I have read a lot of the threads on here concerning cat DM & have been to a lot of useful & informative sites. I plan on doing glucose testing & have read the recommendations for meters, etc. Right now he has been prescribed Humulin, vet says to start with that & then we will work from there.
Cat is already on a low carb/hi protein diet. He has a bubbler to encourage drinking (he has always been a huge drinker, even b/f this)
I am not really asking any specific questions, but for those of you with diabetic cats, what would you have liked to have known?
This is my absolute favorite cat (I tell him all the time) & he also has lots of fans around town. He is a huge orange fluff ball who just loves everyone. He has really been through the ringer the past few weeks.
Last edited by Hippolyta; Oct. 4, 2012 at 03:20 AM.
Need pics! I had one. She was overweight. The DM didn't show up until she was quite old. Our routine was (dry food out all the t ime) feed wet food exactly every 12 hours, exactly one hour after feeding give her a shot (can't remember what the medicine was, if it was insulin or something else, this was a long time ago). At the time, I had to travel fairly extensively for business so when I was out of town had to board her at the vet because no cat sitter at the time could comply with precise feeding/med schedule. This went fairly well for about a year, at which point she became urine incontinent and would pee gallons and not in the litter box. It was horrible. I ended up keeping her in my spare bedroom when I was not home or sleeping and would have to wash the floor daily. It got worse. This was no kind of life for her, she was half meezer and very needy/social. Finally decided to euthanize her because her quality of life was not good. She was about 19.
Hope this info helps.
Armando del Fuego, Best Boy Ever (almost always)
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((hugs)) for both ~ monitor monitor monitor ~ plan your work & work your plan ~
Frist ((hugs)) for both of you ~
Monitor Monitor Monitor ~ plan your work and work your supplies ~
If something doesn't 'feel' right just off you go to emergency vet to have blood checked ``` visit the closest clinic BEFORE you need them for blood check ~ have your vet write and send an introduction for your cat ~ stating that he has advised you to run to the overnight clinic for checks when needed & you will not need the ALL comprehensive $$$$ examine !!!
Just plan ahead extra suppplies ~ extra viligence and extra patience and strength ~~
** please get acquainted with those people at the over night emergency clinic for your 'peace of mind' so you can have a quick blood check if needed ( during off vet hours)
Again ~ ((hugs)) know it is overwhelming at first but you two can do this ~
Welcome to the world of FD...it's not easy, but cats can live normal lives with correct care.
If you have not already, sign up for the Feline Diabetes Message Board. The members there are awesome; they talked me down from the proverbial ledge on more than one occasion!
One thing that stands out from your OP: Humulin is NOT a good insulin for cats. (It once was considered ok, but that is from older studies. The most up-to-date studies do not recommend it and many vets will no longer prescribe it. Some vets, however, are not up-to-date in their research on FD and still use the older protocols and often learn very little about it in vet school, according to mi vet, they glossed over it in one seminar.) It is very fast acting and wears off too quickly...it doesn't last 12 hours in cats, so their cycle is a series of sugar spikes and drops. It WILL bring the numbers down quickly, but they don't usually stabilize there for long. Sometimes it can cause too fast an too big a drop, and you do not want to deal with hypoglycemia as it can very quickly be fatal without much warning. The more recent protocols, and the ones that have by far the best remission rates call for using a long-acting insulin, either Lantus or Levemir. The cycle is much gentler, with a slow drop for about six hours and then a slow rise. Definitely Google the Roomp/Rand protocol and bring it to your vet; if begun very soon after diagnosis it has over an 80% remission rate. It does involve at-home testing, but tests done at home will produce more accurate numbers anyway as stress can cause glucose to go way up or way down, depending on the cat. I would talk to your vet about switiching to a more appropriate insulin ASAP.
My cat is on Lantus and, while I don't think he will go into remission (diagnosed too late, as vet misread test results; long story...), his numbers are very, very good all the time...I just checked his average for the last 30 days and it's 98-well within the normal range for a cat on a human meter.
Feeding has made a HUGE difference for my FD cat. Dry diabetic foods are all too high in carbs, low-carb canned food is what will help. You will want to keep a hypo kit available at all times-gravy canned food, like Fancy Feast gravy lovers, is often enough to do the trick if you catch a drop in glucose soon enough as gravy is high in carbs. If you have a dangerous hypo, you will want Karo syrup, which can be rubbed on the gums if the cat can't swallow, or can be given rectally.
I agree that the 12-hour feeding schedule is silly. Think of human diabetics...they are specifically instructed to eat many small meals and snack through the day as you want the levels to stay steady, not spike up and down. Generally, when the cat is on an appropriate insulin, you can feed throughout the first six hours after the shot as the insulin is doing its job. You don't want to feet within two hours before a shot as it can artificially inflate the numbers. My cat eats six times a day.
It is a LOT to deal with at first. It will get better, though! Do check out FDMB and the Roomp/Rand studies (and share those with your vet!). Once you get into a routine of caring for your cat, it gets easier...the hardest part for me is that I can rarely go anywhere in the evening or overnight as the 12-hour insulin schedule is strict.
I had a diabetic cat for many many years, & he was on Humulin as well - tolerated it just fine. Both the Humulin & the needles were relatively inexpensive. One bottle lasted in the fridge for quite a long time since he only received a tiny amount, & a box of the needles was like $14 for 100 (though this is going back a few years).
I kept a stock of pricey fancy-schmancy small-container cat foods on hand, & "Floyd" would come running for his injection every morning, since he knew it would be followed by a "special meal" that the other cats didn't get.
Squish, Bacardi, please read the most recent published studies on insulin in cats, particularly the ones by Roomp and Rand...they indicate that a long acting insulin is best and has the highest remission rate. They are endocrinologists (an internist is like a GP). Lantus is NOT a once a day insulin, it is a twice a day insulin, and it has a gentler curve. My vet will not prescribe Humulin for fear of a malpractice suit...seriously. My cat started on Lantus, was regulated at home in a couple of weeks and well regulated within a couple more. Well regulated means BG is under 200 at all times with no hypo episodes.
The problem with Humulin is it's not safe to give to a cat when the preshot BG is in the normal range, so it's harder to keep a cat tightly regulated (in the BG range of a normal cat all the time). The dose is based on the pre-shot BG reading, not the nadir of the cycle. It also rarely, if ever, lasts a full 12 hours. The way Lantus works, a tight regulation protocol can be followed, which in turn leads to a much higher chance of remission. When the Roomp/Rand protocol is started immediately at diagnosis or within the first few weeks, the remission rate is 86%. The remission rate on Humulin is around 40%. And remission should be the goal.
And I'm not a vet...just a pet owner who decided to take the time and do the correct research. Luckily my vet did too, because we were on the same page from day one. Many cat owners are not nearly so lucky, as some responses show.
Humulin is an excellent short acting insulin for treating something like diabetic ketoacidosis because it is fast and short acting. It does not last a full 12 hours in a cat. It is considered a good insulin for dogs, and many vets assume that means it's good for cats. That isn't the case.
Here is a link to part of the Roomp/Rand study that clearly states that Humulin is 4th on the list of insulins of choice for cats behind Lantus/Levemir, PZI/ProZinc, and Lente.
I work for those boarded internists (actually 4 to be exact) I curve several cats per day on a 24 hour hourly schedule. Many of the cats are on Lantus (and yes, some GP vets do prescribe it once a day). For most cats, it works quite well and some do go into remission. However, Humulin N is an insulin that really does get cats back on track with hard to challenge new diabetes, and unregulated ones (ie. ones that arent well regulated on Lantus). Im not disagreeing that lantus isnt good...it is, for a stable diabetic it really is the best one out there and I have had my own cat on it with remission! But, there is a time and place for Humulin N. Maybe not for the OP's cat, but for you to come and say "tell you vet to switch the insulin" is maybe a little premature without knowing the curve.
Again, looking at the big picture, the remission rate of Lantus is SO much higher (DOUBLE the rate on Humulin!) and while Humulin has its place, I feel it would be wrong not to suggest that the OP discuss the current studies with her vet ASAP. Regulation does not have to be done in the vet's office, nor do curves. My cat has not been to the vet's for a curve since the day he was diagnosed. I do them at home and email them to my vet and have since day one. Ao many vets insist on keeping the vet for a few days at diagnosis to "regulate" them.
The truth is, regulation takes more than a few days to be done correctly, it can take weeks or even months, and owners should be testing at home and working on the dosing protocol that keeps their cat in the normal range most of the time.
By definition, regulated means the cat is under a certain number all the time (I think 300?), well regulated means under 200 all the time, and tightly regulated means within normal BG range all the time, and studies show the best way to achieve tight regulation is with the longer-acting insulins because the dose isn't based on the pre-shot number, but on the nadir. It would be dangerous to give a cat in the normal range at shot time a dose of Humulin. Once the owner has the correct data, it's not dangerous with Lantus or Levemir and the tighter regulation has such a great remission rate that it should be promoted far more than it is.
The OP should know that there are options out there that could lead to her cat having a better chance for remission, IMO. While Humulin does have its uses, (DKA being an example), it has one of the lowest remission rates, and OP should know that so she can discuss better options with her vet.
Uh - thanks for the info Henry, but frankly, my cat started on Humulin around Age 5, & lived a long healthy life until just past 18. So I really do not doubt my vet's expertise, diagnosis or prescription.
You're obviously on a quest for your particular diagnosis/prescription which is fine, but would be much more effective if you weren't so preachy about it.
Yes, I know regulation takes more than a day, it can take months!
All Im saying is that when we get the ones that ARENT well regulated, the ones that regular vets cant figure out, the ones that need specialists to work on, SOME of these cats are put on Humulin. Most can be regulated with a better Lantus protocol, but not all. Although most cats respond so well to Lantus, there are some that simply dont. Im not implying this is the reason the OP's cat was on Humulin.
When we curve a cat on humulin N (on a 24 hour schedule), we do not "play" with the dose based on the first reading. THIS, in my opinion, is why the curves dont work well with it.
Sure OP, go tell your vet you want to switch insulins...vet should be ok with this, or give you reasons why he/she prefers not to. Lots of info out there and a good vet will listen to your concerns, and explain his/her choice
Also, remember that some people with financial constraints have few options. Humulin is much cheaper (at least here), as are the needles. While it may not be the best choice, for years and years it has helped many diabetic cats.
<<hugs>> Your kitty will be ok - it's going to take some adaptation on your part, but isn't that what pets are for! Useful tips:
Find a reputable vet & trust them - bulletin boards are great, but when push comes to shove - your vet is going to be the one you call in an emergency. If you opt to do home testing (highly recommend it), work closely with your vet. The biggest thing I learned is that you have to be careful if your cat vomits - this can cause them to go hypo. So definitely check glucose if kitty gets sick - before you give insulin again. Kitties learn to deal with the picks & pokes. Also, you're going to need a back up when you travel - start looking now. Get your cat used to taking food & insulin from this person. It is overwhelming at first, but it does get to be routine. Good luck
Bacardi1, I'm sure your cat did fine on Humulin; it did used to be the go-to for all pets several years ago. OTOH, on a better insulin, perhaps you could have achieved remission and not had to give insulin at all for all those years? There are no guarantees, but 86% remission rate is a much better number than 40%. As I said, why wouldn't remission be the goal instead of long-term maintenance on insulin? But, of course, I forgot that you are perfect in all aspects of animal husbandry...
Anyhow, OP, I hope that you will check out the FDMB, the people there, including some who are vets, are amazing--knowledgeable, up-to-date, and available. I've seen them sit up all night and help another member through an emotional crisis or slip a few dollars to a person in need. They have free test kits available for newbies and it's an awesome resource for cat owners.
And again, I'm not saying you should go demand a new insulin, but DO talk to your vet about the newer protocols for long-acting insulins and take the info with you to show him or her. IMO, a much better chance of remission is worth at least a discussion, don't you think?
Squish, how are Humulin syringes less expensive? The insulin, yes, but insulin syringes are insulin syringes. I get a box of 100 at Walmart for about $13. I think the U-40's for PZI might be more, but U-100s are standard and available from any human pharmacy. Most states don't require a prescription for the syringes.
Last edited by HenryisBlaisin'; Oct. 5, 2012 at 03:45 PM.
I am sad to say that right now he has having so many other issues (gut has more or less shut down) that I think we are at the point where I have to say goodbye. We have an appointment on Monday. Right now he at least feels good enough to still come around looking for snuggles & I want to make sure that he doesn't get to the point that he his hiding or in extreme pain. I can't put him through any more, we have been back & forth to the vet, the ER, he HATES going there.
It really stinks. He is my all time favorite: an absolute giant red cat, super cuddly, lots of headbonks & purrs. He has always let me do anything to him, even if he doesn't like it, never a hiss or a growl. Due to his color & size, he really rocks out his lion cut. Everyone who meets him falls in love.
I'm so sorry to hear this, but in his case it's most likely for the best. My thoughts, good wishes, & prayers will be with both of you. While it's sad to lose any of our critters, the favorites are obviously always the hardest.