Updates

Well.... surprisingly things are going well here.  Thought I would let you know... we tried a few different meds on Pippin and they seem to be working.  Merry even dropped down a unit on his insulin!!  So he is doing really well.  I am quite pleased with the cats.  Merry has puked a couple times this week and he never does... but I am hoping that it's nothing.  Usually it's Pippin's puke I am cleaning. Merry also decided to pee for me today.. I put him in a box since he loves them and he got so excited he just peed.  The joys of diabetic cats.. they just can't hold it in!

Not much longer....

So Pippin had a little episode of puke last night.  He couldn't hold his food down this morning either.  I called the vet and told them there was just no way I could have another $1000 day and that we keep going in and doing tests to only find out that his pancreas isn't doing good.. and same old same old.  She told me to bring him in and that she would do an ultra sound for free to see how he is doing inside.  When I called today I also told her we would probably have to put him to sleep.  I picked him up this evening and turns out that of course his pancreas is still bad and has a lot of scaring in it.  The gallbladder still has sludge in it too.  The only organ that doesn't have any issues right now is the liver.. which will probably eventually will be going soon.  This is called Triaditis. 

So we talked about what is next.  She said there is really nothing left to do, the pancreas will not get better but can be managed.  We are going to try that route... so Pippin will get a steroid twice a day, and nausea meds twice a day along with his insulin.  She did say if this doesn't work we'll have to put him down.  I asked about them putting him down after hours.. but they said for some clients they will come to your house and do it.  Since we have been long time clients they will come to my house, I am quite happy about this. 

Having a good vet even if they are pricey can really been a good decision in your pet's life.  Today all the procedures and medicine I was sent up with were all free.  That isn't something you get if you don't have a relationship with your vet.  Even if you have a healthy cat be sure to do their check-ups and teeth cleanings and get to know your vet.

 

EDIT:  It is now February 18th, 2014 and Pippin is doing really well.  The mix of pills has turned his pancreas around.  He takes a steroid, 1/2 nausea pill, and his diabetes medicine everyday. 

Glucose Readings

Glucose readings are tough.  We don't take them everyday.  I know that some people out there do.  My vet has doing the curve every two weeks.  The numbers are looking fantastic lately.  I thought though I would give you a glimpse of what we do.

On the weekends we will go and poke their little ears.  The reading can be all over the place so be ready the first few times you do this.  It might just make you worry and panic. Never fear though!  Keep honey and Karo syrup on hand at all time.  If your kitty goes under 65 then put this on their gums.  Make sure they eat if they are this low and give them some treats.

OK... so one things that is probably important is to keep a log on the days when you do this.  We mark it with the time the cats received their shots, which ear we poked (very important because you probably will forget through out the day and you want to rotate which ear), the time you took the reading, and the name of the cats (if you happen to have more then one cat with diabetes like me).

This is a great video on how to take a reading. We use One Touch Ultra for our glucose reader.  I will say that my vet told me NOT to use the type of needle used in the video to poke my cat.  This is because the needle in the video will go right through your cats ear.  We use BD PrecisionGlide Needle REF 305122.  This allows you to just poke the vein on the outside... though.... lets be honest.  We have pierced the cats ears a couple of times.  One time we poked Merry and he moved and the needle was hanging through his ear!  I was totally panicked.  He acted like nothing though.  So I was more scared then he was. 




The cats do know when it's time. We get out our little bag of cat medicine goodies and then hold them down!

 

So here is today's readings:

Merry 7 units of Prozinc, 3 units of vetsulin, 5mg glipizide
Pippin 4 units of Prozinc, 5 MG glipizide, and 1 whole steroid at night (tomorrow we start half a steroid). 


Time           Merry      Pippin

7 am          215           277
9 am          159           243
11 am        74             125
1 pm           52            97  

630 PM      81            321

As you can see Merry is very low.  The vet has us switching him to 6 units of Prozinc and 1/2 a pill of glipizide starting tomorrow.  We will do the results again in two weeks.  These numbers are very good for Pippin and Merry.  We are finally getting them under control. Luckily... our vet will monitor these readings for free.  We email in the readings and she usually responds in a couple of days.... sometimes she responds right away.  Hopefully you can find a vet who will also do this.  Make sure your vet uses a glucose reader that pokes the ear.  The first vet we went to actually made us bring in the cats and actually drew blood from their legs.  There is no reason for this and only causes more stress to the cat.  

You really should invest in buying a  glucose reader yourself and just do it at home.  You can find readers for like $40!  Don't buy your reader from your vet.  Go to Amazon.com and get a great deal on one.  You can use any reader. 

10 years... adopt your pets!

This month I have had my two kitties for TEN years!  I adopted them both from a no-kill shelter called No More Homeless pets in Utah in 2003.  Merry was already 3 1/3 and Pippin was 6 months.  I almost didn't get two cats but my mom was there with me and when I went to adopt Pippin my mom was like "he needs a friend"!  The guy working there told me he and Merry got a long so that is how Merry came home also.

I did learn one thing that I would like to share.  When adopting a microchipped animal, which mine were, MAKE SURE THE AGENCY CHANGES THE ADDRESS!  I turned in a piece of paper with my address and they were supposed to change it for me.  I just assumed they did.  Then years and years later when we moved I called the microchip company to change it and they said I had to pay like $100 a cat to change it because it wasn't a change of address but a change of owner now.  (The company told me they are still registered under No More Homeless Pets).

I tried to call the agency that I adopted my cats from who of course by now had changed names they are now Best Friends Animal Society... no one would email me back or call me.  Hell I was even willing to pay the $15 fee (that was included in my $165 fee that I had paid to adopt both of them) to simply change the address (I need them to do it though) 10 years later I still have all the adoption paperwork too, so I could prove I adopted them from this agency (which I did say on the messages I left them).  So in the end .. I don't have $200 to switch owners for the microchip.  I think the cats suffer because this adoption agency won't step up and help me.  I know that it is a non-profit so I was willing to do what I could on my end, I just need them to call since they are technically the "owners". I mean... if they get lost does this agency still have the paperwork with who adopted them?  I doubt it. So please if you adopt your pet and it is microchipped included check with the company of the chip to make sure the address is updated. 

Don't Shop, Adopt!!

Feline Acromegaly- Treatments

So now that we know that Merry has Acromegaly... then you probably know I decided to treat him by giving him 2 insulins and controlling it that way. My vet and I discussed the radiation therapy but I chose to not go in that direction.   I asked my vet the other day what will happen when it's the end of his life.  How will I know when the disease is too much.  She told me that he will start having seizures.  I am pretty scared about that.  I just hope it isn't bad and that I make the decision to put him down when the time is right.  Sometimes I wish I was one of the lucky people who come home and find that their cats have passed away and they don't have to make the decision about when the time is right to put them down.  Anyways...

My vet gave me their new magazine Veterinary Medicine which has an excellent article on Acromegaly.  That is a link to the article but incase someone finds this post out there in the world of the internet and it is gone I would like to repost it here for information.  I don't have permission to do this but hope that the magazine doesn't mind so we can spread the information out (just incase the link is ever pulled).  

Feline acromegaly: Treatment options

Somatostatin analogues, dopamine agonists, and growth hormone receptor antagonists are commonly used to treat people with acromegaly. Should you be giving them to your patients?

Oct 1, 2013 By: Justin Wakayama, DVM, David S. Bruyette, DVM, DACVIM VETERINARY MEDICINE

Feline acromegaly is a disease characterized by excessive growth hormone released from a functional pituitary adenoma, resulting in a wide array of clinical signs and, commonly, insulin-resistant diabetes. For information on the pathophysiology, clinical signs, and diagnosis of feline acromegaly, see the article on page 467. This article provides an overview of the many treatment options for this disease. MEDICAL TREATMENT
Medical options for treating acromegaly range from increasing a patient's insulin dosage to manage the diabetogenic effects of acromegaly to instituting treatment with a somatostatin analogue, dopamine agonist, or growth hormone receptor antagonist. Several of these treatments are common in human medicine but have not been studied widely in veterinary medicine. 


Somatostatin analogues Somatostatin is a hypothalamic hormone that acts on the pituitary gland to inhibit growth hormone release. Somatostatin analogues are commonly administered in people with acromegaly and have efficacy rates of 50% to 60%. In addition to acting centrally by suppressing growth hormone release and peripherally by interfering with growth hormone receptor binding on hepatocytes, somatostatin analogues are also thought to result in tumor shrinkage of pituitary adenomas by promoting apoptosis.¹
The somatostatin analogue octreotide has been evaluated in a few cats with acromegaly with limited success. In a study of four cats with acromegaly, no change in serum growth hormone concentration was noted after treatment with octreotide.² Another study, which measured the short-term effects of octreotide in five cats with acromegaly, found a decrease in growth hormone concentrations for up to 90 minutes after octreotide administration.³ However, a recent study evaluating a long-acting somatostatin analogue (Sandostatin LAR Depot—Novartis) showed no benefit in cats treated for three to six months.⁴
The failure of these drugs to inhibit growth hormone release may be related to differences in somatostatin receptor subtypes found on pituitary adenomas. Future studies to identify the somatostatin receptor subtypes in feline growth hormone-secreting pituitary tumors are required to determine if these subtypes are similar to the ones found in people and if human somatostatin analogue therapy, at least in theory, may be beneficial in cats with acromegaly. 

Dopamine agonists and growth hormone receptor antagonists
Dopamine agonists and, more recently, growth hormone receptor antagonists are also given to people to treat acromegaly.
Growth hormone receptor antagonist therapy has not been reported in cats, but in people, response rates have been reported to be as high as 90%.¹ However, it has been noted that these medications have no effect on tumor size (do not result in tumor shrinkage) and, thus, would not benefit patients with neurologic signs.
A single case study on the treatment of feline acromegaly with a dopamine agonist (L-deprenyl) showed that the medication had no effect on reducing insulin requirements or clinical signs of disease.⁵ In people, dopamine agonists are typically only 10% to 20% effective but are often combined with other medications.¹
 
Increasing insulin
Increasing the dosage of insulin to improve glycemic control and clinical signs of diabetes is the most conservative—and most common—method for managing insulin-resistant diabetic acromegalic cats. While helping to control the clinical signs of the diabetes, raising the insulin dose has no effect on growth hormone secretion, progression of the clinical signs of acromegaly, or continued growth of the pituitary tumor.
In addition, some patients treated with high doses of insulin unpredictably and inexplicably become sensitized to the effect of the insulin, resulting in hypoglycemic crises.^6,7 The timing of the insulin sensitization and occurrence of hypoglycemic episodes was extremely variable. In one study, several acromegalic cats were euthanized after experiencing hypoglycemic comas.⁶

SURGICAL TREATMENT
Surgically removing the pituitary tumor (adenectomy) is the treatment of choice in people with acromegaly. The procedure can be performed in cats and dogs but typically results in the complete removal of the pituitary gland (hypophysectomy). Complications associated with the surgery include hemorrhage and incision dehiscence. After surgery, patients require treatment with cortisone, L-thyroxine, with or without desmopressin, to compensate for the loss of pituitary function. Because of this, only patients that are easily medicated should be considered for this procedure.
Few case reports exist for the treatment of feline acromegaly with transsphenoidal hypophysectomy. In one case, a patient was receiving 25 U of insulin detemir (Levemir—Novo Nordisk) four times a day before surgery, and three weeks after surgery, the patient no longer required insulin therapy.⁸ Up to one year later, the patient's insulin-like growth factor-1 (IGF-1) and growth hormone concentrations remained normal.

In a case we treated at VCA West Los Angeles Animal Hospital, a 13-year-old castrated male domestic shorthaired cat with acromegaly underwent transsphenoidal hypophysectomy. The patient had a history of insulin-resistant diabetes mellitus and was receiving 15 U of insulin glargine every 12 hours. The patient's diabetes mellitus resolved two weeks after the surgery and remained in remission for eight months, at which time the cat was euthanized for an unrelated issue. Availability of this procedure is limited in the United States, and as of this writing, the procedure is only available at the VCA West Los Angeles Animal Hospital, although other institutions may soon be able to offer this option. 

RADIATION
Radiation therapy is another option for the treatment of feline acromegaly, especially if the tumor is inoperable or surgical treatment is not available in the area. In human medicine, radiation therapy is regarded as a second-line treatment since beneficial effects may take years to develop and patients typically experience undesired late-term central nervous system radiation effects.
Most studies that have been performed in veterinary medicine focus on radiation treatment of pituitary masses regardless of functional status. There is no standard treatment protocol for pituitary masses, and varying methods have been used, including both single- and multiple-dose fractions, administering total doses from 1,500 to 4,500 cGY.^9-14 Most of the cats included in these studies had insulin-resistant diabetes (suspected acromegaly or Cushing's disease) or neurologic signs.
Radiation therapy has been shown in these studies to be successful in improving both insulin resistance and neurologic signs. Neurologic improvement was generally seen within weeks to months. Improved insulin response was seen within the first month; however, most patients still required insulin therapy. In cases in which repeat imaging was available, a decrease in tumor size was also noted.
Disadvantages of radiation therapy are the early and delayed effects of radiation, repeated anesthesia, and expense. Early effects from radiation therapy include hair loss, skin pigmentation, and otitis externa.^12,14 Reported late-term side effects include brain necrosis, tumor regrowth, loss of vision, and hearing impairment.^11,12
In one study, 12 cats with pituitary tumors were treated with a coarse fractionated radiation protocol, delivering a total dose of 37 Gy in five once-weekly doses.⁹ Eight of these cats had insulin-resistant diabetes mellitus secondary to acromegaly. After radiation therapy, five of the eight cats no longer required insulin therapy, two became stable diabetics, and one required less insulin. In addition, three of four cats had improved neurologic signs. The mean survival time of cats in this study was about 18 months.
In another study, 14 cats with confirmed acromegaly and insulin-resistant diabetes mellitus were treated with a total dose of 3,700 cGy divided into 10 fractions (three a week).¹⁰ Thirteen of the 14 cats had improved insulin responses, with an average insulin dosage reduction of about 75%. Six of the cats went into complete diabetic remission, and three of the six remained in remission at the time of this writing. The median survival time of cats in this study was 28 months. 

CONCLUSION
Many options exist for treating feline acromegaly. However, clinical studies on their long-term safety and efficacy are limited and often lack controls. Until more work is done evaluating medical treatments such as somatostatin analogues and growth hormone antagonists, most patients are best treated with radiation therapy or surgery to control growth hormone concentrations and neurologic signs, or with increased insulin doses to improve glycemic control.
When making your recommendation regarding treatment, be sure to consider the patient's clinical status (state of diabetes control, any coexisting diseases, whether or not it is a candidate for anesthesia), the availability of treatments in your area, and the advantages and disadvantages of each treatment modality.
Justin Wakayama, DVM Department of Veterinary Clinical Sciences College of Veterinary Medicine University of Minnesota St. Paul, MN 55108
David S. Bruyette, DVM, DACVIM VCA West Los Angeles Animal Hospital 1900 S. Sepulveda Blvd. West Los Angeles, CA 90025
Veterinary Diagnostic Investigation and Consultation 26205 Fairside Road Malibu, CA 90256

Feline Acromegaly

Recently when I went into the vet for my crazy cat Pippin (who is doing well after being on all the meds but tonight he eye looks crazy.. what's next???), the vet gave me their new magazine Veterinary Medicine which has an excellent article on Acromegaly.  That is a link to the article but incase someone finds this post out there in the world of the internet and it is gone I would like to repost it here for information.  I don't have permission to do this but hope that the magazine doesn't mind so we can spread the information out (just incase the link is pulled).   In my next post... I'll post what they say about treatments so be sure to look for that.

Feline acromegaly: The keys to diagnosis

Caused by excessive growth hormone secretion, this likely underdiagnosed endocrinopathy may be lurking in your feline patients—especially older, poorly controlled diabetic males. Here's a look at which diagnostic tests can help you detect it.

Oct 1, 2013 By: Justin Wakayama, DVM, David S. Bruyette, DVM, DACVIM VETERINARY MEDICINE

Feline acromegaly is a disease characterized by excessive growth hormone secretion, leading to a wide array of clinical signs caused by the hormone's effects on multiple organ systems. These effects can be divided into two major classes: catabolic and anabolic. The catabolic actions of growth hormone include insulin antagonism and lipolysis, with the net effect of promoting hyperglycemia. The slow anabolic (or hypertrophic) effects of growth hormone are mediated by insulin-like growth factors. Growth hormone stimulates the production of insulin-like growth factors in several tissues throughout the body. Insulin-like growth factor-1 (IGF-1), which is produced in the liver, is thought to be the key factor that facilitates the anabolic effects of growth hormone that are responsible for the characteristic appearance of people, dogs, and cats with acromegaly.
Similar to its etiology in people, acromegaly in cats is the result of a functional adenoma of the pituitary gland that releases excessive growth hormone despite negative feedback.¹
 

ANATOMY AND PHYSIOLOGY Growth hormone is produced in an anterior lobe of the pituitary gland, specifically by cells called somatotrophs. The regulation of growth hormone is complex, and many factors—both environmental and endogenous—are responsible for its control. The two most important regulators of growth hormone production and release are growth hormone-releasing hormone (GHRH) and somatostatin, which are produced in the hypothalamus. While growth hormone release is stimulated by GHRH, it is inhibited by somatostatin as well as by negative feedback from itself and IGF-1.¹
 
SIGNALMENT
Feline acromegaly is an uncommon disease, although it is thought to be underdiagnosed. It most commonly affects middle-aged and older, male castrated cats. In one study, 13 of 14 cats with acromegaly were males, with an average age of 10.2 years.² This association may be biased, however, as most cats in which acromegaly is diagnosed are presented for complications associated with diabetes mellitus, which is also common in older, male castrated cats. Based on available data, no known breed association for feline acromegaly exists. 

CLINICAL SIGNS

1. This domestic shorthaired cat with presumptive acromegaly is exhibiting a broadened face, a physical change commonly associated with feline acromegaly. The cat was presented for unregulated diabetes.

Cats with acromegaly are commonly presented for insulin-resistant diabetes mellitus (insulin doses dependent on insulin type) with concurrent weight gain rather than weight loss.² Other clinical signs vary because of the wide range of effects the disease has on the body. Physical changes associated with feline acromegaly include increased body weight, a broadened face, enlarged feet, protrusion of the mandible (prognathia inferior), increased interdental spacing, organomegaly, and a poor coat (Figures 1-3).

2. The same cat as in Figure 1 exhibiting another physical change associated with feline acromegaly—protrusion of the mandible.

Respiratory disease may result from excessive growth of the soft palate and laryngeal tissues, leading to stertorous breathing and even upper airway obstruction. Cardiovascular signs include the presence of a heart murmur, hypertension, arrhythmia, and congestive heart failure associated with hypertrophic cardiomyopathy.³ Neurologic disease associated with feline acromegaly is uncommon but can occur with large pituitary adenomas. Neurologic signs that have been observed with acromegaly include dullness, lethargy, abnormal behavior, circling, and blindness.

3. This close-up of the cat's teeth (the same cat as in Figures 1 & 2) highlights increased interdental spacing, another physical change associated with feline acromegaly.

Glomerulopathy and secondary renal failure have also been associated with feline acromegaly. Histologic evaluation of the kidneys of cats with acromegaly has revealed thickening of the glomerular basement membrane and Bowman's capsule, periglomerular fibrosis, and degeneration of the renal tubules.² Because of an associated degenerative arthropathy and peripheral (diabetic) neuropathy, lameness has also been noted in cats with acromegaly.

Gallbladder and Pancreatitis

Another day, another problem.  My cat Pippin was so sick last night.  Lots of throwing up... this throw up was even the color of blood and stunk really really bad.  It was Nasty!  Poor guy... I stayed up with him in the bathroom most of the night till it settled down.  I called the vet first thing in the morning and brought him up there.  I knew it was going to be his pancreas again.

 

I walked out of the vet today with a $900 bill!!!  WHAT!  I was not expecting that.  I mean .. WHAT!  So the vet did two blood tests... one is the normal panel and I guess the other one was to check the pancreas.  Then it was all this meds... and a urine test and a $50 vet visit charge.  And then they did an ultra sound since there was blood in the vomit.  Turns out that the gallbladder has some gunk in it which we discovered with a ultra sound. So Pippin now has to take Denosyl to help him out. 

Today sucked as far as money that is for sure.  Pippin is now on a steroid for life.  Which isn't great for cats with diabetes because now we will probably have to up his insulin (3 units of Prozinc).  He will be taking a narcotic for 5 days, nausea pills for 5 days, novifit, his insulin meds, and his steroid.  The cost of today's visit was a tough one.  Now we also know we will have to spend an additional $30 a month on steroid pills for Pippin.    Just a tough day all around.  Though I am glad we figured out his gallbladder isn't well and have time to correct it.

For those of you wondering whether or not to get a pet... remember they aren't cheap!

Vetsulin

All is ok over here.  Merry is now on both the Prozinc and the vetsulin and still taking the Glipizide with it.  No changes with his Acromegaly either.  Pippin just got over another bought of Pancreatitis. This time my vet did put him on steroids despite him having diabetes. The nsaid just wasn't getting rid of it. He was on it everyday for about 4 weeks.  We tried to just give it to him everyday for 1 week but that didn't get rid of it so we needed to put him on it a little bit longer. He has been off of it for about two weeks and we did have to increase his Prozinc does to 4 units (plus his glipizide) but that should go back down once the steroids are out of his system.

My vet did tell me about a clinical insulin trail out of CSU Fort Collins for Merry.  It was listed as especially for cats with Acromegaly.  She asked me if I was interested.  It would all be free.. the insulin, the tests. I thought about it and thought it might be a good thing to try to get his glucose readings down.  Then I found out that this study would have placebos and he might just get one.  There is no way Merry can go without insulin with his glucose readings being between 300-400.  So she and I decided this wouldn't be a very good study for him. 

I don't know what to expect for Merry the next year with the Acromegaly.  This month I have had both my cats for 10 years.  I adopted them from a petsmart at the same time way back then... and I don't regret a thing!!

Acromegaly in Cats

New update on cats.  Pippin has Pancreatitis again.  Last time he had it we put him on a NSAID because typically you don't put a diabetic on a steroid which is the normal way to treat Pancreatitis. Since it has come back (symptoms are throwing up bile a lot) the vet has now gone ahead and put him on steroids.  We first tried it one everyday for 7 days and then every other day after that for about 20 days, but when we started the steroid every other day he began puking again. So after taking him back to the vet she decided to go ahead and give him a steroid pill everyday for 30 days.  This may make Pippin a full diabetic though since right now he is borderline. I think that if you are a diabetic and you take steroids that makes your glucose levels go up since it releases sugar in your system (though you will have to check the facts on this).

 Medicines, food,  and Medicine schedule

So now for Merry's news.  He has always had to take a large amount of insulin.  He is on 8 units and a Glipizide pill (5mg). My vet asked me to come in and do a few tests.  As I understand.. when a cat's insulin is that high they are insulin intolerant so there are a few tests to do.   After looking at a few things it turns out Merry has Acromegaly.  This is where there is a tumor of the pituitary gland in the brain.  One of the signs of this is uncontrolled diabetes. So I suppose I am lucky my vet was watching for these signs.  There are two treatments, one is radiation.  I have chosen to not do this.  I think this is too hard on a cat and they don't even understand what is happening.  The vet said the radiation only shrinks the tumor and it usually comes back in about 8 months anyways.  The other option is to give him another insulin.   Which I have chosen to do.  I am not sure the name of it yet.. they had to order it and I pick it up next week.  She did tell me that after a cat has been diagnosed with Acromegaly that they typically will live 14-22 months more.  I am very sad about this.  I can only do my best to provide him a great and comfortable life.  More updates soon.  Here is my Merry!

Glucose Reader trouble & new insulin

Well.. we were doing pretty good with our reader till about a month ago or so.  Suddenly we kept getting an error message ER 6 and had to use multiple test strips until finally the reader took a reading. We tried a new battery.. we tried everything to fix it. The vet ended up allowing us to borrow one of theirs for the last curve we did.  We use One Touch Ultra (the first series I think) and it has a life time warranty.  So we did call the company... who I might add was very friendly and sent us a brand new one with new test strips for free. We didn't even have to send the old one back to them! (the picture is the Ultra2 not the one we have but I am too lazy to take a picture of the one we have right now.. ha!)

The vet has changed Merry's insulin. The name of it starts with a B and I am posted this post after we tried it so I don't remember the name. It didn't work on him at all.    The litterbox is like concrete and he is drinking a lot. He switched from Prozinc.  Now he is back on the Prozine and Glipizide pills.  I am not really sure why the vet changed him because he was having good numbers?  I think she was trying to make it cheaper for us but in the end now we are just starting all over and building him back up to 8 units of insulin. Pippin is doing fine but he does get constipation a lot since he's been on the diabetic food. We started him on some stool softeners today to see if that will help.  When he gets constipated he pukes and stops eating.  Till the next update!

Clump litter with diabetic cats= NO!!

So as you know with diabetic cats they pee a lot.  We deiced to try out clump litter thinking that it would make a difference in their litter. We would be able to simply scoop out the pee and keep the litter box a little cleaner.  What a nightmare!  They pee so much and so heavily that it is like straight concrete in the box.  It is like digging out hard chunks of litter.  It takes like 15 minutes to just scoop the boxes each day because now the urine is like a paste that is just stuck to the edges in the box.  It's very very hard.  Plus.. since a diabetic cat pees so much you scoop out a lot and so they I am constantly added litter everyday too.  Plus clump litter is expensive.  $12 almost for the bucket you see above.  We tried this for about a month and it was a lot more work then I thought.  So now we are back to the regular Tidy Cats litter.  Much easier to just scoop that out then to use this clump litter.  Hoping this helps someone out there who is wondering what type of litter to use with their diabetic kitty.


EDIT:  9/30/13  My husband loves the clump litter for their diabetes!  So we do use it actually.  He is the one though who scoops out the box everyday because I think that stuff sucks.. but he loves it!

Edit: 5/22/16  Still using the clump litter.  I have come to really like it for the litter... it just took time to adjust.  I would recommend it now with all the pee that diabetic cats do.

Bloglovin

I know not a lot of people follow this blog... but GFC is going away and I want to make sure that those who do want to follow it can.  So I am added it to Bloglovin so people can follow me there if they want.


Follow my blog with Bloglovin So here it is!!

Tips for taking Care of a Diabetic Cat-how much does it cost?

I found this great list of tips for Taking Care of Your Diabetic Cat.  One tip that is very important is the cost.  Diabetic cat medicine is NOT cheap.  Each month we buy insulin at $100 a vial about one per month, Glipizide $15 a week, needles $35 about 1 box per month, diabetic cat food $35 for 6lbs about one bag per month. We mix that with regular cat food which is about $12 per month, and then we have to buy a large Tidy Cat bag of litter per week because of how much urine the cats have and that is about $25 a month.  That didn't include all the tests done at the vet, the glucose reader, the needles for that, the strips for that as well. Sometimes we have to buy more of the items listed above because we may use more one month then we normally do. 

So as you can see this costs at least $200 a month.  And that's if we don't have anything else crazy go on with their health.  Which it always does.  Possibly if Merry's diabetes wasn't so bad (8 units a day and Glipizide) the cost wouldn't be so bad.  Pippin only gets 3 units of insulin and that means the insulin would last much longer if it was just him. This is a great article on the cost of cat diabetes. My vet even has a diabetic cat that lives in the vet office his name is Ringo and he has a facebook page!

Just remember that it is not going to be cheap.. we budget the cost into our bills every month.  Your cat can live a great life.  Just check out Merry and our neighborhood squirrel that we have named Mama Squirrel!

Edit... (Oct 22nd 2013)in just 5 months since I have posted this the cost has already gone up. If you read my other posts you can see more of what has happened... Merry we discovered has Acromegaly which has added a new insulin for him and Pippin now has to be on a steroid $30 a month and has gone up a unit in his insulin. The costs adding up never really stops.

Edit 2017:  Look online for resources to make things cheaper.  It took us years to finally figure this out.  Prescription cat food (we use Purina DM for diabetic cats dry food) is $20 cheaper through Petsmart if you sign up for their auto refill.  Needles are much cheaper online too.  Nice thing is that Petsmart or 1800petmeds will contact your vet for you so you don't have to worry about getting a prescription sent over.  As time as gone by we have figured out ways to make diabetes way more affordable. I just took time to do research online. There really is no way to find cheaper insulin so that we have kept getting from the vet office.  There are so many cheaper resources out there then your vet office.  Don't buy your glucose reader through them either.. order it through amazon.com.  Get your test strips through amazon too.  It was like $10 for a box of 50.

Glipizide Trial & Pancreatitis

Well.. we are trying a new technique with Merry.  He is now on 8 units of Prozinc and his glucose readings are about 300-400 still.  So the vet has us trying out Glipizide in the liquid form along with the 8 units.  This weekend he will be on it about 3 weeks and so we will do a curve on Saturday and see how his numbers are.  If they aren't any lower still then we're going to switch him to a different insulin.

Pippin is now on 2 units of Prozinc and his numbers are perfect.  Today they were 203.  But then all last week he has been doing some EPIC pukes.  It's straight bile.  This happened to him in 2010 and we went to a different vet then who took xrays to see if anything was blocking his intestines and discovered he was constipated . That vet just sent us home with an enema and had us do it ourselves at home.  Well today we went to the new vet that we love with Pippin and told them about what is going on.  This vet not only took an xray but also took blood to check the pancreas.  Pippin does have Pancreatitis which she said is common in cats that have diabetes.  He is also very constipated (like last time). The vet I take them to now actually did the enema for me this time which was nice! It turns out when a cat is diabetic you can't give them medicine that is given to cats normally for diabetes.  Sooooooo (my cats always have drama) we have to give him pain meds because pancreatitis is very painful, he gets NSAIDS to help with the inflammation of the pancreas instead of steroids that are normally given. My vet posted a picture on facebook of Pippin getting the enema!  Yea... so I'm going to post it here too!

So in a month we go back and check Pippin's pancreas numbers and see if they have gone back to normal.  Also we must make sure he doesn't puke because the vet said that this is very bad for a cat's pancreas.  Diabetic cats are drama!

Update on 5/1/2013  The Glipizide is working.  Merry's glucose is perfect.  He is on Glipizide and 8 units of insulin and everything is perfect! 

Wet Food VS Dry Food

I have no idea what or why... but now Pippin is back to eating his dry food.  Which is good because it is cheaper and then he can get the prescription diabetic cat food.  I think once he is feeling better then he eats normally.  The hardest part for me with diabetic cats is feeding times.  These cats are so used to free feeding that trying to feed them only three times a day is almost impossible.  They cry, fight, stare at me, everything they can to get food.  It is the worst at night when trying to sleep.  But I do my best. 

The other hard issue with cat is finding someone to give them a shot if you want to go and do something.  The other night was practically impossible to find someone to come over since we wanted to go out to the city for the night.  My advice... teach as many people as you can how to give shots so that when you are in a crunch you can find someone to help you out. 

This website has a good picture of testing your cat's glucose reading with the ear.. and giving a cat a simple shot:
Cat Diabetes

Diabetes is back!!

Well everything with Pippin was going so well... then the last 3 weeks he hasn't been eating very well.  Snubbing his food again.. biting a little bit and then spitting pieces out.  We tried wet food and he kinda ate that as well.  Took him back to the vet who did another teeth cleaning.  There were no teeth to be pulled.  So there really is nothing wrong with his jaw.  So I took him back to the vet today who ran a bunch of blood panels and his glucose is 426.  Ughhh..  so we are back to giving him insulin.  2 units in the morning and 2 units at night.  Merry (my other cat with diabetes) is getting a little better.  His insulin numbers have really dropped.   So now the vet has us giving him 6 units of insulin and mixing his diabetic food with Pippin's food (which is Purina One Indoor Cats).  We will do another glucose curve on Merry this weekend. 

 (Pippin at vet)

I said before I would show pictures of the glucose reader... and never did it... so I am doing it right now.  I will say that I bought the reader at the vet because I was in a hurry to get Merry better.  But now I would shop around for one to find a better price.  Also I would recommend people to get a good vet even if they are pricey if your cat has diabetes.  My vet is expensive for the visits but when I do the glucose curves on the weekend and call in with the numbers on Monday they always tell me what to change the insulin to for free.  So that is nice.