Clueless, overwhelmed furmommy of kitty recently diagnosed. Help!

[TLio]

Hello! I’m going to apologize in advance for my obnoxiously long post but I’m desperate for answers and guidance.

My 13 y/o furbaby, was recently diagnosed with diabetes on 12/28. His vet “ball parked” how much insulin he should give him, given the fact he’s 12.5 lbs and his sugar was over 400 when they tested/diagnosed him. He gave him 5 units of insulin at the vets and then when he checked his level again, it was 66. The vet said that’s low and we want to avoid that! So, he suggested I give him 3 units of Novolin N, a NPH insulin, every 12 hours. My biggest fear is that I will put my cat in a hypoglycemic state without knowing what his levels are before dosing him. The vet said it’s not necessary to check his levels before giving him insulin, which I do not feel comfortable with. The vet said my cat will be very unhappy with getting pricked twice a day for the rest of his life. For some background info, my cat has always been “free fed.” The vet said to keep his diet as is. My cat is very picky. He will not eat wet food or any type of cat treats. He’s been eating Meow Mix Original Choice Dry Cat Food since I got him. He won’t eat anything else. After doing some research, I learned that is very high in carbs and I’m thinking this is how he got here in the first place

So, since I felt uncomfortable with my vet’s suggestions, I got a second opinion. His new vet doesn’t want me to stress too much on changing his diet right now. He said once he’s stabilized, to not “free feed” him anymore. In the beginning, which is now, he said it is not necessary to check his sugar before giving him insulin because we know it’s high. It’s going to be high for a little bit. Once stabilized, I can then check his levels before giving him insulin. He did change his insulin to Vetsulin, 2 units daily BID until he improves and then go down to 1 unit BID. Was that appropriate or a better move on his part?

After I gave him his first dose of the 2 units of Vetsulin at home, I pretty much convinced myself I put him in a hypoglycemic state because he was extra tired and sleepy. I got so nervous, I rushed him to the vet and they checked his sugar and it was 417. I’m so nervous to continue dosing him because he’s not eating much. Was his level 417 because it was bouncing back from being too low and his body was dumping extra sugar to save itself? Should I be using a different insulin? How can I get him to eat? What should I be giving him? I’m so overwhelmed and worried. When he’s not sleeping or constantly drinking or urinating, he just walks around aimlessly. He doesn’t appear to be in any pain or uncomfortable but what’s with the pacing? Maybe that is a sign he is uncomfortable?

 

[Bron and Sheba (GA)]

/Hi and welcome to the forum. It is overwhelming in the beginning but we can help you get on the right path.
5units of Novolin N is an insane amount to give a cat first dose.
I would go back to 1 unit twice a day if you are feeding dry food or 1/2 unit if you are feeding a canned diet.and see how that goes

Should I be using a different insulin? H

Novolin is not a good insulin for cats so I would ask the vet about changing over to Lantus or Prozinc which are both suitable for cats.

I would strongly advise you to home test the blood glucose so that you know if it is safe to give the dose and you will be able to see how low the dose is taking your kitty.
If you live in the US, you can buy a ReliOn premier meter for $9 and a box of 100 test strips for $17.88.
You will also need a box of lancets….get gauge 26 or 28. And some cotton rounds to hold behind the ear as you prick.
I will give you a link on hometesting at the end.

A low carb wet or canned food with carbs under 10% is best for diabetic cats. But until you are hometesting I would not change the diet as it could drop the BG (blood glucose ) up to 100 points. A lot of people feed fancy feast pates.

After I gave him his first dose of the 2 units of Vetsulin at home, I pretty much convinced myself I put him in a hypoglycemic state because he was extra tired and sleepy. I got so nervous, I rushed him to the vet and they checked his sugar and it was 417. I’m so nervous to continue dosing him because he’s not eating much. Was his level 417 because it was bouncing back from being too low and his body was dumping extra sugar to save itself?

Yes it is possible that he bounced up high after being low. The only way to find out if this is so is to home test.

How can I get him to eat? What

What are you trying to get him to eat?
It really important he eats well so let him eat the dry food until you are a bit more organised and settled.it’s not ideal but it’s really important he eats.
With Novolin you need to feed him 60 minutes before you give the insulin. This is because Novolin hits hard and fast and he needs to have food aboard.
Apart from his 2 main meals it is a good idea to give him several snacks during all the cycles, mostly in the first 6 hours after the insulin. If you want to free feed him, that’s ok too as long as you pick up the food for the 2 hours before you test for the preshots, once you start testing.
I am going to give you the link to BEGINNERS GUIDE TO NOVOLIN N .click on the blue type. Please read carefully and print off.

HOMETESTING LINK

SUGGESTIONS TO IMPROVE KITTYS APPETITE

This link has information about a hypo kit, setting up a spreadsheet and signature and other useful information HELP US HELP YOU

Are you testing for ketones in the urine? I would strongly suggest you to pick up a bottle of Ketostix from Walmart or a pharmacy when you get the glucose meter and test daily for a while until his numbers improve. To do this you collect a urine sample and then test as per the instructions on the bottle. If there is more than a trace of ketones please tell us and the vet.
Keep asking lots of questions. We are happy to help you.
Bron

 

[Noah & me (GA)]

It's a sad fact that diabetes management is not taught very well to vets. If your child was diabetic would you just "ballpark" the amount of insulin? Good for you to seek another opinion.

vet said my cat will be very unhappy with getting pricked twice a day for the rest of his life

Eventually he won't be very unhappy, it will just be an inconvenience. Better that than a hypo episode.

 

[FitzC]

Hello. New to this too. Just what we have noticed. If dry food is given to Pilchard (the diabetic management type) his figures rise. So he is on low carb wet food only. I was doing a pre-shot check and mid point. My partner felt it was mean to our cat to do this each day. Vet suggested I relax a bit and just check a couple of times week. He got sick and was in a bad way pretty quickly. Overnight he was being sick, he was pacing and lying by his water bowl, paddling in it. He was hospitalised and had pancreatitis and DKA. With him the clinical signs were pretty sudden.
Currently closely monitored as I am doing a week of curves to try to get info to persuade vet to consider an insulin change. After that I will do am/pm pre-shot and mid point when I can (work). My partner is now as keen as me to monitor and getting better than me at getting his ear sample. As people on here suggested I got the Keto Stix on line, about £6 and the cat granules to get a sample in his tray. I test for ketones now. Pilchard is currently "Pilchard" again. The boy is back. I still have concerns about his dose and type of insulin so recording his data and rocking up to my vet is the next step. I phone the vets odd figures and alter the dose.

From our experience of 3 hospitalisations since the beginning of October I would recommend getting a monitor and doing it closely, certainly to start with. Get the Keto Stix. Have a hypo kit (higher card food, honey or icing sugar paste). We have a timer feeder, just a simple one £15. I can set it for the middle of the day or night. Fortunately our other cat does not steal Pilchard's food when it opens. We fitted a wooden block to the base and Pilch finally stopped booting it around the house.

On top of the data we are watching for excessive thirst and wee, coat change, abdomen tenderness, depression, lethargy, sickness, lack of appetite, pacing around. When entering a bad phase we have noticed that Pilch pads his water bowl everywhere.

I hope your cat improves and you can get him to eat some wet food. Pilch also liked Bozita and Grau. Monitor away, you are trying to help him and it is the best action I think you can take. I felt overwhelmed and anxious but I am doing everything I can. That is what you can do. All the best to you and your pal.

 

[TLio]

/Hi and welcome to the forum. It is overwhelming in the beginning but we can help you get on the right path.
5units of Novolin N is an insane amount to give a cat first dose.
I would go back to 1 unit twice a day if you are feeding dry food or 1/2 unit if you are feeding a canned diet.and see how that goes


Novolin is not a good insulin for cats so I would ask the vet about changing over to Lantus or Prozinc which are both suitable for cats.

I would strongly advise you to home test the blood glucose so that you know if it is safe to give the dose and you will be able to see how low the dose is taking your kitty.
If you live in the US, you can buy a ReliOn premier meter for $9 and a box of 100 test strips for $17.88.
You will also need a box of lancets….get gauge 26 or 28. And some cotton rounds to hold behind the ear as you prick.
I will give you a link on hometesting at the end.

A low carb wet or canned food with carbs under 10% is best for diabetic cats. But until you are hometesting I would not change the diet as it could drop the BG (blood glucose ) up to 100 points. A lot of people feed fancy feast pates.


Yes it is possible that he bounced up high after being low. The only way to find out if this is so is to home test.


What are you trying to get him to eat?
It really important he eats well so let him eat the dry food until you are a bit more organised and settled.it’s not ideal but it’s really important he eats.
With Novolin you need to feed him 60 minutes before you give the insulin. This is because Novolin hits hard and fast and he needs to have food aboard.
Apart from his 2 main meals it is a good idea to give him several snacks during all the cycles, mostly in the first 6 hours after the insulin. If you want to free feed him, that’s ok too as long as you pick up the food for the 2 hours before you test for the preshots, once you start testing.
I am going to give you the link to BEGINNERS GUIDE TO NOVOLIN N .click on the blue type. Please read carefully and print off.

HOMETESTING LINK

SUGGESTIONS TO IMPROVE KITTYS APPETITE

This link has information about a hypo kit, setting up a spreadsheet and signature and other useful information HELP US HELP YOU

Are you testing for ketones in the urine? I would strongly suggest you to pick up a bottle of Ketostix from Walmart or a pharmacy when you get the glucose meter and test daily for a while until his numbers improve. To do this you collect a urine sample and then test as per the instructions on the bottle. If there is more than a trace of ketones please tell us and the vet.
Keep asking lots of questions. We are happy to help you.
Bron

Hello,
Thank you for your response. The only time he received Novolin was when he was at the (first) vet. I did not give him any after that because I felt uncomfortable doing so. The vet that gave me the second opinion recommended Vetsulin, so that's what I have been giving him. What are your thoughts on Vetsulin? Have you heard any good/bad things about it? Like Novolin, does Vetsulin hit hard and fast? This new vet has a cat with diabetes and gives his cat Vetsulin, so I'm assuming it's okay? Is there a beginners guide to Vetsulin? My head is spinning. Everyone I talks to has a different opinion, which is very much appreciated and definitely helpful. With all of the different responses, I'm wondering if I need to get a THIRD opinion? What would you do?

Anyway, since he hasn't been eating, I have been giving him "barely" 1 unit because I'm so scared to put him in a hypoglycemic state. As I said, he hasn't been eating. He hasn't been eating his Meow Mix, which he use to love. I bought a few cans of Fancy Feast Pate's and he's showing no interest. I purchased a home test kit but it hasn't arrived yet.

I have not been testing for Ketones. This may sound like a silly question but how do you collect a urine sample from a cat?

I made an appointment with his new vet today because he's not eating and I want his levels checked. Let's see what he says. Thanks again!

 

[TLio]

Hello. New to this too. Just what we have noticed. If dry food is given to Pilchard (the diabetic management type) his figures rise. So he is on low carb wet food only. I was doing a pre-shot check and mid point. My partner felt it was mean to our cat to do this each day. Vet suggested I relax a bit and just check a couple of times week. He got sick and was in a bad way pretty quickly. Overnight he was being sick, he was pacing and lying by his water bowl, paddling in it. He was hospitalised and had pancreatitis and DKA. With him the clinical signs were pretty sudden.
Currently closely monitored as I am doing a week of curves to try to get info to persuade vet to consider an insulin change. After that I will do am/pm pre-shot and mid point when I can (work). My partner is now as keen as me to monitor and getting better than me at getting his ear sample. As people on here suggested I got the Keto Stix on line, about £6 and the cat granules to get a sample in his tray. I test for ketones now. Pilchard is currently "Pilchard" again. The boy is back. I still have concerns about his dose and type of insulin so recording his data and rocking up to my vet is the next step. I phone the vets odd figures and alter the dose.

From our experience of 3 hospitalisations since the beginning of October I would recommend getting a monitor and doing it closely, certainly to start with. Get the Keto Stix. Have a hypo kit (higher card food, honey or icing sugar paste). We have a timer feeder, just a simple one £15. I can set it for the middle of the day or night. Fortunately our other cat does not steal Pilchard's food when it opens. We fitted a wooden block to the base and Pilch finally stopped booting it around the house.

On top of the data we are watching for excessive thirst and wee, coat change, abdomen tenderness, depression, lethargy, sickness, lack of appetite, pacing around. When entering a bad phase we have noticed that Pilch pads his water bowl everywhere.

I hope your cat improves and you can get him to eat some wet food. Pilch also liked Bozita and Grau. Monitor away, you are trying to help him and it is the best action I think you can take. I felt overwhelmed and anxious but I am doing everything I can. That is what you can do. All the best to you and your pal.

I'm sorry you had to go through all of that but I am so glad your boy is back I hope he continues to thrive! And thank you for your response and suggestions!
It's very much appreciated!

 

[Diane Tyler's Mom GA]

Hi and welcome to the forum. It is overwhelming in the beginning but we can help you get on the right path.
5units of Novolin N is an insane amount to give a cat first dose.
I would go back to 1 unit twice a day if you are feeding dry food or 1/2 unit if you are feeding a canned diet.and see how that goes

Hi Bron, her kitty is on Vetsulin now
@Bron and Sheba (GA)

I'll also tag
@JanetNJ

@FrostD

This is/what she said in her post #1
He did change his insulin to Vetsulin, 2 units daily BID until he improves and then go down to 1 unit BID. Was that appropriate or a better move on his part?

 

[Diane Tyler's Mom GA]

If you can fill out your signature so members can help you
Tap on Help Us/Help you Tap on your name and you will see signature fill out all the info and then hit save
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help.
I would also suggest to start home testing, Bron gave you info on the Relion Premier human meter from Walmart , its the only way to jeep your kitty safe.
I can ask
@Bandit's Mom to set up our spreadsheet for you so you can enter is BG numbers in
Also ask for help

 

[Diane Tyler's Mom GA]

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
VIDEO: How to test your cat's blood sugarsugar

Here is a video that one of our members did

 

[FrostD]

I'll reply here to keep it all in one thread

Some cats do well on Vetsulin, mine was one of them. I eventually changed insulin because we ran into high numbers that just wouldn't go away (it turned out to be caused by other underlying conditions, which also would have required a change in insulin anyway).

But the majority of cats fare much better on the other insulins mentioned. Vetsulin often doesn't last long enough, or drops them hard and fast which causes BG to skyrocket after, and the vicious cycle continues. I personally would go for ProZinc or Lantus/semglee.

As for dose - I am uncomfortable recommending 2U without any test data or home testing, that's a high-ish dose for many cats. We usually start at 0.5U if on a low carb wet diet, or 1U if high carb.

 

[FrostD]

@Ashleigh & Ares is a perfect example of the problem with Vetsulin

Here's her post today, you can find her spreadsheet in her signature, and see the night and day difference between insulins

 

[Diane Tyler's Mom GA]

Please be sure to feed him 30 minutes before you give him vetsulin
https://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/

I also agree with Larry from your other post where you asked about vetsulin
Semglee which is a lot s less expensive than real Lantushttps://www.goodrx.com/semglee?dosa...ulin glargine&quantity=1&sort_type=popularity) and Levemir.

If you do decide to switch to semglee please let us know as you will need different syringes to use

 

[Ashleigh & Ares]

it is overwhelming at first. i my boy was just diagnosed 1.5mo ago. my vet began me at 2, then 3 then 4...all with just one test each while he was at vet after just about a week or week n half apart.
Luckily @FrostD had me do more tests and saw he was too high!!
The pricks DO get better. up until a few days ago, Ares would fight me 1 out of every 2 tests...but today, he is being so nice)
Swaddling helps if they like to move
You get used to it, and once you can do it well, it doesnt hurt them. just keep perfecting / watching videos on it.
The memebers on this board who advise are amazing and will help you understand a LOT
Do not give up Tlio!

 

[Bron and Sheba (GA)]

made an appointment with his new vet today because he's not eating and I want his levels checked. Let's see what he says

Your kitty may well be nauseated. Ask the vet for some antinausea medication such as cerenia or ondansetron. Ondansetron is often better for nausea whereas cerenia is better for vomiting.

have not been testing for Ketones. This may sound like a silly question but how do you collect a urine sample from a cat?

Not a silly question at all…we don’t have any silly questions here.
Try slipping a large ladle under his butt as he squats to pee or try putting a low small plastic container in his favourite spot in the litter box..
If he’s not eating and he’s only getting a small amount of insulin it’s important you test for ketones. You can ask the vet to check for you while you are at the vet but please do get the bottle of Ketostix to have at home to test often.

 

[Sienne and Gabby (GA)]

First, deep breath. You've just started the marathon that is feline diabetes.

You have great instincts and your first vet needs to take some continuing education classes on feline diabetes. (I'm trying very hard to be politically correct.) The second vet needs to read the literature regarding what's currently recommended for the treatment of feline diabetes. The American Animal Hospital Association publishes periodic guidelines for treating diabetes. Their current recommendation for insulin is Lantus/glargine (Semblee is the generic or more accurately, a biosimilar for Lantus) or Prozinc. These are both long lasting insulins. Vetsulin is no longer recommended as it lasts only 8 - 10 hours causing wide swings in numbers.

You need to have food on board before giving a Vetsulin injection. It is relatively fast acting and can drop blood glucose numbers hard and fast. If you're cat's not eating, it's a problem. An anti-nausea medication may help. Since you're going to see a new vet, please ask about pancreatitis. It's not uncommon in diabetic cats. It is painful and can cause a cat to not want to eat. Getting pain meds, meds for nausea, and if there's an infection, antibiotics will help.

As for your cat hating you for home testing, ummmm..... that's wrong too. If you look at my spreadsheet, I tested a lot more than twice a day. (You do not need to be a testaholic like I was.) Needless to say, my cat didn't hate me. Your cat will understand that what you're doing will ultimately help him to feel better. Treats also help. If your cat associates a treat with a test, it goes a long way to making the process easier.