Casper Diagnosed with Diabetes

sivyaleah

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Hi everyone,

Some might recall that we've been dealing with Casper and some health issues for a year or so with frequent vomiting being the worst of it. A month ago, the vet finally concluded he had either IBD or lymphoma (less likely).  We decided to treat it as if IBD since we had not intention of putting him through a biopsy at 15 years old.  

Short story is he was given a depo injection, which worked really well for about a month which also meant it more likely was IBD.  His appetite improved, he wasn't throwing up as much (only a couple of times vs. many times a week), and his mood/energy levels were much better too.

We were scheduled to come back for a follow up.  Today, while going over everything we mentioned  that in the past week the steroid effects seemed to be wearing off and we'd been noticing some other concerning symptoms; most important was the amount of water he was suddenly drinking.  He used to go through less than 8 ounces a day (anywhere between 4 and 6) and now we were refilling his bowl sometimes 2x a day. The bowl, holds 8 ounces so this was a dramatic difference.  He also had one bout of loose stools - something which never has happened before.  His appetite is still good - but too good. He's been acting like he's starving all the time.

So, the vet's ears perked up hearing all this and decided to test his glucose and it was 300!  Diagnosis of diabetes and now us needing to learn how to manage this.  My fiance was pretty distraught and worried that we'd have no life anymore because of this (he doesn't cope well with these kinds of things) but, me? I had enough info behind me thankfully from TCS not to let it get me too overwhelmed.

Anyway, we were taught how to inject him with the insulin, given more stuff to read, and we have to bring him back Monday for a blood glucose curve test.  He's to get 1 unit of insulin 2x a day until they figure out if he needs more of less on Monday.  Luckily, they found no ketones so it hadn't progressed to a crisis situation and now, with the insulin hopefully that won't happen.

I joined the FDMD site, haven't posted yet but it's filled with good information and I've been reading up online in other places (including here).  Casper and Cocoa are already on a high protein, zero carb diet with very little amounts of kibble or treats so we don't have to deal with trying to switch foods - just have to manage the fact that we usually feed them dinner around 4-5 pm and now, can't do that.  Since the insulin needs to be given every 12 hours, that would make me get up at 4-5:00 AM, which is NOt happening!  I get up already at 5:40 and any earlier is  impossible.

Right now both of them are going bonkers wondering where there dinner is and it's only 4:40. Cocoa keeps jumping all over us and the couch and Casper is doing his usual stare down.  I need to push it off until at minimum 6:00 pm to start getting them on a schedule which we can manage. Weekdays, we leave at 6:30 am (Tom is home for the summer but will be back at school in a month; I feed them when I am getting ready for work).  I don't get home until nearly 7pm when working; Tom if at school doesn't get home until around 5pm.  Feeding can be off by 1/2 to 1 hour maximum so if we feed them at 6-6:30 am and dinner 6:00-7:00, it should be ok according to the vet.

If anyone has stories to share I'd appreciate it - or other sites to look up information. Thanks!
 
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sivyaleah

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Ugh. Just gave him dinner, waited about 10 minutes and gave the injection.

He barfed dinner up a few minutes later.

We just gave him about 1/4 of a 3 ounce can to try and eat. Hope we did the right thing. Vet was already closed for the day.
 

LotsOfFur

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Hi sivyaleah, I just wanted to offer support as I personally have no experience in this area. It sounds like you have a good start with your sources of info and a good vet.

Just wanted you to know that someone is listening and thinking of you and Casper :hugs: & :vibes: :vibes: :vibes:
 
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sivyaleah

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Hi sivyaleah, I just wanted to offer support as I personally have no experience in this area. It sounds like you have a good start with your sources of info and a good vet.

Just wanted you to know that someone is listening and thinking of you and Casper
&
Aww, thank you so much! 
 

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What insulin did the vet prescribe? That's an important piece of info to have when posting for help and advice here or on any other forum
Different insulins have different ways of working and protocols on how to use it properly to get the best results. With some insulins you don't need to dose and feed exactly 12 hours on the dot. There is a little leeway.

With most insulins you can feed the cat and while the cat is busy eating, test the blood glucose level (doesn't sound like you are doing this right now) and give the insulin shot. The process takes less than a minute to do. Some "harsher" insulins require food to be in the tummy first before you can give insulin maybe up to half an hour later.

Treats are ok, dry food of any kind is not. Freeze dried meat treats like PureBites are low carb and work great to get a cat used to being poked by the insulin syringe and the lancet for hometesting. Plain cooked chicken is also good.

Here's one TCS member's positive experience with FDMB if you haven't already seen it: http://www.thecatsite.com/t/318949/does-your-cat-have-diabetes-if-so-please-read

FDMB is a great board and you'll get a ton of help there. The board was extremely valuable when I had a diabetic cat. My diabetic was a "lemon" and never got well regulated but he was happy and semi-healthy (had asthma as well) and that was all that really mattered. Some people focus so much on the blood glucose numbers and getting them into a normal range as quick as possible to limit the time needed on insulin that they fail to look at the whole cat's happiness and health.

Hopefully this helps you some
 
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sivyaleah

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What insulin did the vet prescribe? That's an important piece of info to have when posting for help and advice here or on any other forum
Different insulins have different ways of working and protocols on how to use it properly to get the best results. With some insulins you don't need to dose and feed exactly 12 hours on the dot. There is a little leeway.

With most insulins you can feed the cat and while the cat is busy eating, test the blood glucose level (doesn't sound like you are doing this right now) and give the insulin shot. The process takes less than a minute to do. Some "harsher" insulins require food to be in the tummy first before you can give insulin maybe up to half an hour later.

Treats are ok, dry food of any kind is not. Freeze dried meat treats like PureBites are low carb and work great to get a cat used to being poked by the insulin syringe and the lancet for hometesting. Plain cooked chicken is also good.

Here's one TCS member's positive experience with FDMB if you haven't already seen it: http://www.thecatsite.com/t/318949/does-your-cat-have-diabetes-if-so-please-read

FDMB is a great board and you'll get a ton of help there. The board was extremely valuable when I had a diabetic cat. My diabetic was a "lemon" and never got well regulated but he was happy and semi-healthy (had asthma as well) and that was all that really mattered. Some people focus so much on the blood glucose numbers and getting them into a normal range as quick as possible to limit the time needed on insulin that they fail to look at the whole cat's happiness and health.

Hopefully this helps you some
Thanks!

He's on Vetsulin, 1 unit twice a day.  The vet said it doesn't have to be an exact 12 hours, there was about an hour leeway so that does help a lot.  I expect once we get the test done by the vet, and feel more comfortable with the whole thing that we'll do testing at home.  We are concerned about this, however, as we're out of the home very long hours weekdays.  

Things went much better this morning. I think both my fiance and I were somewhat stressed doing it for the first time last night and that affected Casper.  I tried at first to put him on the counter so I'd have better leverage for the injection (bending is impossible for me - crappy knees)  and he even growled his displeasure. He knows he isn't allowed up there, so I bet he was confused.  

This morning, Tom is still sleeping so I just did it myself and it went very smooth.  Fed him a small amount first (about 1 ounce or less). Waited 20 minutes or so, put him on a favorite spot of the couch, and then while giving him the injection I put down a few pieces of Purebites to distract him. That worked great.  Did the injection in no time.  Fed him the rest of his breakfast. At first he wasn't too interested but I topped it off with Purebites crushed up and that motivated him to finish it off.  He didn't throw up this time, so yay for that!

FYI we don't feed kibble as a meal in general, they get high protein, no carb wet food for breakfast and dinner.  Kibble is only given in small amounts, as a snack but never left down; they do not free feed and we also don't typically give treats for no reason. 

I'll go and read the thread you linked for sure!  

I think right now the thing we're most worried about is that their feeding schedule is anywhere from 6:00 - 7:00 am with dinner at 4-5pm.  This isn't really going to work for us once Tom goes back to school in a month and right now, waiting until 6:00-7pm to keep the insulin at 12 hour timeframes just riles them up too much.  Yesterday, they were INSANE, and we finally broken down about 5:15 for their dinner.  The problem of course is by 9pm, both want food again and, I'm not sure if or how much we can give Casper several hours after the 2nd injection.  I guess, that's why home testing is so important?
 

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I'm not familiar with Vetsulin so I don't know how that particular insulin works in cats. There's a forum on FDMB that has more specific info on it. If Vetsulin ends up not working well for your cat (it happens), there are other insulins to try. I've used both Lantus and Levimir (not at the same time) for my diabetic cat and they worked ok, my cat being a lemon complicated things


Small meals work best for diabetic cats as food helps keeps the blood glucose levels stable as the insulin works. My diabetic had 3 or 4 mini meals in between breakfast and dinner and maybe two post-dinner meals. A spoonful or two of food is ok.

I know there are FDMB members who have multiple cats so they would be able to help you with feeding schedules that work for both you and the cats and how to adjust the cats to a new schedule.

I had a full time job and my hometesting schedule was at breakfast, at dinner, maybe two more checks after dinner. On weekends I would do more checks in between the insulin injections and maybe once or twice a month do a curve at home. I kept track of all the blood glucose numbers in a spreadsheet (FDMB has a template that is Google based) and shared it with my vet. Hometesting is doable even with a busy life
FDMB members can share how they get in testing on busy days.

Some diabetic cats are very carb sensitive and even a few pieces of dry food can send their blood glucose levels skyrocketing. Hometesting is the best way to see how food affects your cat's levels. Supposedly there's a dry food that has no carbs but that has been debated to death on the FDMB many times and the general consensus during my time on FDMB was to avoid feeding all dry food. Not sure if that has changed in the several years since then. Freeze dried or air dried raw are healthier suitable options you can consider for snacks / treats.

I hope you're finding good info on FDMB and the main web site
 

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My Kittyboy (R.I.P) was a 16 yr.old diabetic. I just lost him last week due to no platelets in his blood. My vet suspected that he had cancer. He was on Lantus because at the time there was no cat insulin.
 

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@doggydogood I'm sorry for your loss. Perhaps your vet didn't know at the time or hadn't kept up with the ever changing veterinary world and new treatments but there is a cat insulin available. It's called ProZinc and has been available since at least 2010 if not a few years earlier than that. There are also pet specific insulins like PZI and Vetsulin. Lantus is a popular Human insulin to use in cats because of the high remission rate if started early enough and if what is known as the Rand dosing protocol is followed.

Cancer does complicate everything and it must be hard to have a cat diagnosed with it or pass away from the cancer being at a too far advanced stage. I saw your post on the Grief board. Please feel free to share storeis and pictures of your cat there
 
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sivyaleah

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Just updating for the sake of being informational for those who might do searches for diabetes.

Casper has his blood glucose curve test this past Monday.  It wasn't too terrible and the vet is keeping him on only the 1 unit of Vetsulin twice a day. We go back in 2 weeks for another test.

We've managed to get into a routine injecting him at around 6:15 am and 7:00 pm.  I'm out of the house long hours, so this is the best I can manage.  The doctor said this would be fine.  He seems to be doing well, he's drinking a lot less water than he was last week which is encouraging.  He's tolerating the injections really well too.

I've decided not to be one of those who are obsessively checking.  I can't for one thing, my work hours don't permit it and my fiance is heading back to school full time in a matter of weeks.  A good friend forwarded a 700 page report from a conference she went to which had a big section on the treatment of feline diabetes.  It's very technical so some of it is above my head but there was some good info comparing cats who were monitored constantly over those who were "loose controlled" . To everyone's surprise, those who were not monitored all the time tended to do better overall.  So, for now at least, I'm going to trust our vet.  

We're also adding in a med for his IBD - Budesonide which works ok with the Vestulin.  We found a pharmacy that will compound so he'll get that transdermally.  Will be so much easier to administer, much less stress for all of us.  

For now it is manageable although I do stress a bit at night since my commute is prone to delays a lot.  But knowing that there is a little leeway on the timing of the injections and, that we are allowed to feed him small amounts aside from his two regular meals as long as they are high protein such as freeze dried chicken treats.  

FYI I joined both the group on Facebook and the FD website. Very helpful folks in both groups and I highly recommend anyone with a cat that has diabetes join them.  You will be welcomed, and gain good information quickly. 
 
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LotsOfFur

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That's a nice update. Glad to hear that all is going well so far and Casper is doing good :)

Chronic conditions can be so challenging, good to know there are other sites that are supportive and informational. :hugs: for you both [emoji]128149[/emoji]
 

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Glad Casper is doing well
If you can test the blood glucose levels at least before each and every injection that will be extremely valuable to know if Casper's blood glucose level is at a high enough number for insulin to be given. Blindly giving insulin without knowing what the blood glucose level has been comapred to driving a car with a paper bag over your head. Better be safe than sorry, IMO. Did your vet give you a cut off number for no insulin? It's usually under 150 mg/dl. The "spot checks" are helpful and valuable info to have but not necessary.
 
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sivyaleah

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Glad Casper is doing well
If you can test the blood glucose levels at least before each and every injection that will be extremely valuable to know if Casper's blood glucose level is at a high enough number for insulin to be given. Blindly giving insulin without knowing what the blood glucose level has been comapred to driving a car with a paper bag over your head. Better be safe than sorry, IMO. Did your vet give you a cut off number for no insulin? It's usually under 150 mg/dl. The "spot checks" are helpful and valuable info to have but not necessary.
His curve test values didn't come anywhere near 150 - lowest reading was 295 at 8 hours into the test.  I know that the numbers can be elevated due to stress but he's actually really good at the vet, very placid (they all adore him lol) and because of that, I believe the numbers were fairly accurate.

Again, he goes back in 2 weeks so we'll see how it all changes at that visit.  

Testing at home is not going to be possible right now, if at all.  I don't know how people do it - so many keep detailed daily lists but I'm not home to do so.  I'd imagine most who can, are either stay-at-home parents,. don't have long days out at work or are retired.  I don't see how it's possible to test daily when one works out of the house house and is gone for 12 hours a day.  My commute alone takes 5 hours out of my day (NJ to NYC and back again).

My fiance is home for a another few weeks but truthfully, he's is incredibly forgetful and I don't trust him enough to handle this. If I ask him when the cats ate, he gives me ridiculous answers that I know aren't anywhere near the time they had eaten.  Like, I'll get home and he'll say they ate "an hour ago" but if I question him more, and he thinks about it he means more like 3 hours ago!  Didn't matter before so much but now, to administer the insulin properly I really need to have accurate information.  Until I can trust him to give me that, it's all on me for all Casper's needs right now.  I can only do so much 
 without stressing myself out which won't help any of us.
 
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