New Member - 2 diabetic kitties! Help!

Hi everyone! Thank you for taking the time to read my post. Forgive me if it gets a little lengthy but I'm feeling quite overwhelmed right now.
My name is Karen, I live in south GA, USA and I am a feral and stray cat rescuer. Three of my rescues are indoor cats, Skittles, Biscuits and Purrcey. I have 23 ferals/strays, 6 of which are 2 week old kittens right now. The mother was a stray and came to me pregnant and had her kittens on April 29th. I wish sometimes they weren't so cute but alas, here I am again with more babies to love after my entire colony was finally spayed and neutered. There always seems to be one that shows up after the fact LOL. I also run a page for the cats on facebook called Friends of Ferals - Lois's Lounge, that has been up and running for almost 7 years now. It's been a lot of fun and I enjoy "blogging" about the colony on my page.
I digress, my Skittles was diagnosed with diabetes about 5 years ago. He's 11 years old now and done fairly well considering that his sugar runs high constantly. He gave me a bad scare a couple of months ago when someone told me about a product called Blood Sugar Gold that was mainly plant based but was supposed to help bring his sugar down slowly and keep it down. I showed it to my vet before I ever gave him a dose of this stuff and the vet researched it, called me back and said, "start slowly, with 1/2 the dose recommended and only once a day". Thankfully I followed his advice. Within 5 days, Skittles started acting strange. He was vomiting profusely, he was lethargic, not eating, and he started hiding a lot. That was very odd for him because he is my "bathroom buddy" and has to be with me every time I'm in there except for when I shower, he hates the noise, so when he stopped coming with me to the bathroom, I knew something was up!
I took him to the vet and she was a new one that we had not seen before. It was frustrating having to reiterate his history to her and explain what was going on and that I had started him on this new supplement a few days earlier. She did bloodwork on him and his phosphorous and calcium levels were off the charts to where they could not even get a reading. His sugar was around 600 and he was also in keto acidosis. He was a very sick boy. To make a very long story short, it was the supplement that caused his phosphorous and calcium levels to spike, we're not sure exactly what in the supplement caused this but something did and if I had given him the recommended dosage on the bottle, it would have killed him. She said that his heart and kidneys would have calcified and that would have been it for him. She caught it in time and thankfully there were no lasting effects from it since he'd only been on it a few days at that point. We immediately stopped that supplement of course, and went back to just insulin. He is on Vetsulin at 4 units twice a day and is eating Hills w/d and Weruva Cats in the Kitchen wet food, which this current vet approved after she looked at the ingredients. He gets no other treats or anything aside from this and yet his sugar remains high. He is consistently showing 300+ even 6-8 hours after a dose of insulin. At the clinic they inserted a Freestyle Libre system button into his neck area and he hated that thing, pulled it out constantly and I can't afford to have a new one put in every few days (they charge $80 each time at the vet!). I even put a shirt on him to try to stop him from pulling it off but that stressed him out more, so eventually I just ditched the button and went back to testing with his blood using an Alpha Trak pet glucose meter.
Skittles has a sister named Biscuits, also 11 years old, same litter, and about 9 days ago, she started acting weird, with vomiting, not eating, (obviously), and hiding a little but that was only ONE day that she did this. She was asymptomatic for diabetes before that day and frankly it never crossed my mind that she might be diabetic. She's always had a weak stomach because she is a long-haired cat, so vomiting is not unusual for her and usually produces a hairball and she's good to go. However, that day was different as the vomiting was profuse and not showing hairballs at all and she was just really miserable. On a whim, late that night, I just took her blood sugar to see if that could be what was going on as her symptoms were now similar to what happened to Skittles in the beginning. She had also lost a bit of weight but again it was not significant enough to be of concern yet. Her blood sugar showed a whopping 498. I was stunned. Of course it was late at night, the clinic has someone there 24/7 but I did not want to pay emergency fees, so I ended up staying up with her all night and rushed her to the vet first thing in the morning. Before I left, I took her blood sugar again and it was at 515, and she had not eaten anything at all in over 24 hours.
The vet ran her bloodwork immediately and said that she was in keto acidosis, and her kidney values were off the charts and she recommended keeping her at the clinic for a few days to work on getting her bloodwork back to normal and her sugar down as well. After 3 days she was doing a lot better and her sugar was down in the 200 range, so they released her. She also had the Freestyle Libre button in her neck/shoulder blade area and thankfully doesn't mind it. Unfortunately they forgot to give me the meter so when I tested her sugar at home that first evening, with the Alpha Trak meter, it showed 704. I was freaking out at this point. She was fine at the vet, she barely ate after she got home, just a little of the w/d and yet her sugar was super high. I took her back to the clinic the next morning and they agreed this was a big concern, so they kept her 2 more days. They got the sugar back down to the 200 range and sent her home on Thursday evening after doing a curve test throughout the day. Since she's been home, the lowest her sugar has been is 369. She is eating pretty good, but only Hill's w/d and 1/3 of a can of the Weruva wet food in the morning. She DOES love dog food however, since we have 4 dogs that's been easily accessible and we've had to resort to hiding it from her now. I sometimes wonder if that contributed to her diabetes as we didn't really stop her from eating dog food whenever she wanted to before. I will be honest, she also loved ice cream and whipped cream and I would give her a little squirt of whipped cream, usually the size of a quarter or a teaspoon worth or the same with ice cream. It was never excessive though and not every day. I do feel guilty though after all this because she wouldn't have had all that if I had not given it to her, it's not like she can get it herself, but at the same time I didn't know she was diabetic either.
So here we are a day after she came home from the vet. I gave her insulin at 10:30 am 2 units of Vetsulin and again at 10:30 this evening, same thing. Her sugar has stayed over 500 most of the day, dipping down to 369 this afternoon about 6 hours after her first dose and then steadily climbing the rest of the day. I can't figure out why it's so high with her eating only what the vet recommended and definitely not eating anything bad at all. It's confusing and overwhelming. She is my little soulmate and I am sad that she has been so sick. I know this is not the end of the world and with time we'll figure it out but with two cats that have diabetes, and with 2 cats in my feral/stray colony having serious health scares in the past week, I'm feeling just a bit like a fish out of water at the moment.
I am here to learn about your experiences with diabetes. A friend of mine recommended this site to me and as I said I wish I had known about it when Skittles was first diagnosed. Maybe we would be in better shape by now with his sugar too. I am open to suggestions, advice, or whatever else you have to offer to help my babies get their blood sugar under control. These two and their brother Purrcey, are very bonded with me and I'm paranoid now that Purrcey will develop diabetes as well. He is quite chunky compared to Skittles and Biscuits, so it's definitely on my radar. So far he has herpes and he's had that since he was 10 months old, but nothing else seems to be causing him any issues, thankfully. I look forward to hearing what you have to say and applying tips and tricks that have worked for your own kitties who suffer from diabetes too. Thank you again for taking the time to read my story. Hoping for some positive changes for Skittles and Biscuits in the near future. Have a blessed weekend everyone!

 

Welcome to the FDMB Karen (and the sugarcat twins)!

It used to be that vets thought that diabetic cats should eat a high fiber food, but newer research shows it's the carbs that count!

The W/D is too high in carbs for a diabetic cat, especially the kibble, and there's absolutely nothing in it that treats diabetes. It also contains my personal pet peeve ingredient laughingly called "powdered cellulose"....that's basically a fancy word for sawdust. (which is where the fiber comes in!)

Getting all your cats off of kibble of any kind will not only make them all much healthier, it solves the problem of which food the diabetics are eating as well as drastically reduces the chances of having sugarcat #3.

There's lots of great information on this website that's written by a vet with a special interest in feline nutrition. It's well worth the time to read. There's also a food chart included with the nutritional breakdown of lots of other foods. You want foods that are under 10% carbs.

Also, in all cats, the kidney's are their weakest organ...keeping as much water flowing through them is one of the best things you can do to help keep them healthy. Pretty much every older cat will have some degree of kidney disease so it's worthwhile to do what you can to take care of them.

One thing...make sure you're keeping a close eye on the blood glucose if you do the diet change to low carb. Dropping the carbs can drastically reduce the need for insulin.

Next, let's talk about blood glucose meters. As you're learned the Libre has it's issues so it's really not a long term fix, however, if you've been using the AlphaTrak, you've probably got at least a 2nd mortgage paying for the strips! We understand! Most of us use human meters like the Relion Prime from WalMart. It's $9 and the strips are $17.88/100. Pet meters have only been around for a little over 10 years....guess what everybody used before somebody decided to put a picture of a dog and cat on the box and double the price? That's right!...Human meters! All our dosing methods were developed using human meters so we're very comfortable using them.

There's nothing wrong with the AlphaTrak...it's just pricey! So you may have to put some of your colony cats to work selling carnations at the intersections to keep up!

Next, let's talk insulin. Vetsulin hasn't been recommended for cats for several years but some cats do OK on it but it's really more of an insulin for dogs (only in the US is it called Vetsulin...the rest of the world calls it Caninsulin...."canin" is your big clue here)

The 2018 AAHA Guidelines on Diabetes Management recommend Glargine (Lantus, Basaglar, Semglee are brand names) or ProZinc for cats. Glargine is a human insulin that's very effective in cats and most of us consider it the Gold standard. It has the highest number of cats that make it to remission, especially if they are started on it soon after diagnosis.

It IS pricey, especially in the US...but most of us buy ours from a pharmacy in Canada where we can get a 5 pack of pens of Lantus for $190 (including shipping). That's 1500 units which is enough to last most cats at least 1 year and some up to 2 years. Breaking it down, it's about .13 cents per unit. Here's the information on Mark's Marine Pharmacy in Vancouver. They are wonderful to work with!

ProZinc is a veterinary only insulin originally developed for cats. It's available at veterinary pharmacies like Allivet and Chewy for about $110 but it's a U40 insulin, so a 10ml vial is only 400 units which makes the unit price about 27.5 cents per unit.

If these were my cats, I'd work on getting the W/D out of the diet while testing at least before every shot and also somewhere mid-cycle on the AM cycle (4-7 hours after the shot) and at least 1 "before bed" test on the PM cycle. We have a spreadsheet we all use to record our tests that's one of our most useful tools. It's color coded which makes it easier to see patterns we look for as well as any individual tests that might explain why we're seeing wonky numbers later.

I've probably already overwhelmed you, so I'll stop with this. Here is a useful link for new members. Please take special note of the hypo information and kit and make sure you get one set up ASAP.
https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

Hang in there. You're doing God's work by taking care of all these sweet souls....Now it's time to let us help you with the two that need a little extra help right now.

 

Tagging @Chris & China (GA) for you.
Chris – see https://www.felinediabetes.com/FDMB...-comment-on-initial-post.248186/#post-2799440

 

you certainly have your hands full.


Weruva is a great food to feed. I would feed them this and skip the wd. The wd is 25% carb and totally not a good food for diabetic cats. Keep them out of the dog food. There are lots of high carb filters in dog food. You want to feed foods under 10 percent carb. Here's a link to a food chart. https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf


That's a high dose of vetsulin but it might be needed while feeding the high carb wd. Be very careful as you remove it you may find you need to lower your dose. Consider a longer acting insulin such as ProZinc or lantus if you are getting big drops and sharp rises in numbers.

Please test your diabetic cats blood sugar levels every day.... It's super important in order to find the right dose and keep them safe. I have a video in my signature showing how I tested my cat CC at home. We can help with dosing advice of you set up a spreadsheet. We use a Google spreadsheet to track the numbers so we can help each other when we need advice. It's great you've started testing at home.

We have a link to the template for the spreadsheet in the testing forum. https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

With a history of dka is important to also test ketones. You can get urine strips in the pharmacy... But I find it more convenient to use a blood ketone meter. You can get them on amazon.


Your cats are lucky to have you to take such good care of them.