Diabetic cat

My Jett (the same ol' troublemaker) continues to be the cat to keep us on our toes - now she's developed feline diabetes.  She's only 3, and she's a healthy weight (9.5lbs) according to the vet.  She was tested before she was fixed, at the beginning of March, and her levels were normal then, so this is a fairly recent development. 

We took Jett in (more accurately, she decided she was going to live in our house and just waltzed in the door) on New Year's Day, during two weeks of below-zero temperatures.  We have been feeding her the same diet as our other cats - wet food in the mornings and the evenings, dry food to nibble on free-range as needed (hubster is gone 10+ hours/day for work, I'm gone even longer). Did the dry food in her diet cause her to become diabetic since she'd previously had an "outdoor cat" diet? It's weird that she was doing just fine outside, but now that she's indoors, she's experiencing serious health issues. I feel terribly guilty that I could have done something to harm her when I only meant to help.

We've switched her away from dry food entirely at this point, and she has her first glucose curve at the vet tomorrow (they'd just sold their last two boxes of insulin that morning before I arrived). She seems to be drinking less already, but I know that's probably because of the increased liquid in the wet food. My hubster is going to do her shots (I'm a needle-phobe) going forward, is there anything else I should be doing/should know?  When we travel - we have a wedding to attend in 2 weeks - do we need to board her somewhere to ensure she is eating properly and getting her insulin? Because she wasn't a pet for quite some time before she came to us, she's not super-into people she doesn't know well (the vet can attest to this - she wears a skull and crossbones collar for a reason), and can be bitey and claw-y - will people be willing to board her and do her shots, even if she's a jerkface to them? Are there better wet foods than others? Our vet told us to just give her whatever right now, and pretty much as much as she wants because she's not absorbing it well, but we could give her all the food in the world and she'd still be hungry. What's the normal amount of wet food a day a 10lb cat should be eating? I don't want her to wind up overweight and have troubles from that!

I don't know what I'm looking for here really, I'm just worried about my kitty, guilty that I may have done something to harm her, and don't really know what to do from here (beyond the obvious diet and insulin things). 

First, let me assure you that diabetic cats are easier to manage than diabetic dogs. Cats are type 2, dogs are type 1.

I can only tell you my experience with Mist.

She developed diabetes several years ago. My vet put her on Glipizide, whcih is a pill I crushed and mixed with wet food. No problem getting her to eat the food. For the last few years she has not needed the glipizide at all.

I feed her only Fancy Feast Classic tender beef feast and classic turkey and giblets. Neither contain any carbohydrates - corn gluten etc.

She does get potassium gluconate daily, to balance her metabolism.

On my own I feed her 1/2 of a 3 ounce can four times a day (and the two boys, cannot do one and not the others who would think they were being terribly deprived.) My thought was that if human diabetics are told to eat frequent small meals the same would be good for her.

As she is now 19 years old it is clear that we're doing well.

Good luck with your Jett. If not for you she would have died from this, out on the mean streets.

You'll find more help from the experienced members of the FelineDiabetes.com message board than you can from TCS, although you are most certainly welcome to continue to visit TCS and share stories and pictures of your cat and get general care help The FDMB board can go into detail about diet (feed only low carb canned food. Many good commerical brands out there), insulin, home blood gluocse testing, what to do if you need to go on vacation or business trip, how to feed a multi cat household, how to afford the diabetes supplies without going broke, etc.

My previous cat was diabetic and I found the FDMB board to buge a huge help. I fed only low carb canned food (Nature's Variety Instinct, Innova EVO, and a few others), used a good insulin (first Lantus then Levemir), and tested my cat's blood glucose levels multiple time daily and tracked everything in a spreadsheet (vet found it extremely helpful).

Thanks, I'll check it out!

We started insulin (PZI) yesterday, and she's already gone from lazing on the floor to chasing the other cats like the terror she is again, so I'd say she's perked up some - unfortunately, that means the rest of our cats are back to hiding.  We've also got her on meds for a UTI, since the vet diagnosed that last weekend as well.  For now, our vet doesn't want us doing home tracking or adjusting the insulin levels, just doing the prescribed dosage and doing another curve in a week or two.  My husband did his first shot last night with no problem - This morning it was my turn, and (after she jumped away from me when I tried to put the needle in) had a panic attack and wound up making my husband do it, because I couldn't get my hands (or nerves) steady enough to do it. I hope it gets easier, because I would hate for him to have to be the one doing everything.

The vet gave us hope that this could likely eventually be brought under control with just diet after some time on the insulin, but the vet tech told us last night there was no chance that was going to happen with her.  

ScooterMac said:

 
Thanks, I'll check it out!

We started insulin (PZI) yesterday, and she's already gone from lazing on the floor to chasing the other cats like the terror she is again, so I'd say she's perked up some - unfortunately, that means the rest of our cats are back to hiding.  We've also got her on meds for a UTI, since the vet diagnosed that last weekend as well.

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I'm not familiar with how PZI works so I can't advise you on that. The FDMB board has a section just for PZI help and advice.

It's common for newly diagnosed diabetic cats to have urinary issues. The urine is full of sugar which bacteria love to grow in and cause problems.

Originally Posted by ScooterMac  

  For now, our vet doesn't want us doing home tracking or adjusting the insulin levels, just doing the prescribed dosage and doing another curve in a week or two

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As you will eventually see on the FDMB board, home testing is extremely important for diabetic cats just as it is for Human diabetics. Blindly giving insulin without knowing what the blood glucose level is has been compared to driving with a paper bag over your head - just dangerous. It's really important to know what the blood glucose level is before you give the insulin. Blood glucose levels fluctuate all the time and you can't assume that it's high. If your cat is, say, at 40 mg/dl (normal healthy levels are roughly 60 to 150 mg/dl) you don't want to give any insulin because that would cause the blood glucose levels to drop even more and you will have a hypoglycemic emergency to deal with. Even between insulin shots it's good to test to get an idea of how the levels are doing. And if your cat just seems "off" after receiving insulin, you can test the blood glucose levels to check for possible hypoglycemia.

Some vets discourage hometesting but it's really something that needs to be done. Vet office blood glucose curves are often inaccurate because stress causes blood glucose levels to skyrocket, not to mention the expensive vet bill.

ScooterMac said:

.  My husband did his first shot last night with no problem - This morning it was my turn, and (after she jumped away from me when I tried to put the needle in) had a panic attack and wound up making my husband do it, because I couldn't get my hands (or nerves) steady enough to do it. I hope it gets easier, because I would hate for him to have to be the one doing everything

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It gets easier The insulin shots don't hurt at all. It helps to use insulin syringes with a very fine needle (30 gauge or higher) and to insert the needle bevel side up. The FDMB board can recommend insulin syringes to use with the PZI (some PZI are U40 strength and some are U100 strenght and it's important to use the correct matching  insulin syringes to avoid over or under dosing your cat).

ScooterMac said:

 
The vet gave us hope that this could likely eventually be brought under control with just diet after some time on the insulin, but the vet tech told us last night there was no chance that was going to happen with her.  

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Some cats do go into remission shortly after starting insulin and diet. Others do not. The FDMB board can offer tips on how to achieve remission but don't feel bad if your cat never gets there. My previous cat was diabetic for 4 years before he passed away. I would have loved for him to go into remission but it was more important that my cat was happy and healthy even with being poked like a pincushion multiple times daily. Every newbie focuses just on the diabetes and getting remission and they forget about the whole cat which is the most important thing.

I just posted an introduction over at the FDMB, so I'm on my way over there.

Right now, the vet doesn't want us doing home testing, because her levels are so out of control that he just wants to get them anywhere near normal first. Yesterday, the lowest he saw during the curve was ~275 - still waaayyy too high. He just wants us to get started before we jump into all of that.  

We're using the PZI U40 needles from our vet, and while I know it's not supposed to hurt her (except this morning when I apparently hurt her and she cried and jumped away), it doesn't make me any less freaked out. I hate being in the same room with needles at all, so my hands are shaking from the jump, which doesn't make things any easier. I'm just hoping it's something I can figure out how to deal with so the full brunt of her care doesn't fall to my husband.

I also know that my worry about her going into remission is mine alone....I just feel like this is probably my fault somehow (I mean, she survived for years on the street before we took her in, she's in less than 8 months and has serious health issues?) and want her to be able to have a "normal" life. 

I guess I'm just overwhelmed still!

Totally normal to be overwhelmed  You'll get the hang of the diabetes soon. The FDMB will help you in many ways. There are lots of newbies who were initially afraid of the insulin syringes but soon were able to give injections without even thinking about it. Maybe try practicing injections on a stuffed animal. I think U40 insulin syringes are only available in one needle gauge. There is a way to use U100 insulin syringes with U40 PZI but ask on the FDMB before you change insulin syringes. There is a conversion chart that you must follow so you cat will continue to get the right amount of insulin. 1 unit in a U40 syringe is not the same as 1 unit in a U100 insulin syringe because of the insulin strength.

275 isn't too bad. My cat started in the 400s and stayed there until we got off Humulin N and onto Lantus. Even before he passed away we never really got out of the 200 range with Levimir. I suggest that you test the urine for ketones. Ketones can be a problem with high blood glucose levels. A condition called diabetic ketoacidosis can happen. You can buy urine dip sticks at the pharmacy, either KetoStix or KetoDiastix.

Diabetes is not a death sentence. A diabetic cat can lead a normal life even if insulin will always be needed