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Dr. Bruce
Dr. Bruce, Veterinarian
Category: Cat
Satisfied Customers: 20150
Experience:  Small animal veterinarian with 15 years experience.
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My cat has just been diagnosed with Diabetes. He is a grazer

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My cat has just been diagnosed with Diabetes. He is a grazer so it is proving very difficult to ensure he eats before his insulin shot. Can you please advise how long before the insulin shot is due should he have eaten. Currently he had insulin at 6.45 am and I have been told that his second insulin should be given 10 to 12 hours later. If he has to eat 1 hour before the shot what should I do if he refuses. Can he have the 2nd shot say 13 hours later if it takes this long for him to eat or should it be missed ? I feel so under qualified to carry out this role !!
Welcome. I'm Dr. Bruce and I've been a small animal veterinarian for over 13 years. Thank you for your question. Don't feel overwhelmed with managing a diabetic. It is something that for the most part if an owner has a good head on their shoulders and a cooperative pet, they can be managed pretty well. I know it is overwhelming at first to think about all the things that go into managing a diabetic, but if you keep it simple, then it has a good chance of being not that difficult of a situation.
As far as Tom being a grazer. This makes it a little challenging to follow the goal of giving insulin around 30 minutes after eating. While this is ideal, it is something that again with cats is sometimes a difficult thing to do. What can be done here is one of two things. You could try to get him to more of a meal feeding pattern. Basically putting out food and leaving it out for an hour or two twice a day to try and get him to eat when it is out. This may get him to eat well when you can see it and then you can give the insulin after that.
This may not be the easiest to do though. What some owners will do is put out a little wet food and let them eat that. Once this has been eaten, they will then do the insulin administration and then leave out the rest of their food to graze on through the day. This gives some assurance that they ate well enough to get their insulin dose and that they shouldn't bottom out.
On the other hand, some owners will just get into a routine of insulin administration every 12 hours (as close to it as possible but some days there are variations here). They don't necessarily monitor the food intake with every administration but look at overall trends with the pet. If they are for the most part still their normal selves in other ways, being active, not vomiting and the food is being eaten, then they can most likely assume things are going well.
For the most part, what is hoped for with Tom is that the insulin will keep his glucose levels in check so he can start to drink more reasonable amount and urinate more reasonable amounts. He should also hopefully start to put on weight.
A good rule of thumb is that it is always an option for an owner to decrease an insulin dose for a dose or two or to skip one dose if they don't quite seem right. It is safer to do this to not lower the blood glucose too much in these situations.
Here is a great link on diabetic management.
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