Diabetic Cats

[MS]

If you do get to the point where you have to inject insulin, it is really a painless procedure for cat and human alike. We had a diabetic cat for 3 years before she passed at 17. We gave shots twice a day (and a vial of insulin would last several months in the fridge). Cost of insulin treatment was about $10/month for needles and insulin.

We were told the cat would start to appreciate all the extra attention around needle time, and it was true. She was glad for the attention, the needle didn't hurt, and it was really easy to do.

When first diagnosed, our vet also told us that sometimes diabetes in cats cures itself (or disappears). That did not happen with our cat, and towards the end of her life her insulin needs began to fluctuate (as indicated by occasional full day blood testing conducted at the vet). Eventually she succumbed to age and other complications, but we got 3 extra years with her, and both her's and our quality of life was not adversely impacted.

Good luck and best wishes.

[MS]

FYI - We found this web site helpful when our cat was first diagnosed:

[url]http://www.sugarcats.net/sites/jmpeerson/faq.html

MS

[Marauder]

Thanks again for everybody's input. I definately need a new vet.

Diet is going to be the hardest part. How do you feed 3 cats 3 seperate diets? I have been using a pecking order for feeding which works somewhat. Riki, having the IBD gets first crack at the food. Holly is actually trained to sit and wait till Riki is finished before going to the bowl. Alli is the hard one. She is just a year old and eats like a goat and will barrell through anything standing between her and the food. I've taken to locking her in the bathroom at feedings and letting her out after the other two have eaten.

The "treats" were the walmart "special kitty" brand and were never fed regularly. It was my Idea to feed Riki treats as a supplement to her regular food to induce weight gain and I put that idea to the vet that suggested the kitten food as a diabetic diet and she approved but has never given me any other advice about diet for IBD.

The regular diet I was feeding them for several years was dry purina cat chow put out all the time with friskies chicken and gravy and chicken with salmon in gravy fed 1 can 2-3 times per day.

My biggest concern with Riki is that according to the vet, the diabetic diet she needs, "Purina DM" was designed to REDUCE weight and Riki has always had a problem keeping the weight on.

I had a hard time finding food that Riki was willing to eat let alone one she could stomach. Holly starved herself when we introduced the purina DM, Riki ate it but vomitted it up every time. The purina kitten chow is being eaten by everybody. They still beg for their old food though and I have had to increase Riki's Prednisone to everyday to help her keep down the dry food. The pill is 5MG. It started out once a week then 2-3 times a week then every other day and now every day. She responded to the steroid quickly by adding a pound or two and her coat became sleek again. The vet tells me that the dose is so low that taken every day will have no ill effects. Somehow I doubt that. She has shown behavioral abberations such as constantly licking the wooden furniture. When this behavior becomes severe I skip the prednisone for a day or two and she gets better but longer than two days and the vomitting starts up again.

The other concern with Riki is that the immuno suppressant effects of the steroid will keep her infected with UTI's perpetually. She's had two seperate infections in the past two months and she always has "colds" in her eyes. I am trying to prevent further infections with vitamin C every day to acidify her urine and boost her immune system.

The poor cat is becoming scared to death of me. Every time she sees me I'm shoving pills down her throat. Sometimes as often as 4 a day if she is on antibiotics for an infection. She is becominging less cooperative each day when it comes to "pilling" and the pills are always HUGE. What are the phamacutical companies thinking? You think they would consider the size of the patients when designing the pills. Coating them would help them go down easier too.

I can't believe how this all just came out of nowhere.

The original problem was Holly peeing in laundry baskets if they were left out for mre than a few minutes. We had thought it was Riki at first because of her health problems and the side effects of the steroid but we set up a camcorder and caught Holly in the act. We were hoping it was a simple UTI but in the back of our head we were thinking Holly was having "emotional issues" about the new cat Alli. The urinalysis for infection is what showed the sugar. Then a week later Riki starts squatting all around the house trying to go and straining really hard. I thought it was constipation at first and tried hairball remedy and butter on the paws to loosen things up. When nothing improved we took her in. First came the X-rays of the abdomen then the urinalysis and again with the sugar and again with the bloodwork. This has all been unbelievable.

I am going to keep them on the kitten chow diet for several weeks then bring the cats in for a fasting blood workup. Hopefully the Lansingburgh vet will check out OK. I don't know, You hear one bad story and you think could happen to anyone, two might be coicidence or maybe an overprotective owner didn't like what they heard. But when you hear complaints all the time......

As far as the skill of the technicians... well it could be nonexistent around here. The lansingburgh vet hired the boyfriend of an aquaintance of mine as a tech. His only prior work experience was working on a loading dock. I don't beleive he ever owned a pet either. One day loading trucks on a dock, next day a vet tech in scrubs doing triage. Unbelievable.

On the upside Riki is acting better and her coat is starting to smooth out. Hopefully this is a sign she will put on some weight. Hard to tell. She goes through these ups and downs two or three times a year. Lasts about 4 weeks then she gets better again. Not well but better. I feel so bad for her. I have gastroparesis (paralyzed stomach) and I know first hand how painful gastrointestinal problems can be.

I will keep everyone posted and thank you all for your prayers and advice.

One last thing. How do you post a picture on this board? I click the image tab but only get a bracketed IMG text response. I have a Jpeg of all three cats sitting together and I thought you might like to see the kitties you've been so helpful to.

Howie

[Traci]

Howie, I am going to stress this one more time...I do not mean to sound condescending, but I need to warn you about the prednisone.

You cannot keep adjusting her dosages, you can't skip a day or two or form your own dosing schedule, simply based on her behavior. Chances are, it's NOT the prednisone affecting her, it's the stress in the environment, her condition, etc. Probably a combination of things.

Do NOT adjust the pred on your own, ever. If you do, then you WILL see obvious changes in her health and behavior. It is meant to be prescribed and dosed according to her individual need, requirements, etc. It would be better to keep her on the vet's prescribed dose, and recheck her platelets, etc every two months or so, then your vet may decrease or taper it as needed, depending on her health status and signs of improvement. A sporadic dosing schedule such as what you're doing, is asking for big trouble. Prednisone is a corticosteroid that can't be played around with. Her 5 mg dose once daily is the lowest loading dose possible.

If your vet is not aware of what you're doing, you need to inform them immediately.

As for posting pics....please see the "Announcement- Read Me First" post at the top of every forum or you can find the picture posting topics in the Support Forum. Remember, if you are posting an image, make sure your picture resides on a web server host that allows remote imaging, otherwise, you can only post a link to the actual picture's page.

[Guest]

Hi Howie,
Maybe sharing my story with my diabetic will give you some ideas.

Blackie was diagnosed with a BG of 627, which is pretty high. We started insulin immediately and the vet got us started with Purina's DM diabetic food. The *idea* of the food is that much of the problem in diabetics is that most cat foods, especial dry, are loaded with carbahydrates. Lower the carb intake and the cat needs less insulin, it's own or injected.

I was overwhelmed by the cost of testing too. Added to that I knew that the stress of going to the vet will elevate the BG. So I decided to test at home with a human glucometer. Blood is blood and glucose is glucose. I found a great deal and for maybe $50 was all set up. (one glucose curve in the vet's office was around $100)

I won't tell you I wasn't scared to try the first time. I was scared to death! Practiced on myself until I was full of holes But when I did the cat it went okay, despite how badly my hands were shaking! Some people have to try a number of times to get the hang of it but I was lucky I guess.

By doing the hometesting I could watch how diet affected the cat's BG. Because I was giving insulin I could see how the insulin acted.

But the biggest thing I did was the food. Canned food is almost always lower in carbs than dry. Some kinds of canned are VERY low. I switched Blackie to a high quality canned food, non-perscription, and in a few more weeks he was off of insulin. From a BG of 627 he is now about one tenth that with no insulin.

As a control, I tested one of my non diabetic cats as soon as I got the glucometer. Her BG was 106 I think. Months later, after I changed her diet to a better quality lower carb food her last BG check was 67. Food and carb intake makes a HUGE difference.

If you go to http://www.sugarcats.net/sites/jmpeerson/ and look at the food charts you can see the carb content of various foods. What isn't obvious is the quality of ingredients the foods are made from. (That could be a whole book in itself.)

By selecting canned foods with the lowest carb content (under 10% is okay, under 5% is great) then looking for the ones with the highest protein content secondary, you can offer a cat food which may lower your kitties BG enough so that diabetes isn't an issue.

Kitten foods tend to be higher in protein and fat than adult foods an some are very reasonable foods to try instead of perscription food. There isn't anything magical about the perscription foods. They are formulated specifically for a certain purpose, but by understanding what is trying to be achieved in many cases, especially diabetes, the same result can be had by carefully selecting foods and reading lotsa labels.

The food I have chosen to feed is non perscription but certainly not inexpensive. But I would much rather spend a couple of extra bucks that way than for insulin, syringes, and BG testing strips!

My situation had a very happy health outcome and I know that won't be the case for every diabetic cat. But there is almost nothing I would be differently if I should ever find myself with another diabetic.

Check out the food charts at the link above and consider hometesting. It's easy and will save you a FORTUNE!

Beth

[Traci]

Beth,

While I appreciate the care, time and effort you put into your post, I must caution about a few things.....

First, Howie's cats have yet to be confirmatively diagnosed, he is getting conflicting opinions from two different vets. Until a competent experienced vet re-evaluates the cats, nothing said here or elsewhere can take the place of a physical exam or diagnostic approach or treatment plan.

Second, one of the cats has been presumptively diagnosed with IBD, this kitty needs additional focus on her health and treatment approach, diabetes may or may not be the ultimate concern for this kitty in particular. Only a qualified vet can make that assessment and form the correct treatment approach pending diabetes confirmation.

Third, perscription diets do indeed, surpass the nutritional requirements for specific conditions than those of commercial formulations. Not all commercial diets are full of carbohydrates, nor are they the proper approach to the majority of diabetic patients. Each patient has individual needs and each patient will fair differently on one diet than the next. Purina DM has been an excellent dietary treatment approach for many diabetic cats, and if it is prescribed, it is done so under the premises that it has been proven to work. Blood glucose curves used in combination also help to achieve the correct dietary approach.

Fourth, until the diagnoses are confirmed for the cats in question, the blood glucose monitor is moot at this point. Owners also have to be comfortable with the procedure, and even then, frequent curves in the clinic are necessary to achieve the most accurate results during initial insulin regulation.

We shouldn't be telling other owners to what content percentage fat, carbohydrates, or any other analysis is appropriate for their cats, no matter what the condition. Each case is individual, each case has individual requirements, based on disease factor, response to treatment, lifestyle, age, weight, physiology, and other factors that affect the patient as an individual.

Lastly, Howie is aware he needs to get a full assessment on each cat and get their individual requirements met. Until glucose curves are performed and a consistent, accurate assessment is made, especially during any initial insulin regulation, me must keep in check about the advice given.

As you said, what you are doing with your cats is not for every cat. Yes, diabetes testing is expensive, as are other diagnostics for all health conditions, but we owe it to our cats to do whatever is necessary to reach the diagnosis and form a rational and effective treatment approach. Owners need to work in close relation with their vets and treating health conditions should be under the strict supervision of their vets as well.

[Beth]

I did not suggest eliminating veterinary care. My vet was always working with me and was kept informed. However as one of the concerns is financial, it only makes sense to explore all the options if diabetes is the final dx. It is widely known that *vet stress* causes a rise in BG. Office glucose curves are of course better than no glucose curves but don't you agree that readings taken in a relaxed home setting better reflect the cat's day to day condition? What most caregivers do is provide the vet with the readings they receive at home. I always did. She was DELIGHTED!

Here are some links targeting both vets and caregivers you might find interesting:
http://www.dvmnewsmagazine.com/dvm/arti ... p?id=13315
http://www.dvmnewsmagazine.com/dvm/arti ... sp?id=5336
http://www.imakenews.com/catconnection/ ... c,a12q693k
http://www.veterinarypartner.com/conten ... &C=O&A=605

As far as perscription foods go, there are some which are very hard to duplicate using non perscription foods. Hills S/D for struvite crystals is a good example. But the perscription diabetic foods are designed to reduce carb intake. Here are the first 8 ingredients of Purina's canned D/M with 7% of calories from carbs:
Liver
water
beef
corn gluten meal
trout
fish meal
beef tallow preserved with mixed-tocopherols (source of Vitamin E)
wheat flour

The dry is worse (13% of cal. from carbs):
Poultry meal
soy protein isolate
corn gluten meal
soybean flour
beef tallow preserved with mixed-tocopherols (source of Vitamin E)
corn starch

And here's Hills brand new diabetic canned food w/ 13% of calories from carbs:
Pork by-products
pork liver
water
corn starch
powdered cellulose
soy protein isolate
chicken fat (preserved with mixed tocopherols and citric acid)
guar gum
locust bean gum
carrageenan
rice flour

And here are the first 8 of the non perscription canned food which I have been using, 2% of calories from carbs:
Beef
Chicken Liver
Deboned Chicken
Beef Broth
Sweet Potatoes
Carrots
Vegetable Gums
Flax Seed

Cereal products are replaced with vegetable which provide complex carbs as opposed to simple carbs. As cats are obligitory carnivores with little or no need for carbohydrate, especially simple carbs it makes sence to avoid cereal products. (By the way, Eukanuba does NOT make a food especially for diabetics. They have one which claims to glycemic control actually has something like 30% of calories from carbs.)

If you haven't already read it, I would highly recommend the JAVMA Article "The carnivore connection to nutrition in cats". You may request a copy of it here:
http://www.catnutrition.org/JAVMA.htm

An article which mentions the above paper is at:
http://www.catnutrition.org/MainLettertoVets.htm
It also includes several links all of which are worth reading.

My apologies if it appeared I was suggesting diabetic diagnosis and management WITHOUT involving a vet. That was not the case. Of course not every cat will have the same success with the protocols used in Blackie's care. But I was really honored when my vet (after Blackie no longer needed insulin) commented that, in her opinion, I was providing exemplary care and Blackie would be used as the *poster child* for FD management in her practice. She was greatful for all the new information I was able to provide to her Practice.

I hope some of the links given above will be of help to you Traci, Howie or someone else who later read them.

Respectfully,
Beth

[Traci]

Again, what you are doing with your cat is probably not going to be the same approach as for Howie's cats. Strict supervision under a competent vet is the key. When getting lengthy about diet and carbs and dietary products, please remember that individual cases vary. I'm not saying Howie shouldn't explore his options, but he should be working with his VET before attempting to treat on his own, diet foremost included.

I never said home glucose monitoring was not acceptable. Howie's cats are not even diagnosed confirmatively yet, and even then, the fructosamine can't be achieved at home, nor can followup hemoglobulins, urine testing, other testing methods often used in initial regulation of insulin.

And yes, Eukanuba does provide a diet that is used for diabetes management, it is the veterinary restricted calorie formula, similar to Hill's W/D, fiber content is properly formulated for maintenance.

While JAVMA usually contains informative, peer-reviewed literature, the one link you provided contained notes of abstracts which are not fully published material for laypersons. Abstracts tend to omit much vital information, sometimes all areas of the study are included with relevant conclusions not always published in an abstract. As for the actual article bit, I will only comment that the "carnivore" argument is an old argument and not one I am going to explore with you, for it is mainly used as a tactic to promote a certain food type or commercial brand of diet.

If you in fact read your own links, you would have learned that there is no one perfect approach to managing diabetes. You would also take note that the veterinary articles warn that frequent and followup evaluation is necessary in management of disease, and owner compliance is crucial. I've met many owners who go on to take treatment into their own hands, and their kitties come in in a comatose state because their insulin was not properly regulated, dietary approach was not compliant, or the owner failed to attend to a hypo or hyperglycemic crisis, or failed to attend that followup appointment.

Its great that you worked closely with your vet during the initial crisis and management and apparently, the resolve. However, those cases are relatively few, and in the face of not even having a confirmed diagnosis or appropriate treatment approach, the last thing we need to do here is prompt owners to investigate the web when they should be consulting directly with their vets. The information is available to vets in their practice, they recieve updated information on a daily basis, and they are fully aware of new treatment approaches, and whether or not those approaches are approved, studied, researched and/or applied.

[tippy]

my post isn't really addressing marauder's issues but i want to support what beth was saying. i grew up in a very rural community and the only vet in town was more of a livestock vet. when my cat (the first that was really mine) developed diabetes (after receiving steroids) we had to drive nearly an hour to a proper small animal vet. he would get horribly stressed and usually vomited before we got there. i followed the vet's instructions to the letter but the cat had several hypo episodes and it was a LONG way to the vet. when i moved away to college he came with me and now i had good veterinary care nearby but absolutely no money. he got care but i went hungry many nites. my new boyfriend, now husband is diabetic as were both his parents. bob had plenty of general knowledge in the disease. he suggested we try ourselves to get a blood glucose test from the cat. once we figured out how, it became obvious that my poor cat would get himself so worked up going to the vet that his curves were worthless as he was soooo upset. please remember that by now tippy had been diabetic for a couple of very shaky years and clearly wasn't well regulated and probably not long for this world. bob and i did our own curve and was shocked at how low he went with no symptoms. thinking maybe it was a fluke we tried again the next weekend. pretty much the same thing. i talked to the new vet about this and he was very surprized, more that we had done it ourselves than the actual numbers (this was before hometesting was so popular). we compared the meter with his equipment on one of the resident cats and they were close enough to consider the results we got valid. he agreed that in office curves were known to be elavated but he never had his own example. after reducing the dose to a safe level with only mild improvement, we started to discuss diet and for this i brought bob the diabetic along. i had been using a hi fiber diet (forget the letters) and it just wasn't working well. the vet was willing to try different foods as we were able to test for the glucose at home. what we finally had success with was, of all things, fancy feast flavors like the plain beef, chicken or fish (not the fancy gravy kinds) plain poached meats, mostly chicken, and some squash or pumpkin for a little fiber. the broth the meat was cooked in was offered in addition to plain water to encourage good hydration. daily rations were very consistent in proportion. honestly within a month tippy looked years younger.

i really wish i had the information beth was writing about back when tippy was first diagnosed. it may have saved him over 2 years of hell and me probably thousands of dollars. really, i did everything just as i was told with two separate and i believe competent vets. bob and i used different words but what she described is very close to what we did with amazing results.

thanks beth for sharing the info, i hope it will help someone else.

tippy's gone now, cancer not diabetes, but my new guy checkmate is trying to fill his paws.

Ann

[jason]

thanks beth for sharing the info, i hope it will help someone else.

couldnt help but notice similar ip subnets as beth in addition to locating you to the same geographical location.

her last post was deleted due to her tone and lack of respect for the board.