Posts Tagged ‘diabetes’

The new AAFP-AAHA feline life stage guidelines are published.

My initial thoughts, after a quick review:

I like that they recognize that the efficacy of dental treats/food is debatable.  One more “mark” against the myth that dry food benefits cats’ dental health! 

The use of dental treats and chews may be a realistic, practical alternative to daily tooth brushing, although data about their comparative efficacy is lacking.



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I’ve generally used a U-40 insulin (PZI-Vet) with U-100 syringes.  The advantages being that U-100 syringes are more widely available, and by using U-100 syringes with U-40 insulin I was able to make smaller dose adjustments.  (Before Meow Meow went off insulin, she was getting 0.2 units (two-tenths of a unit) of insulin!  NOT TWO UNITS – two-tenths of a unit!  No way I could measure that amount using a standard match of syringe to insulin.

Many find converting insulin to a different syringe confusing – and if, for that reason, you want to match – GREAT!  I recommend ALWAYS checking to make sure you KNOW which syringe and which insulin you’re using.  I’ve seen disasterous results when people don’t, and aren’t working with what they think they are.  Some insulins come in different strengths (like compounded PZI) and syringes obviously come in various markings – and there have even been cases where syringes were in the wrong box!  ALSO – make sure you understand whether your syringe is marked only for whole units, or also half units!  I’ve seen people advise others to count “lines” – well, whether you have lines only for whole units or whole and half units can DOUBLE YOUR DOSE!


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So, your cat is diabetic and you’re wondering which insulin you should be using to get those nasty blood sugar levels down (hopefully permanently so your cat can be managed on diet alone!)

My personal preference is PZI (protamine zinc insulin).  It’s duration is a little over 12 hours, which works well for a twice-daily dosing schedule.  (We WANT some overlap between doses, so we’re not dealing with very high blood sugar levels caused by no insulin being in effect.)   Once my supply of PZI-Vet by Idexx is exhausted, I’ll use a compounded PZI by BCP or Veterinary Pharmacies of America (VPA).  I’ve used BCP-PZI before with success – I noticed no difference between it and the PZI-Vet (except the lower cost).  As I’ve noted in the past, PZI-Vet by Idexx has been discontinued but that does NOT mean PZI is not available!  Compounded PZI is still available for use.

Louie says PZI works for me!

Louie says "PZI works for me!"


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My friend Adrienne said if vitamin B12 was a person, she thinks I might marry it. Maybe she’s right. I’m a big fan. Oh, I like lots of the vitamins, don’t get me wrong… love me some vitamin D for example, but you can overdose vitamin D, so you need to exercise some caution, and some feel supplementation of vitamin D can cause problems if you suffer from a autoimmune disease. As far as I know, while B12 is the only B-vitamin that seems to be stored by the body (in the liver), there are no known risks of overdose.

Where does vitamin B12 come from? It’s found in meat and dairy products. Vegans should consider vitamin B12 supplementation. Of course, my interest is in cats and if they’re fed properly (recognizing they are true carnivores) they should be getting vitamin B12 in their diet, but most commercial foods and homemade recipes supplement all the B-vitamins, just in case. The B-vitamins are water-soluble and, as I noted, generally not stored by the body, so there’s no known risk of overdose.

What can cause deficiency of Vitamin B12 in cats? Anything that causes excessive drinking and/or urination (diabetes, hyperthyroidism, kidney disease, etc.) can deplete B12 and the other B vitamins as they are “washed out” of the body. Giving sub-q fluids could deplete vitamin B. Chronic diarrhea can also deplete B12 as most B-12 is lost in fecal matter. Cats with an inflamed gastro-intestinal tract (such as cats with IBD) may not absorb B12 properly as it’s absorbed in the intestines. Vitamin B12 deficiency can cause anemia, neuropathy, other neurological issues, etc.

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 I’m pleased I’ve had more and more caregivers talk to me about putting their cats on a raw diet.  For those new to raw, I often recommend a pre-ground meat/bone product such as Hare Today, supplemented with a multi-vitamin/nutrient for cats such as Platinum Performance, as described in Dr. Elizabeth Hodgkins in her book “Your Cat: Simple New Secrets to a Longer Stronger Life“.

One problem – it seems some of these caregivers view this Hare Today/Platinum Performance combination to be some magical “cure” for what ails their cat (diabetes, IBD or chronic diarrhea, obesity, “allergies”, etc.)  In a way, it is a “cure” in that the cat becomes healthier and may no longer show any symptoms of their prior ailment (no more need for insulin, no more anemia, no more diarrhea, etc.)  However, in my opinion, it’s not so much that the particular food is a cure in that you’ve eliminated the *problem* (dry food). 

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I’ve worked with nine diabetic cats now – one of my own that was diagnosed after I adopted her (and responsible for teaching me so much), four adopted diabetics, and four fosters. Five were able to be “diet-controlled” (no requirement for insulin), the other four need/needed small doses of insulin along with an appropriate diet. (Two or three of those four had temporary bouts of remission.) As many caregivers ask my thoughts on feline diabetes, I thought I’d summarize my “personal beliefs” as they presently stand regarding effective treatment. I am always studying and learning new things when it comes to diabetes mellitus, so I expect as I learn more I’ll fine-tune my beliefs further.

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Gotta Have Faith

I gotta have faith… or do I?

Faith in veterinarians, that is.  Something foremost in my mind again, because of a couple of comments/emails lately.  One from a woman inquiring about raw diet and feline hyperthyroidism who said something to the effect of “I feel like I learn everything from an [internet forum] and you guys, and then have to turn around and teach my vet!”

I’ve sometimes felt the same.   For years, I just blindly followed the vet’s advice.  They went to school for years to learn just how to care for my cat, right?  Well, that was pretty naive of me.  First of all, we all know professionals in every industry imaginable that just aren’t that good at what they do.  Ergo, there must be veterinarians who aren’t the best as well – and how do we, the lay people, know whether our vet is the best or the worst or just somewhere in the middle?  If we’re not proactive and do some of our own research, we’re relying entirely on their “bedside manner”.

Secondly, vets generally get a four-year Bachelor’s degree in biology, then attend four years of veterinary school.  Do we really think they can learn absolutely everything about every animal species in four years?  Really?  As I often say, I’m sure I have less than 5% of the knowledge of most vets – I know next-to-nothing about any animals other than cats.  (Cows are the ones that say “moo”, right?)  I know little about feline parasites and next-to-nothing about surgeries and probably can’t name more than one or two bones in their little furry bodies and struggle with most terms, and have to think (hard) to remember which end is proximal versus distal.

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Jellybean, aka Jelly Belly, aka Jelly Belly Bean, aka The Firecracker… formally “Jellybean II” as named at the shelter.  Funny (to me) as the name “Jellybean” always makes me think of a black cat (like the anise/licorice-flavored jellybeans), but my Jellybean is a tortie (tortoishell), black and red.

Jellybean in window

Jellybean was admitted to the shelter in February 1997, as a newborn kitten with her mother and littermates.  She was adopted quickly after she was old enough to be weaned and spayed.  She was returned years later for urinating outside the litter box.  The shelter staff discovered her urine red with blood and treated her for an infection.  She was adopted again.  Again, returned – this time to a different shelter, one that wasn’t no-kill.  That shelter scanned her microchip and returned her to the original shelter. 

In the summer of 2007, shelter staff noticed increased drinking and urination, and Jellybean was diagnosed with diabetes.  She was monitored for a time, and eventually placed in the new canned food-only room at the shelter, and placed on the oral medication Glipizide.  Glipizide doesn’t work for the majority of cats, and it didn’t work for Jellybean.  She was placed on insulin (PZI-Vet).

I adopted Jellybean in November 2006 – only a few days after she’d started insulin.  I continued the low-carbohydrate wet diet (canned or raw) and tested her blood sugar levels at home.  On December 30, 2006, Jellybean received her last insulin injection – she’s maintained normal blood sugar numbers on diet alone since then.

Jellybean with BG log

We had other issues to work out, though.  When Jellybean moved in, she determined she was going to be “queen of the castle”.  She picked on the other cats, even my large boy Studley.  My friend Jenny laughed the first time she met her, and exclaimed “Wow, she’s a *pistol*!”  (several times)  I think she’s a *firecracker*. 

Eventually, Jellybean made the mistake of attempting to start a spat with little old Afer.  Afer may be 19 years old, and have kidney insufficiency and heart disease, but Afer does not take guff from *any* cat.  Afer promptly chased Jellybean into the bathroom and stood in the doorway, forcing Jellybean to take a time out.  It happened a few times after that, until Jellybean learned not to mess with the Afer E Granny!  However, in the process, the other cats decided they had no reason to be intimidated by this little firecracker.  If Afer could stand up to her, so could they!  They did, and a few of them even started picking on Jellybean.  She lost much of her confidence and spent more time sleeping in a cubby of the cat tree or in a pet tent, and became very fearful of Studley.

I tried separating her in her own room many times, either alone or with Latifah.   Then, I’d attempt to re-introduce them, but it didn’t work out great.  It’s been over a year now that Jellybean’s been with us, and things are better but not perfect.  I’ve seen her sleeping on the bed with Kitty.com (not cuddled together but both on the same bed), and she’ll lick Ralph on the head, and hide behind him from other cats.  She used to lick Louie on the head, but he has teased her several times (chasing her or swatting her pet tent) and she no longer likes him much. 

Jellybean does not have perfect litterbox habits, unfortunately.  She seems to think boxes, matts, rugs, and even dish towels lying on the kitchen counter are just as nice for doing her business as litter boxes.   She is doing better – we’ve found she prefers the Smart Box or “pellet” litter (like pine) rather than clumping.  We have a litter box with just  a puppy housebreaking pad in it that she uses often.   I find it’s easier to find something they’ll use and work with that than re-train them.  Perhaps I’m just lazy or a bad trainer.

Jellybean is very sweet and very cute.  Her fur is very soft and she has the adorable habit of rubbing against you or furniture, arching her back so high she goes up on her tippiest of tiptoes.  Though she is feisty, she quickly learned to cooperate very nicely for her blood sugar testing.  I’m optimistic we’ll continue to make progress toward more peace and harmony at home.

Jellybean face

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One of my five bazillion pet peeves…. a caregiver is convinced to change their cat’s diet (usually because the cat is now very ill with diabetes or gastro-intesinal disorders – or is severely obese)… and after a week or less they respond with “It’s a Miracle!  Fluffy’s diarrhea/diabetes/vomiting/whatever is GONE!”

IT IS NOT A MIRACLE.  It’s simply good nutrition!

 If I was covered with big red itchy hives, and I finally decided to eliminate all peanuts from my diet – and the hives disappeared, would we conclude it was a miracle?  NO!  We’d conclude I must be allergic to peanuts!  Why is it to hard for people to accept their cats’ ailments were a product of poor nutrition?  Do they really have that much faith in the pet food industry?

It makes me absolutely INSANE whenever someone comments on the “miracles” I work with the cats I adopt or foster.  They ARE NOT MIRACLES!  Though fellow posters on online forums joke about the “magic fairy dust” in my basement – there is none.  I am simply feeding cats the way nature intended – a diet that is meat-based, high-protein, low-carbohydrate, and high-moisture!

But, for some people I guess it’s easier to believe I wave my hands over the cats and chant, or have magical fairy dust, than it is to believe the commercial pet food that fills store shelves could be anything but the best for our feline friends.

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