Stressed to death about my cat

Hi:

My name is Choo and my cat, Bangkok, was diagnosed with Type 2 diabetes five weeks ago.

I had returned from a one week vacation to find him drinking and urinating a lot. I thought perhaps it was due to the salt in the canned tuna I had been feeding him. I had made tuna ice cubes from them and they're tuna for people, not pets. The week I was on vacation, he had eaten two cans of tuna. So I stopped feeding him tuna immediately.

Two days later (July 8), I took him to our usual vet. He said Bangkok's BG was really high at 23 and he was diabetic. He said we could wait a few weeks to begin treatment.

During the three weeks I was waiting to begin treatment, I did a lot of research and immediately threw out all the kibble and any treats containing grain. Bangkok never did eat much kibble to begin with. I always fed him one can of Friskies every day and 3-4 tbsp of Royal Canin Indoor Light kibble. But he had been eating Temptations, Greenies, you name it. So I threw them all out and tried to transition him from Friskies (contains rice) to Nature's Variety Instinct. The only treats he could have were those that were 100% freeze dried meat.

I also decided to consult a holistic veterinarian. On July 29, I met with a holistic veterinarian (Dr S). She diagnosed hypertension, extremely low potassium, as well as diabetes. His BG was 20. She said I had two choices: put him down or put him on insulin. I was taken aback. When I told her about my fear of needles, she said, "Deal with it!" She said we could wait up to 3 months to begin treatment due to his good condition. I said I would prefer to wait a month and during that month, change his diet and see if that would work to bring his BG down to normal. She was okay with that.

The next day, I spoke to another holistic vet. She advised that Bangkok begin insulin treatment immediately because the sooner we began, the better our chances for remission. So I contacted Dr S and said I had changed my mind and was ready to begin insulin ASAP. Three days later, I went back (Bangkok's BG was 17 that day, before insulin) and was taught how to give the insulin shots and draw blood from Bangkok's ear. I didn't do the blood drawing. I only watched the vet do it.

We began with 5 ml of Levemir.

Giving Bangkok shots twice a day was extremely stressful for me. Once, he cried. That broke my heart. By the end of the first week, I was a complete mess. Depressed, crying all the time, unable to sleep. The first BG test was done by the vet a few days later. It had gone up to 18. So she increased the dose of insulin to 6 ml.

The petsitter came to do the BG testing at the end of the first week. It was a very good 7.2 so I felt hopeful. The second week, I hired her to give Bangkok the night shots so that I could have respite. A few times, I stayed home to watch how she gave the shots and I learned from her as well.

The next week when she came to do the BG test, she poked both his ears 4 times and was unable to get enough blood for a reading. Bangkok cried and struggled. We could not continue. So I took him in to the vet for his BG test a few days later. I brought my own glucometer and they used mine and theirs. The results were 12.3 and 14.4! Their meter was the same brand as mine! I was surprised that there was such a discrepancy between meters. The vet increased the dose to 7 ml!

During the two weeks that Bangkok was on Levemir, I also ran urine tests using Keto Diastix test strips. Unfortunately, his vet did not want the urine test results. She said they were rubbish and a waste of time. But I had tested his urine on 6 occasions during the 2 weeks he was on Levemir. Every time, his BG was high (dark brown on the test strip) and his ketones were negative. So the Levemir was not working all that well, IMHO.

I began to worry about the high dose of Levemir that Bangkok was on. My petsitter said that one of her clients managed to get her cat into complete remission by switching to an all raw meat diet. Her cat had been on insulin for one month. After that, she just couldn't handle the twice daily shots and the BG testing so she forced him to eat raw food and it worked. Her cat has been diabetic free for years.

So on Sunday, August 16, I switched Bangkok to a raw meat diet. It was not that difficult because he already liked eating raw beef except this time, I bought him whole animal meat (Carnivora) from a pet store. I stopped giving him insulin.

Today is Day 3 that he is on a raw meat diet and not being given insulin. He drinks a lot. He was drinking quite a lot when he was on Levemir, too, but he is drinking more now. I have an appointment with Dr S on Aug 25. She wants to check his blood pressure. I haven't told her that I have stopped the insulin.

I don't know what to do. Bangkok is my dearest, best friend. It's just him and me. My husband died 8 months ago and if not for Bangkok, I'd have gone stir crazy. So he means the world to me. But I don't like Dr S. She is rude and has no compassion for me or Bangkok. I don't know whether I should resume the insulin shots. I don't believe that Levemir works. Why cause Bangkok pain by injecting him twice a day with something that doesn't work all that well? The ear pricks are painful too. Since he began receiving shots, his back twitches. When I run my hand gently over his back, I can feel the tremors.

 

Since you are trying Carnivora food, I suspect you are in Canada. So am I. Welcome here, to the best place you never wanted to be. I also replied to your post on Health about the raw food.

5 units is too high a starting dose of insulin. 1 unit is a much better starting dose, unless he was diagnosed with DKA. His numbers are still high enough that he needs insulin. The second holistic vet is correct, the sooner you can get him into good numbers with insulin, the higher your chances of getting him into remission. Levemir is a great insulin, you just haven't got the right dose yet.

You can practice giving injections by using something like an orange. Testing your cat at home is much preferred, and essential to his health. Cats often test higher at the vet due to stress than at home. My non diabetic cat once tested over 11 at the vet, at 2.9 at home the next day. You wouldn't want to use those inflated numbers to determine what dose of insulin to use.

 

Hi Choo. I'm new here too and I understand how you're feeling. It's all so scarey and confusing. The best thing you can do for Bangkok is relax and get educated about DM. In the beginning(only a week ago) my cat, Colin, too hated his ear pricks but now he's starting to associate it with cuddles and feeding time and actually comes to his testing spot! It WILL get better. Also don't get too upset by high numbers especially in the beginning. Right now Colin's BG's are all over the place, but the people here are a big help and I'm starting to feel better about things- you will too.

 

I strongly urge you to find a different vet. Diabetes is a complicated diagnosis, and based on the info you've provided about this vet above (rude, dismissive, and does not believe in ketone sticks?), it's going to be very difficult for you to have a productive relationship with this vet. I would suggest looking into a vet that sees mostly (or only) cats, if possible. I have no opinion on whether holistic ones are better or worse, but one thing is for sure, you need a vet you can work closely with and communicate well with. Building a partnership with a good vet is important.

Also, please don't panic. There are a lot of very experienced people on here who can help you. In the meantime, please let us know what kind of needle/syringe you are using. My kitty's back twitches sometimes even just from petting his flank- some just have hypersensitive responses to touch in certain places. Have you tried laying your hand firmly on his back while giving the shot? Where on his body are you giving the shots?

Please hang in there. I know a lot of people are about to respond with helpful ideas!

 

For ear sticks, definitely a baby sock filled with rice, warmed in the mircowave (mine takes less than 15 seconds - check on yourself first to make sure it is not too hot!) and a small strip of vaseline/neosporin on the edge of the ear (helps the blood to bead up) helps me. However with Bojangles, her left ear definitely is harder to get a drop from than her right. I still try the left ear as I don't want to constantly be poking one ear. For the insulin, I read up on that as sometimes Bojangles struggles more than other times and moves away mid-shot. From what I've read, it sounds as though the best thing to do to make sure to get a "tent" of skin between the shoulders, making sure to inject under the skin, not into the muscle which can be more uncomfortable for the kitties. It is challenging, we're just about 2.5 weeks in, but rest assured, it does get easier. Thankfully, I seem to have a very supportive vet. While she's still learning too, she reaches out to internists who help her to give me the advice I need. Bojangles is doing well on Fancy Feast and/or Friskies pates - bonito flakes and freeze dried salmon sprinkled on the food do sometimes help to encourage her to eat the wet food (previously she only ate dry). Your cat will still love you, but they can read your tension/fears and react to that. Just make sure to give extra loves, hugs and kisses to help reassure them that you are only doing this to help them.

 

Hi Choo. Welcome to you. It's going to be okay, really it will.
Please let take a breath.
I am very new myself here. The diagnosis alone is a huge shock! Then a steep, fast learning curve!
You can do it. I felt JUST LIKE YOU a month ago, very overwhelmed.
Wonderful people here will respond with care and experience. Frankly, I trust THEM more than the vet.
I have one common sense thing to say, since I am still learning myself...THIS THING I KNOW..
You MUST put a VALUE on this. The VALUE being, your sweet friend Bangkok NEEDS YOU to give his injections, AND test his blood.
Can you look at it this way? Put away your own feelings, in respect for Bangkok. After all, he was there for you..?
You can do it. You will be helped every step of the way here on FDMB!!

 

I agree, I would start looking for a different vet. 5 units is too high of a starting dose.

A raw diet could be very beneficial for lowering the glucose levels, but it still sounds like he still needs insulin. With some cats they only need insulin for a short time to get the pancreas active again. Hometesting is the best way to determine if he needs insulin. I understand that you are nervous, but it is not as hard or bad as you think it will be. There are many on this group that were once afraid of needles that have been able to overcome that fear.

 

Hi Choo, so glad you found this website I was! I am very new as well, and I felt exactly how you did back in May/2015 when my Hershey was first diagnosed. I still get stressed about the injections and tests, but as Tucker's mom said above you have to find a "zone" where you know that you have to do it for you and for your kitty! Hang in there, take one day at a time, and believe he will get better!. Hershey started off at with a blood sugar count of 488 when initially diagnosed and today he is at around 250 and on 1 unit twice a day with Prozinc. I believe our turning point was his diet. Once we switched over to low carb canned we began to see a difference. For Hershey it has taken 3 months, but he definitely has gotten better, his pees are smaller and he drinks less, he is way more active! My vet didn't seem to worry how much insulin was being given either, he had him up to 3 units twice a day and his nadir at that time was 202. That was the day, I found this website and I started home testing. Although I hate pricking my Hershey's little ears, (and he still hates it),I know that I can't just give him insulin without knowing what his body is doing. Stay on this website, the people here are great. Get your spreadsheet going it helps you to see if visually and then other members can help you as well. I wish my vet had a better feeling for this, but I know he is way to busy and isn't as concerned as I am. Ultimately you have to do what is best for your and Bankok!

I know you can do this, if I can YOU can!

 

About those meter discrepancies - the FDA allows meters to read +/- 20% from what a lab would get.
Also check out my signature link Secondary Monitoring Tools for other assessments you can make to evaluate your cat. In particular, pay attention to thirst, water consumption, dehydration, and urine ketone testing
Finally, if you do go vet shopping, see the Vet Interview Topics in my signature.

 

Thanks, everyone, for taking the time to read my post and respond. You're all so compassionate and helpful. This is a very helpful forum and I feel like I'm not alone anymore. To answer your questions (I hope I've answered them all):

1. I am in Canada. Winnipeg, MB
2. The Levemir that was prescribed for my cat is diluted in a 1:4 ratio so I guess if I'm giving my cat 5 ml, he's really only getting 1 ml of Levemir. The other 4 ml is saline.
3. Great idea to look for a vet who is cat only. I'll do that tomorrow.
4. I'm using a U 100 syringe.
5. I'm mostly injecting my cat on either side of his backbone but not beyond the middle of his back. The vet said the avoid that area. She said we would move to another area later but for now, to stick to the scruff and the area below his shoulderblades, down his back (my cat feels the needle when I inject in the middle of his back so I avoid it now), both sides of his backbone. I pick up the skin and make a tent, too.

I just purchased another glucose meter FREESTYLE INSULINX. It's supposed to require only a pinhead drop of blood. I started giving my cat insulin again today 5 ml. Friday I will try and get a BG reading again at home. I will get the petsitter to help me.

Those of you who do the BG test alone, how do you manage to do it alone with the kitty struggling?

Thanks once again for caring. You guys are the best!

 

Hello again. I am surprised to hear your Levemir is diluted. Did you buy it from a regular pharmacy? I just walk into a regular pharmacy and ask for a 5 pack of Levemir cartridges. You don't need a prescription in Canada. And it's cheaper that way.

I've been injecting Neko in behind the scruff in the shoulder area for over 3 years now - you should be fine doing that. If you get the BD syringes (Ultrafine II, purple and yellow box at the pharmacy), they are 31 gauge so pretty tiny and they barely notice it.

My kitty knows that test time is treat time. I started by sitting her down, rubbing her ears, then giving her a treat. I did that for a while before I moved to poking her and giving the treat. Now she and my non diabetic cat come running when it's test time. And she purrs thr0ughout in expectation of the treat to follow.

 

I also have never heard of diluting Lev. I don't really understand why they would do that. But since you are using diluted insulin, it would be VERY helpful to put that into your signature so anyone looking at your post KNOWS your insulin is diluted.

What is your signature? if you look at the bottom of my post, and those of others, you will see some info in small type. That "signature" shows up whenever you post. To add this information, go to the top right of the page and look for you name. Click on that and your profile will come up. Look for Signature on the left hand side.

You might write something like:
My name is Choo in Winnipeg, Canada and Bangkok is my diabetic cat.
Using Levemir that is diluted in a 1:4 ratio 1 ml Levemir to 4 ml saline.
Bangkok's spreadsheet (link here if you decide to do this). I am using a (whatever name) meter.

 

I'll go ahead and add my signature. One of my friends had a diabetic cat and he was injecting insulin into the scruff for all the 5 years he was on it before he died. But I've read that you should rotate injection sites to prevent fatty lumps from forming. So I've been injecting on his scruff as well as on both sides of his backbone. This morning and evening, though, he felt the needles and I felt so bad. I've been practicing on a sock filled with rice, doing the tenting and injecting into the tent as gently as possible.

Do you use a Lancing device when you do the BG tests?

I've had tremendous difficulty finding the vein on my cat's ears. His ears were frostbitten and the vet tech and two veterinarians have told me that his are difficult ears to do a BG on. No sweet spot, apparently, and very hard to find the vein. The vet tech's have a ton of experience and even they have difficulty getting a drop of blood.

 

Depends on your cat whether to use the Lancing device- most people don't from what I've gathered and neither do I. Sometimes the noise it makes scares the cat- just depends on your cat.
If the ears don't work, there are people here who can advise you on how to get blood from the paw pads instead. Might work better for you.
With regard to the insulin injections, since you're just starting out, you could consider giving them in his flanks (right above his hind legs) instead for now. We shaved two little patches (with an electric trimmer- took 2 seconds on each side) at my cat's flanks and started injecting there instead. That way you can see it go in and he does not seem to notice the injection as long as he's eating a treat at the time. Later, when you are more comfortable, you can start alternating the injecting sites, etc.

 

Thanks for adding your signature - it will help all of us immensely!

Bangkok is feeling the injections? What gauge is your syringe? The higher the gauge, the thinner the needle. For example, a 31 gauge needle is thinner than a 28 gauge needle. BTW, I always used the scruff, alternating left and right sides, with no problems.

Edited to add: Bangkok is very pretty! Is he siamese?

 

Bangkok is mixed Siamese. He was a stray. Your cat looks like Bangkok!

I'm not sure what gauge but it's a U 100 insulin needle. This morning, I used the scruff and he felt the needle. He made a noticeable "Oh!" That broke my heart. This evening, I injected on the left side of his backbone beneath the shoulder blades. I got hold of as large a wad of skin as I could, made the tent, and injected near the middle of his backbone as he was eating. He didn't seem to notice. Phew! I feel my stress level going way up before shots!

 

Wonderful! Seems like you found what works for you and him! That's great!

 

I'm not sure what gauge but it's a U 100 insulin needle.

Hi Choo!! You can just look on your syringe bag, at the bottom should be clearly marked the needle gauge.
So happy to hear you are working very well through your needle aversion!!
All the best
-Brenda

 

Maggie was a blue-point siamese, not registered or anything. Her littermate was a red-point siamese. Bangkok does look like Maggie, doesn't he? Which means he's beautiful!

Do check out the gauge of your insulin needles. Too thick needles may be the reason he's feeling the shots.

 

I'm using 31 gauge needles that are 6 mm long. What type are you using?

Maggie is beautiful. How long has Maggie had diabetes?

 

OK. You are using thin needles. I'm really surprised Bangkok is bothered by them.

To answer your question about Maggie, we sure thought she was beautiful! She was diagnosed in 1999 and died of heart disease in 2008, so she was diabetic for 9 years (though she did go into remission a couple of times). We still really miss her, though we now have two wonderful kitties, a red-point Siamese (Erik) and a tortie (Fanny).

 

Hi Choo,

My cat Martian seems to feel the needles going in too. Then I read in one of the many useful articles here somewhere that the needle has a diagonal tip. If you use a magnifying glass to see which side the point is on and make sure that goes in first, it seems to help (Martian has stopped running away when he sees me holding the syringe, anyway ). Doing it while Bangkok is eating is a good idea too.

I'm lucky with Martian's ears. As long as they are warm enough, getting blood is fairly easy. It was awful at the start though - sometimes it took several tries - Martian was growling at me and I was getting horribly stressed. So I went back over all the testing tips I could find here and started over. It sounds like using a paw pad to test might be best for your boy. Lots of info here: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

You should also have a look at the Lantus/Levemir forum: http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/

You obviously love your Bangkok very much. Keep doing what you're doing - you'll get there!


Carolyn