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Dr. Deb
Dr. Deb, Cat Veterinarian
Category: Cat
Satisfied Customers: 9452
Experience:  I have been a practicing veterinarian for over 30 years.
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My 7 years old neutered male cat is diabetic. This began at

Customer Question

Hello
My 7 years old neutered male cat is diabetic. This began at Christmas when he started drinking and peeing lots. Urine test and blood test confirmed sugar levels just too high. As he was borderline we tried to control him with diet only. A change from dry to wet food and then to wet diet food seemed to do the trick for a time. He stopped over drinking and peeing immediately. However, weight loss continued. Eventually, 4 days ago he started insulin. The first day he went out for the first time in a number of days. Since then he has eaten well but has stayed generally quiet at home, going out just briefly this evening. He seems brighter but is still tired. We think he has put on a little weight already. My real question is with regard to his food. The main thing at the moment seems to be that he eats and gains weight. However - his favourite is the dry prescription food. He will eat the wet food but not so enthusiastically. When he hasn't fancied anything he can be tempted with tuna in spring water. When he was initially diagnosed, changing his food from dry to wet helped at once. I think that having the dry prescription food is making him drink more. I know that he will have to as it does not contain the moisture of the wet food, but I think he is drinking more than he should. He is using his litter and not going out at the moment. He had peed overnight last night and has had another pee this afternoon and a third just now (10pm). He has generally been peeing twice in 24 hours since starting the insulin. I feel the wet food would be better for him but he doesn't fancy it as much. What would you advise?
Submitted: 5 months ago.
Category: Cat
Expert:  Dr. Deb replied 5 months ago.

Hello, I'm Dr. Deb and will do my best to help you today.

I'm sorry for this concern for your cat. There's no question that diabetic cats will be better controlled if we can get them to eat a diet which is low in carbohydrates and high in protein....a ratio more typically seen in canned foods than dry.

While there are several different prescription foods which meet this criteria (and perhaps some over the counter canned ones as well), I personally prefer Purina DM since I've the best success with it. It comes in either dry or canned.

The following link may be of help since it covers this topic in some detail. You'll also be able to access links which list access to lists of both canned and dry foods. I aim for <10-12% carbs.

http://www.veterinarypartner.com/Content.plx?P=A&C=&A=3057&SourceID=

I hope this helps. Deb

Customer: replied 5 months ago.
Thanks Dr Deb. Do you think the dry food (Hills) might be making Woody drink more than if he were on the wet food? Do you think that two reasonably sized pees in 24 hours are ok?
Expert:  Dr. Deb replied 5 months ago.

You're more than welcome.

What brand of Hill's is he eating?

Deb

Customer: replied 5 months ago.
Hills m/d
Expert:  Dr. Deb replied 5 months ago.

M/D dry is a good choice for him.

I do find that cats who eat 100% canned food tend to drink far less than those eating dry so it would make sense that he might be thirstier on the dry M/D.

Most average, healthy cats are going to urinate about twice in a 24 hour period so this seems pretty reasonable to me. One way which owners will monitor their cat's diabetes will be by water consumption and urine production. It's not a precise measurement, of course, but a rough way of determining if their cat is reasonably controlled or not.

Deb

Customer: replied 5 months ago.
Thanks. That reassures me. I'm coping ok with the twice daily insulin injections and Woody doesn't even know he's having them. As I said in my original question, he does seem brighter and a bit happier with himself since he started the insulin on Wednesday evening and his appetite is better. However, he remains quite tired and is generally getting up to eat and pee and then going back to sleep. Not unusual for cats generally I know! How long should it take before he starts to pick up a bit?
Expert:  Dr. Deb replied 5 months ago.

Glad I can help:)

Most cats tolerate insulin injections quite well so I'm glad to hear that Woody is one of those patients.

It sounds as if his blood sugar values are likely reducing but without a glucose curve, we can't really know how quickly the insulin is working in his body, for how long it's working and how low the insulin is taking his blood sugar.

I've found that managing diabetes in cats can sometimes be a challenge but I would expect him to start acting more like his old self after at least a week or so.

The following link discusses at-home testing for diabetic cats which actually isn't quite as daunting as it might first appear. Taking blood from an ear vein and using a glucometer at home is vastly superior to hospitalizing a cat since stress can so dramatically affect their blood glucose numbers.

At this point, we don't know if he's a hard to regulate diabetic or not but the following link also discusses this particular situation:

http://www.veterinarypartner.com/Content.plx?P=A&C=&A=1605&SourceID=

In fact, if you look to the right hand side of the page of any one of these links, there's a number of other articles which discusses diabetes in great detail. I suspect you've already done a large amount of homework on the subject but if you haven't, then they may be useful.

Here's another great link as well: http://www.vet.cornell.edu/fhc/health_information/brochure_diabetes.cfm

Deb

Customer: replied 5 months ago.
Thanks. *****'ve read quite a lot about diabetes in cats since Woody was diagnosed. I will read those links you've given me. My vet is really good and I think very realistic. It isn't going to be easy. Woody is by nature an outdoor cat. When well he would be out all day or all night or sometimes both. He often hunts and eats what he hunts. I think keeping him regulated will be very difficult. However, the small dose he has been started on seems to be helping. May I ask you this please - the vet also said that he thinks there might be - he doesn't know but thinks it is possible - some other underlying condition apart from the diabetes. He says that if this is so then management would be the same. I'm realistic. I don't think it would be fair to subject Woody to loads of other tests. The reason the vet said this is I think because Woody doesn't exhibit all the usual signs of diabetes - breath smell for example. Weight loss has been his main continuous symptom. Do you have any suggestions about what the other underlying condition might be and what this might mean for him? I imagine it wouldn't be good. In any event, the insulin does seem to be helping his symptoms so it seems worthwhile anyway.
Expert:  Dr. Deb replied 5 months ago.

Sorry that I had to step away from my computer and have just now seen your additional reply and questions.

For what it's worth, regulating diabetes in older cats seems to be much more difficult than when they're diagnosed at a younger age...not that it isn't a challenge regardless of the patient's age (since it is!) but perhaps just less of one, if that makes sense.

For me, the classic signs of diabetes are increased thirst, increased urination and weight loss...all of which he had initially if I understand you correctly. Unless a patient is ketotic, then I don't typically smell anything unusual about their breath.

Most of the diabetic cats that I've diagnosed don't have other systemic issues going on with them. I always want to check a urine, though, to ensure that there isn't a urinary tract infection since diabetics are so prone to them.

I always worry about cancer when I diagnose this condition in older cats but it's less of a worry when they're his age.

I'm certain that blood work as ruled out many other conditions such as kidney issues or Hyperthyroidism so I'm not sure if your vet is having a sixth sense that something else is an issue with him (which is certainly possible, I suppose) but at least he's visibly responding to his insulin (and diet) which is a good thing thus far. There's no evidence that he has a secondary problem that I can see at this point.

Deb

Customer: replied 5 months ago.
Thank you Dr Deb. You have been very helpful. Can I ask one further thing and then I'll leave you in peace. Is it ok for me to keep giving Woody some tuna in spring water - he really likes it and he'll tend to have a bit of that and then attack his dry food on the other side of his dish? Finally, might I come back to you over the next week or so if anything worries me? My vet is on holiday this week. I would be very grateful. You have helped and reassured me. Adele
Expert:  Dr. Deb replied 5 months ago.

Adele,

No worries about the additional questions although I'm sorry that we keep missing each other:(

I don't see much harm in giving Woody a small amount of tuna in spring water several times a week. I probably would avoid a large, steady diet of it since there might be mercury concerns for him just like for us.

Please feel free to continue to contact me this next week if you have additional concerns; we may play the equivalent of "telephone tag" but I'm on my computer multiple times during the day; I'll get back to you as soon as I can if I'm offline when your post another question.

Additionally, even after you've rated (if you do, of course), we can continue to discuss Woody's diabetes at no additional charge to you.

In the meantime, best of luck with him:) Kindest regards, Deb

Customer: replied 5 months ago.
Good morning Dr Deb
Thanks for that. I will rate you as 'excellent' and am grateful that we can stay in touch through this next week. Woody ate nearly a full tin of the Hills md food this morning. I gave him his insulin at the same time without a problem. He had a sit beside the open door and looked out, taking notice of what was going on. I had wondered if he might go out but he decided to retreat back under his chair for a sleep. He does look brighter within the space of 4 days. He was clearly very poorly before and very flat. May I ask a couple of questions about the insulin? I know the injections are to be given 12 hours apart but is there any leeway in that? When he went out on Thursday he came in about an hour after his injection should have been given which put us back to an 8am and 8pm routine. This isn't always convenient. Is it ok to give the injection half an hour early or half an hour late? Also, I had a quick panic this morning. After taking the insulin out of the fridge and preparing the syringe I gave Woody his food and encouraged him to eat. Before I realised it, 20 - 30 minutes had passed before I could manage to give the injection. Will being out of the fridge this length of time have harmed the insulin? I'll make sure to put it straight back in after preparing the syringe in future. I hope these aren't daft questions but I'm new to this and want to do things as well as possible. Many thanks.
Adele
Expert:  Dr. Deb replied 5 months ago.

Hello again, Adele:)

Clearly what's morning for you is way early morning for me since we're in different countries:)

That's good news that Woody appears to be brighter today and has a good appetite.

If you can't manage to get the insulin into him every 12 hours, that's preferable but if there's an hour's or so difference either way, that should still be fine.

Specifically, yes, 1/2 hour either way should be ok. If you have to give it a little later one day, then just restart at the time you'd like to give it the next day. ...as long as we're not talking about 4-5 hours later than it should be given (which isn't likely to be the case). But if it is, then I might skip that dose and restart as normal the next day.

It's always better to run a little higher on glucose in the system as opposed to worrying about hypoglycemia (because he's given too much insulin).

You're not the first person, nor will you be the last, to leave the insulin bottle out of the refrigerator for a short period of time. It should be fine.

There are no "daft" or inappropriate questions from my perspective; only the ones not asked:)

You'll be old hat at this before too long although I know it can be a little intimidating at first. Deb

Customer: replied 5 months ago.
Thanks again Dr Deb. You're really helping me more than you know. Watch this space! Adele
Expert:  Dr. Deb replied 5 months ago.

Adele,

I'm glad to hear it:)) Deb

Customer: replied 5 months ago.
Help! I've just given Woody his evening insulin and it wasn't easy. I prepared the syringe - and put the insulin straight back in the fridge! Then gave him some food - he was asking for food even though he had some in a dish - he seems to like something fresh from the tin or packet. I let him eat some of it and then gave the injection. I found it difficult. I got hold of the skin round his scruff and parted the hair as I find it hard to know if the needle is in place if I can't see the skin. I held the skin as shown so that it was away from the rest of him. The needle went in fine, he didn't feel it, but when I pushed the insulin in he twitched. He didn't cry or jump away but he was aware. I don't want to put him off. I want to be able to do this quickly but I'm finding my uncertainty and concern to do it ok is making me dither. You wouldn't believe I did some nursing many many years ago and gave injections without a problem. It seems more difficult on a cat somehow. Can you help me at all please? Adele
Expert:  Dr. Deb replied 5 months ago.

Adele:

I'm not sure exactly what you're asking. A small twitch when giving an injection isn't an uncommon reaction and doesn't mean that he's being hurt...just that he may feel it a little bit. The insulin needle is exceedingly small, as you know. Perhaps, he felt pressure from the insulin being injected? I'm not sure but this isn't something to be overly concerned about.

I'd advise you to approach the procedure with confidence in your ability to do so and recognize that this is bothering you more than him.

I don't know if a video will be helpful in easing your mind but there are a number of them on YouTube; just google "How to give your cat an insulin injection".

Deb

Customer: replied 5 months ago.
Thanks. I just wondered if you had any tips for making it easier. Suppose I'll improve with time. I think I just find it awkward. Many thanks
Expert:  Dr. Deb replied 5 months ago.

Adele,

I think this is a situation where the comfort level improves the more often you do it. There aren't any "secret" tips or I'd definitely share them with you:))) Gently lift the scruff, create a "v" and inject into it....that's usually what I tell my owners to do and to vary the site where you inject a little bit each time. Of course, I usually demonstrate the procedure in person and have them also inject with sterile saline a few times to get a "feel" for when the needle punctures the skin.

Deb

Customer: replied 5 months ago.
Thanks Dr Deb. Good news - after insulin and food this morning Woody went out at 9am and has just returned 2pm - full of himself and asking for food. I gave him some of the wet Hills and then some of the dry Hills. That seems to tickle his taste buds. Presumably it's ok to to offer the variety? He's had a small drink and is now asleep under his chair. That seems like progress to me! Early days but what a different little lad to a week ago when he seemed to be on his last legs. Thanks again for being there for me this week. I remain really grateful. Adele
Expert:  Dr. Deb replied 5 months ago.

Adele:

What wonderful news about Woody:) I'm so glad that he seems to be responding to the insulin as well as he appears to be. You must be absolutely thrilled!

Yes, it's perfectly fine to offer him both canned and dry prescription food since he prefers the variety. Since some cats like to graze, I'll often suggest that owners leave out a small portion of dry for their diabetic cats.

Deb

Customer: replied 5 months ago.
Thanks. Will do that. Yes, I'm really pleased. I know it's early days but he's happy and that's the main thing. I've just had a thought. I've been able to take some time at home over the past couple of weeks but the day will come when I'm out for a few hours at least. Because of the insulin affecting his blood sugar, will Woody need food available through the day? Such as today, he came home really hungry. We don't have a cat flap so can't leave food in the house for him. Am I going to have to think of some way of leaving food available? Adele
Expert:  Dr. Deb replied 5 months ago.

Adele,

If he's well regulated, then he shouldn't need food available throughout the day especially if you're only gone for a few hours at a time.

If you leave food outside, you're likely to attract all sorts of unwanted critters who will eat the food and thus it won't be available for him....not to mention all of those critters expecting a future free meal:)

Deb

Customer: replied 5 months ago.
That conjures up a wonderful picture of a line of different creatures waiting to be fed. Thanks
Expert:  Dr. Deb replied 5 months ago.

If only the reality were close to what you envision, then you could start a soup kitchen for the local critters in need :)))

Customer: replied 5 months ago.
Hi Dr Deb. I think I may just have cracked it with the injections. Had managed to get myself into a real tizz leading up to 8pm when this evening's was due. The result was that, having drawn up the insulin, I bent the needle as I dithered putting the needle cover back on while I gave Woody his food. So, I had to discard that and start again. Gave myself a stern talking to and managed to draw up and give the injection without a problem. Woody was totally focused on his food! I gave him a few spoonfuls of tuna after the injection and he gave that just audible little purr when I put it into his dish. He's had a good day thus far. Thanks again for being here this week. You will have sensed my anxiety and you are really helping me - and Woody - as we start what will hopefully be a long lasting new way of life. Adele
Expert:  Dr. Deb replied 5 months ago.

Adele,

Woody and I never lost confidence in you and knew that you'd figure it out given enough time:)

I'm glad that I've been able to help you help him; he sounds like an amazing cat and I hope he's one of the fortunate feline diabetics who are easily controlled.

Deb

Customer: replied 5 months ago.
Hello Dr Deb
Having spent quite a few hours out yesterday morning-afternoon, Woody then went out for about an hour late last night. This behaviour is normal for him. When I got up this morning he had eaten most of the food I had left for him at bedtime. He was alert and hungry and ate virtually a full tin of his Hills food with gusto - more than he had been having. I gave him his injection (without problem) as he was finishing his food. As soon as he had eaten, I could see he looked sleepy and he lay down for a sleep. He got up for a drink - not a huge drink - and then returned to his slumbers. That has been the pattern today. He had another good feed at lunchtime. It is now nearly 4pm. Whereas yesterday he was much more alert, today he is only alert when coming and asking me for food. He isn't unhappy in himself and his appetite is much better. But he's tired and thus far has not looked like going out at all. I don't understand the difference in his behaviour. He had a big breakfast and I can understand him needing a sleep after that. Perhaps I'm hoping for too much too soon. He has been getting worse for a while now and he is a different cat to last week at this time. Should I expect these differences in his behavior? I can only reason it by thinking of a recuperating patient who has become weak and needs to gradually build his strength up. What do you think?
Adele
Customer: replied 5 months ago.
Just as I finished the above, Woody made his way through to me and cried for extra food. He's clearly off the dry food today and on the wet food. He has thus far - just after 4pm - had about 2 and 3/4 tins of the wet Hills. He looked pleased with himself after eating it, had a little wash and then back under his chair. Do you think this sounds ok for this stage in his treatment? Adele
Customer: replied 5 months ago.
I suppose I'm wondering about him being vocal and active when hungry and then, as soon as he's eaten (well) and had his injection he's very sleepy. It is now 6pm and less than 2 hours until his next injection and he's still sleeping????? Apologies for the anxiety!
Expert:  Dr. Deb replied 5 months ago.

Adele,

I'm really glad to hear that Wood's appetite is so good; that's definitely a barometer of his overall well-being.

The behavior that's troubling you may be absolutely normal for him, under the circumstances, but it may also reflect his blood glucose levels. Every cat will respond differently as to how quickly the insulin which is given takes effect and how long it lasts before the glucose might creep up again.

And, remember, most cats spend the largest percentage of their time sleeping anyway especially if they over do it a bit too soon after being ill.

I probably wouldn't be too concerned unless what we might call his lethargy is a recurrent pattern of behavior over the next few days. Deb

Customer: replied 5 months ago.
Many thanks Dr Deb. I'll report more later. Adele
Expert:  Dr. Deb replied 5 months ago.

As usual, glad to help:)

Customer: replied 5 months ago.
Would you believe it. Woody has just asked very vocally for more food and has then scratched his claws on the front door mat and asked to go out. It is an hour until his next injection is due so hopefully he'll come back before then but I felt it was the right thing to do to let him out when he asked to go. If he's late home I'll give him his injection then and just give it late tomorrow morning as I'm not pushed for time tomorrow. I want to give him his head as much as I can at the moment. If he feels like a trip out then I want to let him go. Do you agree? I will stop asking you questions at the weekend - or, if I need to continue, I'll pay another fee! Adele
Customer: replied 5 months ago.
He's come straight back in - obviously just needed a pee or poo - that's some progress as he's generally been using his litter up until now. He's having another little snack! I know you said it varies from cat to cat but how soon after injection could the insulin start to work? I'm just wondering if it's more likely to be a raised blood sugar or the insulin or his general not being well that made him so sleepy this morning?
Expert:  Dr. Deb replied 5 months ago.

Adele,

Well, he's back in now but I agree that you should let him do what he wants to do. If he misses his insulin injection by a short amount of time, no real harm will be done.

how soon after injection could the insulin start to work?

That's a difficult question to answer since it depends on the insulin and the patient. Most insulins will last about 12-14 hours in a cat's body which is why injections are given twice daily. It might start to work within 1-2 hours after being given or might take longer.

That's why a glucose curve is invaluable to analyzing how quickly a particular insulin takes effect, how long it lasts for peak effect and when it starts to wear off.

Deb

Customer: replied 5 months ago.
Thanks Dr Deb. That's interesting and helpful. I wonder if my vet might suggest doing a glucose curve when we have our review. Woody's been brighter since he was out. I know the following doesn't fall into the remit for your expert help but please excuse me if I share my experiences with you as it does help me just to say how things are going. I'm afraid I didn't do too well with his injection this evening because it was different to normal. Woody had already had a snack when he came in so was laying quietly on the floor when his injection was due. I tempted him to get up by putting a little tuna in his dish. Because he wasn't actually eating I think I dithered too much and took too long in actually giving the injection. Rather like last night he clearly felt the needle go in. I suspect it was because he wasn't otherwise engaged with his food. I must admit that picking up the skin to create a 'v' isn't as easy as it appears on the various videos on the internet - the cats on the films seem to have plenty of skin to go at whereas Woody doesn't - his scruff is quite thin really. I think I'm doing it the right way and I'm going to have to just be more positive or else I might make him wary. Hopefully, any memory of the injection was masked by the tuna he had afterwards and I made a point of stroking him a little so that he doesn't always associate me touching his scruff with the injection. Oh well, tomorrow is another day. Ever onward! Adele
Expert:  Dr. Deb replied 5 months ago.

Adele,

Most cats seem to be pretty forgiving about insulin injections especially if they don't appear to react in any way when the majority of them are given.

I probably don't have to tell you this but cats are pretty emphatic and can sense our anxiety or moods. My pep talk for today is to approach this procedure with confidence and authority; no trepidation allowed.

It will become second nature before too long.

Deb

Customer: replied 5 months ago.
Thanks Dr Deb. Received and understood. I will do this, I will, I will, I will .................
Expert:  Dr. Deb replied 5 months ago.

Yes, you can.

Yes, you can.

Yes, you can:)

Customer: replied 5 months ago.
Hello Dr Deb. It's been a good day thus far. Woody has continued to eat very well. I was positive and managed this morning's injection without a problem and without Woody knowing anything about it. He has definitely been brighter today than he was yesterday. He has come out from under his chair occasionally and ventured through the house to find me and ask me very vocally for food - although he still had food in his dish, he clearly likes something fresh. He seems to be starting to put a little weight on. He doesn't look quite the pathetic little thing he did. Only two things to mention to you today - when I came downstairs this morning at 7.30 he had clearly peed in his litter through the night. Not a flood but a reasonable amount from what I could tell. He then had another pee about 1pm this afternoon and he has just had another at 6.30pm. He's had more of the dry food today as well as making a good job of the wet food. I know the dry food makes him drink more - naturally so. I have found him having a few good drinks - usually after he has eaten. He isn't camping out by the water bowl though. Apologies if this is rather silly but I'm wondering if the amount he drinks is being affected by the increased amount of food? He was eating before starting the insulin, but not nearly as much as now and it wasn't doing him any good as he was continuing to lose weight and failing. He seems to enjoy his food now whereas before it was rather half-hearted. He did not over drink and over pee then though. The increased fluid traffic has happened since starting the insulin. This is why I wonder if it is linked to his increased food consumption. 8 days after starting the insulin, it's as if his whole system has been jump-started. My second query is this. I know it's early days and we don't know how things will go. However, I'm wondering if there is any chance that Woody could return to being the cat he was? He was so independent. He was out in all good weather, would stay out overnight, catch things to eat. We were really his hotel and hotel staff. While a bit brighter today, he generally eats and sleeps and uses his litter. I just wonder if there is a chance he might be his old self? Or is the best we can hope for a Woody who is much dampened down. I know this is all conjecture at the moment. I just wonder what your experience is? Many thanks. Adele
Expert:  Dr. Deb replied 5 months ago.

Adele,

Thanks for today's update.

I'm wondering if the amount he drinks is being affected by the increased amount of food? The amount of water he'll drink in any one given day depends on a lot of factors including (but not limited to) how well his diabetes is controlled, dry versus wet food consumption, activity level, ambient heat/humidity.

However, I'm wondering if there is any chance that Woody could return to being the cat he was? That's certainly the goal and what has been achieved for some diabetic cats, especially if they're well controlled.

Deb

Customer: replied 5 months ago.
Thanks Dr Deb. Not a perfect day - pricked my finger with his needle this evening - not the first time! Last week when I did it I thought I'd better check it out and was sent by our 111 helpline to the local A and E where I saw a lovely young doctor at the desk who has three cats himself and said I could catch nothing except whiskers! This time the newly confident Adele pushed the needle straight through Woody and into herself - just a pin prick though. Woody knew nothing about it as he was eating at the time. Ahhhhhhhhhhhhh. Adele
Expert:  Dr. Deb replied 5 months ago.

You don't want to know how many times I've done the same thing to myself! I've yet to stab an owner, though, and hope to never do so.

Customer: replied 5 months ago.
It's comforting to hear you've done the same. Would you believe I discarded the insulin and started again for Woody's sake! No wonder he hides under the chair!
Expert:  Dr. Deb replied 5 months ago.

Well, I probably wouldn't have done that but I can understand why you did:)

Customer: replied 5 months ago.
That's kind of you to say so! Dr Deb - you've been helping me for a week. If I complete the 'rating' can I just request you again and are you ok to keep helping me? I don't want to abuse your kindness and think I should pay another fee. Adele
Expert:  Dr. Deb replied 5 months ago.

Adele,

Even after you've rated (and I'll thank you in advance for doing so), we can continue to discuss this issue about Woody at no additional charge to you. Pretty good deal, right?

The site does prefer that a new question be asked if a different topic is raised; however, we've been essentially discussing the same issue now since we first started communicating.

If you feel that you'd like to provide additional compensation, then you can leave a "bonus" when you rate although it's not mandatory nor expected. It's appreciated but not required in any way.

And, yes, you can always request me at any time; I'll be happy to help if I can. Just add "For Dr. Deb ONLY" at the beginning of your question so that other experts won't answer. Of course, if it's something critical, you may not want to wait until I'm back online (if I'm off when you post, that is).

Deb

Customer: replied 5 months ago.
That's great. Thanks. I've said it before but I am so very grateful. Woody has just made his way through to lay down outside the living room door - the nearest he ever gets to being with his family! That is a good sign indeed. Adele
Expert:  Dr. Deb replied 5 months ago.

Adele,

It sounds to me as if he's improving slowly but surely each and every day....which is, indeed, a very good thing:) Deb

Customer: replied 5 months ago.
Hello Dr Deb. Today's update on Woody. Very much as yesterday. He doesn't seem to have much energy but it is warm today. He's still eating and drinking ok and took himself outside for 10 minutes or so instead of using the litter which is a positive. Can I just ask you today's little worry please - I told you I pricked my finger (twice) with the needle I'd used on Woody and the doc said not to worry as I couldn't catch anything from him (although I could have the usual sort of infection from a wound). Would I be right in thinking you agree with that? Adele
Expert:  Dr. Deb replied 5 months ago.

Adele,

If it helps to reassure you about needle accidents, I can't tell you how many times I've inadvertently stabbed myself and have yet to have had any issues.

If the needle is sterile (before he's injected), even less of a concern but even if you prick yourself after it's used, if you wash the penetrated skin thoroughly with soap and water, you should be fine in terms of any infection which might develop.

I also agree with your vet that there are no diseases which you can pick up from contact with his tissue or blood in this way.

Deb

Customer: replied 5 months ago.
Thanks Dr Deb. I'm totally reassured. Just done this evening's injection. More difficult because Woody had already eaten and didn't appreciate my gathering up his scruff. My husband was there and suggested we use the skin a bit further down from his scruff and, indeed it seemed easier to 'pick up' the skin there and Woody was oblivious. I then managed to grab his attention with one of his little toy mice. He didn't exactly play but he did paw it to one side and watch it - a lot more than he would have done last week at this time. My vet said the needles could be used a couple of times but I am finding it much easier to use a new one each time. It's probably because I know it's guaranteed to be sharp and that helps my confidence. Thanks again. Adele
Customer: replied 5 months ago.
I am going to tax my technical inabilities over the weekend and try to send you a picture of the patient. A
Customer: replied 5 months ago.
Ah bless him! It is 10.30pm and Woody has just had his supper and gone out onto the lawn and is watching and chasing moths in the dark - as he would do when well. It is lovely to see. A
Expert:  Dr. Deb replied 5 months ago.

Adele,

I hate to disagree with fellow professionals but I NEVER use a needle more than once. The risk of infection is just too great in my opinion especially in a diabetic.

I would love to see a picture of him if you can manage it; I love putting a face to the name, so to speak:)

A beautiful picture is in my mind's eye of him acting like a cat should act.

Customer: replied 5 months ago.
I do agree with you Dr Deb and I will follow what you say about the needles. My instinct told me that as well. Little tinker came in from watching the moths to have a drink and pee in his litter!
Expert:  Dr. Deb replied 5 months ago.

Well, he could have shared his waste products with the wild outdoors but I guess he thought you'd appreciate it more if he used the litter box:)

Customer: replied 5 months ago.
Hi Dr Deb. Today didn't start too well. Woods clearly felt this morning's injection so this evening I will revert to the higher up scruff I had been using generally. Didn't put him off his food though which he ate with great enthusiasm. He's been out a couple of times briefly, the last time to follow a little bird. Apart from the injection, quite a good day for the little chap. A
Expert:  Dr. Deb replied 5 months ago.

Adele,

It might be too much to expect that he'll never flinch or react when an injection is given but he may have a "sweet spot" where he tends to feel it less.

I'm happy that he's interested in hunting but I hope the bird was not his victim:( D

Customer: replied 5 months ago.
Thanks. I did wonder if further down from his scruff is more sensitive. I think that might be so which is unfortunate as there's more skin to take hold of. No, the little bird got away safely as Woods was carried in - much to his disgust. Was good to see a flash of the old Woods though!
Customer: replied 5 months ago.
Success! Back to the scruff - Woods didn't notice a thing! A
Expert:  Dr. Deb replied 5 months ago.

:)

Customer: replied 5 months ago.
Hi Dr Deb. Today has been ok. Woods has been out from under his chair quite a bit although he hasn't tried to go outside at all - yet anyway and it is 8pm. He had peed sometime through the night, I suspect early morning-ish by the state of the litter. He then had another pee about 8.30am but hasn't had another until just now - nearly 12 hours later - so that seems quite reasonable really. He has eaten well again. This morning's injection went without incident, it again seemed not to be noticed. This evening's also seemed ok although he did register something was happening. When I took the needle out it was slightly bent. Might this be because I'm sometimes still a bit slow at inserting the needle? It is getting easier generally so I hope in a few more weeks I'll be able to do it without any bother. I am using a new needle every time now. You did say that I could 'rate' you but still continue this conversation didn't you? You've been providing really invaluable help for the past week and I'd like to mark that but not lose the thread. Many thanks. Adele (oh and I've found a rather obvious way of slightly varying the injection site - Woody has both black and white fur on his scruff - white for daylight and black for night)
Expert:  Dr. Deb replied 5 months ago.

A,

What a difference a week makes, right?

You did say that I could 'rate' you but still continue this conversation didn't you? Yes, I did:) We can continue to communicate exactly as we have been.

I love that you've simplified where to give his injections; glad his color pattern makes it so easy:) D

Dr. Deb, Cat Veterinarian
Category: Cat
Satisfied Customers: 9452
Experience: I have been a practicing veterinarian for over 30 years.
Dr. Deb and other Cat Specialists are ready to help you
Customer: replied 5 months ago.
Review supplied plus a small additional sum - wish it could be much more to reflect the professional care you provide.
Expert:  Dr. Deb replied 5 months ago.

A,

The rating as well as the "additional sum" is appreciated; thanks... and, no worries about the amount:) Something is always better than nothing as they say:))) D

Customer: replied 5 months ago.
Hello Dr Deb. A good day for Woody. He decided to take himself out this morning for an hour or so and has generally been awake more than previous days. He has also discovered his voice and is quite vocal - having been very quiet. His weight looks better, as does his coat. He does still appear a bit 'spaced' some of the time. However, he is a completely different cat to two weeks ago. I don't have any questions for you today - but I'm sure I'll have thought of something by tomorrow! Thanks. A
Expert:  Dr. Deb replied 5 months ago.

A,

Always glad to hear good news so thanks for sharing:) Deb

Customer: replied 5 months ago.
Hi Dr Deb. Another good day for Woods. He actually decided to take himself out for an hour or so this morning. Injections have gone without issue today. I'm wondering about the injection sites. Can you actually give the injection wherever you can make the skin 'tent'? Are there places other than the scruff that you think work well? My vet returns next week and Woods sees him on Wednesday so will keep this thread going until then. Many thanks again for your help. A
Expert:  Dr. Deb replied 5 months ago.

Good afternoon, A.

In theory, you can give insulin injections subcutaneously (under the skin) anywhere on a cat's body; it's just easier around the scruff, neck area where there's looser skin to lift

I suspect your vet is going to be impressed with how well Woody looks when he sees him:) D

Customer: replied 5 months ago.
Thanks Dr Deb. I do hope so - present signs are good. I weighed Woods for the first time since being at the vet. He was 3.45 or 3Kg when last weighed. While my scales aren't as accurate he is now about 3.85Kg. On the scale of things that seems pretty good? Exactly 2 weeks since we started the insulin. Adele
Expert:  Dr. Deb replied 5 months ago.

Yes, I would agree that your scale probably isn't as accurate as the one at the vet's office, but the fact that he seems to have put on a bit is definitely a good thing:)

Customer: replied 5 months ago.
Hi Dr Deb. A little hiccup today. Injection and food all well this morning. Then at lunch time, Woody had a little to eat and was suddenly sick. Just the bit of food he had eaten. He recovered quickly though and within 20 minutes was back at his dish and has eaten well a couple of times since without incident. While he's certainly not back to being the cat he was before he was ill, he remains brighter and more alert than he was. I'm hoping this was just a one-off. Adele
Expert:  Dr. Deb replied 5 months ago.

A,

It doesn't take much to trigger vomiting in a cat so I don't tend to worry too much about it unless it's a consistent problem.

D

Customer: replied 5 months ago.
Hi Dr Deb. This morning when I first saw Woods he looked distinctly 'spaced'. However, he surprised me by eating a hearty breakfast and didn't register his injection. He has picked up through the day and been much more alert. He has just been outside on the lawn for a good 45 minutes, come in and had a snack before laying down tired! A good day. Still just over the two week mark since he started insulin. I'll keep this link going until we've seen our vet next Wednesday. Many thanks. Adele
Expert:  Dr. Deb replied 5 months ago.

A,

Continued good news is always welcomed:) Deb

Customer: replied 5 months ago.
Hi Dr Deb. Generally good news. Woody went out yesterday morning and didn't return until late afternoon. He was shattered! He hadn't been out much at all this week so this was a huge step forward for him. He was very tired though. I don't think he had eaten and he alternated a little food with a long sleep for the rest of the day. Only tuna could tempt him out from under his chair when it was time for the evening's injection. I was a bit concerned when I saw him first thing this morning. He still looked very sleepy and he hadn't eaten during the night, although I think he had water and he certainly peed in his litter. He took quite a bit of tempting - and combing! - to persuade him to eat. Once he started though he ate quite well. He's slept most of today but has gradually picked up and I've just (late afternoon) given him the good part of a tin of m/d. He's had a wash and returned to his slumbers. I keep reminding myself that it is only 17 days since he started on insulin and, when I do so, his progress seems quite good. I assume it will take him a while to regain his lost ground. I remain really grateful for your support while my vet is away. We see him midweek. Adele
Expert:  Dr. Deb replied 5 months ago.

A,

It sounds as if he might have overdone it a bit since he stayed away all day. I'm not surprised that he slept the remainder of the evening.

This pattern of behavior may be the new "normal" for him so as long as he's eating, engaging with the family, not hiding and still wants to explore the big outdoors, I'd assume that this is the case:)

Certainly his quality of life is tremendously improved from what it was pre-insulin. D

Customer: replied 5 months ago.
Thank you. It is so heartening to see him looking better. I have been wondering what will be normal for him in the future. He is a different cat in many ways than before he was ill. He comes to look for me when he wants something to eat even if he has food in his dish and he is much easier to handle. This was not the Woods of old who was quite a solitary little thing. It is fair to say that he and I have bonded. Not something I ever expected. He still looks spaced sometimes and seems to have some days that are better than others but I imagine this is still a work in progress so to speak. Thanks again. Adele
Expert:  Dr. Deb replied 5 months ago.

A,

Glad I can be here for you both. I suppose if we're going to look at the "glass at half full" (as opposed to the opposite), then at least his diabetes has caused a more affectionate side of himself to emerge.....which is obviously a very good thing:) D

Customer: replied 5 months ago.
Hi Dr Deb. Review appointment tomorrow with our vet. Will let you know how we get on. Thanks. Adele
Customer: replied 5 months ago.
Dr Deb, are there any 'treats' a diabetic cat can have? Woods used to love Dreamies and also our dog's Webbox chews. Thanks. Adele
Expert:  Dr. Deb replied 5 months ago.

A,

Will look forward to a report:)

As for treats, you'll just want to avoid those which might have sugar in them (more of a problem for dogs than cats). A few of any kind are likely to be fine, though, regardless of what they are.

D

Customer: replied 5 months ago.
Hi Dr Deb. A good report from the vet. He is happy with Woody and says he has regained some muscle. We are to continue as before. However, I've just given him his evening injection and I made a mistake. I think the needle must have gone straight through his skin and out of the other side as a drop of insulin appeared. Am I right that I should just wait until his next injection is due in the morning? I feel so stupid. Adele
Expert:  Dr. Deb replied 5 months ago.

A,

That's great news that your vet is so pleased with Woody's progress. I just knew he would be:)

Don't feel stupid about making a mistake with his injection; it happens to the best of us all the time! But if you haven't already heard back from your vet about what to do, your instincts are correct: you don't want to give him another pm dose since there's a risk of overdosing him and causing hypoglycemia.

He'll be fine even though he may not have gotten his normal amount of insulin.

D

Customer: replied 5 months ago.
Thanks Dr Deb. That makes me feel a bit better. I've tried to reassure myself by thinking that if Woody continues to improve he is likely to spend the odd night out and won't get his dose then. I just need to relax a bit for the evening dose. The process wasn't helped by the fact that I had already dropped the insulin bottle while putting it back in the fridge - one of those slow motion instances when it seemed to take ages for it to hit the floor. Fortunately, it didn't break and is back in the fridge. I was going to say I would sign off and not trouble you any further, but perhaps you could be there for a further few days just in case of need be. Thanks again. A
Expert:  Dr. Deb replied 5 months ago.

A,

I'm not going anywhere so if something else happens, you know where to find me:)))

Not every situation is ideal when it comes to our pets so an occasional missed dose isn't a huge concern or problem in most cases.

D

Customer: replied 5 months ago.
Hi Dr Deb. Woods wasn't himself this morning. I wondered if he had been thrown off a bit by the visit to the vet (although he seems to accept the vet as an additional staff member now) and/or the missed insulin dose. He didn't want food this morning, only a drink, and he seemed more sleepy. I gave him his insulin and, after a doze for 20 minutes or so, he seemed to perk up and ended up going out for about 5 hours. He was ready to eat by the time he came in. He's had his insulin this evening and seems back to his new normal. After dropping the insulin bottle yesterday (which fortunately bounced) I think I'm going to collect another one to keep in my fridge for when the current one is finished - or just in case of accident!
Expert:  Dr. Deb replied 5 months ago.

A,

I wouldn't be surprised if the stress of the car ride/visit as well as a higher than normal blood sugar caused him to behave as he did this morning, especially since he's acting more his new "normal" now.

If you do purchase a spare bottle of insulin, just be sure to double check the expiration date if it's not used relatively soon. I'm sure you'd know to do this, but just reminding you:) A

Customer: replied 5 months ago.
Thanks. Will do. A
Expert:  Dr. Deb replied 5 months ago.

:)

Customer: replied 5 months ago.
Hi Dr Deb. Apologies if this is a daft question. I'm wondering if I can expect to see differences in Woody's behaviour from day to day? He's had a good couple of days, eating plenty, going out occasionally. Today, I sense he isn't so good. Difficult to put a finger on it but he just seems a bit 'off'. He has eaten, but not with huge enthusiasm. He's been out for an hour this afternoon but doesn't seem too happy with himself. An hour after this evening's injection he came looking for me but when I offered him some food - a variety! - he ate just a little and then lay down again with much tail flicking. Is he likely to have good days and not so good days and is there anything I can do or do we just go with the flow? Thanks. Adele
Expert:  Dr. Deb replied 5 months ago.

A,

Unfortunately, I don't really quite know how to answer your concerns. In most cases, once a diabetic patient is reasonably stabilized (their blood sugar isn't fluctuating wildly in other words), they tend to behave about the same from day to day.

A blood glucose curve hasn't been done on him so as I mentioned before, we don't know how quickly the insulin takes effect, how long it lasts and how low his values go in response to the insulin.

Perhaps his behavior is reflective of the fact that his blood sugar is better than it was but perhaps it's still somewhat high? Or he's just having a less energetic or hungry day.

D

Customer: replied 5 months ago.
Thanks Dr Deb. I understand. Strangely enough, 2 hours after his insulin injection he's headed off for a wander looking more like himself. Contrary creature! A
Expert:  Dr. Deb replied 5 months ago.

I think he's trying to mess with your head:) How's he doing????

Customer: replied 5 months ago.
I think he's doing very well indeed at confusing me! When I think back just over 3 weeks, there was no way he'd even think about having a wander, he was poorly. He's much different to then - even on a not so good day.
Expert:  Dr. Deb replied 5 months ago.

Cats are famous for making us crazy but I suspect you already know this:)

I probably wouldn't try to over-think his behavior for one day unless he's obviously not himself (like he was three weeks ago).....although I know this isn't easy to do.

Customer: replied 5 months ago.
You are right! They keep us guessing and on our toes. I understand what you say - I suppose it's just a case of taking seeing how he goes from day to day and seeing the general trend. Will try harder! Thanks.
Customer: replied 5 months ago.
just read that again - ignore the 'taking'!
Expert:  Dr. Deb replied 5 months ago.

That sounds like a good plan to me:)

Customer: replied 5 months ago.
Hi Dr Deb
Woods has had a good few days. He's been much brighter yesterday and today and has wandered in and out a few times. The litter tray has not been used at all for two days! It is exactly four weeks since he started on insulin. It really is a miracle drug. I'm so grateful you're at the other end of the 'ask'.
Adele
Expert:  Dr. Deb replied 5 months ago.

A

I assumed he'd been doing well since I hadn't heard from you in a few days; glad to have my assumption confirmed:)

As I think I've mentioned before, not all diabetic cats will respond as well as he has; thank goodness, he's one of the lucky one.

D

Customer: replied 5 months ago.
I'm just so grateful he's happier and brighter than he was. I know it's still early days really but progress thus far is a bonus. We're all giving it our best shot. Thanks. A
Expert:  Dr. Deb replied 5 months ago.

He's doing great from the sounds of it and it must be so heartwarming to see him back to a semblance of his normal self:)

Customer: replied 5 months ago.
Hi Dr Deb. All continues well. Woody is certainly regaining a bit of weight - not surprising in view of his improved appetite! He is going out a little and is using his litter less and less. He also seems to be losing that 'glazed' look and is more alert and interested in what is going on. Totally unexpectedly he presented himself and pleaded for the fish we were having for our tea. He has never done that before. It is lovely to see him looking happy again. Many thanks for your continuing support. A
Expert:  Dr. Deb replied 5 months ago.

A,

Continued good news....I always love to hear it:)))

D

Customer: replied 4 months ago.
Hi Dr Deb. We've been doing ok. The boy is up and about more, spending less and less time under his chair and more time actually near us - which he never did before! I'm sitting looking at him now. He's just had a bit to eat and his injection and, as normal, after about 5 mins he lays down for a while with his tail flicking. He's going out more as well. The only thing is that he doesn't seem to be putting on much weight. Might it be as simple as the fact he's out and about, exercising more and is therefore using up energy and hopefully regaining a bit of muscle? He really is much more active and alert over the past few days. Thanks. A
Expert:  Dr. Deb replied 4 months ago.

A

Continued excellent news:)

I can't seem to recall if he's eating a diet with higher protein and lower carbs; if so, then in addition to the increased exercise he's getting, he may not be getting as many calories as he used to. Carbs can contribute to weight gain in cats; when you reduce them, they tend to lose weight or not gain.

D

Customer: replied 4 months ago.
he's on Hill's m/d low carbs for diabetic cats. He eats quite well I think. He had nearly a full tin this morning and has eaten a little more of the wet food and a bit of the dried food through the day. He was always a 'grazer'. He does seem too thin to me but he seems happy and perhaps, in view of his diabetes, it is better for him to be lean rather than his former chubby self???? I suppose I'm just concerned as prior to the insulin he lost more and more weight. That has ceased and if anything he is just a little less lean. A
Expert:  Dr. Deb replied 4 months ago.

A,

When I reviewed our rather long exchange, I saw where he's on the M/D. This may account for not gaining weight.

I personally think it is better for our pets (and for us) to be on the leaner side as opposed to carrying a few extra pounds.

Longevity studies have confirmed that leaner cats tend to live longer, healthier lives.

D

Customer: replied 4 months ago.
Thanks. I'm putting myself on Hill's m/d as from tomorrow!!!! A
Expert:  Dr. Deb replied 4 months ago.

Yeah, me, too:))))

Customer: replied 4 months ago.
Hi Dr Deb. Some more good days for Woods. Over the past week he seems to have moved up a gear and has been going out for a few hours every day. The rest of the time is spent resting! Will keep in touch until after our next review at the vet in about a fortnight. Thanks again for your support. A
Expert:  Dr. Deb replied 4 months ago.

A,

Believe it or not, I was wondering how the boy was doing just this morning:)))

That's excellent news that he's moving ever closer to being his old self with his established routine. If he keeps this up, he'll get a gold star at the next vet visit:) D

Customer: replied 4 months ago.
Ah thanks. You have honestly made this time so much easier than it would otherwise have been. I would have sent you a picture of him if only I could work out how to do it! I never expected him to get to this stage at all really - and certainly not only five weeks after starting insulin. I'm still a bit concerned that the wheel might come off somehow but so far so good. I did wonder how he would be if he ever did get to this stage of going out a lot - which is his nature - but he seems to be doing alright. The exercise actually seems to be doing him good. My main hope was for him to be happy again and he certainly seems to be much more content. Thanks again. A
Expert:  Dr. Deb replied 4 months ago.

I'm just so glad that things seem to be turning out well for him:)

I'd love to see a picture of him. The following link walks you through the process although it's not always the easiest thing to do for some folks for some reason: http://ww2.justanswer.com/how-do-i-send-photo-or-file-expert

It's fun putting a face to the name so to speak:)

Customer: replied 4 months ago.
Hi Dr Deb. Progress continues. The boy's behaviour is reverting more and more to what was normal for him, particularly with more time being spent out and about. Strangely, though, we have certainly developed a much closer bond over the past weeks - and that is continuing. I remain amazed at the difference made by just a small dose of insulin. What a wonderful thing it is. Will keep you updated. Many thanks.
Expert:  Dr. Deb replied 4 months ago.

I certainly wouldn't have suspected that the two of you would have become closer but what a wonderful side effect to the insulin he's being given...if that's what's responsible for this new "Woody":)

I'll take it!

Customer: replied 4 months ago.
Hi Dr Deb. Things are moving on day by day. Woods is just a totally different cat in the space of a few weeks. I can hardly believe it. Could we just revisit one thing please? Woods is going out more and is behaving as he used to do. He was due insulin at 7 am today but did not return until 10 am at which time I gave him his dose. This obviously throws our 7 and 7 pattern out. I need to get him back to an earlier injection time. Is it ok to give the insulin say half to three quarters of an hour early tonight and then early again tomorrow morning? What leeway do we have? Many thanks. A
Expert:  Dr. Deb replied 4 months ago.

A,

Everything is always a trade off, isn't it???

You don't have to give him his insulin injections exactly 12 hours apart although as close to this as possible is the ideal.

I wouldn't give him his insulin earlier tonight but I would probably give it to him around 8:30 pm.

Then just restart him tomorrow morning at 7 AM or at 6 Am if you're trying to give them to him earlier.

It's better to give insulin longer than 12 hours apart as opposed to fewer hours than this ....although one hour earlier isn't likely to make much of a difference if this makes sense. D

D

Customer: replied 4 months ago.
Hi Dr Deb. Thanks. I've re-read my question and realised I was very unclear. May I just clarify with you? Woods had his insulin at 7pm last night and had his next dose at 10am this morning - 3 hours late. From what you say it would be ok to give him his insulin around about 9pm tonight and then 8am tomorrow morning (which would actually be the ideal time for me)? and it seems from the timings you give that if for any reason I'm really stuck a couple of hours early would be ok??? Thanks. A
Expert:  Dr. Deb replied 4 months ago.

A,

I think you were clear but my answer may not have been:(

Yes, I'd probably give him his insulin tonight around 9'ish and then 8 am tomorrow should be fine. Then, I assume you're trying to get him on an 8am and 8 pm schedule. D

Customer: replied 4 months ago.
am aiming for 8 and 8, though we know the success of that depends on the cooperation of the little one! At least he has decided to stay in tonight so that should make the morning easier - famous last words. Many thanks. A
Expert:  Dr. Deb replied 4 months ago.

Yes, don't go predicting what he's going to do since this will guarantee that he'll do just the opposite!!!

Customer: replied 4 months ago.
Review at the vet tomorrow morning. Fingers crossed! A
Expert:  Dr. Deb replied 4 months ago.

He's going to get another gold star, I think:)

Customer: replied 4 months ago.
I do hope so - that is if he deigns to come in, in time to go!
Expert:  Dr. Deb replied 4 months ago.

Well, there's always that problem!!!!

Customer: replied 4 months ago.
Hi Dr Deb. A good report from the vet this morning. He thinks Woods has put on a little bit of weight and is doing well. We're to continue as we're doing and go back for a further check in two months. Good news! A
Expert:  Dr. Deb replied 4 months ago.

Way to go Woody:)))

Customer: replied 4 months ago.
Hi Dr D. All goes well. The boy seems to be regaining some of his strength and appears to be more and more like his old self. His back and hips are not quite as thin as they were. The increased time out and exercise seem to be doing him good. I never imagined we would make such progress in less than two months - I never imagined we'd make such progress at all actually. Perhaps I'm just over-cautious but I'm still not taking anything for granted. Brilliant thus far though! I'll keep sending updates if that's ok with you. A
Expert:  Dr. Deb replied 4 months ago.

A,

I'd love to keep receiving updates on Woody, especially if they continue to be good ones:)

If I've said it once, I've said it literally a million times: cats are simply amazing creatures and it's rarely a sure thing to bet against them. There's not always a positive outcome when things happen with them but there often is. D

Customer: replied 3 months ago.
Hi Dr Deb. All has been going very well. The boy has been spending more and more time going out. But oh no - I've done it again tonight - I think! For (only!) the second time I think we had a fur shot. I stroked him after giving him his injection and these droplets appeared - I think I'v gone straight through the skin and out the other side. I thought it was ok but I think it was the insulin as it looked as if it had the slightly cloudy appearance of insulin after it has been agitated in the bottle. I'm so cross with myself. I've referred to your previous answer and am taking reassurance from that. There's a chance it could have been a drop of water but I don't think so. I'll give him his injection half an hour or so early in the morning. I don't know, just when you think you have it cracked! A
Expert:  Dr. Deb replied 3 months ago.

A,

Don't beat yourself too much up about this. I've been practicing for over 30 years and from time to time, I still somehow manage to do the same thing when vaccinating cats and dogs.

It happens to the best of us, unfortunately:( D

Customer: replied 3 months ago.
Ah thanks for saying that. It does reassure. He's so improved that he's been fending for himself today - so I suppose at least he'll have had high protein and low carb food! Would never have believed he'd improve to that extent. Suppose that's why making an error with the insulin is so annoying. Never mind. Ever onward! Thanks Dr D. A
Expert:  Dr. Deb replied 3 months ago.

He'll be fine although I can understand why you'd be so annoyed with yourself. But, think of it this way: it could have been worse. You could have given him an overdose of insulin!!!

Customer: replied 3 months ago.
Ah, now that's very true - that would have been a worry - you would have seen me circling in orbit if I'd done that!
Expert:  Dr. Deb replied 3 months ago.

It might not have been as bad as it sounds but you'd have had to monitor him like a hawk for signs of hypoglycemia....not a pleasant prospect.

Customer: replied 3 months ago.
No - it would have definitely meant a sleepless night. Honestly, Dr D, I do hope you realise what a difference you make to a new diabetic feline carer. I know I've said this before but you have made all the difference to me - and the boy - over the past couple of months. I am so grateful. It is just amazing to look at the boy now - you are right when you say cats are amazing creatures.
Expert:  Dr. Deb replied 3 months ago.

A,

Your words mean a lot to me so thanks for saying them:)

Each and every day, I'm appreciative for how special and amazing cats are; I simply can't imagine my life without one....or more:) D

Customer: replied 3 months ago.
All has been good over the past couple of days. No more fur shots! He's a happy little chap. A
Expert:  Dr. Deb replied 3 months ago.

Always good to hear:)

You may inadvertently give his fur another insulin bath at some point in time but I hope you'll roll with it. D

Customer: replied 3 months ago.
Hi Dr D. An eventful week. The boy has been back to the vet today. All was well until yesterday afternoon when Woods took himself out at about 4.30 pm and did not come back in until 8 am. So, he missed his evening insulin. When he did come in this morning - after a long walk for me with much calling - he went straight to his water bowl and was very thirsty indeed. Assuming he'd eaten out I gave him his insulin. By this afternoon I wondered if he was hypo - sleepy, wobbly and a bit spaced. He still wasn't hungry but did eventually eat some cod. Cutting out all the middle bits I took him to the vet this afternoon. His BG was up and the vet thinks he ate something that has thrown him off when he was out overnight. Because he isn't eating much now though I was advised to reduce the amount of insulin he has this evening. I am not to give him any insulin in the morning before taking him back to the vet for 9 am. I assume his BG will be retested. I'm wondering what he might have eaten that would have that effect on him. I would have thought his natural food would be ok for him. Needless to say that has all thrown the week a bit and I feel disappointed because he has been doing so well. He is picking up this evening and eating a bit however. Oh dear! A
Expert:  Dr. Deb replied 3 months ago.

A,

I suppose it was unrealistic to think that there wouldn't be set backs from time to time, especially since he goes outside where it's much more difficult to completely control his environment.

I might not have given him the full dose of insulin after he returned home unless he ate breakfast for you but am glad that your vet suggested a lower dose for this pm.

I'm not sure I understand why you're not to give him his insulin in the morning, though. D

Customer: replied 3 months ago.
I wondered about that. I actually rang up to make sure what he wanted me to do. I could only think - but this might not be right at all - that he wants to check his BG to review the amount of insulin he receives - but I might be wrong with that. I also didn't understand - but you clearly do - why I had to give a lower dose of insulin this evening when his BG was actually up this afternoon. I think it was 20 or 21??? I know I'd feared he might be hypo earlier on but the reading didn't show that - unless the piece of fish he'd had before going to the vet had raised his levels. I admit to being a bit confused. I've given him the one unit of insulin this evening, following which the boy refused his usual food but followed me into the kitchen with interest when another small piece of cod was on offer. He's eaten that. Following his very big drink this morning when he returned home he hasn't had much more - if anything - to drink. He hasn't used his litter either. I know you're right that we can't expect everything to always be regular - because he goes out - but it had seemed that things had settled. It was a bit of shock to find him so different within the space of 24 hours and I'm uneasy. He seems more like himself this evening and has settled for a sleep after this fish - he's staying nearby and isn't hiding away. Apologies if that's all a bit garbled. A
Expert:  Dr. Deb replied 3 months ago.

A,

No apologies necessary.

Every vet manages their diabetes somewhat differently so I don't want to second guess what your's is doing or thinking.

When a diabetic is not eating (for whatever reason) or if I'm uncertain as to what they did eat, then I typically suggest 1/2 of the normal dose of insulin, regardless of what a "spot check" BG may show. I previously keep harping on glucose curves but we can't possibly know how quickly the insulin works and how far the BG drops based on one value alone.

Clearly he wasn't hypoglycemic when your vet evaluated his BG but stress (ie the car ride) can elevate it,too......sometimes to quite a high degree.

Whatever may have been going on would seem to have passed or is resolving which is obviously a good thing.

D

Customer: replied 3 months ago.
Thanks Dr D. Your replies always have a calming effect. I understand what you say. I'll ask the vet tomorrow about possibly giving a lower dose if - when - something similar happens again. I know that the vet wasn't keen to do a BG curve in our case - I think because of Woody's outdoor tendencies but I'll discuss everything with him again in the morning. Thanks again. I'll report back tomorrow. A
Expert:  Dr. Deb replied 3 months ago.

A,

Always glad to help you and Woody, of course:)

I'll look forward to an update. Deb

Customer: replied 3 months ago.
Hi Dr D. The boy was better this morning - up and ready for a hearty breakfast. No insulin before being at the vet for 9am. His BG yesterday afternoon had been 21. This morning it was 35. The vet said that was what he anticipated it would be as he had eaten and not had his insulin. We were home and he'd had his proper insulin dose only an hour after it was due. He is much brighter today, just about back to himself and he's certainly found his appetite today. I am resisting the temptation to never let him out again! The vet was very reassuring this morning. He says the boy is generally doing very well. Oh and I asked him whether I should only give half his dose if he again comes in after a night out and doesn't eat and he said yes - which is what you said yesterday so thanks for raising that possibility. Ever onward ...................... A
Expert:  Dr. Deb replied 3 months ago.

A,

Wonderful news:) And, glad that your vet and I are on the same page:))

I, too, might be tempted to keep him inside but I suspect his quality of life would significantly suffer and that wouldn't be at all fair to him as I'm sure you'd agree. So, you'll just have to live with the possibility of the unexpected happening from time to time. I'm sure that some might say that a standard routine is....just, well, DULL!! Although in this case, dull wouldn't necessarily be such a bad thing.

D

Customer: replied 3 months ago.
I totally agree. My best hoped for outcome was to give him back some quality of life which, for him, involves regular trips out, though I didn't think this likely to happen at all. So, what we have is major success and I am trying never to forget that. It is a case of living with uncertainty. I must say I'm rather relieved that he hasn't made much move towards going out today and has just made use of his litter. I think he's still recovering from whatever happened yesterday. He's certainly eaten well today and looks more like himself this evening. He's been eating his proper diet food today. However, he clearly wanted something I was failing to provide this afternoon and again it turned out to be a small piece of cod - cooked from frozen in the microwave. He's settled again after that. He has really kept me on the hop today! Thanks Dr D. A
Expert:  Dr. Deb replied 3 months ago.

That's not a spoiled boy at all, is it???

Perhaps he will stay a little closer to home over the next few days so as to provide you with a certain peace of mind about him.

You and I both know that he knows when you worry about him.....but some days, he probably can't be bothered to put your needs above his own. Some cats are just selfish that way:)))

Deb

Customer: replied 3 months ago.
Very spoiled I think! As you predicted, he hasn't been too keen to go out today and only popped out for about an hour this morning. Mind you, I wouldn't be that bothered to go out if I had a member of staff to hand all day answering my every call! I think he's still recovering from his incident on Thursday morning. He has eaten about half to three quarters of a tin of his food but has regularly asked for fish throughout the day. The pieces of frozen cod/pollock are small and even smaller once cooked in the microwave, providing just enough for a tasty small meal for him. Once he's eaten that he settles for a few hours. I wouldn't want to give him that as a permanent diet. However, if he's feeling a bit 'off' and it's all he'll really eat then I'm assuming it is better to have that. Also, he's still a thin little thing - even though he's put on a bit of weight - and I think every little helps. I checked the packet and there is no - or virtually no - carbohydrate in the fish and just a trace of salt if anything. Presumably the extra protein should be good for him - for a short period anyway???????? A
Expert:  Dr. Deb replied 3 months ago.

A,

I wouldn't have a problem giving him fish, especially the small amounts which he's getting. If it keeps him happy and satisfied, then why not? would be my response. D

Customer: replied 3 months ago.
Thanks Dr D. They are small but I must say he's had the equivalent of good sized cod today! I have tried to add a further bonus for you but there doesn't seem to be that facility - it only offers me the option to write a further review. If you can tell me how, I'll send something extra - which won't reflect at all your super support but I would like to do that. A
Expert:  Dr. Deb replied 3 months ago.

A,

This is one very lucky cat who has found his way into the life of someone who spoils him so unmercifully!!!

Unfortuantely, I can't see what you see on your end of things although I have received bonus amounts from other folks on this site even after the question was rated....but perhaps the UK site is different for some reason. I appreciate your wanting to do so but it may require contacting Customer Service if there's no easy link or icon that you can see.

Deb

Customer: replied 3 months ago.
Will do. It allowed me to add the bonus once but that facility has disappeared. Hopefully my contact with customer services will be more successful than my attempts to send a picture of the boy! A
Expert:  Dr. Deb replied 3 months ago.

:)

Customer: replied 3 months ago.
Having a quick panic! I see you are on line. Will explain.
Customer: replied 3 months ago.
Hi Dr D. Just having a little worry in view of what happened last week. The boy has been in most of the day and has eaten very well. Getting on for two tins of his food through the day and a decent sized piece of fish two hours ago - he had plenty but wouldn't give me any peace until I supplied the fish! He has then been out for two hours. He has just come in and I've given him his usual insulin as it was spot on time. I assume this is ok as he's had plenty to eat through the day? I'm assuming there's only a possible problem if he hasn't eaten for a number of hours? I suppose there's an outside chance he could have been sick over the past two hours but I don't see why and I would imagine we can't cater for that outside possibility all the time. Is that ok? A
Expert:  Dr. Deb replied 3 months ago.

A,

It sounds as if you're ok since he's been eating this much food throughout the day. Since so many diabetic cats do like to graze (they're not fed at specific times of the day in other words), insulin is often given when it's due but not necessarily associated with a big meal.

D

Customer: replied 3 months ago.
Thanks Dr D. I was just suddenly a bit concerned in view of what happened last week. That certainly describes Woods - he usually has a good feed first thing in the morning and then grazes throughout the day, often eating well again quite late. Oh - I managed to track down a way to pay a small bonus. The option to pay a bonus disappears once you've paid one bonus but the customer support folk are making arrangements to forward a further small payment. I wish it could be more. Many thanks again. A
Expert:  Dr. Deb replied 3 months ago.

A,

I completely understand why you'd be so worried given last week's adventure but I think he'll be fine.

And, any additional bonus is always appreciated so thanks for making the effort to figure out how to do it:)) D

Customer: replied 3 months ago.
Thanks again. It always seems to be in the evening when uncertainties arise. A
Expert:  Dr. Deb replied 3 months ago.

Well, of course!!!! At least it's better than in the middle of the night.

Customer: replied 3 months ago.
A token of thanks should be winging its way to you Dr D. I wish it could be more than just a token. All seems to have been ok today. The rain is acting in my favour and making the boy's trips out particularly brief! A
Expert:  Dr. Deb replied 3 months ago.

A,

Sorry it's taken such a while to get back to you; my computer went on the fritz and I've just got it back. Whatever additional amount you sent is always appreciated so no worries about the amount:)

If you need the rain as badly as we do, then it's one more reason to be glad that you're getting it...in addition to keeping Woody inside, of course:) D

Customer: replied 3 months ago.
Hi Dr D. The past few days have been ok without further real issues. Must admit I'm not completely happy with the boy though. Difficult to say why. He just doesn't seem 100%. He's still going out, though not for too long - which is a good thing I suppose and could have something to do with the weather. I don't know whether it is general behaviour for cats but he regularly asks for food - even though there's food out for him. For example, he ate a full tin of his diet food this morning. Had his injection. A good sleep. Then asked for his new favourite at lunch time - fish! Ate a good sized piece of fish. Another rest. etc. All the time, some of his diet food is available - biscuit and wet food. I wonder if he's chancing his paw in asking for something else when he has food available that he does eat in the morning? I don't like refusing him as it would still be good for him to put on a bit of weight. He seems to manage to eat a lot but then he always has done so. I just wish he could speak! A
Expert:  Dr. Deb replied 3 months ago.

A,

Not sure what to say about him.

Some cats will develop behavioral issues where they beg for something different than what is already put out for them.

I believe I've mentioned that hypertension can cause some cats to act in odd ways.

Early senility or cognitive dysfunction issues can also cause them to behave differently.

Not sure that I think either one of these is the problem though. D

Customer: replied 3 months ago.
He's a mystery. He often seems to like to eat every two or three hours or so. I honestly don't know what to make of him. Sometimes he seems fine and at others he just seems a bit off - though not unhappy - he actually spends more time with us than he ever did before. Watch this space! A
Expert:  Dr. Deb replied 3 months ago.

Sounds like he's trying to keep you on your toes...or drive you crazy, one or the other:)

But you do know that many cats are a riddle, wrapped in a mystery, inside an enigma, don't you???

Customer: replied 3 months ago.
Woods is the first cat I've had since a kitten so my knowledge is limited. Enigma is the right word though. He is teaching me - slowly - to take things as they come. It is impossible to anticipate what the next hour let alone day will bring! Thanks for the input. A
Expert:  Dr. Deb replied 3 months ago.

Cats have many talents and you've listed just one of them:)

Customer: replied 3 months ago.
Just checking in Dr Deb. No further trauma to report! The boy hasn't seemed to look 'spaced' so often over the past few days and continues to enjoy the white fish - in fact, I think he might have put on a little weight. However, it looks to me like we've reached the maximum improvement in him since he started the insulin. He is clearly much, much better. I don't think he's the same cat though. He goes out but not as much as before and he doesn't seem to have as much energy - though the word 'energy' is a bit iffy for cats anyway I suppose. He still uses his litter sometimes whereas before he never, never used it. I was a bit bothered this week because he had started to use it most of the time again. However, he has started going out more again. He may have had a few off days? His best time of day is first thing in the morning. He 'goes off' a bit from late afternoon which I wonder might be related to dropping insulin level and increasing sugar level???? He then seems to pick up very late on - a while after his second injection. It seems that we just have to take each day as it comes. His 'picking up' a couple of days ago coincided with a new bottle of insulin. Probably coincidence. How long is an opened bottle likely to be ok? Thanks for the continued support. A
Expert:  Dr. Deb replied 3 months ago.

A,

Thanks again for the update about your special boy.

This new pattern of behavior is likely to be the norm for him although I've long ago given up trying to completely understand why cats behave as they do! (please reference my earlier remark about a riddle, mystery, enigma)

I know when the weather changes and becomes cooler, my outside cats tend to spend more time indoors. Not sure if this might be a factor or not.

I don't doubt that diabetes has likely changed him but he's also a mature cat now; many cats often tend to be a little less active as they age so this may also possibly play a role.

There should be an expiration date on the insulin bottle that you have. As long as it's refrigerated after each use, then it should still be effective.

Deb

Customer: replied 3 months ago.
Many thanks. I think you're right about the cold weather. After sending you the message, having scratched his claws on the front door mat, the boy sat there waiting to be let out. However, when I opened the door he stuck his nose out and then looked as if he was thinking 'won't bother, too cold' and turned tail! Watch this space! A
Expert:  Dr. Deb replied 3 months ago.

Smart boy:)

Customer: replied 2 months ago.
Hi Dr D. Just checking in with you. Things much as before. Woods seems to have some days that are better than others. He is generally tending to venture out each day - definitely for longer when the weather is better. I think we can say he is holding his own. I will report back in a few days - or earlier in the even of some happening! Many thanks. A
Expert:  Dr. Deb replied 2 months ago.

A,

I think I know how he feels since I, too, have better days than others:)

but glad that he's stable and no crisis has arisen with him:) D

Customer: replied 2 months ago.
I know what you mean! No, no crisis recently, though after I sent the message I remembered something a bit odd. He had been out during one evening. When he came in he went straight to his water bowl. This is what he tends to do when he's eaten something out. My husband remarked that he looked very full later on. When I got up in the morning he had p'd in his litter but had also had what looked like a minor flood where he sleeps. He seemed fine and was as normal. He hasn't done that before. The full look must have been water?? I wonder if he'd eaten something that hadn't quite agreed with him. But that has never happened on the floor before. Odd that he did that and also used the litter???
Expert:  Dr. Deb replied 2 months ago.

One of my dog's stomach tends to expand quite a bit to the point where it's really obvious after she drinks a fair amount of water; more than likely this is what you observed.

Cats don't typically leak when they sleep or have incontinence issues but that's not to say that they can't develop them; it's just more of a problem observed in dogs. I suspect if he did drink more than normal, then his bladder was so full that there was some spillage.

Customer: replied 2 months ago.
Thanks Dr D. Just had a little issue. Giving him his evening injection, I tried not to disturb him from his rest too much and he maybe wasn't laying quite straight. I went into his scruff and I wonder if I went too deeply as it seemed to touch something that felt like bone? He didn't notice anything at all. I removed the needle and did it again properly. Again he didn't notice anything. After no mishaps or poking my finger with the needle for ages I'm a bit annoyed with myself - not for the first time. He seems fine though. Ahhhhhhhhh.............
Expert:  Dr. Deb replied 2 months ago.

A,

You might have hit his scapula although I can't be sure. He most likely wouldn't have reacted much unless you hit a nerve, though.

So, no harm, no foul, as they say. Deb

Customer: replied 2 months ago.
Ever onward! Many thanks. A
Expert:  Dr. Deb replied 2 months ago.

:)

Customer: replied 2 months ago.
Hi Dr Deb. Unhappy developments I'm afraid. Will send details immediately. A
Expert:  Dr. Deb replied 2 months ago.

A, I don't like the sound of that:(

I may have to log off soon, although I'll check back in soon, if I do. D

Customer: replied 2 months ago.
Woods had been doing ok and was going out for a few hours now and then. Yesterday at 5.30pm he asked to go out and, as it was at least 2 hours before his next insulin was due, I let him go. He did not return last night at all. So missed his insulin. He was not waiting to come in this morning and I couldn't find him. I went out again this afternoon and eventually found him laying down beside a stream. He appeared unable to move. I managed to reach him and, after much effort, we got him home. He was very wobbly and went straight to his water bowl and had a huge drink. I telephoned the vet for advice and was told to give him his insulin and try to get him to eat. After a little while he seemed to pick up a bit but didn't want to eat. A further consultation with the vet advised to watch him and if he started to become more 'wobbly' again to give him another, but just very small, dose of insulin later in the evening (which should tide him over until the morning). He's still been camping out by the water bowl and it did seem the right thing to do to give him a small dose of insulin. We're watching him but he does seem more settled and not quite so wobbly now. I'm just going to watch him and see how he goes. I would be happier if he would eat something. By chance he has his review at the vet the morning after next so,as long as an emergency dash isn't necessary, we'll review things then. I just don't understand what has happened. I am surprised that he was in such a bad state so quickly. He wasn't like that before he started on insulin so I don't understand what could have brought about such a - what can only be called - collapse. A
Customer: replied 2 months ago.
I've just been and checked on him. He's settled again in his box but is responding ok. I just hope I've done the right thing.
Expert:  Dr. Deb replied 2 months ago.

I'm not sure I have a good explanation for why he collapsed either although I'm not sure I would have advised you to give him his full amount of insulin if he wasn't eating.

I usually suggest 1/2 th dose since I worry about hypoglycemia. If he won't eat on his own, then you may have to force feed him (not something you'll probably relish doing) or rub honey or pancake syrup on his gums every so often so that his blood sugar doesn't plummet.

I know this may seem counter intuitive but full dose on insulin in a patient who isn't eating is always a possible recipe for hypoglycemia.

Customer: replied 2 months ago.
Oh dear. It is now ten hours since he had the full dose of insulin and two and a half hours since he had the additional small dose. How long do I need to be wary of hypoglycemia? I've just checked on him again and he's awake and alert.
Expert:  Dr. Deb replied 2 months ago.

You did what your vet told you to do so don't feel bad; it's just not what I would have done (although different vets do practice differently). Given this timeline, he's probably not at a high risk for developing low blood sugar...which is obviously a very good thing.

Most insulins will last 12 hours but can peak at different times. Unless he's had a glucose curve done, we don't know when that might be for him.

But, having said that, the full dose of insulin (given 10 hours ago) is likely not going to be a factor since it's already losing effect in his body.

The small dose you gave may not cause any issues for him either if is was less than 1/2 of what he'd normally receive.

Customer: replied 2 months ago.
Hello Dr Deb. The saddest news. Woods was no brighter this morning so I took him to the vet who said he was still very dehydrated and had ketones. Woods was put on a drip and treated to see if he would pick up. However, he did not and the vet and I agreed that the kindest and only thing left to do was for him to be put to sleep. Woods and I have received the most wonderful help and support from our vet and the nurses. I have also received the best support from you and you have supported me in those times when I really needed help. I am so grateful to you. Thank you so much. A
Expert:  Dr. Deb replied 2 months ago.

Adele,

This saddens me beyond words:( For some reason, I thought that more might be going on with him this episode although I can't explain why I thought that.

I know there's going to be a huge hole in your heart for a long time to come but I hope that in time you'll be able to remember him with tears of joy, rather that sadness.

My heart is breaking for you. Deb

Customer: replied 2 months ago.
Thanks Dr Deb. I do appreciate that. Thank you again for all the support you have given. I do hope you realise how much of a difference you can make in difficult times. I think you're right about something else going on with Woods. He just couldn't rally this time. I am so sad. Looking at the clock and the window and the door .............. However, there is much for which I am grateful. He was a true miracle and he and I have been surrounded by many who truly care - including you. A
Expert:  Dr. Deb replied 2 months ago.

A,

It's been more than my pleasure and an honor to share even this small portion of Woody's journey with you. D

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