Wuffy has been on Lantus for about 3 years

Wuffy is my Norwegian Forest Cat who came to me as an abandoned cat 9 years ago. He developed diabetes about 3 years ago and was placed on Lantus Insulin. That same week he began vomiting and been doing it regularly ever since along with what seems to be constipation and howling during defecation.

He has been checked for these conditions, including a rectal exam, [boy did that ever make him mad!]. Sometimes he throws up undigested food, or partially digested food, and sometimes he just seems to gag and spits up liquid or foam. There seems to be no solution for this other than an occasionally pepcid. He is a hearty eater and tries to bamboozle me out of more food as often as possible. He is not overweight.

I have tried many foods from Friskies, to Fancy Feast, to many of the very expensive ones. My income is limited and I have 3 other cats to feed at this time. No one food seems better or worse than another.

Any ideas here?

 

Love, love, love the picture.

Have you tried any meds for nausea and/or stomach acid? Any other health issues?

 

Before we got Zeke to getting better numbers he was vomiting frequently.

What dose are you giving and are you testing at home?

If you could add more information about your kitty into your signature that would help. Also, if you don't already have a spreed sheet and you are testing, here is the link for getting that set up and then you can add the link to that in your signature also.

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

 

One of my civvies (non-diabetic cat) would throw up frequently after he ate. I thouhght it was because he was wolfing down his food too fast. Then I started finding vomit arpound or near the litter pans, and realized he had some constipation, and was vomiting when he tried to defecate. I started him on a very small dose of Miralax twice a day with his food, and the problem stopped completely. I also add two tablespoons of water to his food to make sure he stays hydrated.

 

Is he vomiting many hairballs? I read an article yesterday that hairballs can block the opening to the intestines from the stomach so the hairballs and food come back out orally instead of rectally. He is a long-haired kitty.

 

I have no advice, but that picture is so cute!

 

I am brand new here and I really appreciate all the advice. To answer some of your questions:

Wuffy started on .1 units every 12 hours. As I stated above the vomiting, etc started with that.
About a year later he had his A1C test and the dose was increased to .2 units every 12 hours. The vet said as he gets older it was likely the dose would increase.

Before I go on, I'll say my vet, who I have been going to for 25 years, is highly respected.

As for other meds, I occasionally give him a Pepcid tablet when he appears nauseated and off his feed. It helps a lot. Sometimes I add a little pumpkin to his food for constipation.

He currently weighs 9 1/2 lbs. Before he got sick, he weighed about 16 lbs, had lost 3 lbs at diagnosis, but lost more in the early months. [I gave him a very bad haircut about a month ago and I know I took off at least a pound of fur]. He is a big cat and his fur tends to mat very badly. Anyway, his weight has remained fairly steady.

Do you all recommend any particular brand of food? The vet just said high protein. He gets cans and dry. The vet's dry food is so expensive I cannot afford it. How many meals a day should he get and what total amount of food for the day?

I will experiment with your suggestions and see what happens.

One last question; does anyone know if drug companies provide lower cost meds for felines if the owner is lower income as they do for humans? I currently get his insulin from Sam's Club.

 

check our supply closet forum frequently.... members often sell pens, vials, or even donate them.

someone will come along and tell you about mark's marine in canada .... several here buy it from them, I believe they are the cheapest.

Eliminating the dry would help him immensely. There is only one dry food that is low enough carb for a diabetic. But let's find out your dose and numbers befoer making food changes.


I'll be back to help more later, gotta run....

 

My cat has had major issues with constipation, so I'm a bit poo-obsessed. When Girlie was really straining to poo, she'd vomit from the sheer effort of it all. Now that her constipation is under control and she's on a completely wet food diet, no more pukas.

So, to the poo: what's the shape? Round or oblong? Is it soft or hard? How often does Wuffy poo - every day, two days, three days? Is a lot of straining involved?

We use Cisapride liquid to help with the motility (making it easier for older Girlie to contract) and Miralax to make the poos softer and easier to pass. Pumpkin is a lifesaver and she has fresh pumpkin with every meal.

Howling when pooing sounds like there might well be a poo issue, but I'm no expert. Before Girlie got sorted out, her poos were round as marbles and very hard and going to the litterbox was a decidedly unpleasant experience for her. I hope you can find a cause - and a solution!

 

Just a quick note - the dry food is not helping and likely a huge contributor to the constipation, not to mention it is not good for them. Kitties need all the water they (we) can get in them - especially with constipation issues and double especially with FD.

Here is the list a lot of us use to "pick" our food. You need to stay under 10% carbs.

http://catinfo.org/chart/index.php
pdf format here.

 

Hello and welcome to you and Duffy, I hope that we will be able to help you with wuffy and his FD.

These seem like odd doses do you mean 0.1/ 0.2 units (these are micro doses) or are you talking ml? What syringes do you use?
With a u100 insulin syringe this is what a 0.1 dose would look like, click on this link and scroll down to see a pictorial representation of a 0.1u dose.http://www.felinediabetes.com/FDMB/...insulin-info-handling-drawing-fine-doses.151/

Am I to understand that the dose is being based on Duffy's AC1??? (This is not an appropiate method for assessing insulin dose )
Are you testing blood glucose/running curves at home?

As for the constipation, miralax, as others have mentioned can help. Another option is adding some pumpkin to his meals daily, you can use fresh pumkin, some folk cook up a batch and freeze it in trays to use at their convenience, another option is buying canned(as long as it's plain pumpkin, no sugar added.

Feeding wise ideally they would get their main meals at shot time with snacks, at regular intervals,, some folk free feed, but it sounds like Wuffy is a guzzler like my 17year old BFG (who is in remission at the moment., So dishing up snacks at bregular intervals may be a better option, ideally you want to avoid feeding late in the cycle, this can help keep his numbers flatter. Feeding late in the cycle can put the breaks on the insulin and result in high ps numbers.
That said if he is having problems with vomiting/acid tummy making sure he has a snack every 3 hours can help with acid problem, but in this case what I would do is give some zero carb treats like pieces of boiled chicken breast or freeze dried chicken treats. Uf acid tummy is the problem, making sure he doesn't go too long without something in his tummy can help.

Though dry food, as others have said could be contributing to his health issues, I would recommend considering removing it from his diet slowly. Dry food, being high in carbs can impact BG dramatically, going cold turkey and removing it overnight can see his insulin needs reduce dramatically, so it's best done slowly, and under close monitoring. Please ask for advice on how to do this if you wish to remove the dry from his diet.
Here's a post written by Dr Lisa about the problems with dry food
http://www.felinediabetes.com/FDMB/...r-more-than-just-carbohydrate-content.175004/

She has a very informative website BN on feline nutritionCatinfo.org

 

Ok, you all have given me a lot to think about. Thanks. To answer some questions, etc;

• I guess I stated the insulin dose wrong. It should read 2 units currently being administered 2x a day. [Is 12 hours apart sealed in stone? Sometimes I give it earlier.]
• The vet told me no need to do home testing as his periodic blood tests for A1C give an average. And, by the way, tests show his kidneys are fine.
• I went through the food chart. I was surprised at some of the analysis. The one's that seemed to be within the range recommended, were Fancy Feast, Natural Balance [delectable delights], Nature's Recipe [grain free in broth] but the pate was low protein/high fat, and the grilled was high protein, high fat. Nulo shredded, and ProPlan true nature. My vet stocks Royal Canin. Meow mix was acceptable but I always thought this was a low quality food; guess I was wrong.
• One of the problems I have with all 4 cats, is that they are lazy beasts and if I feed them the gravy varieties, they lick off the gravy and leave the chunks. So I concentrate on buying pate. I hate waste! Everybody's teeth are fine or have had extractions. Wuffy's teeth are fine.
• I do most of my cat shopping at Petsmart because they have lots of brands and varieties. I don't buy store brands of much of anything, not even for my own personal shopping. We have a Petco close to my house, but they are more expensive. We also have several new small pet food stores in the area, but again, they are much more expensive for the same things I can buy at Petsmart. One of my daughters recently went to work for Pet Valu and is really sold on what they sell. Any thoughts on that store?
• Finally, I am headed out shortly to buy cat food as I am out. If you have any comments before I leave, they would be appreciated. As cats are 'grazers' I keep dry food available at all times, but I am willing to stop this or really concentrate on 'no grain types', if that will help Wuffy.

 

Welcome to the world of people who stand in the cat food aisle and stare at the shelves.

The Fancy Feast pates and the Friskies pates are fine.

 

The only kibble I have on hand right now is Iams. I know it does not meet the criteria recommended here. But, something that perplexed me is that it shows the % of protein and fat, but not the carbs. So, I called the company and they told me it was 29%.

While shopping today, I looked at other brands that were recommended here on the wet food sheet and found that none of them listed the carbs. What is up with that? Why is it such a big secret?

 

That is why we appreciate Dr. Lisa and all her hard work putting together the list. Food/carb is one of the biggest nightmares in the dance.

 

Thanks Lizzie. I see you are in Houston, TX. Hello to a fellow Texan! I don't live in TX now, but I am a native of Dallas. Sure do miss it.

 

I moved to Texas in 1985 - got here as soon as I could. Best move of my life. I lived in the RGV for 9 years and then moved to Houston. I can't imagine living anywhere else.

 

LOVE YOUR ILLUSTRATION! What does RGV stand for?

I know it is too early to make a judgement about Wuffy's diet progress, but I started him on only recommended canned food yesterday and he did not throw up during the night. Everyone keep fingers crossed this can continue.

I also bought some high protein snacks and offered him one of the dried shrimp. Would you believe he rejected it? Ungrateful beast! But my 16+ momma cat loved them.

 

Rio Grande Valley. Quite a culture shock . Moved from Oregon to McAllen at age 19. What an adventure

 

If you have cut out the dry food complete my, I would strongly urge you to start home testing. Their insulin needs can plummet when high carb dry food is removed. We have seen it happen time and again. The 2u that he has been on could end up overdosing him.
The only way you can keep him safe is to home monitor, relying on an AC1 done at the vets does not give you enough data to keep him safe with the food transition.

It's great that you are changing his diet, and it should have a positive effect on his BG and health,and it is great that he's not been sick, but I am seriously concerned about the possibility of his BG crashing once the dry food is out of his system.

 

http://www.felinediabetes.com/FDMB/...-55-16-93-17-114-18-128-20-134-21-170.114022/
Scooter went into remission, from 5.5 u to nothing in the space of a week, once the kibble was removed.
Look at 18th Feb 2013 on scooters as.

Here is another example of dry food being removed and insulin requirement changing, cat went OTJ in the space if a couple of weeks.

https://docs.google.com/spreadsheets/d/1xsKTuOSZFGYICylB3G-s1rDrvHukah_h5Seo_hKHY4k/pubhtml

In this instance dry food was slowly removed starting 6/4 transitioned to wet low carb food only by 6/8, and Spider was in remission (OTJ) by 6/15


In both these cases the only way the CG could keep up with the rapidly changing insulin needs and thus keep kitty safe was by testing at home, relying on visual signs and an AC1 would have likely had disastrous consequences.

Wuffy, might not have the same strength of reaction, but it wouldn't be unusual, so please, please, in order to keep him safe, monitor him at home, it's really easy to do, and will save you $ as you won't need to get curves or blood tests done at the vets. You can pick up a human glucose meter and test strips at any pharmacy, using a human meter is more economical than a pet meter, and will supply you with all the data you need to keep Wuffy safe and make informed decisions regarding his dose.
@LizzieInTexas which are the most economical ones available in the us? Am I right in thinking relion from Walmart??

 

Thank you all for this info. Today is Saturday and vet is closed now. I will watch him carefully and see what happens. If he 'crashes' what will the symptoms be? Is this when he should get a rescue dose of white Karo syrup? If so, how much.

I've never done home testing. Where is the blood sample drawn from? What would be an acceptable reading?

Please tell me what the acronym OTJ means. [off the juice?] And CG. For the sake of a newbie here, please spell it out. Thanks.

 

It is RARE for a company to disclose the carb content. One of the reasons so many cats are now diabetic.
There are only a small handful of dry foods under 10% carb. (my favorite being young again zero carb at about 1% carb). I do feed some young again dry along with fancy feast classic twice a day... but if my cat had constipation issues, I would eliminate dry completely, go to all wet with added water to it, and put a teaspoon of plain pumpkin in the food . I'm surprised after being diagnosed and constipation issues your vet never insisted on you switching to wet.

 

yes, OTJ means off the juice. here's our info on how to handle hypos. Home testing is DEFINITELY the way to go. I have a video in my signature below that shows how I home test my cat CC.

 

Sorry CG= caregiver
OTJ= off the Juice/in remission
Juice= insulin.

Most of us take the sample from the ear.

Under 50 is the point at which we would take action, ie feed high carb food/Karo.

I'm on my phone, just bear with me, while I get my laptop going and I'll link you some videos of home testing, what to look out for in a symptomatic hypo, though this is best avoided, we like to take action before kitty gets to this point.

 

Yes.

This is what I (and several here) use:
https://www.walmart.com/ip/ReliOn-Confirm-Blood-Glucose-Monitoring-System/13863716
https://www.walmart.com/ip/ReliOn-Confirm-Micro-Blood-Glucose-Test-Strips-100-Count/16795579

Please, please test!!! I didn't realize you were not.

 

Here is a link to testing info and videos:

Hometesting Links and Shooting Tips

 

How to treat hypos
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/
When I was starting out I printed this and kept it with my tool box, in case power or internet was down I wanted to be sure I had the info to hand.
Below is a list of things you should include in your emergency hypo kit.
JoJo's hypo toolbox

I would also suggest that you consider setting up a spread sheet to track his numbers when you start testing.
Here's a link to the spread sheet (SS) instructions if you have trouble setting one up just holler and there are folk here who can help you with that.

If you haven't already I would recommend reading the stickies at the top of the forum, the New to the Group sticky is a great place to start.

Thanks @LizzieInTexas for the home testing links, it's worth looking through the different videos, George just comes and sits on my lap for his ear poke, I still check his BG every morning to make sure his remission is holding strong. It may seem daunting at first (we've all felt that way) but with lots of love, and in Georges case, bribery (freeze dried chicken breast) it will become routine.

When you get u and running with the hometesting, we can help you make sense of the numbers, to start with i would aim to get a test before you give insulin and at least one other in each cycle (minimum of 4 tests a day) .
If your schedule allows, you may want to try getting a test around nadir in the am cycle, which typically occurs around +6 (though not always), and then maybe grab a before bed test in the pm cycle. If numbers are low or falling dramatically, you may need to be prepared to test more frequently. Please just shout if you needed any guidance.

 

I am so grateful to all of you for taking time to educate me. I think, when I have to 'fess up to my vet, that I have been getting outside advice, I will have to tell him he needs to share his fee with you all; maybe about 80/20. [20 for him. LOL].

We've gotten through today with no issues except that he walks over to his now empty kibble bowl several times a day, looks at it, and then looks at me as if I am abusing him. He is a very spoiled, very loved, cat.

I watched some of the videos about ear-sticking. I want to share a couple of photos of Wuffy's ears. Have you ever seen such hairy ears? All that fur will probably soak up some droplets of blood. Oops, did not mean to post so many pics. But, I am sure you get the picture.

 

you can shave the ear for yourself until you get better practiced at testing.
I had a tuxedo cat with hair black ears.... I found that putting a small flashlight in my mouth ( and later got a head lamp ) helped me to see where I was poking.

 

Thanks, I'll keep that in mind.

Now, night #2: No vomiting, no howling, no constipation. You all may be on to something here.

 

A little bit of Neosporin ointment or Vaseline on the ears to hold the hair out of the way will help. It will also allow the blood to "float" on top vs. absorbing into the fur. A warm, moist towel will help with the hair too, again not too wet, just enough to lay the hair down do you can poke and test.

Also use the Neosporin with pain relief to help ease the tenderness due to multiple pokes. I usually put it on before I leave for work or before I go to bed so it is on for a longer period of time and am more generous with the quantity then.

 

Hello again,
You all have been such a big help to me regarding Wuffy's problems with his insulin. I want to report that I have strictly followed your diet advice for him with wonderful results.

After researching the foods recommended by your vet, I settled on Nulo and ProPlan canned food. I took away all of his kibble, [he did not like that], and started feeding him only cans in 4 meals a day. During this time, he has had almost no vomiting or constipation.
He looks better, behaves happier, and has gained 2 1/2 lbs.

He is going to need a new bottle of insulin by Christmas. You all told me I could get it from Canada at a much more reasonable cost. How do I do that? Will I need to get a paper prescription from my vet? What if he has reservations about Canada? I will appreciate all advice on this.

Again, thank you, and Wuffy thanks you.

Chris

 

It's great that you have transitioned him with such success, and that it's helped his GI issues.


This is Very Important
Moving from dry, which is high in carbs, to a wet low carb diet, can have a huge effect on BG.
Here are a couple of examples

Spider got rid of dry food starting 6/4 and ending 6/8
Here is the link to his spread sheet, he went from 2u of insulin to nothing in a week, with hometesting his CG was able to keep him safe.
Here is a link to Spiders BG numbers,

Scooter went from 5.5u to nothing in two days once kibble was out of the picture altogether.
Scooter's ss (look at February 19th)

In both these cases if the CG had not been testing at home they would not have known that their kitties were on too much insulin and the consequences of that would have been tragic.

I would urge you to start monitoring his BG at home if you haven't already started. Aim to get tests before each shot and at the very least one midcycle in each cycle. Maybe more especially if numbers are below 200.

The wet LC food is so much better for them but you do need to be cautious when you have insulin in the picture, as illustrated by the examples above, they're insulin needs can reduce dramatically and the last thing we want to have you gave is a symptomatic hypo, they can be fatal.

I think that you should be able to get a script easily enough from your vet. I live in Spain so haven't used Marks Pharmacy, but I'm just going to tag @Chris & China , I know they've used Marks for a long time now, so she'll be able to give you some pointers on that.

 

Here's the information on Buying insulin from Marks Marine Pharmacy in Canada

You will need a new script.....You can have your vet fax a script or call it in or you can ask for a paper script so you can "shop around" and send it to them yourself (if you're worried about your vet not wanting to allow you to order from Canada)

You can take a picture of your script and send it to them or attach it to an email

Also, even if your vet writes for a vial, you can still get pens....Just tell Marks that's what you prefer. The pens are the better buy because you can use every drop instead of possibly having to throw away half a vial when it starts to poop out on you.