New Member - Starting insulin

[Auri's Mom]

Hello! New member here (Michaila) with my 12-year-old dumpster blessing Auri from New Hampshire. Auri was semi-feral when I rescued her 10 years ago, but after lots of work, has mostly adjusted to domestic cat life and become a snuggle bug with myself and my husband. She's had regular vet visits the entire time she has been with me but started seeing a new vet during Covid who noticed that her teeth were not doing well. Since then, she's had two dental surgeries and has just one canine tooth left (which has not stopped her from killing 3 mice this year, though). During the lab testing for her most recent surgery, the vet noticed elevated blood sugar, which they chalked up to Auri's extreme stress at the vet. Unfortunately, at her next visit, her blood sugars were still elevated, so they ordered a fructosamine test which showed that her sugars had been elevated for some time. With our vet's advice, we tried several months of diet control, but recently Auri has lost more weight than we are comfortable with so we scheduled another vet visit/set of labs. The labs came back with continued elevated blood sugar (365) and traces of ketones in her urine. The vet has recommended that she start insulin and we have our appointment to learn how to do injections on Friday. Thankfully, she is otherwise healthy but for some arthritis in her back legs.

From reading this message board, I understand I need to start BG testing at home, so I will work on getting those supplies. I know that she will be on ProZinc as that is the only insulin my vet office supplies. For food, we have recently started Auri and our 4-year-old Maine Coon on Young Again LID Mature Zero, which I understand is an acceptable dry food and one that they both seem to like (we have struggled to find a zero-carb food that did not cause GI distress previously). Auri will not eat wet food - she will starve rather than eat any wet food or human food. We do supplement our other cat's dry food with wet food. We free-feed them so there is always food available.

I am reading all of the guides and trying to educate myself the best I can. I am especially nervous because we will be away for a week at the end of December (I have a message out to our normal pet sitter about whether she is okay giving insulin).

I would love any tips on helping Auri to gain weight, helping to acclimate a cat who hates being picked up or touched to getting her BG checked/getting insulin shots, and also any reassurances that she will be okay because I am rather panicked.

 

[CORKY]

Hello! New member here (Michaila) with my 12-year-old dumpster blessing Auri from New Hampshire. Auri was semi-feral when I rescued her 10 years ago, but after lots of work, has mostly adjusted to domestic cat life and become a snuggle bug with myself and my husband. She's had regular vet visits the entire time she has been with me but started seeing a new vet during Covid who noticed that her teeth were not doing well. Since then, she's had two dental surgeries and has just one canine tooth left (which has not stopped her from killing 3 mice this year, though). During the lab testing for her most recent surgery, the vet noticed elevated blood sugar, which they chalked up to Auri's extreme stress at the vet. Unfortunately, at her next visit, her blood sugars were still elevated, so they ordered a fructosamine test which showed that her sugars had been elevated for some time. With our vet's advice, we tried several months of diet control, but recently Auri has lost more weight than we are comfortable with so we scheduled another vet visit/set of labs. The labs came back with continued elevated blood sugar (365) and traces of ketones in her urine. The vet has recommended that she start insulin and we have our appointment to learn how to do injections on Friday. Thankfully, she is otherwise healthy but for some arthritis in her back legs.

From reading this message board, I understand I need to start BG testing at home, so I will work on getting those supplies. I know that she will be on ProZinc as that is the only insulin my vet office supplies. For food, we have recently started Auri and our 4-year-old Maine Coon on Young Again LID Mature Zero, which I understand is an acceptable dry food and one that they both seem to like (we have struggled to find a zero-carb food that did not cause GI distress previously). Auri will not eat wet food - she will starve rather than eat any wet food or human food. We do supplement our Maine Coon's dry food with wet food. We free-feed them so there is always food available.

I am reading all of the guides and trying to educate myself the best I can. I am especially nervous because we will be away for a week at the end of December (I have a message out to our normal pet sitter about whether she is okay giving insulin).

I would love any tips on helping Auri to gain weight, helping to acclimate a cat who hates being picked up or touched to getting her BG checked/getting insulin shots, and also any reassurances that she will be okay because I am rather panicked.

Welcome Aury and mom, you are in the right place, all of us have had panic attacks when told our precious furr babies have diabetes, but not to worry, it is manageable, home testing is very important, not only for you but for us to be able to help you, Main Coon, My Gosh! how I love those creatures, ProZinc is a great insulin for cats it last 12 hours, so you will be dosing in the morning an at night, most of us members use the ReliOn Premier monitor and strips, very reliable and inexpensive, it would be great if you consider transition from dry kibbles to wet food, dry foods contain between 25-35% carbs and diabetic cats need to consume between 0-10% carbs, Fancy Feast has a numerous varieties of flavors, below you will have several links for you to review, one is a Drs Food List, the third column will contain the quantity of carbs per food, we need you to create your signature and spreadsheet to the Forum, this is to be able to assist you guide you with dosing and advise, you need to have what is called a HYPO KIT , this contains Karo syrup or honey, some medium carb foods between 11-15% carbs and some High carb foods between 16-24%, this you should have once you begin the insulin, in case his BG gets to 50 or under, we can help you along to hike up the BG with food slowly, always know that no concern is a small concern, post it, there will always be someone to help you, so let's get started on those links, also, if you are leaving him with a sitter, you can always have the syringes full with the dose in the fridge, ProZinc must refrigerated, that way you are sure he gets the right dose at the right time, the protocol for ProZinc is Test, Feed, Shoot. there are sticky note in the Main Forum that are very valuable

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/
https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

 

[Wendy&Neko]

Hello and welcome. If you haven't seen it already, lots of tips on this page, including videos: Hometesting Links and Tips Key to a lot of this is treats. Is there something special she really likes? Many cats love the freeze dried all meat treats. We call them kitty crack.

FYI, many of us use human insulin types, such as Lantus/glargine, which you get from a human pharmacy. Depending where you live, you may or may not need a prescription written from the vet. Prozinc is still a good insulin for cat though. I think some people get it from Chewy, so you aren't dependent on your vet to get it.

For gaining weight, most important is getting her onto insulin and better regulated, so her body can utilize the food properly. Some people give slightly higher fat foods, but you are limited with only dry food choices. YA is rich, glad to hear it isn't causing GI upset as it does in some cats.

 

[Auri's Mom]

Hello and welcome. If you haven't seen it already, lots of tips on this page, including videos: Hometesting Links and Tips Key to a lot of this is treats. Is there something special she really likes? Many cats love the freeze dried all meat treats. We call them kitty crack.

FYI, many of us use human insulin types, such as Lantus/glargine, which you get from a human pharmacy. Depending where you live, you may or may not need a prescription written from the vet. Prozinc is still a good insulin for cat though. I think some people get it from Chewy, so you aren't dependent on your vet to get it.

For gaining weight, most important is getting her onto insulin and better regulated, so her body can utilize the food properly. Some people give slightly higher fat foods, but you are limited with only dry food choices. YA is rich, glad to hear it isn't causing GI upset as it does in some cats.

Thank you for the information! I am slowly reading through everything on the site. Her favorite treats have historically been the Wellness Kittles Crunchy Cat Treats, but I think these might be too high carb for her? She does not like the Stella & Chewy's freeze dried meats that we have tried, but I am doing some more research and we will try some new brands. I swear, her favorite foods are the McDonalds-equivalent of cat food.

She actually really likes the YA and we have had no GI issues so far. Wysong and Dr. Elsey's were awful so I am glad we have found one that works for her (and our other cat).

 

[CORKY]

Thank you for the information! I am slowly reading through everything on the site. Her favorite treats have historically been the Wellness Kittles Crunchy Cat Treats, but I think these might be too high carb for her? She does not like the Stella & Chewy's freeze dried meats that we have tried, but I am doing some more research and we will try some new brands. I swear, her favorite foods are the McDonalds-equivalent of cat food.

She actually really likes the YA and we have had no GI issues so far. Wysong and Dr. Elsey's were awful so I am glad we have found one that works for her (and our other cat).

For treats I give Corky(diabetic) and Coco (non) Frick’s gourmet ham or any 1%card ham cut it into little squares and they love it!

 

[Auri's Mom]

For treats I give Corky(diabetic) and Coco (non) Frick’s gourmet ham or any 1%card ham cut it into little squares and they love it!

We will try ham! Chicken, shrimp, and fish have been no-gos for her in the past, but I don't think we have ever tried ham. When I got her 10 years ago, she would only eat dry Friskies and Temptations treats, so we have come a long way, but not far enough!

 

[CORKY]

We will try ham! Chicken, shrimp, and fish have been no-gos for her in the past, but I don't think we have ever tried ham. When I got her 10 years ago, she would only eat dry Friskies and Temptations treats, so we have come a long way, but not far enough!

Just make sure you read the ingredient label 1% carb and no honey or sweets in the ham, my kiddies love it!! You can also try to lure him in for the shot with 1 tiny piece just before testing and after, and a suggestion, I ahoot Corky after he’s eaten 1/2 of his food, I just go behind him pick up the scruff and VOALA!! he never knew what happened, make sure he does’nt see the needle in your hand!!

 

[Wendy&Neko]

Corky and Auri almost look like twins!

One common brand of freeze dried treats is Purebites, but there are others. Purebites comes in all sorts of protein types. A fav here is anything from heart, such as turkey heart pieces. Liver bits are usually popular too. From what I see, the Wellness Kittles have peas, potatoes and chick peas in them, all high carb. Try to find something that is just one ingredient, the meat. Do be careful of deli meats, some of them are brined in sugar.

 

[Diane Tyler's Mom GA]

@Auri's Mom
Hi Michaila
Here is the link for the meter and test strips so you don't have to search for them
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197
At least if you need more test strips you can run into Walmart and pick them up or if you're running low you can just order them from Walmart

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
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with

Try putting a thin layer of Vaseline on the ear so the blood will bead up
Here's a video one of our members did so ignore where she had to code her meter because she is using a pet meter. With a human meter you don't have to
VIDEO: How to test your cat's blood sugar

Here is the link to set up our spreadsheet, where you can track your cats BG numbers, it also explains how to use it. You can look at anyone's spreadsheet to see what it looks like
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Be sure to get U-40 syringes with the half unit markings , we adjust the doses by 0.25 units

Here's a good video below on how to give a cat insulin

 

[Diane Tyler's Mom GA]

 

[Auri's Mom]

Thank you @Diane Tyler's Mom GA for all of this information! We have a visit with our vet tomorrow to learn how to give insulin and I will watch this video in advance. I greatly appreciate it!

 

[Auri's Mom]

Corky and Auri almost look like twins!

One common brand of freeze dried treats is Purebites, but there are others. Purebites comes in all sorts of protein types. A fav here is anything from heart, such as turkey heart pieces. Liver bits are usually popular too. From what I see, the Wellness Kittles have peas, potatoes and chick peas in them, all high carb. Try to find something that is just one ingredient, the meat. Do be careful of deli meats, some of them are brined in sugar.

I bought four brands/types of all meat treats including liver, which were delivered today - we will find one she likes!

 

[Auri's Mom]

Very frustrated this morning - our vet called and told us that they sold out of insulin last night so they need to move our appointment to next Wednesday. My husband and I both had to take a day off of work to make today's appointment work that is now wasted and Auri is going to go another 5 days with high blood sugar/no medication. I am just very disappointed and annoyed with our vet.

 

[CORKY]

Very frustrated this morning - our vet called and told us that they sold out of insulin last night so they need to move our appointment to next Wednesday. My husband and I both had to take a day off of work to make today's appointment work that is now wasted and Auri is going to go another 5 days with high blood sugar/no medication. I am just very disappointed and annoyed with our vet.

he can send the prescription to CHEWY.COM he or and you can call so the ship it express. Is unacceptable and irresponsible that he gave you no other options, below is where he needs to send the prescription to

mailto:Vetdiet@chewy.com

 

[Diane Tyler's Mom GA]

Thank you @Diane Tyler's Mom GA for all of this information! We have a visit with our vet tomorrow to learn how to give insulin and I will watch this video in advance. I greatly appreciate it!

@Auri's Mom
You're very welcome

You can get Prozinc from Chewy ,
https://www.chewy.com/prozinc-prota...S33nbsOvphn-TDSYC6O2c4XD-smCRHKgaAmLnEALw_wcB

You can call them and they will contact your vet , give your vet a heads up, and ask for refills.
How much does your get charge you for a vial
Check out the price on Chewy's

 

[Auri's Mom]

@Auri's Mom
You're very welcome

You can get Prozinc from Chewy ,
https://www.chewy.com/prozinc-prota...S33nbsOvphn-TDSYC6O2c4XD-smCRHKgaAmLnEALw_wcB

You can call them and they will contact your vet , give your vet a heads up, and ask for refills.
How much does your get charge you for a vial
Check out the price on Chewy's

Thank you both for the Chewy information! We actually don't know what the cost of her ProZinc is going to be from them. I was overwhelmed in the initial call and didn't ask any pricing information and when I asked how we get the insulin, the vet tech I spoke to said that they provide it and I didn't think to question that. I just called the office and was told that they don't have a doctor in today (interesting because I was supposed to have an appointment today...) and they won't write a prescription without seeing her, so I feel pretty stuck. I greatly appreciate the option to vent here though!

We also tried some of the all meat treats this morning without success with our sugar baby (my other cat hoovered them like she does with all food). We will keep offering them and hopefully she will start getting interested in them!

 

[Diane Tyler's Mom GA]

@Auri's Mom
Well that stinks , see what they charge you next Wednesday for the Prozinc and if it's more than what Chewy will charge ask the vet can you get it from Chewy next time. But between the shipping cost from Chewy you might be better just getting it from the vet

Also maybe Auri might like these
You can get any freeze dried treats ,information is there
https://www.felinediabetes.com/FDMB/threads/brand-new-many-questions-3.255627/#post-2878703

Freeze dried treats that only contain one ingredient (the meat or fish) is zero carb andfine to feed to a diabetes

 

[CORKY]

@Auri's Mom
Well that stinks , see what they charge you next Wednesday for the Prozinc and if it's more than what Chewy will charge ask the vet can you get it from Chewy next time. But between the shipping cost from Chewy you might be better just getting it from the vet

Also maybe Auri might like these
You can get any freeze dried treats ,information is there
https://www.felinediabetes.com/FDMB/threads/brand-new-many-questions-3.255627/#post-2878703

Freeze dried treats that only contain one ingredient (the meat or fish) is zero carb andfine to feed to a diabetes

Chewy charges $120.26, it is delivered in an ice box

 

[Sienne and Gabby (GA)]

I would have been seriously annoyed with my vet if that had happened. You may want to consider the insulin choice if you re going to purchase insulin from your vet. You would either need a prescription to leave with Chewy as a back-up or ask the vet to consider prescribing glargine (Lantus) since every human pharmacy stocks it. The vet is making $$ by having you purchase insulin at their office. In case you need support for using Lantus, this is a link to the guidelines for treating diabetes from the American Animal Hospital Assn. Prozinc and Lantus are the two insulins that are recommended.

Given the delay in starting insulin, I'd encourage you to start home testing now. It will give you time to practice so both you and Auri get used to the process. It will also allow you to be certain that her numbers are not scary high. Since you mentioned that she typically doesn't like to be held or touched, quite of few of our members use a continuous glucose monitor (CGM) like the Freestyle Libre on their cat. This is a monitor that has a sensor that it attached to your cat and you can read glucose levels on a phone app. The Libre is not without its down side (i.e., it tends to read incorrectly low if your cat is in lower numbers) and some cats are like Houdini when it comes to removing the sensor. However, for a cat that doesn't like to be handled, it has been very useful.

You might see if you can find any jerky style treats. Would Auri consider Churros or any of the brands of lickable cat treats?

 

[Auri's Mom]

Hi all, I apologize for the delayed response - Auri was not acting herself this morning so we made the decision to bring her to the emergency vet. She was found to be in DKA and will be hospitalized there for the next few days while they help her get stabilized. Unfortunately, since her BG was only 300, emergency vet is worried that something else is going on. I am beside myself with worry. I thank everyone who has given me advice over the last few days.

 

[CORKY]

Hi all, I apologize for the delayed response - Auri was not acting herself this morning so we made the decision to bring her to the emergency vet. She was found to be in DKA and will be hospitalized there for the next few days while they help her get stabilized. Unfortunately, since her BG was only 300, emergency vet is worried that something else is going on. I am beside myself with worry. I thank everyone who has given me advice over the last few days.

Hoping Auri gets better soon. Keep us in touch

 

[Diane Tyler's Mom GA]

Sending prayers for Auri

 

[Sienne and Gabby (GA)]

Michaila --

Your instincts were completely on target. I'm glad you got her in to the emergency vet. Ketones are not something to be taken lightly. Many of us began our feline diabetes journey with our cats hospitalized for diabetic ketoacidosis. We have lots of information to support you when Auri comes home.

I would let your vet know what the consequences were of their not having insulin available and not advising you that a human insulin is an effective treatment. That was a very poor choice on their part. You may want to see if there is a cat only practice in your area. If I were in your shoes, I'd not have a great deal of confidence in this veterinary practice.

You may want to think about bringing a smelly t-shirt to the vet hospital. Having something that smells like you may be a calming influence.

 

[CORKY]

Corky and Auri almost look like twins!

One common brand of freeze dried treats is Purebites, but there are others. Purebites comes in all sorts of protein types. A fav here is anything from heart, such as turkey heart pieces. Liver bits are usually popular too. From what I see, the Wellness Kittles have peas, potatoes and chick peas in them, all high carb. Try to find something that is just one ingredient, the meat. Do be careful of deli meats, some of them are brined in sugar.

yes they are both very similar

 

[Auri's Mom]

Michaila --

Your instincts were completely on target. I'm glad you got her in to the emergency vet. Ketones are not something to be taken lightly. Many of us began our feline diabetes journey with our cats hospitalized for diabetic ketoacidosis. We have lots of information to support you when Auri comes home.

I would let your vet know what the consequences were of their not having insulin available and not advising you that a human insulin is an effective treatment. That was a very poor choice on their part. You may want to see if there is a cat only practice in your area. If I were in your shoes, I'd not have a great deal of confidence in this veterinary practice.

You may want to think about bringing a smelly t-shirt to the vet hospital. Having something that smells like you may be a calming influence.

I greatly appreciate your response and I do plan to look for another vet. Not only did they cancel on us, but they were unapologetic and unkind when I pushed back.

Unfortunately, we heard back from the emergency vet and it was not good news - an ultrasound revealed intestinal lymphoma, which apparently explains why she was in DKA with a “low” blood sugar. The emergency vet was very kind and stayed on the phone with me for a long time while we discussed options. They are going to watch her tonight and we will have a call with the oncologist tomorrow about whether she is a candidate for chemo. At best, it appears we will have a few more months with her. I am heartbroken. I greatly appreciate all of the information I received here and how willing every poster was to try to help us. Thank you all.

 

[CORKY]

I greatly appreciate your response and I do plan to look for another vet. Not only did they cancel on us, but they were unapologetic and unkind when I pushed back.

Unfortunately, we heard back from the emergency vet and it was not good news - an ultrasound revealed intestinal lymphoma, which apparently explains why she was in DKA with a “low” blood sugar. The emergency vet was very kind and stayed on the phone with me for a long time while we discussed options. They are going to watch her tonight and we will have a call with the oncologist tomorrow about whether she is a candidate for chemo. At best, it appears we will have a few more months with her. I am heartbroken. I greatly appreciate all of the information I received here and how willing every poster was to try to help us. Thank you all.

I am so sorry for the bad news, you are been a great mommie, others would’ve given up, hang in there there’s still hope my prayers to you and Auri

 

[Christie & Maverick]

I believe Wendy @Wendy&Neko has experience with small cell lymphoma and if memory serves, her kitties had several years with treatment.

 

[Wendy&Neko]

I'm glad you took Auri to the ER - best place for her right now. We'll all be thinking of you and Auri and hoping for the best.

an ultrasound revealed intestinal lymphoma

First of all, you can't tell what type of lymphoma with just an ultrasound. Did they say small cell lymphoma or large cell lymphoma? Is there a mass or general thickening. General thickening of the bowels is small cell lymphoma or IBD - you need a biopsy to see exactly which one. IBD is generally as a result of food allergies, Small cell lymphoma is a very slow growing cancer and with a mild chemo protocol a lot of kitties go into remission. The one snoring near me was diagnosed in 2018 and is currently in remission. My previous two kitties with SCL (one in remission) ended up passing from something else.

Large cell lymphoma needs a more complicated chemo, but can still be treated though prognosis is not as long. One of the kitties currently around in the Lantus forum was diagnosed with large cell back in April this year. Cats tend to handle chemo fairly well.

 

[Auri's Mom]

@Wendy&Neko

I really appreciate all of the information - the emergency vet did not say “large” or “small” - I am not well versed in medical terms but I know she definitely did not say either of those things. I did ask her about what our options were and what amount of time we could expect and she said “a few weeks or months of good time”. They do not do chemo at their facility so they are putting us in touch with a hospital that could take her as early as Monday. At some point, we will have to start considering cost as the emergency vet was already $4,500 on the low estimate and I am not sure we can afford to keep her in a hospital for very long at those costs (which is devastating). BUT, I do not have all of the information to make those decisions yet. It sounds like today I need to be asking:

1) Is it large or small cell?
2) Is she a candidate for chemo and what does that process look like? How will it affect her?
3) Given her age and current health, how much time with good quality of life could we get with chemo treatment?

The doctor is supposed to be calling me before noon EST today. I spoke with the staff last night before I tried to sleep and they said she was doing okay, but still wouldn’t eat. I am not surprised - she is very stubborn with food

 

[Auri's Mom]

A little bit of good news - Auri was discharged from the emergency vet this afternoon. She would not eat for them, but they gave her an appetite stimulant and when we got home, she took some food from my hands and then went to her bowl. She also got lots of treats and cuddles. She is definitely weak and tired, but we have a week of steroids to give her and will be following up with the oncology vet this week. The vet tech who helped discharge us actually works at both facilities and was really wonderful to talk to. They did a BG curve while she was there and the emergency vet says they do not want her on insulin right now, so we are going to try to test at home and keep a record for the oncology vet. We are really grateful for the emergency vet staff.

 

[Sienne and Gabby (GA)]

If she's not getting insulin, please get Ketostix. These are urine test strips that will let you know if ketones are present. Treating ketones is expensive! Testing for ketones is a good means of preventing a major problem.

 

[CORKY]

If she's not getting insulin, please get Ketostix. These are urine test strips that will let you know if ketones are present. Treating ketones is expensive! Testing for ketones is a good means of preventing a major problem.

Auri is beautiful, I am glad to hear good news! a good appetite medication is MIRATZ, just rub a small amount in the upper inner ear once a day exchanging ears for 5 days, and she will devour her food, it's awesome

 

[Auri's Mom]

If she's not getting insulin, please get Ketostix. These are urine test strips that will let you know if ketones are present. Treating ketones is expensive! Testing for ketones is a good means of preventing a major problem.

I can absolutely get these. It looks like Target has them by me, so I can get them in the morning. I am going to work from home so I can keep an eye on Auri.