UK newbie, diagnosed this week

Hi folks!

Our cat was diagnosed as diabetic this week and I've been furiously trying to get up to speed on the whole topic since, hence stumbling across this board and registering today.

Rebus is a regular short haired domestic cat, (previously) healthy, 11 year old male (12 tomorrow :thumbup ).

The main sign was that he'd lost a bit of weight. He's always been fairly stable around the 5.5kg area, but the vet measured that he'd lost 20% - so there was obviously something amiss. Blood tests revealed that he was in good health with the exception of his sugar which was (I think) 25. I have no idea how bad that is.

We went back in the next day and I was schooled in giving injections to the poor wee man!

I've been given 29G syringes and Caninsulin. I have to give him 3 units twice a day. I'm also transitioning him onto Hills M/D from Hills Nature's Best - both dried foods.

We've to go back to the vet in a week and at that time Rebus will be kept in for a day while they do tests - presumably to check on the effect of the dose and type of insulin. I'm pretty sure that's what he said.

I'd like to be a bit better informed so that I can ask/direct the vet as appropriate next week, so any comments on our situation would be greatly appreciated.

At this point I'm quite curious about what to be feeding. I've skimmed a lot of posts all over the net about why I shold be feeding wet food rather than dry, and also a low carb, possibly raw, diet. Rebus has no problem with raw meat, he often gets that from us as a treat. I also have no problem trying to change his food, my priority is to give him what he needs. I'd dearly love to believe that he could go into remission if I got his diet right, but I guess that's not a realistic goal. Not impossible hopefully, but maybe not realistic. I don't know.

I hope I gave enough info there for starters, thanks for reading, and thanks in advance for your thoughts and advice.

Welcome Nick and Rebus,

This is a great plan to educate yourself on the best way to treat Rebus' diabetes. We have a protocol that has been very successful, getting most cats to regulation and many to remission:

1. A slow, long lasting insulin. UK Vets are required to start with Canninsulin. Until it is shown not to work, then they have been known to prescribe the UK form of PZI or Lantus. But Canninsulin does work for some cats, especially if you will monitor carefully and change the dose as needed. We like new diabetics to start low and go slow. Three units is more than most cats use here. We suggest starting at a low dose of one unit twice daily every 12 hours. And increase slowly, by .25 or .5 units as the numbers indicate. That is the safest approach. If Rebus is eating dry high carb food, then the 3 units could be okay (like a donut diet supplemented with insulin for humans ) but when you switch, you will want to be hometesting and monitoring carefully as the numbers can decrease rapidly.

2. A low carb, wet diet. We like to feed under 8-10% carbs. Here is a thread with UK foods:
http://www.felinediabetes.com/FDMB/... [url=http://www.catinfo.org]www.catinfo.org

Whatever food you can afford that your cat will eat in that lower range. BUT do not change over to wet until you are hometesting. With our Oliver, the switch meant an overnight change of 100 points downward. If we hadn’t been testing and had given our usual amount., he could have hypoed.

2. And most importantly, hometesting. We think cats tend to be stressed at the vet
and we know stress raises blood glucose levels. So we test our cats at home. You want to know what the number is before you give the shot to be sure the amount you are planning to give is safe. And testing midcycle will show you how the insulin is working. We use human glucometers and test on their ears or paws. Here is a video that shows you how it is done: Video for hometesting

Be sure to read the Nutrition and Health threads on the Main Forum Index page. Ask questions and let us know how we can help.

Hello, Nick (and Rebus) and welcome to FDMB!

I was going to post a lot of info here, but then saw that Sue had already posted all that I was going to say (and more), so I'm kind of left twiddling my thumbs now! :lol:

All I think I can add to what Sue said is some UK-specific info. For example, if you are willing to have a go at hometesting (nowhere near as hard as it sounds, honestly!) then a glucose meter that is quite popular with Brits (and fairly easy to get in pharmacies) is the Accucheck Aviva. Alternatively I can send you one of my spare meters. It would be a One Touch Ultra. (The test strips for both meters are usually available on Ebay for around half the RRP.)

Essentially, testing involves pricking the outer edge of the cat's ear to get a teensy weensy drop of blood, putting that onto a test strip in a glucose meter, waiting for that to count down and give a result, and giving your cat a treat or a wee cuddle as a reward.
Testing shouldn't hurt your cat because there are very few nerve endings in the outer edge of the ear. And there are a lot of benefits to testing. It gives incredible insights into how insulin is working in your cat, helps to keep the cat safe from hypoglycemia, and will almost certainly save money on vet's bills too.
Here are 2 links to pages of pics and info on hometesting and the 'reasons why' hometesting can be helpful.
http://www.sugarpet.net/bloodtst.html
http://www.sugarpet.net/reasons.html

We look forward to getting to know you and Rebus,

Eliz

PS. Edinburgh was my childhood home (I was born in Musselburgh.)

Thanks Sue.

It's interesting that you say UK vets have to start with Caninsulin, I didn't know that. The vet did say that there were other insulins available and that, depending on what he found after next weeks testing, he would make a decision about what was the best way forward. FWIW I like, trust, and respect my vet and I've been going there for the whole of Rebus' life - that said, I have no problem in challenging authority when needed ;-)

I'll continue with the transition to Hills M/D for just now, at least it's probably a little better than his regular food. Once things settle down I'll look into the transition to a wet food of some kind. I have found the link on this board to a list of UK diabetic cat foods, I'll study that in preparation.

Hometesting is something I know nothing about, so I have some way to go there. The vet did say that the tests can easily be swayed by stress so I can see that's one (of many) reasons to test at home.

I have a long way to go, thanks for helping with my first steps.

Hi Elizabeth.

The 'Honest Toun', eh? - it's a small world!!

Thanks for the pointer on the home test kit, and also for your kind offer. I've had a very very quick Google of the Aviva thingy and it seems reasonably priced. I'll do a bit more reading before going ahead and buying the appropriate test gear. I'm already getting the feeling that this will be quite empowering in a way, as just now I feel completely detached from what is happening.

I was nervous about injecting Rebus but that seems to be going ok, so I guess the ear test will be breeze..... :mrgreen:

Hi Nick, just a little hello from another UKer (down in Surrey, near Elizabeth) - to welcome you to the board and encourage you to post here as often as you like about anything at all! There is an incredible amount of experience here and it complements what the vets may say (ideally the two should work hand in hand) so we look forward to getting to know you and helping you on this journey. You are absolutely and definitely in the right place!

All paws crossed for you and Rebus.

Diana

Hi Nick and sugardude Rebus and welcome to the message board.

Here are a few reasons we like to get our diabetic cats onto a wet food diet.
1. The higher water content of the wet food. It's difficult for a cat to drink enough water on their own. Unregulated diabetic cats are peeing so much they are often slightly dehydrated.
2. Also, the extra water helps to flush out any ketones if present.
3. More water helps to prevent UTI's (urinary tract infection). As you can imagine, when a cats BG is high, they are spilling the excess glucose into the urinary tract system. That sugar rich environment provides a perfect breeding ground for bacteria to grow. More water helps to flush out the excess sugar because your cat will pee more.
3. Less calories in the canned food and many diabetic cats need to lose weight.
4. Wet food gets digested faster. Important if you cat drops into low numbers and you need to feed to bring those BG numbers up quicker.
5. Many more wet foods available that are low carb, <10%.

As Sue said, please do not switch your cat to a lower carb wet food until you are home testing. The BG (blood glucose) levels can drop dramatically and we want to keep your kitty Rebus safe.

Remission is possible. The old goals in treating Feline Diabetes, used to be “reasonable clinical signs” and reasonable glycemic control. The New Goals in treating Feline Diabetes are rapid glycemic control and cure, not simply management per this infofrom the University of Queensland, current as of 2012.

With your attitude and obvious mental flexibility, you and your cat have an excellent chance at remission.

You've just had amazingly helpful advice that you might never have found outside this group, and I echo all of it. It was far better stated than I could have done.

But I may yet be of use to you: I am in Edinburgh and so can be available for your cat's first ear tests, helping with hometesting, or perhaps with injections when you have to be away. So keep my address in mind. I work from home and I'm in central Edin, near the Castle.

I'm not as female as most of the members here, but I kept Jock alive and in excellent low BG numbers for most of eight years after diagnosis, so I qualify.

Get in touch - 07557091079

Steve!!!

When I read Nick's post I thought of you and wondered if you were still in Edinburgh. How wonderful that you've posted here. :smile:

@Nick ~ if Steve can help you then you could not possibly be in better hands.

Eliz

Echoing Eliz's encouragement to get in touch with Steve - it's a no-brainer, please do it!

Diana

I third the recommendation to get in touch with Steve. He's been around a long time and will help you.

Thanks Steve, I greatly appreciate your input and your offer of assistance - sorry I haven't been back in here before now

We went back to the vet just over a week ago (18th) for Rebus to be assessed again, I think to get a 'curve' done.

The upshot was that his sugar levels were way too high and that we are to increase his insulin. 2 weeks at 4IU and then 2 at 5IU and then he's going back in for a day at the end of that to be assesed again.

In the meantime he's now fully converted to Hill's m/d. He likes that although does seem to be looking for more to eat, but he has always been a chancer . I'd very much like to get him started on a complete wet food (like Lily's Kitchen or Thrive) but I don't want to mess about too much if there's a chance of doing more harm than good - especially as I have done nothing regarding home testing. Yet....

In the meantime, little was I to know how this recent picture would come to seem so apt....

Steve & Jock said:

Get in touch

Click to expand...

Steve, I will get in touch.

I'm away for the next few days on a work related trip so it'll have to wait until the end of the week or next weekend.

If there is a particularly convenient time to get you then please let me know.

Thank you for your help.

Hi Nick,

I'm so glad you've posted; and thrilled that you are going to get in touch with Steve.
(BTW, the email notification thingy isn't working for everyone at the moment. Only some folks are receiving notifications. The rest of us have to pop into the forum to check our mail...)

Nick-F said:

We went back to the vet just over a week ago... I think to get a 'curve' done.
The upshot was that his sugar levels were way too high and that we are to increase his insulin. 2 weeks at 4IU and then 2 at 5IU...

Click to expand...

That's a lot of insulin, Nick. Some cats do need high doses but they are in the minority.
Did you also get a 'fructosamine' test done? (That gives a sort of average of blood glucose levels over the preceding couple of weeks).

Nick-F said:

...I'd very much like to get him started on a complete wet food (like Lily's Kitchen or Thrive) but I don't want to mess about too much if there's a chance of doing more harm than good - especially as I have done nothing regarding home testing. Yet....

Click to expand...

Yes, low carb wet is a good idea, but you're right - don't lower the carb content of the food unless/until you are testing Rebus's blood glucose at home. Lowering the carb content of the diet can dramatically lower insulin requirements, and a dose that is OK can suddenly be too much.

Nick-F said:

In the meantime, little was I to know how this recent picture would come to seem so apt....

Click to expand...

Wow, just love that pic! Absolutely gorgeous.
(And I see Rebus has a very Scottish 'sweet tooth'... ;-) )

Eliz

Elizabeth and Bertie said:

Did you also get a 'fructosamine' test done? (That gives a sort of average of blood glucose levels over the preceding couple of weeks).

Click to expand...

I'm a little embarrased to say I have no idea

I know I should have asked more questions but, excuses aside, I didn't.

I'll be more on the ball next time...

Love the pic!
Nick, it's very likely that the vet did do a fructo test, quite early on in the diagnostic process, probably. You could always ring them to ask (and if they did, also ask the result) as this could be useful info for you when you talk to or meet Steve. He will also be able to discuss those increased insulin doses with you...

Best of luck!
Diana

I've emailed the vet to ask if Rebus had the fructosamine test and what the results were if he has. I'll post up whatever I find out.

It looks like a small window of opportunity for Steve and I to get the ball rolling this week, but hopefully we'll do so!

Thank you all once again

Ok, I emailed the vet and the reply was:

"A  fructosamine test was done on 7 April and the result was 815. The normal range is 160-300. "

What does that tell us?

It tells us that Rebus is very definitely diabetic, Nick. One-off blood tests give a specific reading at that point in time; the fructo test gives a reading for the past couple of weeks or so (on a different scale I think) and this would have been the test the vet took to determine diabetes or otherwise before doing anything else. 815 is clearly out of normal range so confirmed their suspicions, ie no room to doubt, and insulin was appropriate. Sometimes one-off BG readings can throw us as BGs can vary enormously for all sorts of reasons - infection, stress, etc. So the fructo test is a confirmation of the underlying situation and the need for treatment. Vets may well take further such tests at regular intervals to determine the efficiency of insulin dosage being administered, not expecting people to test their cat's blood at home.
Hope this makes sense.
Diana

Apologies for the lack of response, I have many excuses but none that are very good...

I'll cut a long story short: the vet has now diagnosed Rebus as having acromegaly. He's currently on 20 units twice a day (only for the last week) in an effort to see if we can dent his glucose. Readings after a dose of 10 units still showed figures in the 30's - I believe we're looking for single figures although the vet will settle for low teens.

We've been supplied with an alphatrak meter and schooled in it's use by the vet nurse. I have now succesfully drawn and tested his blood quite easily.

I'll try to get a proper curve done this weekend and then discuss that with the vet. He's quite open to trying other insulin but feels he needs to see something approaching a curve from the caninsulin before moving to an alternative.

Rebus seems ok- he can certainly fight his corner when it comes to getting an injection, I have the scars to prove that.... ;-)

Nick, I've been where you are, my Tom had acromegaly. Basically this is now a new ballgame and I would suggest that it would help to post on the Acromegaly/High Gulpers forum here where people with experience will be able to give you specific advice. But do please also post on the general Health forum with any other health related matters. As you've seen, there is a vast amount of experience here and people really do want to help every step of the way.

With all good wishes
Diana

Thanks Diana, I'll do that.