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Old March 19th, 2014, 07:01 PM
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Cat With Diabetes - At my wits end..

Our approx. 9 year old male neutered cat was diagnosed with diabetes last summer. When diagnosed his blood was in the mid 20's. He has fairly severe neuropathy. He was started on Caninsulin and after increasing several units, he was getting big peaks and valleys in his readings but always stayed in the high teens/20's.
Our vet suggested we switch him to another type of insulin made specifically for cats that is longer lasting and supposed to reduce the peaks and valley's. It is called Pro-zinc. It has been a long struggle. We had him up to 5 units, and he was staying approx. between 15-20 during the day. We increased again to 5.5 units and now he started having huge fluxuations from the high teens down to 3-4 and back up. We went back to 5 and his numbers stay again between 15-20. Tried upping him again, and same thing huge changes. This is all over the course of many weeks and with the consultation with our vet. She is telling us to stay at 5 units. He is now getting very constipated despite being on a type of "laxative" and had to go to the vet today and he was straining really bad. Nothing against our vet, but she doesn't seem to have too many suggestions and reasoning why the huge fluxuations and I wonder how much experience she has treating feline diabetes.
We are really at our wits end and hate to see him struggle walking, getting in and out of the litter box and just collapsing on the floor exhausted. I should mention he has been on a Methyl-B12 supplement for a couple weeks but from what I read it is useless until his blood is normal.
Does anyone have any suggestions? I don't want him to suffer any longer without seeing some type of improvement.
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Old March 20th, 2014, 07:24 AM
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Refresh my memory...what does your kitty eat?
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Old March 20th, 2014, 03:01 PM
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Pre-diabetes he was on Nature's Variety canned with some dry supplemented. The vet suggested the diabetic food which my decided to try to see if it helped. It was the food they sell in the office. He would get canned twice a day with a little dry in between. There wasn't much of a difference on the diabetic food and I have heard they are not the best so we have now switched him back to the Nature's Variety.
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Old March 20th, 2014, 07:18 PM
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Pre-diabetes he was on Nature's Variety canned with some dry supplemented. The vet suggested the diabetic food which my decided to try to see if it helped. It was the food they sell in the office. He would get canned twice a day with a little dry in between. There wasn't much of a difference on the diabetic food and I have heard they are not the best so we have now switched him back to the Nature's Variety.
The prescription "diabetic" food totally sucks for sure and is a waste of money. Is he back on just NV canned, or does he still get dry as well? Which NV is it (Instinct, Homestyle)? So did all these diet changes occur while the dose was being raised? I'm wondering if rebound might be an issue, especially considering the roller coaster numbers. One way to check would be to drop the dose back to 1 unit for a couple days, testing his blood sugar every few hours if possible. You test at home, right? I can't quite tell from your post, is he getting 5 units twice a day or just once a day?
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Old March 21st, 2014, 05:33 PM
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He gets the Natures Variety morning and night. And a little bit of dry in between as he is always starving. It is the Instinct. The diet changes did happen during the time while his dose was going up, but we were careful not to do it right at the same time as an insulin change. He gets insulin twice a day, and his blood is checked 3x daily. He is getting so tired of the ear pricks. What do you mean by rebound?
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Old March 21st, 2014, 07:58 PM
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And a little bit of dry in between as he is always starving.
Any possibility you could feed him more canned instead? I always left some out for my guy.

Unfortunately the insulin you're using isn't well suited for constant snacking though. Perhaps a longer-lasting, gentler onset kind of insulin like Lantus or Levemir would suit your kitty better.

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He is getting so tired of the ear pricks.
Tasty treat rewards can go a long way to making the experience more tolerable. 100% freeze dried meat such as PureBites, Halo Liv-a-Littles or Whole Food Toppers are great for diabetics since they're low carb and high in protein.

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What do you mean by rebound?
When a cat's blood sugar goes too low from too much insulin, there's often a corresponding period of high blood sugar. More detailed info here:
http://petdiabetes.wikia.com/wiki/Somogyi_rebound
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Old March 24th, 2014, 06:44 PM
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Just to confirm, he IS on a long lasting type insulin. Do you think we should switch to another type?
Talked to my mom today, and she said she has been feeding him wet food 3-4 times daily, and he gets a little bit of dry in between. Today he had a tiny bit of dry after breakfast but was sleeping later on and didn't ask for the dry after lunch (normally he would) and tonight he got the really low reading of 8. (from 19.3 in the morning, and 23 the day before) Maybe the dry food is affecting it? We are going to try without it for a few days to see if it makes a difference.

The vet told us if he is under 10 not to give insulin and call the office, of course it is after hours tonight, and we have called so many times and all she will tell us to do is drop the insulin dose. So we do, then he just stays at high numbers for weeks until we decide to try upping it again. When we skip his insulin dose by morning he is really high again and back to square one. We are concerned about him dropping too much, but should we continue with his dosing even if the number is below 10?

I will ask about changing the brand of insulin, and also if this "dry food" theory doesn't work we would be interested in trying to drop his dosage to see if he is having the "rebound". Anything else we should do?
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Old March 25th, 2014, 07:39 AM
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Just to confirm, he IS on a long lasting type insulin.
My understanding of ProZinc is that it's a medium-long lasting insulin, with anywhere from 10-14 hours duration, but that there is quite a bit of variability between cats. What dose did the vet first start your kitty on? Do you use U40 or U100 syringes?

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Do you think we should switch to another type?
Not necessarily, but many vets don't realize there are other options besides just the "animal" insulins like Caninsulin (usually horrible for cats) or ProZinc.

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Maybe the dry food is affecting it? We are going to try without it for a few days to see if it makes a difference.
Dry food, even the lower carb varieties, can still have a profound affect on blood sugar. Good idea to eliminate it, but please make sure to test him more frequently (especially around when his bg typically goes the lowest) in case he goes TOO low.

Are you keeping a log book at all? I had one for my cat where I would write down what he ate, roughly how much, how often he went pee, how much insulin he got, and what his blood sugar was. It really helped to spot trends.
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Old March 25th, 2014, 08:13 PM
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So it's either the biggest coincidence ever, or you are right about the dry food. 1st day today he was without it (although not happy about it!) and this is the first day his blood has been more normal readings. Highest reading was 11 and lowest was 6. So we are going to keep up with the no dry food for a while to see the result.

My mom keeps a detailed graph of his blood levels, the amount of insulin recieved and anything odd that happens... puking, constipation etc.

I will have to check which syringes she is using and he started on .5 unit of Caninsulin. He was switched to Pro-zinc at 2-3 units. We are going to talk to her about switching insulins. He is getting his blood checked 3-4 times a day now. Will keep you updated.
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Old March 27th, 2014, 01:16 PM
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Glucose levels still down yesterday, so much so that the vet would like us to begin to reduce the insulin. Thank you SO MUCH for the advice of eliminating dry food. It makes me really angry that my vet did not suggest this, and sold us a bag of the diabetic dry food.

One month ago we were so frustrated with the process, having no change and him deteriorating we had made an appointment to put him down. At the last minute we decided to cancel and try one more this which had not worked at all and now were coming to the same conclusion. It is so frustrating. We have been treating him with insulin and testing blood for 3+ time a day since last fall and the poor guy is like a pin cushion. It is probably something that could have been solved right away.

Again, thank you and i will be sure to update again as we go.
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Old March 27th, 2014, 08:13 PM
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Quote:
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Glucose levels still down yesterday, so much so that the vet would like us to begin to reduce the insulin.
Yahooooo!!!!


Quote:
Originally Posted by Miaow View Post
Thank you SO MUCH for the advice of eliminating dry food. It makes me really angry that my vet did not suggest this, and sold us a bag of the diabetic dry food.
Unfortunately many vets really haven't made the connection yet between dry food and the detrimental effects it has on feline health. A big part of that is due to the rather unethical influence from pet food companies like Hill's, Purina, Royal Canin etc on not only the profit margins of most vet clinics, but also the education of the vets themselves. Hopefully your vet is open to learning from this situation and will take diet more seriously next time she's treating a diabetic kitty.

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i will be sure to update again as we go.
Please do! Crossing my fingers that he continues to improve, maybe even to the point of not needing insulin.
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Old May 15th, 2014, 06:29 PM
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An update on Edward:

His blood glucose levels have become more normal, still not exactly where we want them but definitely more stable. In the AM he is reading between 10-14, my mom stopped the reading at noon as we hate to pick him more than we have to. It had been generally lower. And by the PM reading he is back up in the teens and we assume he drops overnight after the insulin.

That being said, Saturday evening my mom noticed that he had one pupil that is extremely dialated and one that is constricted. It didn't seem to cause him any pain or discomfort. On Tuesday evening he walked into the living room and his back legs gave out on him, followed by his front legs. He toppled over onto his head and just proceded to lay down. He does have trouble walking at any given time because he really walks down on his hocks, but never like this. He didn't seem to be stressed or in pain, he was responsive and continued purring. After about 20 minutes he got up and walked away normally.
He had a couple more episodes between then and 1:00am.
Wednesday, same thing. He had a couple episodes during the day. Otherwise he is completely normal. Nothing has changed on him. We took some glucose readings during these episodes and blood was in the high teens. He runs outside every morning and has to go down two flights of stairs to the backyard (it is fenced and he is unable to jump) just as perky as ever, eating normal etc.
We made a vet appointment for today (Thurs) and thus far he has had no episodes today. The vet is completely stumped, she is not sure what is causing the dialated eye or the collapsing. The best guess she could come up with is that maybe it is related to the neuropathy? She said she could give us a referral to a specialist if needed. I think at this point we are going to wait and see whether is gets better or worse. Vet admits she is not an expert on these difficult diabetic cases. Im just wondering if you have heard of these symptoms?
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