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georgepds
April 16th 08, 07:03 AM
My 10 year old 10 pound tuxedo (Bella, neutered male) was just
diagnosed with diabetes. The vet says his BG is 400, my wife and I
measured it ( first timers... what excitement) at 437 with a one touch
ultra mini glucometer this evening. The cat does not like it, but it was
not that difficult (we used a paw pad prick with the very strong kitty
wrapped in a towel, she held him and I pricked)

Previously we were feeding him dry food that was ~50% carb. After
reading up on feline diabetes we switched to 7% carb (EVO), and are
thinking of switching to raw meat. The plan is to watch the BG ( read
every other day) and, should it start to rise, begin a treatment of
insulin. Given my druthers... I'd rather treat the cat by change of
diet, but am willing to go further if needed

My question is should I just simply begin insulin treatment now? I'm
extrapolating from humans.. my GP tells me he has patients that come in
year after year with BG of 400. From what I've read change of diet can
help. I just do not know how serious 400 is in a cat, and if I have the
time to wait for the change in diet to kick in.

Rest assured, should he not improve, I'll start the course of insulin

Phil P.
April 16th 08, 09:58 AM
"georgepds" > wrote in message
...
> My 10 year old 10 pound tuxedo (Bella, neutered male) was just
> diagnosed with diabetes. The vet says his BG is 400, my wife and I
> measured it ( first timers... what excitement) at 437 with a one touch
> ultra mini glucometer this evening. The cat does not like it, but it was
> not that difficult (we used a paw pad prick with the very strong kitty
> wrapped in a towel, she held him and I pricked)
>
> Previously we were feeding him dry food that was ~50% carb. After
> reading up on feline diabetes we switched to 7% carb (EVO),

Excellent move! High-carb diets put a heavy demand on beta cells in the
pancreas to secrete insulin- and probably contributes to- if not actually
causes- beta-cell failure in cats that are predisposed to diabetes. I've
weaned several cats off insulin completely simply by feeding them a low-carb
diet--- which is the cat's natural diet in the wild, anyway.



and are
> thinking of switching to raw meat. The plan is to watch the BG ( read
> every other day) and, should it start to rise, begin a treatment of
> insulin. Given my druthers... I'd rather treat the cat by change of
> diet, but am willing to go further if needed
>
> My question is should I just simply begin insulin treatment now?

Because you're monitoring his BG at home, you can combine both therapies
(low carb and insulin) and adjust his insulin dosage based on his response
to the low-carb diet. I would check his BG twice a day before giving him
insulin rather than every other day for better control and to avoid insulin
overdose and overlap- especially if you're using glargine (Lantus) insulin-
which is the insulin of choice for diabetic cats.

The quicker you get his BG under control the better the chances of beta-cell
recovery and remission.

Best of luck,

Phil

MaryL
April 16th 08, 02:24 PM
"georgepds" > wrote in message
...
> My 10 year old 10 pound tuxedo (Bella, neutered male) was just diagnosed
> with diabetes. The vet says his BG is 400, my wife and I measured it (
> first timers... what excitement) at 437 with a one touch ultra mini
> glucometer this evening. The cat does not like it, but it was not that
> difficult (we used a paw pad prick with the very strong kitty wrapped in a
> towel, she held him and I pricked)
>
> Previously we were feeding him dry food that was ~50% carb. After reading
> up on feline diabetes we switched to 7% carb (EVO), and are thinking of
> switching to raw meat. The plan is to watch the BG ( read every other day)
> and, should it start to rise, begin a treatment of insulin. Given my
> druthers... I'd rather treat the cat by change of diet, but am willing to
> go further if needed
>
> My question is should I just simply begin insulin treatment now? I'm
> extrapolating from humans.. my GP tells me he has patients that come in
> year after year with BG of 400. From what I've read change of diet can
> help. I just do not know how serious 400 is in a cat, and if I have the
> time to wait for the change in diet to kick in.
>
> Rest assured, should he not improve, I'll start the course of insulin

In addition to what the others have written: It is preferable to prick the
ears, not the paws. Cats barely notice when you use that location. I also
suggest that you use a quality canned food that has *no* grains. Cats
simply do not need carbs! Wellness is an excellent product, and many people
with diabetic cats have achieved normal BG on this diet.

MaryL

Dick Ballard
April 17th 08, 07:42 AM
On Wed, 16 Apr 2008 08:24:38 -0500, "MaryL"
-OUT-THE-LITTER> wrote:

>In addition to what the others have written: It is preferable to prick the
>ears, not the paws. Cats barely notice when you use that location. I also
>suggest that you use a quality canned food that has *no* grains. Cats
>simply do not need carbs! Wellness is an excellent product, and many people
>with diabetic cats have achieved normal BG on this diet.
>
>MaryL

I also would suggest using the ears. I've been treating our 19 year
old orange short hair (Alf) with PZI insulin and monitoring with ear
sticks twice daily for many months now.

His bg of over 600 mg/dL was initially precipitated by dexamethasone
therapy given for asthma. We quickly gave that up and switched him to
canned food without the grains along with the insulin therapy. He then
went into remission for about a year.

But then his bg's started creeping up again and we had to resume the
insulin. His age may be a factor, partly because he has become a lot
less active, so it looks like a lifelong insulin commitment now.

As for the insulin types, there is no clear answer. Several versions
are in common use for cats. See:

http://www.felinediabetes.com/insulin_selection_Nelson.htm

Also explore the entire site at:

http://www.felinediabetes.com/

There are several references and videos about BG testing in the link
box on this page:

http://www.felinediabetes.com/bg-test.htm

This next site is by a veterinarian who emphasizes "tight control" by
way of dietary modifications along with insulin and home testing. She
doesn't describe the actual testing process, but refers to it in her
"Protocol" section.

http://www.yourdiabeticcat.com/index.html

This next one is a UK site, so watch out for the BG units used in the
graphs (mmols/liter). Multiply by 18 to get mg/dL.

http://www.sugarpet.net/index.html

And yet another pet diabetes site (many topics here - home testing is
under "Diabetes Education"):

http://www.petdiabetes.org

And from Pet Diabetes Wiki:

http://petdiabetes.wikia.com/wiki/Hometesting_blood_glucose


A glucose meter suggestion:

The EasyPRO meter purchased from Target for $8.99. The test strips are
$21.99 for a vial of 50 strips. That price for the strips is half the
usual rate for most meters. 1.5 ÁL sample and 15 second response time.

This meter has since been replaced by the EasyPRO Plus meter,
identical except for shape, 1 ÁL sample, and 10 second response time.

The meter is quite small and light, is simple to use, and has no
distracting audio beeps. It doesn't have meal/activity labels for the
readings (before/after meals, exercise, injection, etc) as do the
fancier meters, but that doesn't seem important for this use. It does
record date/time with each reading, stores 250 readings, and does 14
and 30 day averaging.

Dick Ballard

Phil P.
April 17th 08, 08:48 AM
"cindys" > wrote in message
...
>
> "Phil P." > wrote in message
> news:[email protected]
> >
> > "georgepds" > wrote in message
> > ...


> >> My question is should I just simply begin insulin treatment now?
> >
> > Because you're monitoring his BG at home, you can combine both therapies
> > (low carb and insulin) and adjust his insulin dosage based on his
response
> > to the low-carb diet. I would check his BG twice a day before giving him
> > insulin rather than every other day for better control and to avoid
> > insulin
> > overdose and overlap- especially if you're using glargine (Lantus)
> > insulin-
> > which is the insulin of choice for diabetic cats.
> --------
> I can attest (from personal experience) to this part about checking his BG
> before administering the insulin is straight on. When Alex (of blessed
> memory) was diagnosed, and our veterinarian explained about giving the
> Lantus and monitoring the BGs, she gave us explicit instructions to *not*
> adjust the Lantus dose on our own. She said that clients often try to do
> that and get into trouble because they don't know what they're doing.


That's good advice since most people with newly diagnosed cats don't know
what they're doing. But it doesn't take long to know what you're doing if
you do your homework and your vet educates you rather than merely gives you
instructions to follow without explaining them.


She
> said we should phone her before making any changes in his dose.


I'm surprised she didn't give you a guide sheet with doses for various BG
levels- especially when using glargine- which is well known for producing
rapid declines in BG and rapid remissions when therapy is initiated early.


>
> We were advised to check BGs but only once weekly (but five or six times
on
> that one day) in an effort to graph how Alex's BG fluctuated at various
> hours of the day.

Glargine has a very long duration of action in cats that usually results in
a carry-over effect from the previous dose. So, its a good idea to check BG
before giving glargine injections. This is especially important if the cat
is starting on the road to remission as your Alex was. You're very lucky his
testing day fell on a day when his BG was very low. If his testing day fell
on a day later he would have been in big trouble.

Hopefully, the high success rate of glargine will reduce the number of
owner-surrenders and euthanasia of diabetic cats. Most of the diabetic cats
we've had we got from vets- the owners brought the cats in to be euthanized
because they couldn't- or didn't want to- be bothered with treating their
cats. Some of the owners signed their cats over only because it was cheaper
than euthanasia.

Phil

Phil P.
April 22nd 08, 11:18 AM
"cindys" > wrote in message
...
>
> "Phil P." > wrote in message
> news:[email protected]..
> snip
> >
> > Glargine has a very long duration of action in cats that usually results
> > in
> > a carry-over effect from the previous dose. So, its a good idea to check
> > BG
> > before giving glargine injections. This is especially important if the
cat
> > is starting on the road to remission as your Alex was. You're very lucky
> > his
> > testing day fell on a day when his BG was very low. If his testing day
> > fell
> > on a day later he would have been in big trouble.
>
> Yes, and that's why I posted about it and agreed with you that it is a
good
> idea to check a BG before giving the cat his Lantus (glargine) each time,
or
> at least check the BG once a day. Once a week is not nearly enough.


Absolutely- Insulin needs wax and wane in a lot of cats. The correct dose
today could be an overdose tomorrow.


And in
> retrospect, I don't see what was the point of trying to chart his BG highs
> and lows (by testing five or six times in one day but doing this only once
a
> week).

Generally, a glucose curve is plotted at the beginning of therapy to see how
the cat metabolizes the insulin. This helps to determine the correct dose
and dosing intervals. Its a good idea to also plot a new curve whenever you
make changes in the cat's diet or feeding pattern, and, if you see changes
in the cat's daily pre-meal BG levels. If there are no changes, and the cat
is regulated I see no reason
to plot a curve on a weekly basis.



And we didn't know that the situation could turn around to that
> degree in only a few days. In fact, we didn't know Lantus could send him
> into remission. We just assumed he would need it indefinitely. When have
you
> ever heard of a person with diabetes going into total remission/being
cured
> in a week or two?

I've seen cats lose their need for insulin in a matter of a few days just by
changing them over from dry food to canned kitten food. So, I completely
understand your surprise. The first time it happened, I rechecked the BG
with 3 different meters including a lab bench meter.


In my wildest imagination, I wouldn't have anticipated
> this outcome for Alex. But as I wrote in another post, it's my
understanding
> (based on what our new vet said) that this isn't true diabetes mellitus
> (like a person would have). For simplicity, the vet calls it "diabetes"
but
> it's actually some sort of acute pancreatitis, and the Lantus gives the
> pancreas a little rest, and the cat recovers.


Actually, it sounds like Alex's diabetes might have been transient. Chronic
hyperglycemia impairs insulin secretion by the beta cells. Switching him
over to the low carb diet lowered BG levels and allowed beta cell function
to improve which made the glargine work much faster. From anecdotal reports,
it seems that glargine coupled with a high-protein, low-carb diet results in
diabetic remission in >25% of diabetic cats.


> > Hopefully, the high success rate of glargine will reduce the number of
> > owner-surrenders and euthanasia of diabetic cats. Most of the diabetic
> > cats
> > we've had we got from vets- the owners brought the cats in to be
> > euthanized
> > because they couldn't- or didn't want to- be bothered with treating
their
> > cats. Some of the owners signed their cats over only because it was
> > cheaper
> > than euthanasia.
> >
> Couldn't you just cry?

Actually, I really wish I could make the insensitive, selfish owners cry-
and cry... (if you take my meaning).


One of the (many) things I love about the new
> practice where I take the cats is that they refuse to euthanize if the cat
> has a treatable condition. When an owner wants to do that, they talk
him/her
> into simply turning the cat over to them, then they rehome the cat with
> someone who is willing to treat the illness.

That's the best thing to do. You have a great vet. Once the owners make the
decision to kill the cat- I *never* try to talk them into keeping her. As
soon as the guilt wears off there's a good chance they'll just dump the cat
leaving her to die a slow, miserable death rather than being made to like
the cold, selfish, insensitive *******s they are.


> Best regards,
> ---Cindy S.

Phil

georgepds
April 26th 08, 03:53 AM
georgepds wrote:
> My 10 year old 10 pound tuxedo (Bella, neutered male) was just
> diagnosed with diabetes. ...
> Rest assured, should he not improve, I'll start the course of insulin

So I took Bella in so the vet could decide the dose. The next day I get
a call.."what's with his breathing". An x-ray confirmed fluid on the
lons, and inspection of the fluid showed white blood cells. The
vet/nurse tells me it's an indication of cancer. The vet tells me there
is no point in treating the diabetes

My wife, who was distraught at how the cat would handle the vet put her
foot down, stopped further tests, and we took him home to make him
comfortable. Every morning I great him with a "so you're still among the
living". He's lethargic and , for the most part, seeks out the odd
corner to sleep. He has none of the strength that he had (years playing
the role of big strong kitty). But, he's not crying, his eyes are clear,
he manages to walk to the kitchen to greet us as we come home, and purrs
when we pet him. It's been like this since Monday. He looks better than
when he came home from the vet, but he's not well

So long as he's not in visible distress, we'll just keep him
comfortable. Damn, but I'm going to miss him if he goes. Kitty
mortality sucks, big time. It turns out, I'm ill equiped for this type
of loss.

If any of you have experience in what to do for a failing kitty, please
let me know

-george

georgepds
April 26th 08, 03:56 AM
georgepds wrote:
.... An x-ray confirmed fluid on the >> lungs <<

MaryL
April 26th 08, 07:44 PM
"georgepds" > wrote in message
...
> georgepds wrote:
>> My 10 year old 10 pound tuxedo (Bella, neutered male) was just diagnosed
>> with diabetes. ...
>> Rest assured, should he not improve, I'll start the course of insulin
>
> So I took Bella in so the vet could decide the dose. The next day I get a
> call.."what's with his breathing". An x-ray confirmed fluid on the lons,
> and inspection of the fluid showed white blood cells. The vet/nurse tells
> me it's an indication of cancer. The vet tells me there is no point in
> treating the diabetes
>
> My wife, who was distraught at how the cat would handle the vet put her
> foot down, stopped further tests, and we took him home to make him
> comfortable. Every morning I great him with a "so you're still among the
> living". He's lethargic and , for the most part, seeks out the odd corner
> to sleep. He has none of the strength that he had (years playing the role
> of big strong kitty). But, he's not crying, his eyes are clear, he manages
> to walk to the kitchen to greet us as we come home, and purrs when we pet
> him. It's been like this since Monday. He looks better than when he came
> home from the vet, but he's not well
>
> So long as he's not in visible distress, we'll just keep him comfortable.
> Damn, but I'm going to miss him if he goes. Kitty mortality sucks, big
> time. It turns out, I'm ill equiped for this type of loss.
>
> If any of you have experience in what to do for a failing kitty, please
> let me know
>
> -george

I am going to make a recommendation that I seldom make. That is, it is time
to take Bella back to the vet and have him put to sleep. ASAP. You are
doing your cat no favors by keeping him alive because he is obviously
already in distress. Cats are noted for being stoic and hiding pain, so a
cat that shows discomfort is already suffering.

Please let me tell you a story. Years ago, I had to have one of my cats put
to sleep. I had friends (a married couple) who were absolutely horrified.
They said they loved their cats so much that they could never do that. Some
time later, they came to me and told me how much they had regretted that
decision. Their cat had become extremely ill and was in declining health
over a period time, and this was at a time when there was no 24-hour-service
or emergency veterinary service available. They said they sat up *all night
long,* crying and crying, as they watched their cat literally drown in his
own fluids. It was agonizing. They have regretted to this very day the
fact that they did not make a decision in time to save their beloved pet
from suffering through this incredibly painful night.

Unfortunately, there are times when we must make this most painful of all
decisions in order to protect our cats. It is far better to make the
decision before the cat has to endure the type of death I just described. If
your cat has fluid on the lungs, it is likely that it will only get worse,
and it is now an act of cruelty to simply watch him die. I know you brought
him home and intended to keep him comfortable. If that were possible, then
that is what I would want to see you do, but it really is not possible. A
cat with fluid on the lungs can *suddenly* go into respiratory distress. At
that time, your cat is essentially drowning. You will have no warning, no
time to make a decision at that time to get to a vet. So, please, for the
sake of your cat, take action now.

You really do have my deepest sympathies. I have been through this, and
there is nothing more difficult or traumatic than having to make the
decision for euthanasia, but it is a final act of love (and responsibility)
on our part.

MaryL

georgepds
April 30th 08, 06:42 PM
cindys wrote:

> do, you would. But there isn't. You're not doing him a favor by keeping him
> around. But you can show your love for him by ending his suffering.
> Purrs and hugs for you and your kitty.

Thank you for the purrs and hugs. Bella has recovered, at least to the
point he was before he went to the vet. His breathing is normal, he
eats, poops, pees, and pukes (hairballs) on his old schedule. He can
jump on tables, climb upstairs tussle with Zeno, the other cat, and purr
with delight. I've changed his diet and feed him canned food now, in
addition to the dry EVO, and he looks forward to it with anticipation
each morning

My best guess is the vet used a strong sedative and it took Bella a few
days to recover. That said it is a little soon to tell the seriousness
of the illness, and I'll keep an eye out for distress, respitory or
otherwise. I've made my peace with letting him go, but I do not want to
pull the plug on him if he is just feelin a little blue.