I'm new and completely confused

Hi guys,

I inherited a cat from my Uncle when he passed away in May. She recently started drinking a ton of water and peeing a ton, so I took her to the vet. Her blood glucose was 500, so the vet kept her there to get her regulated. I've spent the last few days researching feline diabetes, and I am currently trying to switch all of my cats from Friskies dry food to Friskies canned food. I am so confused as to how much I'm supposed to give them all! I should mention that I have six cats. I'm a cat lady; what can I say? :mrgreen: I have one cat that the vet said was pre-diabetic, so he put him on Hill's w/d. I bought the glucose tester this evening for the diabetic cat, and since she's still at the vet, I tried the tester on my pre-diabetic cat. His blood glucose was 88 at 9:44 P.M. (central time zone). Is that too low? I know nothing about any of this, so I am so confused and overwhelmed. I am seriously worried about what to do when the diabetic cat comes home; I can't even figure out what to do with my normal cats!

Any help would be appreciated. Thank you!

-Miss E

 

Hi and Welcome
It does seem scary at first. You will find that there are a lot of experienced people on this board. I have had a sugar cat (that means a cat with diabetes) for a year and a half and I owe my cats life to everyone on this board. Without them I could have never done it!!! Have no fear, someone will be along soon to answer all your questions and help you more than I could.
I can tell you 2 things. The first is to just sit back and relax and breathe!! The second is to home test.
I dont want to overwhelm you so I'll leave it to the experts to answer some of your other questions. You are at the right place so dont worry!!
Nice to meet you and I think that it is a wonderful thing you did to take in your uncle's cat. God bless you!
Terriy & Chicken Little

 

Well, I'm no expert - I've been here less than a week - but this place is amazing, and the people here are THE experts on feline diabetes. And I've learned a few things already:

For the blood glucose reading, an 88 is beautiful. Below 40 is dangerously low (hypoglycemia). 40-130 is normal range for non-diabetic cats. Around here, they advise not to give insulin is the blood glucose is below 200 in the pre-shot test.

For food, Friskies has a little note on the back of the can about how much. I think the estimate is that the cat needs about 1 ounce of food for each pound of body weight each day (usually split among two or more meals).

Welcome to the neighborhood!

 

We encourage home blood glucose testing to keep your cat safe. All you need is an inexpensive human glucometer such as the WalMart ReliOn Confirm or Confirm Micro (generic version available at our shopping partner ADW as the Glucocard 01, link at top of page), test strips for that meter (which is where the pet-specific meters become extremely costly!), and 27-28 gauge lancets to prick the ear, or the paw pad.

Some glucose reference ranges for decision making using a human glucometer

< 40 mg/dL
- Treat as if HYPO
- At nadir in long term diabetic (more than a year), may earn a reduction

< 50 mg/dL
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50.
- At nadir, often indicates dose reduction is earned

50 - 130 mg/dL
- On insulin - great control when following a tight regulation protocol
- Off insulin - normal numbers

> 150 mg/dL
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol

180 - 280 mg/dL
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine. Test for ketones, glucose is too high.

>= 280 mg/dL, especially if for most of the cycle between shots
- Uncontrolled diabetes and in danger of DKA and hepatic lipidosis
- Test for ketones; more than a trace, go to vet ASAP.

 

If you are already giving insulin, DO NOT CHANGE THE FOOD UNTIL YOU ARE TESTING. This is because it may reduce the glucose level 100 mg/dL or more and could be unsafe.

If you are not giving insulin yet, then diet change is your first step. You want to select a canned or raw diet with high percent of calories from protein, and low percent of calories from carbohydrate. The minute you look at a can of cat food, however, you'll think that is impossible because it isn't on the can! But wait - a number of folks have gotten information from manufacturers, done the math, and created lists of diabetic safe over the counter food. Its less expensive than the prescription foods are, has more diverse flavors, and is generally less expensive. Some inexpensive ones are any of the Fancy Feast Classic pates and any of the Friskies pates. Barring some unusualy condition, these foods may be eaten by all your cats.

You may be asking "Isn't there a dry food I can feed?". We suggest you avoid dry food due to the stress it places on the kidneys; you don't want to encourage kindey failure in a cat. For more reading on this issue, please go to Cat Info, written by Dr Lisa Pierson, DVM. There's a printable pdf food chart with all the data on the canned and some raw foods there.

That said, there are a very few dry or freeze dried foods which might be used - Evo Cat and Kitten, Wellness Core in the gold and tan bag, Young Again 0 carb (5% calories from carbohydrates, actually, and internet sales only), Stella And Chewy's Freeze Dried (meant to be rehydrated; watch out for constipation).

 

Thank you for your replies!

I feel so much better knowing I have people to help and support me. I'm so glad I found you!

The vet will be putting Kitty, the diabetic cat, on Purina DM. I told him that I planned on changing her diet to a high protein, low carb wet diet, and he was fine with that. I bought the glucose tester so that I could check her sugar before injecting her with insulin. From what I've read, changing her to the new diet can lower the glucose level, and it would make it dangerous to just blindly give her the dose of insulin the vet prescribed. When I first found out about Kitty being diabetic, I asked the vet if I would need to check her sugar, and I thought it was odd when he said no. I guess the norm for them is for you to blindly inject your cat twice a day. I have diabetic family members, and they would never dream of doing that to themselves, so why do that with cats? It seemed so odd. That's when I started doing my own research. I don't understand yet anything about the numbers I get from the tester, or anything about insulin and how much I should give her if her blood glucose is a certain number. I don't even know what insulin the vet is using right now. I'll find out tomorrow when I pick her up.

Thanks again for your replies. They really help!

Miss E and gang

 

First thing, your diabetic cat is not sick and will NEVER be regulated at the vet office.
Bring your cat home. There is no reason at all for you to be paying for your cat to be miserable at the vet office.
Get a prescription for insulin; Lantus or Levemir.
Do NOT put your cats on any expensive vet food; it's not special at all, so go with any choices from Dr. Lisa's list catinfo.org/docs/FoodChartPublic9-22-12.pdf
Select foods under 10% carbs... pates are the usual and just avoid grilled, marinated, gravy, sauces.
Switching from dry food to wet food will make a huge diff in the amount of insulin your cat may need, if needed at all.
Find out from the vet what was done, what was given and at what times. Get copies of the records so you can start up your own file for the cat. Get copies of all blood work done as well.
How was your cat diagnosed as diabetic? Was it based on the glucose value on blood work or did the vet have a fructosamine test done which is an average of the cat's numbers over the last few weeks.

You are perfectly capable of treating your diabetic cat yourself, and at home. There is no worry to have about bringing the diabetic home to be among non-diabetic cats. Just feed all of them a good healthy low carb wet food diet, and your "pre-diabetic" cat may not ever need insulin w ith the diet change.

Gayle

 

Welcome! It sounds like your vet may not be completely up to date on feline diabetes treatment, so you may have to be proactive in educating and insisting on certain courses of treatment for your cat. First, unless your cat is currently experiencing a dangerous complication from diabetes called Diabetic Ketoacidosis, then I would bring her home as soon possible. Your vet is not going to be able to regulate your cat at the office--it's a waste of time and money, as regulation is a process that usually takes several months. Vets that think they can regulate a cat that quickly also tend to overdose the insulin, so you want to be careful. So I would ask your vet if he's tested for ketones and if there are no ketones present, I would insist on bringing your cat home.

As others have mentioned, insulin choice and diet are very important, and along with hometesting are the three key points of diabetes treatment. Your vet sounds a little old school, so make sure you insist on a script for an insulin that is effective in treating cats. Lantus and Levemir are ideal (they have very high remission rates), and Prozinc is also acceptable. Do not let your vet start you on Humulin N (also called NPH or Novolin N) or Vetsulin. Those insulins work well in diabetic dogs, but are mostly ineffective and dangerous to use with diabetic cats.

There is no Hills food that is appropriate for a diabetic cat, so if you're still feeding that W/D, return it to the vet and get your money back (just say your cat wouldn't eat it--they'll take the bag/cans back). It's important to use a low carb food for diabetics and pre-diabetics, and the W/D is VERY high carb. Friskies pates are low carb and good to feed--just make sure you're not getting anything with gravy. You'll also want to pick up some diabetic safe treats to help reward testing (anything that's 100% freeze dried meat is good--they have these at most pet stores, or you can use anything that's just plain meat if there isn't a pet store near you). What type of glucometer are you using? Is it a pet meter or a human glucometer (I ask because some vets say you have to buy the pet meter from them, but a human meter is cheaper and works just as well.) 88 is a great, normal number (and not a pre-diabetic number). Your vet can't determine that your cat is diabetic or pre-diabetic from doing a blood test in his office, because when cats are stressed out their blood glucose is elevated, whether they are diabetic or not. That's why office testing (and office regulation) is inaccurate, and making dosing decisions on those numbers is dangerous, because they are too often inflated.

And also, no need to worry about low blood sugar if a cat is not on insulin. Cats that are not on insulin can't become hypoglycemic (dangerously low blood sugar) except in incredibly rare situations.

If your vet gives you any resistance on any of these points of treatment, you can print out the American Animal Hospital Association Guidelines for him, which contains all of the information that I outlined. A good vet will be grateful for the information and will be happy to work with you. Often, vets are just unaware of current recommendations because they've changed a lot in the past 5 years or so.

 

Is it canned DM or dry? The dry DM is still too high in carbs for a diabetic, so if she will eat canned food, I would not buy the dry. The canned DM is ok carb-wise, but its pretty the same thing as Fancy Feast pates (also made by Purina) except you pay and arm and a leg for it. Remember that vets make money of prescription diets, so they do have their own reasons for pushing it on you.

What kind of insulin did your vet prescribe, and what dose is your cat currently one? You have fantastic instincts--you're absolutely right that it is dangerous to dose a cat blindly, and not only that, it makes it incredibly difficult to determine the correct dose without knowing how the cat is reacting to the insulin on a daily basis. I'm just worried from the advice that your vet has given you already that he may be overdosing the insulin. Most cats on a low carb, canned diet do not need much more than 1u of insulin.

 

Hello Miss E and Gang to the FDMB, the best place in the universe for helping your diabetic cat.

Would you please tell us your name? You told us your diabetic cat was named Kitty.

Please, ask all the questions you need to and ask us to clarify anything you do not understand. We are happy to help you. We have a broad range of experience and keep help with most any questions. We live and breathe feline diabetes, 24/7 and can help you with the day to day management of Kitty.

The first thing I want you to do is some deep breathing exercises. Deep breathe in, hold, release, Deep breathe in, hold, release, Deep breathe in, hold, release, Deep breathe in, hold, release, Deep breathe in, hold, release, Deep breathe in, hold, release. Repeat as many times as necessary to help relieve the stress.

The second thing I want you to do is read this post. a message from your cat

Third thing is to answer a few questions so we can help you better.
So far, people have asked a lot so I have tried to consolidate them here for you to answer.
1. what meter are you using?
2. what insulin were you prescribed? (hopefully lantus, levimir, prozinc are the best for cats)
2b. What dose is your cat currently on?
3. canned DM or dry food?
4. Is the vet testing for Ketones?
4b. are there any ketones present? and if so, what is the reading?
5. What glucometer are you using?
5b. pet specific or human?
6. how was your cat diagnosed diabetic? single blood test at the office?
6b. fructosamine test done?
6c. clinical symptoms also?

Again, welcome aboard. Remember to do those deep breathing exercises and let us know how else we can help.

 

Hello and Welcome !!

YES !!!!! Exactly !!!

Treating human diabetes is the same as treating feline BUT the really good news is that with proper insulin, diet, home-testing, and insulin adjustments based on those home-tests and the data you collect from them, there has been an incredible remission rate in our kitties :RAHCAT

And chiming in with everyone else, yes, please do not switch the food while kitty is on insulin because diet alone will bring his BG numbers down possibly significantly....they did with mine...about 100 pts.

Welcome Aboard

 

Hi everyone!

The vet just took a blood sample from Kitty's leg and used a glucose tester like I bought. I bought a ReliOn Micro tester last night.

I had no idea about that! Thank you for that info!

He is more than likely giving her the dry food. I told him yesterday that I would be changing her to Friskies canned food since it's lower in carbs and because of the water content.

I honestly don't know yet. Kitty has been at the vet since last week, and my vet only said that she is not regulated yet.

My name is Missy (Miss E..get it..get it.. ;-) ) My diabetic cat is Kitty (not very original, but she answers to it), my pre-diabetic cat is Pumpkin (although I like to call him Cap'n Pumpkin because he had to have his left eye removed last year due to a parasite in there). As far as I know, all of the other cats are doing OK. I have two outdoor cats, and the rest are indoors.

1) ReliOn Micro
2) I don't know yet
2b) I don't know yet
3) I'm thinking my vet is currently giving her dry DM food.
4) I'm not sure, he didn't say, and I didn't know to ask.
4b) I don't know
5) ReliOn Micro (Isn't meter and glucometer the same thing? Now I'm nervous.)
5b) Human
6) Single blood test at the vet's office
6b) I don't know
6c) She was drinking a ton of water, peeing a ton, and she was acting depressed..just laying on a table..never getting up to look out of the window or anything.

I was going to bring her home and do a blood glucose test. I was going to change her over to a wet food diet and then test her blood glucose again before ever injecting insulin. Is that correct? I understand that the glucose level drops once she is on a low carb diet, so I would check her glucose before giving her any insulin.

 

Hi Missy!

A glucometer is another name for a meter.

Does your Kitty have DKA (diabetic ketoacidosis)? It's the only reason I can think of for your cat to still be at the vet, a week later. Diabetes can take month's to regulate, and is best done at home.

This must be really expensive to have your cat at the vet for more than a week. It is not necessary unless there is something else wrong with your cat. I'd bring her home now if I were you.

Did your vet also run thyroid tests? Hyperthyroid has many of the same symptoms you described.

Also, a BG at the vets can be 180 points higher than in more familiar surroundings like your home. What was the BG reading your vet got?

Yes, you always want to get a BG (blood glucose) number before you give the insulin. We have a shoot/no shoot threshold of 200 here on the Health forum.

Where do you live? Country, state/province, city/closest city or area would be nice to know.

 

Yes, the ReliOn Micro is a glucometer or meter.

If I understand correctly, Kitty is at the vet's still? Are they giving Kitty insulin? If they are, and continuing to feed dry food, they sure won't get Kitty regulated that way.

I'm still pretty new myself, so I don't want to advise, and will leave that to the much more experienced people here. The things you need to know before you bring Kitty home though is the brand of insulin they used while there (if they were), the dose size, and if they were giving it every 12 hours. I, personally, would want a record of ALL the glucose tests they did along the way, and any other test results...blood, urine, etc.

You have the correct glucometer, so it's best to pile up on strips for it. I'm thinking the first step is to find out when you can bring Kitty home and exactly what was done at the vets office so you will know how to proceed from there.

If they are keeping her only for regulation purposes and not treating her for DKA (diabetic ketoacidocis) or any other illness that you can't treat, then there really is no reason for her to be there because everything they are doing you can do better at home, PLUS Kitty will be so much more relaxed, and that will affect her blood sugar also.

Has the vet told you of any other health issues they have found with Kitty?

 

Hi KarensPoe,

Yes, Kitty is still at the vet's. He said she would be better regulated by tomorrow, but I'm picking her up no matter if the vet says she's still not regulated. Yes, they are giving her insulin, but he never told me what kind or how much. I assume he will tell me that when I pick her up tomorrow.

Agreed! I will ask for those things tomorrow. I wouldn't have thought to ask for those things if you guys hadn't told me! Thank you!

I bought 50; I hope that's enough for a while!

No, he hasn't said anything. I think it may be because he hasn't tested her for anything else. With the amount of time she's been there, I don't think I could afford to have any additional tests done at this time. I spent a lot yesterday on the food and test stuff. When I left her at the vet last Friday, he said it would cost about $100 to have her there until Monday, but then he wanted to keep her until tomorrow, so who knows how much it will cost now! nailbite_smile

 

You'll want to test before every insulin shot, to make sure Kitty is safe and the BG is high enough to give the shot (>200). You'll want to test mid-cycle to find how low she drops. That is 4 tests a day.

At 4 tests a day, those 50 strips will last 12.5 days. If I were you, I'd go buy another 50 or even 100 test strips before you bring Kitty home.

 

Hello and welcome to the board!

This is correct. Give her a few days on a low carb wet food such as the Friskies pates ( you need them to be under 10% calories from carbs - not all flavours are low enough ) before adding insulin to see how the BG drops.

For now - you have all the testing supplies? Check what you have with the below shopping list and pick up what you dont have:

Getting started shopping list
1. Meter ie Walmart Relion Confirm or Micro.
2. Matching strips
3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool.
4. Cotton balls to stem the blood
5. Neosporin or Polysporin ointment with pain relief to heal the wound
6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against
7. Ketone urine test strips ie ketodiastix - Important to check ketones when blood is high
8. Sharps container - to dispose of waste syringes and lancets.
9. Treats for the cat - like freeze dried chicken
10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast


Testing tips: https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

Get the insulin prescription from the vet anyway. Ask for Lantus, Levemir or prozinc and get the prescription for the pens if you get the first two since they last longer ( up to six months when "opened" and kept in the fridge) and you will be using syringes to remove the insulin from the pen.We can advise on syringes etc if/when we get to that point

Wendy