulin. Cats get stressed at the vet, so curves done there are inaccurate because their blood sugar goes up with stress. Also, vet curves are too infrequent--daily testing helps you reach the correct dose as quickly as possible without endangering yoru cat. You can use any human glucose meter--you don't need a pet one.

Good luck! Definitely come back and give us an update! Everyone here has lots of tips and suggestions for just about every scenario you can think of.

 

Hi Jen, and welcome to you, Squeaks and Nemo.

I really enjoyed reading Squeaks' and Nemo's story-so-far. Lovely picture of the two of them, as well.

You've got a great leg up the learning curve with your prior knowledge and experience of diabetes.

Like yourself and many others I hadn't a clue how bad dry food is. Actually when I adopted my first two rescues I asked their vet which was best - wet or dry? He told me that dry food was far superior to wet as it was much better for their teeth. I'm upset with the vet for pointing me in the wrong direction and very angry at myself for not educating myself better. Any health problems my kitties have had down the years (excluding scratches or accidents) can be directly attributed to their being fed a dry diet.

It's great that Squeaks and Nemo will be able to eat the same low-carb food. I note that Squeaks is not yet on insulin. Provided his current blood glucose (BG) levels will permit, if you are transitioning from a higher carb food it can be really helpful to get that well under way before starting insulin as it will give you a better baseline for determining starting dose. If you can home test Squeak's BG levels prior to starting insulin again that can assist in selection of starting dose as home readings reduce the likelihood of stress-related BG elevation.

Most people here use human glucometers with a cat-specific human meter reference range to monitor their kitties. Pet meters are also available (e.g. the Alphatrak 2) and they are designed to give readings close to lab values, but the test strips are much more expensive than those for human meters.

With respect to insulin choices, cats metabolize insulin much faster than humans or dogs. As I'm sure you've already read in your research, with treatment cats may go into diabetic remission (normal numbers on low carb diet only, no insulin). The chances of achieving remission may increase significantly for newly diagnosed cats who are put onto a low-carb, wet diet and who receive a longer-acting insulin (Lantus, Levemir, Prozinc/PZI). My cat, Saoirse, was treated with both the intermediate insulin, Caninsulin (legal requirement to prescribe it first in the UK), and thereafter with the basal human insulin, Lantus. I was able to keep Saoirse safely and tightly regulated on Lantus (impossible on the harsher Caninsulin - plus the Caninsulin BG roller coaster left her absolutely miserable) and she achieved remission three months after starting on Lantus. I also found it enabled me to safely keep her keep her in tightly regulated numbers; something which was impossible on the harsher Caninsulin. (Sadly she's no longer in remission - issues with chronic pancreatitis - but she is again being treated with Lantus and most of the time her BG levels are within the normal range for non-diabetics.) That said, some cats do great on Caninsulin/Vetsulin and may achieve remission on that insulin, too.



Mogs
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Thank you to everyone who has been so welcoming and helpful! I feel relief knowing I wasn't the only one silently seething because I knew I wasn't over-feeding my cat even if everyone else smiled and rolled their eyes thinking I was an over-indulgent mommy.

I have actually directed my vet to this website as we have been corresponding via e-mail today discussing treatment options. She was quite pleased with this website and said it certainly seemed like a good resource. She said that we could certainly try non-Rx food as well to see how he responds and 100% supported going all the way canned. I am so hopeful hearing everyone talk about how their 'pudgy butts' trimmed up and got healthy with a proper diet of canned food and that my little one may not have to take shots forever! I can hardly wait to put my boys on a canned diet (which they will be THRILLED ABOUT, literally) and hopefully with time I can see my Squeaks return to the slender, healthy, playful boy I remember.

She would like to start Squeaks on Glargine, aka Lantus. I must admit that it ties my tummy up in knots just thinking of my little one. Not the needles or blood or anything, but just knowing he'll be looking at me and wondering why I'm poking him everyday. :-( One the flip side, he LOVES for mommy to rub his tummy. (But only mommy... maybe daddy too.) So getting him to roll over and let me touch his tummy without his paws closing in like a Venus fly-trap is probably pretty helpful.

Have any of you found the "best" spots to test glucose levels? I'm sure it's in the literature somewhere, but there's a lot to take in and I don't recall seeing it mentioned.

 

The syringes we use for Lantus (31g, 3/16" (8mm), .3cc) have really tiny needles. I've always given Bandit his shots while he's eating, and he doesn't even seem to notice I'm doing it! As for the tests, we use the tip of his ear. Here's a link to a thread on hometesting, that gives you all sorts of advice and tips, including exactly where to poke: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Some things are very important to start. First, you'll want to make sure you're using a 26-28g lancet--the very thin ones are hard to get a drop of blood with at first. You'll also want to warm his ear up before the test (using a pill bottle or rice sock), because it helps get the blood flowing! Finally, make sure you give a diabetic safe treat after every test! Your kitty may not like the tests at first, but after a few weeks of treats, you'll have a much better time with him. Bandit fought me tooth and claw at first, and now he comes running, sits at my feet and starts purring when he hears the glucose meter beep on.

 

Hi Jen, welcome to you, Squeaks and Nemo. You couldn't have found a better place for support and advice. The people on here are wonderful. I'm new myself and have come to rely on my online family. Here's one picture below that helped me
This is actually the one that I was looking for http://i106.photobucket.com/albums/m267/chupie_2006/testingear/sweetspot.jpg

 

Ask and you shall receive!

Testing and Injecting Tips

Most people get blood samples from their cats' ears. The above link has a very helpful diagram of the testing 'sweet spot' where it's usually easiest to get a sample. For cats that can't get on with ear testing, paw pads are another option.

I see you've met my civvie.


Mogs
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Welcome Jenn, Squeaks, and Nemo. Gotta love belly rubs!

 

Wow! Liz & Ittybit, your bio was a gut punch for me! Squeaks had a HORRIBLE reaction to depo once and has since been marked as allergic by the vet. (I was in tears on the phone with the emergency clinc at 3 AM... Terrifying!) I wonder if that one shot could have started this diabetes? I'll have to think hard, but immediately my gut said he'd been 'healthy' up to that point.

 

Hi Jen. So sorry to hear about Squeaks' reaction to the depo, I can't even imagine how awful that must have been. Every time one of my babies gets a new medication I'm a wreak until I figure the time for any kind of reaction has passed. IttyBit has had a few depo shots in the last years and never had any reaction, but right after this last one the excessive, drinking and peeing started. I knew that the depo would make him thirsty and therefore pee more but not like that. He was the opposite of Squeaks, he was hungry all the time but lost a lot of weight. I called the Vet five weeks after his depo shot and was told by the "receptionist" that the effects of the shot last six weeks and that he could still be extra hungry and thirsty even a week after, so against my better judgement I waited another two weeks before getting him in and sure enough he was diagnosed with diabetes If your Squeaks started these behaviors right after the shot, then I'd guess there's a chance the the shot was responsible. On the bright side, steroid induced diabetes can be reversed. Stay tuned for IttyBits OTJ (off the juice = off the insulin) party. We've got one day left before he's officially OTJ. You don't need an RX diet, I've been feeding IttyBit Fancy Feast Classics and some Friskies Pates and I bit the bullet and splurged on Young Again kibble because they were used to having food down all the time. It's expensive but they don't eat that much of it because it's very filling. IttyBit and my civvie boy Boo are only eating about 1 cup total every 5 days. My civvie girl Buttons hasn't eaten it up to now, but that could be because her gums hurt and civvie Roo has her own dish in her own room (she's anti social) You can call the company and they will send you sample packs to try before you buy. Hang in there Jen, you are among friends. Ask all the questions you have and the good people here will provide answers for you.

 

So, I borrowed an accu check from my dad to test Squeaks. Once I got my courage up, we snuggled and then I went for it. Squeaks is a tux with black ears, so I had to feel for the vein with my fingers. Thankfully he's a big head snuggler and I've always played with his ears, pretending to bite them with kisses. (I did this to warm them up!)
HE NEVER FLINCHED. Even with the click pen! He never stopped purring. But epic mommy fail... I couldn't get a drop! I tried once on each ear and stopped because I could tell he was getting fidgety and I want to make this as positive as I can. What am I missing? The lancets are 30 or 33 (Dad couldn't remember which) but I set it to a 5 for a good draw. That's what I would use for my own finger so I thought surely that would work. I'm so frustrated and afraid my ineptitude will make this a bad thing.

 

Good job getting started home testing. Now you know that you're not hurting him. It's very common to not get any blood the first few times. You made the right choice to stop and take a break. Did you warm his ear really well? We use a sock filled with about 1/2 cup rice, heated in the microwave 30 seconds. Test on you wrist to make sure it's not too hot, then warm his ear with it. The more you test the easier he will bleed (that sounds awful doesn't it) The ears learn to bleed. 30 or 33 gauge might be a bit small to start with, but will work great later. Maybe try 28 gauge for now. Also try a bit of folded up tissue, paper towel or cotton ball on the other side of the ear to support the ear. The hardest part is to not let your frustration show. No matter the results give lots of love and a little treat he loves. It takes a little practice but you will get it I promise.

 

I pretended to 'nom' his ears which is something we've always done. I hoped all my hot air would be warm enough, along with lots of rubbing.. and I'm not sure how he'd react to a warm sock. I'll give anything a try! Lancets and pens aren't as pricey as strips, so I'll see if Dad has any 28s or go get some tomorrow morning.

Silly question, but how dense are the nerves in the cat's ear? As dense as a human fingertip, or is it really less painful and just more frightening than anything?

Another silly question, but setting the pen to maxium depth won't pierce all the way through his ear, will it?

 

From what I understand there are very few nerve endings in the ear and I know IttyBit does not show signs of pain when we test. We haven't found a treat that he likes and he still comes willingly to get tested, sometimes I'm a little late and he comes and stares at me like "Are you coming or what?"
I've pierced right through his ear a number of times. I started at maximum setting, then a while later dialed down to 3 and now use the 2 setting. I use a 1/4 sheet of a paper towel folded into a small square on the inside of his ear, and I poke the outside of his ear, this worked better for me then poking the inside and I use a piece of tissue after with a little pressure to stop the bleeding and prevent bruising.
I found this online and it explains it better than I do.

Before you poke, you can shine a flashlight on the ear to see the vein, you don't want to hit the vein, you want to hit between the vein and the outside rim of the ear. Hold a cotton pad (not a cotton ball) behind the ear and set your pen to a setting of about 3. You want to poke very near the outside rim of the ear. You can do the poke from either side but if your cat has black or dark hair, doing it on the inside will be easier to see the droplet of blood. When you do the poke put a little pressure against the ear with the lancing device. After you poke, if the drop of blood is too tiny, try massaging it. Now with the cotton pad, fold it over both sides of the poke and hold it there with pressure for about 30 seconds. This will prevent bruising and sore ears and is a rather important part of the whole process.

 

PS no such thing as silly questions

 

Some one on here said they rub the sock all over their kitty's head and back first, like a kitty massage.

 

Thank you! I don't know why I never considered the underside. There won't be negative effects if I do nick the vein?

For someone who has been called a 'cat whisperer' by my friends, realizing I knew a lot about cats and cat behavior but absolutely nothing about this is quite humbling. It makes me feel silly; like I should know this stuff. But no one here has made me feel stupid. Actually, it's a little relieving to know that everyone else has probably already asked these questions... That's why the answers are so readily available! Kinda like warning lables. You know it's there because someone, somewhere decided to injest some cream obviously not intended for that use....

 

I've done that quite often as well. And even with poking right through his ears and hitting the vein, his little ears look fine and it still didn't hurt him.

 

A novel technique! I like it.


Mogs
.

 

Just a quick update:
I FINALLY made a successful stick this AM! I was about two hours after eating, but right now I'll take what I can get.

He was at 99.

Now, the strips I used expired in December. I wanted to practice before buying expensive new ones. I have purchased new ones since today, but haven't been successful yet.

I can't help but wonder if he was 'borderline' DM. When he was at the vet it was for a dental and they had to exteact a broken tooth. (He's showing signs of possible reabsorption.) Add that to vet stress for a borderline... Could that have made him read 500? Remove the offending tooth, give him proper food and maybe we can halt the progression? (Maybe I'm just hopeful!)

At any rate, I will continue to try for another clean stick so I can get an accurate baseline.

 

Well done with the test, Jen.

Can you confirm that the 99 reading was without insulin, please? (It's in the normal range for a non-diabetic cat.)


Mogs
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It is without insulin. Finally got a good stick just now with good, in date strips. It's 111. Maybe 2 hours since food, give or take. He is not on insulin at this time.

At the doctor Wednesday he was over 500 and has shown other symptoms of diabetes like excessive drinking, hindquarter discomfort, lethargy, and weight gain without over eating.

 

111 is also in the normal range. (Need to know your meter type to gauge whereabouts in the normal range.)

The dental may have made a positive impact on the BG numbers.

Kwestions:

1. Are you testing with a human meter or a pet meter?

2. Have you changed the food to a lower carb variety?

3. Did your vet run a fructosamine test as part of the diabetes diagnostics? (If yes, please can you post the result.)


Mogs
.

 

1.Accu-check Aviva
2. Immediately upon diagnosis
3. Unknown. I will ask Monday morning.

 

Hi Jen, congrats on the successful testing!
I'm sure Mogs will be along shortly to follow up on your conversation last night.
If you could add a signature with info it would help people to get details at a glance and answer questions.
Also set up a spread sheet now that you are testing.
If you need help doing either just holler.
It might be to your benefit to post on the main health forum with Squeaks' symptoms and numbers and get feedback on
"I can't help but wonder if he was 'borderline' DM. When he was at the vet it was for a dental and they had to exteact a broken tooth. (He's showing signs of possible reabsorption.) Add that to vet stress for a borderline... Could that have made him read 500? Remove the offending tooth, give him proper food and maybe we can halt the progression? (Maybe I'm just hopeful!)"
I know that vet stress, dental problems/any medical issues and diet can all add up to higher numbers, but I'm not experienced enough to give further input.

 

Thanks, Liz! I'll do that! I'm still finessing the whole home test thing, so my numbers aren't at reliable times for a spreadsheet. I've actually only gotten 3 good tests so far, from 2-4 hours after food. The range is 99-111. I really am starting to think just switching food has worked that fast. He hasn't vomited or regurgitated his food since. He's no longer hovering over the water fountain. I just scooped the litterbox and there was no loose stool. And he just seems happier. I'm still going to keep testing him until we know for sure, but I am so delighted to see my baby acting more like he did when he was younger!