Sidney's mom. Back from the Vet

Hi all, I posted this on the introduction thread, but here is some background. I also posted an update below.

I'm totally new to all of this, and I'm here because I'm feeling totally overwhelmed and anxious.
A bit about me: My name is Jen, I'm a work-at-home romance author.
My cat, Sidney, is 12 years old.
He's a little over 12 lbs, and last Wednesday he started vomiting. Vomiting other than a hairball is unusual for Sid. He puked four times in twelve hours before I packed him up for the vet.
He got an anti-nausea shot, take home sulcrafate, and blood work done.
His bloodwork came back with a glucuse level of 20.3 (I'm in Canada). The vet phoned and said it was high, but he wanted to do a urine test in a week (giving time for the levels to lower) to see if it was related to stress from the vet visit. He said he'd not seen a level *that* high for stress, but he wanted to be thorough.
I stopped the Sulcrafate on Monday at his direction, and we did the at home urine test with the special litter yesterday, and I delivered the sample.
The sample had blood in it according to the vet, and had sugar evidence as well.
Today, we take Sid back to the vet to get an antibiotic for the UTI and a fructosamine test, which supposedly determines once and for all if he is diabetic.
None of this makes sense to me, quite honestly. Sid isn't really overweight. He does NOT drink a lot of water, barely anything, really. He pees about four times per day, maybe five tops.
He eats every four hours in a 24 hour period- a half a can of fancy feast pate or chicken and cheese (I alternate). So he isn't really showing "typical" diabetes symptoms.
I'm a bit mentally exhausted over all of this, considering what is likely ahead of us in terms of diagnosis for Sid.
We lost our cat Miss on New Years Day 2018 to acute kidney failure. She was an IBD cat and we spent thousands, and I mean THOUSANDS, keeping her stable, and with various hospital visits.
I'm afraid because I don't have that kind of money to spend on Sidney at the moment. So I'm here, just needing some reassurance, or something, that I can get through this again. That familiar anxious feeling of having a sick animal is all too familiar and I am just stressed to the gills.
Weirdly, other than the vomiting episode, Sid *seems* to be doing okay. He's grooming, enjoying cuddles, an posing, something he likes to do for attention, where he rolls on his back with his feet in the air to get tummy rubs. He's eating his meals. He *is* sleeping a lot, but both my cats are big snoozers.
When they were just on a "feed me, I'm hungry" schedule, he was a LOT more vocal. A lot more picky. Now that I've limited the food to four hours, he's not as vocal and seems to know what to expect.
Anyway, that's our story. We are kind of in limbo mode.
Thanks for listening!

**UPDATE:** Sid got his antibiotic shot and the vet did the fructosamine test. He also did a blood glucose at the office via the AccuTrakker? And it was 22. He believes Sid is likely diabetic, and the official diagnosis is leaning this way. I get the results of the fructosamine test tomorrow, then I guess Monday we go in and learn how to do insulin if that is positive. He also lost a bit of weight. He is 11.7 and was 12.3 last week.
Vet is all about learning online, going on YouTube and testing at home, so that's good news. He thinks it's likely early stages, so I guess that's good.

I have to go out tonight and get some more cat food, shop, and eat myself. We won't be gone long but I am worried leaving Sid. I'm one worried mama.

I would appreciate some help on how to get started gathering testing supplies. Where to go, what to get. Any Canadians that have links to less expensive things...it would be helpful.

 

The Fancy Feast pates are fine, as are Friskies pates. You want to keep Sidney's food in the low carb range (below 10%). The Fancy Feast Grilled Chicken and Cheddar Cheese in Gravy is considering high carb, coming in at a whooping 20%. Put it in the back of your cupboard and use it in case Sidney has a low numbers event after starting insulin.
There is a food chart here. There is no acceptable dry food available in Canada. The vet may want you to switch to a prescription diabetic food. Only the Purina DM pate is low carb. You are better off sticking with Fancy Feast. Any prescription food can be returned to the vet for a refund. Just say your cat refuses to eat it.

Canada only canned food list is here:
Canada

• Food Chart

Just to get your head around the numbers while looking at other posts, you multiply the world (Canada) numbers by 18.

Fructosamine test information. The test gives you an average and is useful only for diagnosis. If you are home testing, you do not need to repeat the test.

Lantus, a human insulin, is cheap in Canada. A 5 pack of pen vials will last you a very long time. In the $120 range. You can buy from any pharmacy. A prescription is not needed for Lantus if it is intended for an animal. Only humans need a prescription. Just tell the pharmacist that the insulin is for your cat. Costco, I believe, is the cheapest. You do not have to buy Lantus from the vet.

Prozinc is also a good insulin for your cat. You do have to buy it from the vet. Other pet insulins were designed for dogs and can be harsh. Information about the various insulins can be found at the top of the various insulin threads.

Glucometres. This is where your costs are going to lie. Many Canadians use the FreeStyle Lite metre. Strips are roughly $80/100, and you will be going through more strips than you can now imagine. For a cost comparison, the AlphaTrak pet meter strips are $2/strip. Your vet may insist on a pet meter. Tell them you cannot afford the strips.

You will want a meter that takes the smallest drop of blood. There are numerous tips and testing videos on the forum. We can help with that.

I've probably overwhelmed you already. Here is a list of questions you may want to bring up at the vet appointment. Read through the FAQs page to get an idea of Feline Diabetes (it does need upgrading to include Lantus) and read through the yellow stickies at the top of each of the insulin forums.

 

Hi, and welcome from BC. Around me, Safeway Pharmacy was my cheapest source of insulin, syringes and lancets. I live near the border so cross border shopped for a blood glucose meter and test strips. Many people buy test strips on eBay, they are the expensive part. Look for a meter with as small a blood drop required as you can find. It’ll make your life easier. Aviva and Bayer are alternatives to Freestyle. Do shop around, prices can vary by up to $10 a box of syringes. Wait until you know which insulin first before buying syringes as Prozinc and Lantus use different ones.

A large number of the cat foods on the catinfo website are available in Canada. You want carbs under 10%. Raw food is also an alternative. I found making my own with a premix a pretty cheap way to go. Any other pets in the house? A number of cats steal others dog or cat food.

We occasionally get surprise diabetics, blood sugar found to be high when blood tests done for other things, like dentals. Hopefully that means you caught it early. UTI or other infection/inflammation can raise blood sugar numbers. Treating the UTI will help.

 

Hi, Jen. Welcome to FDMB.

I am not in Canada so I cannot help you with the glucometers there as I believe the Walmart brands are unavailable (?) in Canada. Here is a list of the testing supplies you'll want to stock up on though.

• Vaseline: Use this to lightly coat your cat’s ear to help the blood to “bead up” during testing.
• Cotton Balls/Pads: Use these to hold behind your cat’s ear to prevent getting pricked. You can also use them after to wipe excess blood from the ear.
• Rice Sock: Any old sock will do, simply fill it with rice and heat it up about 10-15 seconds to gently rub on your cat’s ear to draw blood to the prick sight. It can also be used in lieu of a cotton ball/pad to hold against the back of the cat’s ear.
• Lancets: These are used to prick the ear to make small blood drops. Starting out use a larger gauge size (like 26) then go smaller after the ear “learns” to bleed.
• Lancing Device: This device is optional, as some caregivers prefer to prick the ear freehand. This device will make a small clicking noise when it fires and will poke the ear with the lancet.
• Neosporin Ointment: Use this to lightly coat your cat’s ear after it has been pricked to promote healing.
• Glucometer: There are many glucometers brands; any will do. Specialty pet glucometers are the most accurate and the veterinarian standard; however human meters are significantly cheaper to use and still provide a fairly accurate reading.
• Testing Strips: Strips must match the glucometer. Consider the price of testing strips before purchasing a glucometer; many times the meter is cheap or free and the testing strips are expensive. This is especially true with pet meters.
• Ketone Testing Strips: These strips are fairly cheap and last a while. They are designed to test the level of ketones present in the urine.

 

In Canada, we get Polysporin Complete, with pain relief, instead of Neosporin. Black and yellow box.

 

Hi Jen and Sidney, welcome from another Canadian. It's not medical advice but it might help to know weight often has very little to do with diabetes. We had a 28 lb. beast that never showed any signs and both our sugar cats were young and slim when they were diagnosed. If you're as lucky as I was money was never a big issue once we got into a study routine. There are obviously other issues that go along with diabetes but you cannot learn all there is to know in one bite. We tried and it was just too much. Read what we call "Stickies", what look like PostIt notes at the beginning of each forum, and take it one day at a time. What worked for me was printing this stuff to digest on the sofa and away from the computer.
You're in the right place, you'll find practical knowledge and compassion here.
At the beginning I was tearing my hair out until I read Dear Mom. It should be required reading.
http://www.felinediabetes.com/dear-mom.htm

 

Hi Jen and Sidney and welcome to Fdmb. So glad you found us.
It can be a lot to take in in the beginning, but as you learn and get into a routine, it will get much easier.

I’m really pleased you are going to home test. It’s the best things you can do to keep Sidney safe.

It’s a great community here. As all the questions you like, we are happy to answer them.

 

Jen and Sidney, welcome to FDMB from a fellow Torontonian. You've already got lots of excellent info to get you started. There's lots to learn but as you can see, there are a lot of us here willing, ready and able to help you navigate this new journey. What seems overwhelming now will be easy in a very short time and we are here to help in any way we can. Looking forward to getting to know you and Sidney.

What part of the city are you in?

 

I just want to thank every one for your kind words, suggestions, and knowledge. It doesn't help having anxiety while I get news like this. The waiting...waiting to hear definitely about whether he has this. Knowing he has the UTI (though he got an antibiotic shot for it) and knowing he's untreated right now is feeding the anxiety. Odds are if the fructosamine test shows things for sure, we will start insulin Monday. I don't have any testers or anything at the moment. I'm waiting for a definitive diagnosis and then tomorrow afternoon / Sunday will be where I try to obtain my supplies. I just want him to stay stable between now and then.
I don't know enough about this disease, but I'm going to be educating myself. I'm also on deadline to finish this book and it's such a struggle to concentrate knowing my baby is not feeling well.
Tonight is the FIRST night I have seen him pee an amount that would make me suspicious. He had a HUGE pee after the vet, then another pee two and half hours later that was big but not near as much, and then another decent sized pee. So three within five hours...that makes me think yeah, well, something isn't right. However I know he has a UTI so that would make him pee more. But I didn't notice it yesterday.
Anyway, thank you all again. I'm sure you will get to know me well and vice versa on this forum!

 

What part of the city are you in?[/QUOTE]

Hello, Linda! (And the other Canadians here as well)

I am in Don Mills, bordering on Scarborough. Near Eglinton Square. Where are you?

 

I'm in the west end ....in Etobicoke. There are a number of members from Canada here some in the GTA and surrounding area but the vast majority of folks are in the US. We also have members from Australia, India, France, Germany, UK etc so we are quite the melting pot here and one big happy family.

If I can help with anything, just holler.

 

Did the vet draw urine for a culture? That's the only way to know which bacteria is causing the UTI, and to make sure you are giving the right antibiotic. You didn't say which antibiotic, but I'll bet it's Convenia, most of the other antibiotics are pill or liquid.

Good luck with the book. You'll have to do that on your own. You've got us to help you with the feline diabetes.

 

Welcome!
I feed President's Choice Extra Meaty chicken pate. I've found it to be the best quality for lowest carb at a low price.

 

Jen - I don't think there's a single person on this board who hasn't been overwhelmed and scared when they found out their cat was diagnosed with FD. A frequent "welcome" is to mention that FDMB is the best place you never wanted to be. We've all been in your shoes. I'm not prone to anxiety and I was a wreck. I speak fluent medicalese and as a result, the emergency vet never even showed me how to give a shot because he thought I was an MD and knew how! What was worse is that I was so rattled over Gabby being diagnosed and so happy she survived DKA, pancreatitis, and hepatic lipidosis that I didn't realize no one had given me any instructions on how to give an injection, my usual vet's office was closed, and I hadn't found this board yet. (I watched a lot of YouTube videos.) The not knowing is always hard but from everything you've said, all indications are that Sidney is diabetic. You will have an amazing amount of support here along with a great deal of knowledge and experience that you can tap. This is an incredible place where people are very generous with their time and expertise. Please don't hesitate to ask questions. People truly do want to help. There are many of us who have been paying our experiences forward for literally years.

Since you won't be getting your supplies for a bit, if you haven't already done so, how about switching Sidney to a low carb (below 10% - although most use foods that are around 5% carb) diet?

@Noah & me (GA) - just an FYI. Obesity can be related to diabetes. This post from Cornell's Feline Health Center makes note of the relationship. You are correct in that not all overweight cats develop FD nor does being at a healthy weight guarantee that your cat won't become diabetic. It's likely multifactorial but obesity can be a related to diabetes, just like in humans.

 

Thank you so much for your kind words, S&G! I have Sidney on Fancy Feast. The vet didn't want me to switch up his food too much before seeing him.

What I have been doing is giving him 1/2 of a small can every four hours over a 24 hour period, with water added to make it a little bit soupy, especially since he has a UTI. He gets Chicken Feast and Chunky Chicken Feast (I'm thinking those are the "classic" versions here in Canada, without them being called Classics), and every few cans I mix it up with a turkey and cheese. I know that's higher carb, but I'm not giving him the whole can, just a half. I was worried about doing any kind of turkey and giblets or turkey and liver pates since he had vomiting last week, and I thought that might be hard on his tummy. So I've been sticking to the chickens and turkeys.

I don't know much about the food and carbs yet, as I have to do some research later tonight on that.

I updated in my other thread that the vet wants to start Sidney at the lowest dose of insulin and work up if needed. He will be getting Caninsulin, but that's all I know for now. I feel comfortable with the low dose and working up, and he is an advocate of home testing.

 

I have a couple of thoughts. I'm also tagging @Wendy&Neko who's in Canada and her kitty started out on Caninsulin (Vetsulin here in the US).

Aside from the names of the foods in Canada, the best resource on feline nutrition is the website that has been around for quite some time and authored by a vet -- Lisa Pierson, DVM. It is her mission to correct the misinformation that abounds regarding feline nutrition. She is affectionately referred to around these parts as "Dr. Lisa." She will occasionally post on the Health board.

If you can persuade your vet, Caninsulin is really not the best insulin for cats. It's duration is too short, it's harsh, and it can cause numbers to drop hard and fast. At this point, it is no longer recommended for cats. In fact, Caninsulin was developed for use in dogs and as we all can attest, cats are not small dogs. The two brands of insulin that are recommended in the American Animal Hospital Assn guidelines for cats are Lantus (glargine) and Prozinc. The latter is a pet specific insulin whereas Lantus was developed for humans. (You'll need to follow a couple of links in the link I posted in order to get to the pdf of the guidelines.) There is a boatload of research on the use of Lantus in cats.

All of that said, there are cats here that have done well on Caninsulin. There are even more who have started on Caninsulin and switched to Lantus and done better.

 

Well, maybe it's in my best interest to purchase the Lantus and the appropriate needles / syringes tomorrow and take them with me to the appt on Monday. We don't need a script for insulin here. I'd rather start him out right.

 

You might want to bring the AAHA guidelines along so your vet doesn't think you are coming up with these suggestions based on the advice of all of the crazy cat ladies on the internet!

 

My girl was one of those that started on Caninsulin. Both she and I did better with her on Lantus, and ultimately Levemir. My vet had no experience with Lantus at the time. Frankly, not all cat owners treat when they hear the diagnosis. More dog owners do, so she was used to Caninsulin. A locum vet at the clinic got us going on Lantus. We were also the first clients to home test, and the vet was glad I was up to it.

Now that you have started out right with the food, testing can be next. First, make sure you have low carb treats. There are many varieties of freeze dried meat only treats, from Purebites to Origen. Lots of types of meat too, from chicken to kangaroo. Start with fondling Sidney’s ears, then giving a meat treat and praise. Then get your meter, test strips, cotton pads (makeup ones work fine), lancets. I believe one of your other posts had a good list of all to get, including the Polysporin for after poking.

It takes everyone a while to get going on testing. This from someone known to faint at the sight of blood. There were tears to start. It gets better, and ultimately easy. There are tons of videos, and links to these in the Health Links forum, as well as testing tips.

 

I don't know what to do to be honest. This is frustrating. I'm in a bit of a time crunch. Tomorrow is Sunday, the vet isn't in, so if he objects to the Lantus...I'm kind of screwed.. Why do they even OFFER Caninsulin if it's bad for cats? Now I'm just annoyed. I may be forced to start with the Caninsulin, but its' not going to help my anxiety any.

 

Call the vet today or Monday, shop for insulin Monday night. See if any other vets in the clinic use Lantus.

Starting on Caninsulin is better than nothing. You can test and gather data to see how Sidney does on it. Suggest you want an alternative if it doesn’t last long enough. Vets have more experience with Caninsulin, cause it's used for dogs. It’s not bad for cats, just not ideal.

 

Caninsulin will not hurt Sidney. Lantus and Prozinc are just better. If pharmacies around you are open tomorrow, you can always call and see if they have Lantus in stock. I can't imagine that they don't since it's a very popular human insulin..

The other issue is convenience. You can only get Caninsulin from a vet. Likewise, you need U40 syringes for Caninsulin and I haven't a clue how easy they are to find if you run out. (They are available online.) U100 syringes are likely to be far more accessible.

 

Thank you everyone. I'm going to try and ease into this as best I can. I'd like to talk to the vet and bring the insulin and proper needles for Lantus with me, if possible. I appreciate everyone's help with this very much!!

 

U100 syringes in Ontario can be bought in a box of 100 with no legal issue, it's not like that everywhere. I found Shoppers and Metro easier to deal with than Loblaws, sometimes they're restricted to selling only what their suppliers order. I can't speak for Walmart, the one out here is creepy.

 

If I end up *having* to go with Caninsulin (hopefully not), can it be given with smaller needles? To me, the smaller needle the better I think?

 

Yes, you can still use U-100 needles with U-40 insulin. Caninsulin and ProZinc are U-40, Lantus/Levemir/NPH are U-100.

Here is a chart to convert from U-40 to U-100.

I have a U-40 insulin but I use U-100 needles because they are smaller and more comfortable for kitties. Just read it over carefully if you end up using it.