# diabetic cat - not convinced the vet is giving the best advice



## snowathleteq (Jan 1, 2011)

Hi,

My cat got diagnosed recently after starting to drink lots and lots of water, and peeing a lot.

Vet took his blood and said he has diabetes. Fair enough.
They then sold us some expensive hill plan diet food which is apparently good for the cat (i have some issue with this which i will come to in a moment)
they also gave us Caninsulin and told us to give 5units 2 times a day after his two meals.

Regarding the food, looking on the back, its still about 25% carbs, which means his blood sugar will be higher than if we gave him 90-100% meat instead. This seems a poor place to start.

As it is his insulin, doesnt seem to make him much better. After 2 weeks his fluctose test showed he was high, 23 i think she said. He has improved, but not much i dont think.

They told us to start giving him 6 units and come back for more tests in two weeks. After 10 days there is basically no difference.

They want to test him again, which i think is pointless as i can tell by his symptoms that he is still way too high.
They also suggested bringing him in for a series of tests throughout the day...

My wife and I dont work (wife about to give birth and i am disabled) so money is becoming a big issue in this now, so i want to avoid any unnecesary tests...

I am tempted to swap him to 90% meat, and no more than 10% carbs, and see if there is improvement, if not then ask to try a different type of insulin.

What advice can you give me?

Many thanks


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## davidc (Dec 15, 2010)

snowathleteq said:


> Hi,
> 
> My cat got diagnosed recently after starting to drink lots and lots of water, and peeing a lot.
> 
> ...


I can't advise you on the diabetes, but if you have any doubts about your vets, I would say change them if you can. Storm (my gerbil) was incorrectly diagnosed as having a tumour and my previous vets suggested to leave her on her normal, hard food, despite a teeth problem that meant she couldn't eat it and they also suggested putting her down (I would have agreed if I didn't have so many doubts, but I did and wanted to be sure before taking that step). I took her to another vets, it turned out, as I expected, that there was no tumour, and he gave me some Emeraid to bulk her up. I also fed her her normal food blended in a grinder. She became her old self again, active and happy. So although, she died a couple of months or so after she first saw the vet, she didn't die hungry and died naturally of old age.
If I hadn't have changed vets, I wouldn't have had that extra time with her and she would likely have died from starvation.
So it's always worth getting another vets opinion if you can if you have any doubts.


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## Doolally (Oct 12, 2010)

I'm sorry to hear what you're going through with your cat.

It can be difficult to get cats controlled initially, so for the first part at least it will be fairly expensive doing the tests etc to make sure you're on track. 
The fructosamine tests will tell what the blood glucose has been doing over the past few weeks. The series of tests over a day is a blood glucose curve, with blood glucose levels taken at 2 hourly intervals to show when the insulin is taking effect, and if it is having enough of an effect.
If both you and your vet are willing, you could possibly do the glucose curve at home yourself. It'd perhaps save you a bit of money, with you just needing to buy a glucometer, and it'd save the cat the stress of being in the vets for the day which can give cause blood glucose to be high anyway.

Someone else will be along advising of diet, I remember seeing a good link someone once posted to some diabetic cat sites so hopefully someone will post these too.

But the main thing is to have a vet you trust, so if you don't like yours then seek a second opinion


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## snowathleteq (Jan 1, 2011)

I think i will suggest doing the glucose curve at home, my dad is diabetic and i know how easy it is, and not only cost saving but it will be alot nicer for my cat, who hates being in a car, and hates being anywhere unfamiliar.

Its possible my vet will not mind this but who knows. Its not that i dont like the vet, or anything like that. Its just that diabetes is a very misunderstood illness, even (perhaps even especially) by alot of profesionals.

In my view, typically speaking the best start is to reduce the amount of the problem substance, i.e. sugar (carbs).

I also feel that i am paying the vet to use her experience to get to the bottom of things as quickly as possible, rather than take every step in a flowchart to get to the outcome, even when the result of a certain step will be obvious up front.

Thing is if i understand it correctly, i need the vet on side for the sake of getting insulin prescribed (i assume there is no other way to get it?)


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## hobbs2004 (Mar 12, 2010)

snowathleteq said:


> Hi,
> 
> My cat got diagnosed recently after starting to drink lots and lots of water, and peeing a lot.
> 
> ...


Definitely find another vet for a second opinion. When you phone around and/or ask around try to scope how much experience they have with feline diabetes.

You are on the right track with your dietary considerations. Choose a high protein, low carb wet food (if you buy online then foods such as Animonda Carny, which isn't a special diabetic food but 99% meat and no carbs) or even raw food. Also get a testing kit for at home, especially if you are trying to control it to a large part with diet as you will need to keep tabs on how much insulin is needed on the carb free food.

In the meantime, read, read, read.

Fabcats contains info on FD: Managing the diabetic cat

There is a US site dedicated to FD: Feline Diabetes -Diabetes in Cats - Treatment and Diabetic Cat Info - FDMB. They also have a board.

Another interesting site, also talks about food, hometesting and FD: http://www.catinfo.org/?link=felinediabetes

Oh, and send a private message to Paddypaws on here. She has a cat with FD and she is a very helpful soul!

Best of luck!


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## Paddypaws (May 4, 2010)

God Hobbs...you typed a whole response in the time it took me to get comfy and ready to reply!
Snow poster ( sorry cant remember the name ) You actually have a far better grasp of diabetes already than most vets. Congratulations.
You are completely right about the food but PLEASE do not make this change yet....the 5 units of caninsulin is a massive dose and you will undoubtedly send your cat into hypo if you change the carb content of food at this stage.
Please go to Home | Diabetic Cat Care and read the protocol there....we treat a diabetic cat just like a human, by testing the BG and then giving an accurate dose of insulin based on a sliding scale.
From what I have read in your posts so far you sound like a person who will absorb all the given info very easily.
The main problem I foresee is the insulin.....Caninsulin is NOT a good insulin for cats and unfortunatley ProZinc which is ideal, has recently been discontinued. There is another alternative which we will have to look in to....Hypurin which is actually formulated exactly the same as Prozinc but is marketed for human use. Under the cascade scheme any vet has some flexibility around prescribing Human medicines if there is not a suitable licensed veterinary alternative. *
Learning to home test a cat is easy....I recommend the Freedom freestyle lite metre with the newer butterfly strips ( both of which human diabetics get free on prescription, hint, hint )
Caring for a diabetic cat does take time and commitment....but does NOT require expensive veterinary involvement.
Please read the protocol on the site I have listed and sign up on the forum...you will receive expert friendly responses in a very short space of time.
I would also be delighted to be of any help I can via pm or phone call.
See you over on the other forum!
Claire
*http://www.bsava.com/Advice/BSAVAGu...gcascadeandofflabeluse/tabid/360/Default.aspx


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## snowathleteq (Jan 1, 2011)

Hi all,

Spoke to the vet and they said a few things which again I am not sure about.

- she agrees that we can home test (though she did have some reservations which I talked around). We have a blood glucose monitor at home (my dad is diabetic) but she says they cant be used, and only 'special' ones for animals can be used. I dont buy this. what on earth can be different about it? Both use needles to puncture the skin, and then blood goes on the strip which measures the level of sugal per unit of blood.

Am I wrong?

The other thing she says is that in the UK there is only one type of insulin (caninsulin) available now, as the others are no longer sold. I think I read somewhere that a vet is able to prescribe insuline made for humans if its effective also for animals and there is no other animal brand alternative.

Am I wrong?

Finally, she is happy for us to feed him the food we choose, and agrees that the feed she reccomended is expensive. But she says its better because it has slow release carbs which keep the blood sugar level stable, and this is better than having a food with no carbs or very very low carbs in it.
I cant possibly agree with this. Surely the root cause of the problem here is too much sugar being injested. Cut that down then you should need less insulin to counter that.
My thought is that the vet prefers it as it is easier to manage a cat on a highish level of sugar, because there is less risk of a hypo occuring (say if you feed/injected late or whatever) its easier to manage basically, and means that all their customers are doing the same easy thing. But its not best for the cat. Having a highish level of sugar in his blood just means he is feeling ill all the time. My heart breaks for him, he seems fatigued and unhappy all the time.

Am i wrong?

In defence of my vet (because i dont want to make out they are horrible or anything like that - they arent). In fact they are very kind. Because my wife and I have financial difficulties at the moment, they offered to lend us their meter and look at the results for free. This is clearly very generous of them and I am grateful for it. that said, im just not sure I agree with everything im being told about the best way to deal with the problem.

Thanks
Joel


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## holly1 (Aug 10, 2010)

For on going medical expenses, ask the vet for a 3 or 6 month repeat prescription.They will charge you about £7 for the paper,then buy it online.This is what rescues do.
I have a foster dog,which needs tablets every day for his heart.
The vet quoted £43 for a month script,for buying the drugs through them.
The charity get the same stuff of an internet site for £25 a month.


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## BlackCat (Feb 17, 2008)

snowathleteq said:


> We have a blood glucose monitor at home (my dad is diabetic) but she says they cant be used, and only 'special' ones for animals can be used. I dont buy this. what on earth can be different about it? Both use needles to puncture the skin, and then blood goes on the strip which measures the level of sugal per unit of blood.
> 
> Am I wrong?


The first dog/cat specific reader is relatively new (only in about the last 2-3 years) so before that human readers were used-there was nothing else to use so it was made do. They still are in some practices but the readings are more accurate when using one designed for a dog or cat.



snowathleteq said:


> The other thing she says is that in the UK there is only one type of insulin (caninsulin) available now, as the others are no longer sold. I think I read somewhere that a vet is able to prescribe insuline made for humans if its effective also for animals and there is no other animal brand alternative.
> 
> Am I wrong?


To an extent you are. Caninsulin is animal specific now seeing as the other Insuvet ranges are no more. The chance of caninsulin not working is extremely small so I wouldn't imagine any vet would go against the legal cascade (which is what you refer to) to authorise the prescription of a non-veterinary licensed insulin.



snowathleteq said:


> Finally, she is happy for us to feed him the food we choose, and agrees that the feed she reccomended is expensive. But she says its better because it has slow release carbs which keep the blood sugar level stable, and this is better than having a food with no carbs or very very low carbs in it.
> I cant possibly agree with this. Surely the root cause of the problem here is too much sugar being injested. Cut that down then you should need less insulin to counter that.


Its not that too much sugar is being ingested, its that this sugar (glucose) is unable to distribute into cells as energy because of low insulin or failure to respond. The prescription diets are good, and for overweight/obese cats they can certainly give a good kickstart with weight loss/maintaining levels, but plenty of cats can stabilise just as well on their normal diet as well.

Diabetes mellitus unfortunately isn't textbook with regards to a one-treatment-fits-all, especially in cats. There are often lots of alterations to be made to insulin dosages, diet etc before there are any signs of the cat becoming stable. Glucose curves (the regular sampling over the course of the day) is perfectly normal and is a necessary part of stabilising and then monitoring. If you can't get to the practice, do the tests at home if you're happy with this-for cats who get stressed in practice this can work out better as stress contributes to increase glucose in cats.

You really need to discuss this with your vet, it is their job to go through this with you-for most owners its completely new to them.

Good Luck!


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## snowathleteq (Jan 1, 2011)

Thanks blackcat. 
Your right of course about the problem really being about the lack of insulin to get the sugar into the cells. What i really mean is given that situation, it seems to me the best corse of action is to limit the amount of sugar in the blood in the first place. This seems especially sensible to me because cats in nature would i guess get very little sugar in their diet. They wouldnt be eating grains etc, but rather meats.

Also true of humans, I got to be honest with you, I love a donut, but i also think its not good for me. Ive also been alarmed at the amount of sugar in human foods where you would not expect it. Alot of ham and bacon and pork and chicken and so on, sold as raw meat, actually has been soaked in sugar solutions to make it taste nicer, and of course to preserve it for longer so it stays on the shelves longer at the supermarket before the sell by date...sorry im rambling...my point is, i suspect this is why Diabetees cases in the UK are going up all the time.

Thanks for hte advice one and all.

Joel


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## mrswoodwoose (Jan 23, 2011)

snowathleteq said:


> Hi all,
> 
> Spoke to the vet and they said a few things which again I am not sure about.
> 
> ...


Hello,

I have been home testing my +/- 21 year old diabetic cat for over 2 years ans use the Abbot Freestyle Lite as it only needs a very small drop of blood. You can use human BG monitors, they cost a fraction (like £12) compared to the animal ones which are over £100!!

Depending on your insurance, it maybe cheaper to buy test strips and lancets via ebay - it doesn't work out for me cos altho cheaper, insurance won't pay postage, so dearer for me. Yet they are happy to pay MORE money out when I buy the more expensive version elsewhere...go figure! If you order direct from Abbot it is pretty cheap and comes 1st class the next day (usually). Direct from your local pharmacy would be the dearest.

I find zooplus a great website for ordering special food - their nutritional info is good and delivery rates good - their packaging can be hit & miss - be sure to complain if damaged. The best food by far for my cat is Bozita Pate, also available in the Uk from Seapets (more flavours than zooplus).

While taking advice from your vet I think you're right to question and to research - all the vets I have ever spoken to will only tell me to feed Hills or maybe Royal Canin, and they all think the dry is best. 8sigh* EVERY CAT IS DIFFERENT.

good luck!


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## mrswoodwoose (Jan 23, 2011)

snowathleteq said:


> - she agrees that we can home test (though she did have some reservations which I talked around). We have a blood glucose monitor at home (my dad is diabetic) but she says they cant be used, and only 'special' ones for animals can be used.


 hi, I'm pretty sure I replied to this a bit earlier, but it appears to have been lost in cyberspace. The human BG monitors cost about £12 and the other type over £100! I use the abbot Freestyle Lite which only needs a small blood sample. test strips are dear, cheaper from Abbott themselves or ebay if your insurers pays postage costs.



snowathleteq said:


> Finally, she is happy for us to feed him the food we choose, and agrees that the feed she reccomended is expensive. But she says its better because it has slow release carbs which keep the blood sugar level stable, and this is better than having a food with no carbs or very very low carbs in it.


I feed Bozita pate which works best for my cat, see zooplus or seapets. What you want is good quality protein, low carbs and low fat. Zooplus has good nutritional info, Every Cat Is Different tho, it might mean trying different food to see if anything does help, but this could take some time while your cat settles with insulin.

Yes they have stopped Prozinc, a real bummer. Not sure what else is available here now, agree Caninsulin not the best option, certainly not for my old girl.

good luck


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## Doolally (Oct 12, 2010)

For what it's worth we use a human glucometer in practice as the veterinary one we had was given inaccurate results...I can't even remember what it's called the one we've got as we use it so infrequently (was trying to google it but can only picture it in my head, not alphatrak though), but we use the human one almost daily and are more than happy with the results, they compare well to our big lab machine


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