Mulder's diabetes is back after four months in remission. Cat diabetes is super weird--they can just spontaneously get over it for a while. I don't know how many cats remain in remission, given their natural lifespan, but I think most end up with it again eventually (unless it's purely weight/food-related, maybe? Maybe they can be better forever?? That would be cool for those cats/owners). Mulder is a weird case, because he's not overweight and he's only 4.5 years old. The vet said it's not unheard of, but it's pretty unusual. I've read some black cat breeds are genetically predisposed, but who knows? I am not sure it was a reliable source. If it was, I'll add a note. Anyway, it's crappy for him and for us, but we're all trooping on through because DUH, HE IS OUR PRECIOUS CHILD.
I am not a vet, this is not a vet's perspective on anything--this is just a place for me to put things I've learned (I'll update this original post as necessary), and if you have a diabetic cat, then you can utilize my hours of repeated, agonizing research and add them to your ever-growing list of things to think about (and talk to your vet about, or totally ignore!--but still talk to your vet, that part's important). Stuff in bold is relevant to things.
--UPDATE! I haven't used it yet, because I had to urgently buy insulin online (long story about pharmacy confusion), BUT! I found an infinite-use pet insulin discount card (they probably have other discount cards, too) that *should* save you up to 75% at the pharmacies listed on the site.--
See your vet, like, now if:
- your cat is losing weight even though they are eating regularly (+ demanding extra food) (also, always see your vet if your animal is losing weight rapidly!!!)
- your cat is drinking a lot more water than usual (either once a day for a couple consecutive days, and definitely if it's more than once in one day)
- the litter box smells like weird, putrid fruit after the cat pees
These following ones aren't indicative of diabetes on their own, but they are still signs that your cat is sick or ate something stupid, and they do often happen in conjunction with the above symptoms:
- they are barfing more than usual
- they have repeated diarrhea in a short period
- they are acting super weird for them (obviously this means different things for different cats, but: more lethargic than usual, more snuggly...think of a toddler running a temp)
See any medical website's description of ketoacidosis, basically. Cats can tolerate MUCH higher glucose levels than a human before they need to go to an emergency room, but the indicators are all really similar.
FOODS & INSULIN
We give Mulder wet food 2x/day, 12 hours apart (right before his insulin, which is this kind), and we use the Purina ProPlan DM for said-wet food, which we buy from Chewy.com (not sponsored--they're just great) because it is the absolute best deal. The food is expensive (as are the test strips, and the initial pet glucometer purchase), but welcome to having a chronically ill pet. The insulin dosage depends on how well he's responding to it.* If his blood sugar is too high, we can wait for the vet to call us back. If it's a little too low, we give him some karo syrup. If it's a lot too low--and hopefully we never have to deal with that, knock on wood--we will syrup him and take him to a vet ER immediately.
The reason I was compelled to write this long note to myself at midnight tonight is because I just did more research on dry foods and found some really good options. The DM dry food is insanely expensive. Here are two dry foods that have carb content under 10% and are thus safe for grazing (which our vet has us do with Mulder--this may not be the case with your animal,* but if it is, you're in luck! I did all the stupid research for you!)
--Wellness CORE Grain-Free Original Formula Dry Cat Food
--Wysong Epigen Starch-Free Chicken Formula Grain-Free Dry Dog & Cat Food
Keep a spreadsheet. Make it in good ol' G-docs, so it is shareable. Share it with your partner-in-care, if you have one. Share it with your cat-sitters, and family members who are generous enough to be said-cat-sitters. Keep important information on the spreadsheet, like the daily basics (date, time of measurement, glucose reading), and don't forget to utilize a notes section. This is good for keeping track of things like "Raised insulin dosage from X to Y," behavioral changes, or barfing.
I will maybe add photos of this spreadsheet and more notes tomorrow, when it is not midnight.
Ok, it's no longer midnight! Here are some screenshots of how we organize Mulder's spreadsheet:
GLUCOMETERS & TESTING (image 1.a.)
Alright, you'll note that we went through a variety of glucometers before finally getting the AlphaTrak2 (we were given the Henry Shein one by our specialist vet on accident--only vet offices can buy test strips for those for some insane reason--but we were able to exchange it with them for the AT2 when they realized the error. The Henry Shein is equivalent to the AT2, so no drastic number changes. The Contour Next EZ was the first one we bought. It is super affordable, but it's for humans, so I had to come up with an equation to estimate the actual measurement, as compared to the glucometer our local vet was using. If a person was on a super budget and was good at math, the EZ might be ok, but when you're getting down into lower number management, more precise is better so you aren't risking seizures).
The AlphaTrak2 is an initial cost of $55 and comes with the glucometer, 30 lancets, 25 test strips, and an automatic poker that we never use because we can poke his ears manually (probably the most traumatic part of having a diabetic cat). You will go through 25 test strips VERY QUICKLY, especially at the outset when you're measuring levels throughout the day (a glucose curve--see here). Lancets are hella cheap and come in packs of 100. The test strips are mad expensive and come in packs of 50. You'll be lucky to find a way to buy them for $1/strip. This is honestly the biggest cost for us, assuming Mulder isn't having complications that require a bajillion vet visits (we went through a phase like that last spring, and it was awful). You generally have to buy the test strips that go with the particular glucometer--you can't substitute BRAND X for BRAND Z. *However* there is a little hack: if you can establish the manufacturer of the test strips, sometimes you can find a workaround. For example, I just found this and will be buying these from now on, assuming the readings match up as well as everyone says they do. Forums! They ain't all bad.
If you don't want to mess with workarounds but the AlphaTrak2 is too spendy for you: This one, Advocate, is real cheap if you forgo the starter kit and buy the items separately (glucometer is ~$17, and test strips are nominally more expensive, in the $32 range) (if you buy a starter kit with 50 test strips, it's ~$60, but might be wise, given that the glucometer on its own doesn't come with the test liquid, which is pretty important for calibrating the machine) and has better reviews than EverPaw (that's in the $20 range for the glucometer, with test strips in packs of 50 for $30. I don't know anything about this brand, but reviews are mixed-leaning-towards-negative), but the major flaw I read about the Advocate in the reviews re: false lows seems like a thing I don't want to mess with. So I'll just stick with the AT2 (and my sick new hack) for now, but there are options. Given the affordability of these, I'd go for either of them over the headache of a cheap human glucometer. It's nice that there are some options now.
The vet tech shows you how to prick the ear to get readings (it's supposed to be a lot less painful than pricking their paws, and I imagine it's more sanitary for the cat, as well, given that their paws are constantly in litter), but this site provides good backup. In fact, it's just a great general resource. Obviously, take it all with a grain of salt, but when Mulder was first diagnosed, I spent a lot of time on there to get acquainted with everything. Another note: Dirty hands are a great way for anyone (including cats) with an open wound to get infected, so I wash my hands before prepping things, then give them a quick spritz/squirt of hand sanitizer before actually pricking his ear. Make sure hand sanitizer is dry on your hands before doing it, because if alcohol mixes with the blood sample, you won't get a reliable reading, and then you just spent $1 on pain and suffering with no reward.
FOOD TRACKING (1.b.)
This is helpful for seeing how much your cat is eating, and whether or not brand changes in the food impact the glucose levels wildly. You can see above that we--through convos with our vet--changed the frequency of the dry food free-feeding. Today (not pictured), Mulder only ate 1/2 of his 1/2 can of food, but he's also eating some dry food, so I'm not terribly worried. I'd be less happy about that if he didn't have other food out to graze on. The brands above are not brands I'll be using going forward--they were brands we had sample packs of from a friend. They were all grain free, but like 25% carb. But Mulder was eating them, and he was super low weight at this time (it was early in treatment--he'd lost like 7lbs and then he got a really bad face infection, so he was just coming off antibiotics and finally eating/tolerating food other than plain, boiled chicken) so I was totally fine with it. Later, we switched to the Purina DM dry food, but, as I mentioned, it's super expensive, so we're trying out the Core Wellness (see above) for now. We caught this relapse before he lost much weight, so it's more of a priority to make sure he's not gaining weight after he stabilizes.
BEHAVIOR TRACKING (1.c.)
This is an insanely useful thing to track. Be detailed. Add anything that might be anything, because you'll forget quickly when your brain power is taken up by worrying. Doctors of the human and pet variety all love having access to this kind of data. It might be nothing, but it might be a really big deal.
YOU ARE WELCOME, EVERYONE & ALSO FUTURE ME.
REMINDER: this post will be edited and updated as needed by me, so don't freak out if the food list changes or something.
*for questions about this: SEE YOUR VET, I AM NOT YOUR VET