ON FELINE DIABETES...
What I am about to write may anger some veterinarians, but those that do get angry will be the ones that aren't treating diabetic cats properly. Unfortunately, while I'm sure that there does exist a set of veterinarians that take a proactive approach to treating feline diabetes with the intent to put cats into remission, I have yet to hear of any from the numerous people I've worked with and know of only one in my area (my own vet) that is up to date on treating diabetes. It's a sad state of affairs when there is a very successful protocol for proper management of feline diabetes and getting cats off insulin and it is ignored by the vast majority of veterinary professionals.
In the years that I've been helping people with diabetic cats, over and over I've heard things that make no sense and are sometimes harmful in the scope of managing feline diabetes. One vet says re-use needles until they are dull (insulin needles are "single-use" for a reason and re-using them can introduce bacteria into the insulin and contaminate it.) Another says you shouldn't home-test your cat's blood sugar (even though it is imperative for properly managing blood sugar and is always recommended for humans!) Yet another recommends free-feeding high carb diets to a cat that has an inability to process them, which is really no different than feeding a constant diet of candy bars to a human diabetic!
Unfortunately, while some vets may have a "technical" ability to treat diabetes that is learned in vet school, it's not enough and the best experience is that which is gained by actually living with and managing a diabetic cat. In this respect, if you have a cat that has been diagnosed with diabetes, it is imperative and in your and especially your cat's best interests to learn everything you can about this disease and how to manage it. Don't blindly trust your vet or believe everything they say without question. Do your homework!!!! And advocate for your cat if you disagree with anything your vet tells you. Remember, having a diploma does not necessarily mean a vet is competent.
Some key basics to remember when dealing with a diabetic cat are:
*Do NOT feed dry food. Low-carb CANNED food is a more appropriate diet for cats, and the lower carb content of canned food is especially helpful in getting a diabetic cat regulated and well-managed. The insulin needs of a cat fed strictly canned, low carb foods are almost always dramatically lower than those of a cat fed a dry diet, and the lower carb content puts less stress on an already compromised pancreas. I prefer to use Wellness brand Beef & Chicken, Turkey, and Turkey& Salmon canned foods for the diabetic cats I work with.
In many cases, feeding a canned diet with a very low carb content has resulted in diabetic cats being able to go off of insulin completely!
(Read Vinnie's story for one example.)
*If you change from dry food to a canned diet, keep in mind that your cat's insulin needs will likely be reduced by half (or more) VERY quickly (most times a day is all it takes). It is important to monitor blood glucose levels VERY closely during any food change and make adjustments accordingly to avoid hypoglycemic episodes.
*DO NOT give insulin injections in the scruff of the neck. As diabetes expert Dr. Deborah Greco DVM, PhD, ACVIM explains:
"Most vets and owners use the worst site to inject insulin – the scruff of the neck. This site has a poor blood supply and is prone to forming granulomas. Because of these characteristics, insulin is absorbed very irregularly from the scruff. The lateral thorax (chest) and abdomen (stomach) are much better sites. Injection sites should be rotated to decrease the chance of granuloma formation."
*Do not base a diagnosis of diabetes on a single blood test. Cats are easily stressed by vet visits and can often have a spike in blood sugar, sometimes going as high as 300-400 mg/dl. This is also why it is important to do home blood glucose testing. Numbers obtained while at the vet can be unusually high because of stress induced hyperglycemia, and the insulin dose prescribed based on that number may be too much.
*Home Blood Glucose testing is a MUST! That little bit of insulin you inject can KILL your cat if you don't know what your cats blood glucose numbers are at injection time and give too much. Making assumptions and not knowing what your cat's numbers are at injection time is tantamount to playing Russian Roulette with your cat. BG numbers can change quickly and dramatically for many reasons and home monitoring is the absolute best way to avoid tragedy.
*The type of Insulin you use is just as important as what you feed. Humulin N is probably the most innapropriate insulin to use for diabetes due to it's short duration time. Vetsulin is another poor choice and is specifically made for *dogs.*
The best starter insulins for cats are Lantus or PZI. Make sure that the PZI is not a compounded version and instead comes straight from the manufacturer (Idexx) to ensure consistency from bottle to bottle.
*Obesity can result in diabetes, so getting an obese, diabetic cat on scheduled, canned meals, counting calories, and implementing a weight loss plan is not only better for their health, but can dramatically lower insulin needs or even eliminate them.
*If your cats BG numbers keep going higher despite ever-increasing doses of insulin it may be experiencing Somogyl Rebound. This requires that you actually LOWER the insulin dose!
*If your cat's insulin dose needs to be increased, increases should be small, usually .5 units. The new dose should be given at least a week to "settle" before deciding if the cat should have another increase. Note that this is a general rule and works most times, but there maybe instances where a dose has to be tweaked daily. (See the log on Vinnie's page for one example)
*Always have strips on hand to test for ketones in the urine, especially if you are getting high BG numbers and/or adjusting doses.
Here is a list of related links you may find helpful and, as always, questions can be directed to firstname.lastname@example.org"