So frustrated with treating diabetic cat

[fordtraktor]

My delightful kitty Dempsey, he with seven toes who is a stand in for Larry the Cat of 10 Downing Street fame, was recently diagnosed with diabetes. I am so frustrated with trying to get his blood sugar in order. I took him in for a glucose curve, and he did well at first then went scarily hypoglycemic, so I was sent home with instructions to make sure he eats, then an hour later gets 2 units insulin once a day. I took him back for a retest an hour after his insulin on Monday, and his glucose level was over 600. Omg. So now he is on twice a day, 2 units, but he just doesn’t look right.

he also is extremely prone to urinary crystals and blockages, so is on special food for that. He has done well on it for 4 years…

he is very good about his shots, but I do give him a couple of cat treats after so he shows up reliably (he is indoor/outdoor and he will NOT be happy if I change that. We live on a farm and he loves his freedom.)

i can’t seem to find cat treats that even say they are low carb. His UTI food…I don’t know, they don’t even list carbs. None of them seem to.

advice? He seems happy, just…frail. He is only 12 and was never overweight.

[Marshfield]

I’m not a big prescription diet veterinarian–but, I believe Hill’s w/d is considered a good food option for both urinary issues and diabetes. Canned is best. For cat treats; get freeze dried something. My hospital cat is bonkers for freeze dried chicken or freeze dried rabbit. VitaEssentials makes the rabbit. Freeze dried meat will be low card

[fordtraktor]

@Marshfield thank you, I will get some of those and see about switching him to the w/d.

[Angela_Freda]

@fordtraktor

My delightful kitty Dempsey, he with seven toes who is a stand in for Larry the Cat of 10 Downing Street fame, was recently diagnosed with diabetes. I am so frustrated with trying to get his blood sugar in order. I took him in for a glucose curve, and he did well at first then went scarily hypoglycemic, so I was sent home with instructions to make sure he eats, then an hour later gets 2 units insulin once a day. I took him back for a retest an hour after his insulin on Monday, and his glucose level was over 600. Omg. So now he is on twice a day, 2 units, but he just doesn’t look right.

You need to test at home, three times daily at least. I can send you my meter and supplies. Do curves at home too. It will save you money, and save your cats life
His BG is likely bouncing, 2 units is a lot.
So you dose 2 units, he goes way low, then rebounds back up higher.
His optimum dose is likeliest less, and he’ll feel way better without those peaks and troughs.
What kind of insulin (name).
You need syringes with 1/2 unit marks. Most cats don’t need a full unit. Seriously.
How long have you been doing this? I’d advise keeping a diary.
You need a hypo kit. High carb food, some corn syrup, small syringes to force feed if needed.

he also is extremely prone to urinary crystals and blockages, so is on special food for that. He has done well on it for 4 years…

You want him on a wet food with under 10 carbs. You can add water so he hydrates and flushes those crystals.
I think the cat food chart is Dr Emily’s… ill find it for you.
Dr Pierson

https://catinfo.org/docs/CatFoodProt…horusChart.pdf

Rx foods are at the end of the list, all together.

he is very good about his shots, but I do give him a couple of cat treats after so he shows up reliably (he is indoor/outdoor and he will NOT be happy if I change that. We live on a farm and he loves his freedom.)

The risk is him eating carbs while out and about.

i can’t seem to find cat treats that even say they are low carb. His UTI food…I don’t know, they don’t even list carbs. None of them seem to.

Treats: Simply Fancy Feast They are low, low carb. Cheese. Bone broth.

advice? He seems happy, just…frail. He is only 12 and was never overweight.

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[Angela_Freda]

All that said, honest, this is not hard. Does it take some training? Sure, but this is totally do-able. There’s lots of help out there.

[fordtraktor]

@Angela Freda Thank you so much. My vet didn’t suggest this level of maintenance as an option. Did your cat mind the lancets? I am worried about the cat hating it, and also sometimes 3 times a day is not possible because work, kids, farm. I can commit to 2 shots on a 12-hour schedule consistently. His bloodwork has never been under 500 so far.

[HenryisBlaisin]

Most vets don’t recommend home testing–no idea why. It’s really not hard. Also look up the tight control protocol of you are using Lantus insulin–you learn to adjust the dose based on test readings. It’s more work, but the rate of remission using that method is very good–much higher than other protocols. I didn’t get full remission with my guy (his issues were compounded by hyperthyroidism), but his levels were so much better and he felt good. Look online for the Feline Diabetes Message Board (FDMB). The people there are knowledgeable and very supportive. They helped me through some issues when my vet was stumped and some sleepless nights from worry and there are some good resources for reasonably priced test supplies etc there as well.

[Angela_Freda]

@fordtraktor

@Angela Freda Thank you so much. My vet didn’t suggest this level of maintenance as an option. Did your cat mind the lancets? I am worried about the cat hating it, and also sometimes 3 times a day is not possible because work, kids, farm. I can commit to 2 shots on a 12-hour schedule consistently. His bloodwork has never been under 500 so far.

Testing was easy, once I got over it. Once they learn your routine, its not that hard at all. I would come downstairs, unzip my meter case, and Meow would be on his towel on the counter ready to test. It literally took five minutes, tops.

”‹”‹”‹”‹”‹”‹Testing really is imperative to good management, otherwise it’s like throwing a dart at a dart board in the dark. Blindfolded.

After 10 days of diet change, and testing, then 4 doses of Lantus he was in remission.
That lasted over a year, then it came back way worse, and very high, uncontrolled, in the end he had acromegaly, a tumor on his pituitary causing his bg to be super high. But that’s pretty rare.

What insulin are you using?

[fordtraktor]

@Angela Freda

Testing was easy, once I got over it. Once they learn your routine, its not that hard at all. I would come downstairs, unzip my meter case, and Meow would be on his towel on the counter ready to test. It literally took five minutes, tops.

”‹”‹”‹”‹”‹”‹Testing really is imperative to good management, otherwise it’s like throwing a dart at a dart board in the dark. Blindfolded.

After 10 days of diet change, and testing, then 4 doses of Lantus he was in remission.
That lasted over a year, then it came back way worse, and very high, uncontrolled, in the end he had acromegaly, a tumor on his pituitary causing his bg to be super high. But that’s pretty rare.

What insulin are you using?

The insulin my vet gave me is ProZinc. I will google Lantus.

So sorry for your loss. I totally get that anything else is not really effective. How could it be? I don’t care about the time, just the quality of life sticking my poor kitty. If you PM me I would be happy to purchase your testing stuff, just tell me what is fair. I don’t like to waste if you no longer need it, I would prefer that to ordering new. I am not squeamish and can do the tests as long as he Ok about it and happy.

[fordtraktor]

another question…do you feed only a certain amount on a set schedule or do you leave remainders out? I leave his leftover food out now, hoping some instinct has him regulating based on how he feels.

he hasn’t had a crystal in 4 years or more, I have emailed the company of his current food asking about carbs.

[Angela_Freda]

I free feed. If the glucose is high the food they are eating isn’t satiating their body’s hunger because there’s no insulin to help it get into the cells… so they are, in effect, starving.
Meow ate up to 5 or six 3 oz cans a day at times. Yes that seems like a lot, but if only a portion reaches his cells because of low insulin… it makes sense to feed as much as you can
That amount went way down when he was controlled.

Yes, they will eat to self regulate. The only thing you want is for them to not have just eaten a lot right before testing. So really the more frequently they nibble, the better.
To that end I had several timed feeders that I set to offer him food every 4 hours or so. That meant that before his tests he got offered food that he could consume well before testing, so that his bg would be right where it needed to be, not high or low based on a need for food.

ETA a few more thoughts

How much does it cost to take cat to vet for curves?
How often are you supposed to do that?
Consider the time involved in catching and crating the cat, driving to vet, and then picking back up and driving home, on top of the cost and the stress on all involved.

Now consider that the cats curve readings are skewed by the stress of all that, so really not helpful.
”‹”‹”‹”‹
Yes, learning to test means he will stress some, but once its a routine, he won’t, and you’ll be getting much more accurate info to properly treat him, which will save you more time and money, because he won’t end up at the vet for a hypoglycemic event, or ketoacidosis, which will cost you $$$ if it doesn’t kill him.

@HenryisBlaisin’ why don’t vets encourage clients to home test?
Because clients resist, thinking its hard and that doing it at the vets is good enough.
We would never tell a diabetic person not to test, to just guess, inject insulin and get tested once a week/month. It’s hard to fathom why anyone thinks that’s a reasonable treatment plan for an animal with the same disease.

I’m not knowledgeable about insulins besides Lantus/Glargine, but from my understanding the others stink, in part because their efficacy means poor treatment/control, which means the cost goes up.

[Marshfield]

There are options now for implanting a Freestyle Libre to help monitor blood glucose levels. I haven’t done it yet, but have seen it mentioned on veterinary forums

[Angela_Freda]

@fordtraktor how is kitty doing?

”‹”‹”‹”‹”‹”‹@Marshfield, someone on the Feline Diabetes Facebook page had the Libre implanted in their cat. I can’t recall now what the limiting complication was, but it certainly is an amazing thing, alongside the pumps some humans with diabetes have, towards better management of this disease for any species.

[fordtraktor]

@Angela Freda

@fordtraktor how is kitty doing?

”‹”‹”‹”‹”‹”‹@Marshfield, someone on the Feline Diabetes Facebook page had the Libre implanted in their cat. I can’t recall now what the limiting complication was, but it certainly is an amazing thing, alongside the pumps some humans with diabetes have, towards better management of this disease for any species.

To be honest it is a nightmare. I bought an AlphaTRAK2 system to monitor him. His levels are almost always dangerously high despite his high dose of insulin, except when they drop really, really far (only happened once and he outwardly looked the same). I am terrified he is going to get organ damage before I can get this under control. What is the Diabetic Cat forum you use? I need more guidance. I also don’t know what to adjust in his meds, if anything, if his levels are off as so many things say to keep it consistent…but with crazy changes in levels, I worry constantly now as I give him the amount the vet recommended and cross my fingers.

Also, he absolutely HATES the testing and lancet pokes. Hates them. He has been so good about the shots, but this is totally different and he struggles and cries piteously. I am as gentle as possible and this system needs very little blood, but it is not going well.

to be specific, when tested it usually ranges from 450 to 600, except that time it was thirty freaking five. I have never once got a result in a normal range in 3 days of testing 3 times a day. My nerves can’t handle this. He is on 2 units of ProZinc twice a day, with free choice high protein low carb wet food. He is drinking like a fire hose too, so clearly isn’t feeling better.

[HenryisBlaisin]

If I were you, I’d ask about switching to Lantus. It’s well-proven in cats. Personally, I used the Feline Diabetes Message Board when I did this–look at what they have to say about the tight control method with Lantus-you adjust the dose based on daily readings and periodic curves, and it has a high rate of remission if you start it ASAP. The people there are great, very knowledgeable, and can for sure give you tips for better testing. Personally, I had good luck using a lancet pen, which delivers the poke much faster, and the tiniest lancets I could find. Plus, he got a treat (freeze dried chicken or shrimp) during and after every poke which helped a lot.

The tight control method is scary at first–you will learn to inject even when levels are relatively low and to adjust for highs and lows, but it can pay off. It made a huge difference for my Mikey.

[Angela_Freda]

@fordtraktor

To be honest it is a nightmare. I bought an AlphaTRAK2 system to monitor him. His levels are almost always dangerously high despite his high dose of insulin, except when they drop really, really far (only happened once and he outwardly looked the same). I am terrified he is going to get organ damage before I can get this under control. What is the Diabetic Cat forum you use? I need more guidance. I also don’t know what to adjust in his meds, if anything, if his levels are off as so many things say to keep it consistent…but with crazy changes in levels, I worry constantly now as I give him the amount the vet recommended and cross my fingers.

Also, he absolutely HATES the testing and lancet pokes. Hates them. He has been so good about the shots, but this is totally different and he struggles and cries piteously. I am as gentle as possible and this system needs very little blood, but it is not going well.

to be specific, when tested it usually ranges from 450 to 600, except that time it was thirty freaking five. I have never once got a result in a normal range in 3 days of testing 3 times a day. My nerves can’t handle this. He is on 2 units of ProZinc twice a day, with free choice high protein low carb wet food. He is drinking like a fire hose too, so clearly isn’t feeling better.

How old is he?
When Meow relapsed and was super high and all over the place, no matter how high the dose -we eventually tested for acromegaly at Michigan State (I think? Google it) and they sent a whole kit to do it, I believe, and then Mich gets it and tests… And yes he had a tumor in his pituitary causing high uncontrollable diabetes, bg
it is incredibly scary when they dip low, but at least now you know so you can take action if you need to.

The problem with the Diabetes group is they will want data. If you do not have their chart, filled out with tests at varying times in the 12 hours between sides, and curves, they won’t help you much.

They also tend to hate the AT2 meter and will give you a hard time about using it.

For testing I used a 32g lancet, freehand. I hated those lancing tools. You can find the vein at the edge of the ear, I folded the ear inside out to test on the inside… and Bam, done.
I have a video somewhere of my testing Meow. If I can find it, I’ll post it.

[fordtraktor]

@Angela Freda

How old is he?
When Meow relapsed and was super high and all over the place, no matter how high the dose -we eventually tested for acromegaly at Michigan State (I think? Google it) and they sent a whole kit to do it, I believe, and then Mich gets it and tests… And yes he had a tumor in his pituitary causing high uncontrollable diabetes, bg
it is incredibly scary when they dip low, but at least now you know so you can take action if you need to.

The problem with the Diabetes group is they will want data. If you do not have their chart, filled out with tests at varying times in the 12 hours between sides, and curves, they won’t help you much.

They also tend to hate the AT2 meter and will give you a hard time about using it.

For testing I used a 32g lancet, freehand. I hated those lancing tools. You can find the vein at the edge of the ear, I folded the ear inside out to test on the inside… and Bam, done.
I have a video somewhere of my testing Meow. If I can find it, I’ll post it.

Ugh, the whole thing is awful. He is 12 so not ancient, but not a youngster either.

I researched multiple meters and the AT2 was the most recommended at a reasonable price. I will try the ear, maybe he won’t mind it as much. I tried freehand on his paw and he is pitiful, so much so I couldn’t get a result midday today. He struggled so as I was trying to get a reading I had to stop.

My biggest problem is that Dempsey looks completely the same whether his glucose level is 600 or 35. and it can swing such in the space of a couple of hours like day before yesterday. He continues to test wildly erratically. I wouldn’t be surprised now if he also has a tumor, given what you have said. This week I will ask the vet to investigate it. My vet is very good, but also says that cats like mine with highly swinging glucose levels are the hardest to treat and most dangerous because a mistake can kill them. He didn’t give me good odds.

[Go_Fish]

My diabetic cat does well on Tiki Cat but I hear it’s not available everywhere. No carbs…just meat and needed vitamins and minerals. I buy the chicken in consomme.

[Angela_Freda]

The AT2 is fine. It’s all about the number relative to your cat. People like to poo poo it, but they’re numbers. They’re meaning us for you to decide.
I never tested a paw, ears only, ever. Super easy, have him up on the counter, makes it easy to hold him when you need to early on, and test.
I used strips from the Freestyle lite in the AT2 with success for less expensive strips. You can get those or the AT2 strips on Amazon for some savings.

Also if you switch to Lantus, get the RX card from makers, Sanofi to use to get it for $30 a pen.

I would consider getting him tested for acromegaly. I wish I’d done it sooner.
are you on Facebook? There’s a feline diabetes support page that is good, and the acro testing info is there. There’s another thing to also test for, I can’t recall what it is though, but same situation if high, unresponsive bg and can be done with the acro test, sent to Michigan.

And be sure you have a hypo kit on hand. Though since he swings back up… It’s hard.

[Angela_Freda]

If I can get on my desktop I’ll find the acro testing info and post it for you.