First of all, I'm not a vet. I'm just a guy who loves his cat. My cat was diagnosed with diabetes two or three months ago, and since then I've learned a ton, and I thought I'd condense a lot of the most important stuff to a little post in hopes that it will help somebody.
First of all, let me share a bit of good news. Feline diabetes is reversible. You can actually fix your cat's diabetes and take them off of insulin altogether. Read on.
How do you know your cat has diabetes?
The three most obvious signs are (1) your cat starts drinking a lot of water. Sometimes they hover near their water bowl a lot. (2) Your cat pees a lot. He's peeing not only because he's drinking a lot of water but also because that's his body's way of getting rid of excess glucose which he has an excess of because he doesn't have enough insulin to process that glucose. (3) Your cat has developed neorpathy. Neorpathy is damage to the nerve fibers in your cat's legs. It causes them to be weak in the legs, to wobble when they walk, or to sit or stand on their honches. With most cats, this happens in the back legs, but with mine it was all his legs.
If your cat has any of these symptoms or if things just don't seem right, take him to the vet. The vet will diagnose your cat.
How did your cat get to be this way?
Probably because you've been feeding him dry cat food his whole life. It turns out that dry cat food is really bad for your cat. It has way too many carbohydrates, and not near enough moisture, both of which are really bad for the pancreas and the kidneys.
What should you do now
Your vet will probably prescribe insulin to your cat. My vet had me buy insulin and syringes at WalMart pharmacy because it's inexpensive. There are different kinds of insulin and different kinds of syringes. I didn't know anything when I went to Walmart. They just gave me insulin and asked me what size syringes I needed. I said, "I don't know. The smallest ones you have. It's for a cat."
But the reaity is that there are U100 syringes and U40 syringes, and they are supposed to corresponds to the insulin concentration in the insulin that you buy. If you buy U100 insulin, you need to use U100 syringes. Thankfully, even though I didn't know this at the time, Walmart gave me the right syringes to go with my insulin. There's more information about insulin and syringes here.
Your vet will likely start you off on 1 unit of insulin, then ask you to come back in a week or two to do a glucose curve. The reason they start you off on 1 unit of insulin is because it's more dangerous for a cat to have low blood sugar than it is to have high blood sugar. So you have to start off on a low dose, then do a glucose curve after a week or two to see how the cat is doing. After that, you can adjust the dose accordingly.
When you take your cat back for a glucose curve, you're suppose to feed them and give them an insulin shot, then leave them at the vet all day. The vet will take a glucose reading once every two hours or so, then draw up a curve, interpret the curve, then recommend what you should do in terms of insulin. If you have a good vet, they'll also recommend you get your cat off dry cat food.
Unless you are unable for whatever reason, I recommend doing your own glucose curves. One reason is because taking your cat to the vet and leaving him there all day is emotionally traumatic. That stress will cause your cat's glucose levels to rise giving your vet a false high reading. And you'll feel guilty. A second reason is because to get a good glucose curve, you need to feed your cat normally through the day like you normally would. That won't happen at the vet's office. The vet will just assume you feed your cat once in the morning, and that's it. You'll pick your cat up at 5 pm, and he may be starving. In my case, I don't think they gave my cat any water all day.
A third reason is because taking your cat to the vet for a glucose curve every two weeks just to make sure you're giving the right insulin dose can get expensive. It's cheaper to do it yourself. That brings me to the fourth and final reason--doing glucose curves yourself is easier on you, your cat, and your wallet.
A little about insulin and glucose
When your cat eats, some of that food gets turned to glucose. The body releases insulin, and the insluin works like a key to open the cells to accept the glucose. If your cat has too much glucose too often, the body has to work harder to produce more insulin. Eventually, it wears out, losing its ability to produce insulin or the cells become resistant to insulin. Once that happens, the cells cannot absorb the glucose, and this results in hyperglycemia (i.e. too much glucose in the blood), which leads to all the symptoms of diabetes. It can also cause kidney problems.
The kitty cat body tries to maintain a glucose level of between 80 and 130 mg/dL. But since hypoglycemia (low blood sugar) is more dangerous than hyperglycemia (high blood sugar), we want to give ourselves a margin of safety. So we want to shoot for a glucose level between 90 and 270 mg/dL. Actually, I looked at several sources and got slightly different answers. One said 100-130 mg/dL. Another said 90-270 mg/dL. Another said 80-300 mg/dL.
The most important thing is that you keep their glucose level above 60 mg/dL. Anything below that is hypoglycemia which can cause seizures and death.
Doing a glucose curve
You need to get a glucometer with some test strips and lances. I got the AlphaTRAK2 kit, which has everything you need. You can buy more strips and lances on Amazon. Unfortunatly, the strips are kind of pricey, but it's still a lot less expensive than taking yoru cat to the vet every two weeks and traumatizing him. Plus, it allows you to get a reading whenever you need to or want to.
There are a lot of YouTube videos showing how to take your cat's blood glucose with the glucometer. Basically, you stick a test strip in the glucometer. It will turn itself on. An option will come up the first time to enter a code. The code you need will be written on the tube your test strips come in. For example, for a cat it might say "37." There are two buttons on the glucometer. The one on the right makes the number go up, and the one on the left makes the number go down. So just press the buttons until you have the right code. Once that is entered, wait a couple of seconds, and it'll show a little drop on the screen. From that moment on, you have two minutes to obtain a blood sample before it shuts itself off again.
To get the blood sample, rub the outter edge of the ear with your fingers to warm it up and get the blood flowing. Then you prick it with the lance (you don't need the lance shooter, or whatever it's called to do this). Hopefully a little drop of blood will come out. If not, massage the ear on both sides of where you made the prick to kind of push the blood up and through the wound. Once you see a little drop of blood (and it only takes a tiny bit), pick the glucometer up with the test strip inserted, and put the test strip up against the blood drop. The strip will wick the blood up, and you'll hear a beep. Then all you do is wait for the number to come up on the screen.
Don't worry if you're uncertain about my instructions. The glucometer comes with detailed instructions, and there are lots of YouTube videos demonstrating how to do it.
To do a glucose curve, all you have to do is take readings for twelve hours or so, two hours apart. Here's the basic schedule I use:
7:00 am Feed Aristotle.
7:30 am Give Aristotle an insulin shot.
8:00 am Take a glucose reading.
10:00 am Take another glucose reading.
Then take one at noon, 2 pm, 4 pm, and 6 pm. You can do one at 8 pm, too, if you want.
Throughout this time, feed your cat like you normally would. A girl on YouTube insisted on only feeding your cat twice a day, but my cat won't put up with that nonsense.
Once you have all the readings you can either draw a curve yourself, or you can type it into Excel and have Excel do it for you. You really don't need to draw a curve. It just provides a visual for people who prefer visuals over raw data.
What will typically happen is that your first reading will be high. The glucose level will go down and reach its lowest point around noon. Then it will begin to rise again.
I recommend reading this web page about how to interpret a glucose curve. Again, the most important reading is that low reading. When I did my first two glucose curves, I took readings at 11 am and 12 am and got my lowest reading at 11 am one Saturday and 12 am another Saturday. That lowest reading is called the Nadir, and one web page said an ideal Nadir you want to shoot for is between 80 and 150 mg/dL. If your Nadir is below 60 or 80 mg/dL, then you definitely want to reduce the insulin you're giving your cat by at least one unit. If it's above 300 mg/dL, then you should increase the insulin dose by one unit.
You don't want to change the insulin dose too quickly. Change it by one unit at a time, then give it a week and do another glucose curve.
Don't freak out if your Nadir is near 80 mg/dL, but your highest reading is something like 411 mg/dL. Obviously, 411 mg/dL is above the normal range, but the important thing is that your cat's glucose level remain within the normal range for most of the day. If it peaks outside of that range, that isn't nearly as dangerous as dipping below the normal range.
Diet and nutrition
If your glucose curve swings wildly from way high to down low, it might be because you're still feeding your cat dry cat food. Stop that! Dry cat food is terrible for your cat, not only because it has all kinds of carbohydrates your cat doesn't need and that cause it's blood glucose to rise quickly, but because it doesn't have enough moisture. Cats naturally get a lot of their moisture from their food.
Glucose is sugar. Raw sugar is the fastest way to raise your glucose level (and your cat's). It goes straight to the blood. Carbohydrates are the second fastest. Cats need nearly no carbohydrates. A third source of glucose is protein, but since it takes longer for the body to turn protein into glucose, eating protein will not cause your glucose to spike.
Cats are "obligate carnivors," which means they have to eat meat, and they cannot live on a vegetarian diet. Dry cat food is full of filler like peas, rice, potatoes, etc., all of which are high in carbohydrates. They don't need that stuff and are much better off without it. They need meat.
If you can put your cat on wet cat food only, their glucose levels will not spike as much, and you and won't get those wild swings in their glucose curves. It'll level the curve out more.
I realize your lifestyle may inhibit your ability to feed your cat wet cat food all the time. Maybe you work a lot of hours and are away from home a lot. Well, I'm just going to tell you what you should do, not what you are necessarily able to do. I'll leave it to you to do what you can.
You should take your cat completely off of dry cat food if you can. If that's all you've been feeding your cat his whole life, he may not be willing to eat wet cat food at first. One thing you can do is buy him a can of tuna in water. My cat goes nuts over tuna. The first few times he tried it, though, he'd only lick up the water, but not eat the solid part. But after eating the solid parts, he became more receptive to wet cat food. So if your cat won't eat wet cat food, try giving him some tuna and see what happens.
Not all wet cat food is created equal. There's a web page called Feline Diabetes that is a wealth of information about feline diabetes (name checks out). It has links to charts with nutritional information about various canned cat foods (like this one and this one), and you can't necessarily find that information on the cat food itself. The important macro-nutrients they show is protein, fat, and carbohydrates. The most important thing to get is food with low carbohydrates.
I'm going to make it easy for you, though. I have done a lot of searching, and the very best canned cat food you can give your cat is Tiki. Tiki comes in a variety of flavours. In the beginning, Aristotle liked all of it. Now, he's getting a little more picky. Tiki has almost no carbohydrates, and it's high in animal protein. And it's real food. If you crack open a can of Tiki, you'll see shredded chicken and maybe even half a quail egg. You could probaly eat it yourself.
Tiki is expensive, but you love your cat. Think of it like this. Your goal is to get your cat into remission. So you may not have to feed your cat Tiki forever. Just do it long enough for him to go into remission. My cat's insulin needs dropped quickly after I started feeding him Tiki exclusively. He topped out at 4 units and is now down to 1 unit.
A less expensive alternative is Fancy Feast. Fancy Feast isn't as low in carbohydrates as Tiki, but it's less expensive, and its better than most other canned cat food. Unfortunately, you'd be best to stay away from the cream and gravy varieties since they are the highest in carbohydrates. It's unforntunate because those are Aristotle's favourites.
If you want to make your own cat food, then check out this web page. There's some important things in there you need to know, like your cat's need for taurine. What's taurine, you say? It's explained in that web page along with a recipe.
Conclusion
That's the skinny of it. There's a lot more information out there, but I wanted to condense what I thought were the most important things into one post. BTW, giving an insulin shot is not that difficult, and your cat can barely feel it. You just lift the fur on the back of the shoulders or rib cage, lifting the skin, stick the needle in, and push the plunger. Your vet will tell you how to do it, and there are demonstrations all over YouTube.
And read this.
Good luck!
