Testing Leo - Kitty Mayhem and Human Madness

I once wrote up a story about testing Roxanne. You all know Roxanne by now as a very independent thinker. Roxanne does not feel she needs to sit still even if I wish it. It is embarrassing that I, a well-seasoned cat tester, still have so much trouble corralling and containing the smallest cat I've ever owned. I would probably not have all this trouble were it not for the fact that I'm an idiot. Right before I decide to test her, I'm usually thinking something really stupid, like, "Gosh, I've had Roxanne for a year and a half and this morning she was cuddling with me. She probably won't mind if I just quickly put her in my lap."

Testing Leo is nothing like testing Roxanne. For starters, Leo thinks treats are the best thing in his entire life and will do absolutely anything I ask to get a treat. He loves them. He placidly sits in my lap, waits for the poke, flicks his ear to let me know I'm moving too slowly, and listens for the meter beep. At this point he jumps off my lap while I'm still holding his ear because he's so excited that treats are coming.

Conspirator #1

To create a manic situation in my home, all I have to do is say, "Leo, want some treats?" and it begins. Leo comes barreling through the house to get his treats and Rox and Niko assume positions surrounding him. They each have important roles in testing Leo. Niko is in charge of disturbing and distracting Leo by pretending he will get a treat first by pawing the bag of treats in a loud and insistent manner. Roxanne is in charge of The Real Trouble.

This generally starts just as soon as Leo is in my lap. I carefully balance the test strip in the meter, without starting the countdown. I rub Leo's ear to warm it up. Roxanne sneaks around me and steals the strip. I never, ever notice she's done this until I hear the crunching. *sigh* Roxanne just ate $0.34. One-handed, I pop the strip vial open and extract another strip and try to balance the strip in the mouth of the meter. It takes skill to do this one-handed. I see her coming this time and push Roxanne away from the new strip, but am too slow to see her notice the lancet. She darts in, grabs the lancet, and commences chewing on that. Niko begins pawing the bag, wondering why it's taking so long. Leo decides he's done with his test and gets up to leave.

Conspirator #2

I am so practiced at this that I can now, in one fluid motion, reseat Leo, pull the treat bag away from Niko and retrieve my lancet from a now-annoyed Roxanne. I give her back her chewed up test strip, but it no longer holds her interest once out of the meter. She begins to look for other things to steal by positioning herself right in front of Leo's face. Leo, unable to breathe, starts flicking his tail, which momentarily distracts Niko from his attempts to open the treat bag. He pounces on the tail, which might be an intruder that needs to be killed. Leo swats, but hits Roxanne, who jumps just far enough to spot the lancet I've hidden under my leg. Quick as a fox, she's in and out with my lancet before I could react. I pull my backup lancet out from my shirt pocket and poke Leo's ear before further chaos intrudes. Roxanne, happily chewing on the lancet, notices there's a second lancet and begins to stalk me. I quickly shove the second lancet under my foot, stabbing myself in the process. Trying not to howl in pain, I jam the strip in the meter and position the meter to draw up the tiny spot of blood my solitary poke managed to yield. Got it!

Back in the early days of testing Leo, I would place the meter on the floor during the countdown and grab a paper towel to hold to Leo's ear. Roxanne spotted the new test strip and raced to grab it. Watching the countdown as the meter flew away from me at breakneck speed, I was prevented from catching it due to the treat-obsessed kitty in my lap. I would have to pick him up, carry him to retrieve the meter, and begin the whole process over, causing one very sad, overly-poked kitty. Nowadays, I'm well-trained by my cats.

For starters, I always have two meters and two vials of test strips in case the unthinkable happens. I have unlimited lancets stored on my person. I never, ever, staunch the flow of blood until I have a successful test with my meter in my hand. Finally, knowing Roxanne is driven to eat things that are inappropriate for a kitty to eat, I never test Leo without wearing a shirt with pockets to hold the meter during the countdown, the backup lancets and a present for Roxanne: an empty syringe wrapper. Oh the joy! Roxanne's very own treat for putting up with the whole testing process. As Leo and Niko crunch happily through their pile of freeze-dried chicken, Roxanne (who hates "healthy" treats) gets her very own loud, scrunchy toy to bat around.

We still have moments, like when Niko decides there might be treats in the testing container and knocks it over, spilling lancets, strips, meters and tissues. Roxanne will occasionally choose the moment I poke Leo to pick a fight with Niko. Through it all, Leo sits patiently, knowing that soon he will get delicious treats if he can just live through this one test.

Thanks PetConnection.com and Gina Spadafori!

Sure is nice to feel important today!

Help Vets Do Better for Cats

Five Months and a Lifetime

Leo December 2008 - Leo April 2009

Today is Leo's 5 month adoption anniversary! Five months is a short time in the grand scheme of things, but it seems as if he's always been here. More and more, as the days go by, I wish he had been here forever.

Please wish Leo a Happy Annifursary!

Food Rage and the Veterinarian Challenge

Recently I saw a post on Feline Diabetes requesting proof that a high protein diet was proper for a diabetic cat. I think it should be the other way around. The onus should be on the pet food industry to prove to US that they are doing all they can for animal nutrition, for both sick and healthy cats and dogs. Of course that won't happen, because they are the Goliath, and we are just stupid people. Hence my challenge.

I challenge every veterinarian who thinks Hills and Purina, Science Diet and Royal Canin are the go-to foods for sick cats to look into these diets. What are the first five ingredients? We all know that ingredients are listed in order of quantity, so the top 5 really count towards the health of the recipient. Look into the claims these companies make about their foods. While you're looking into it, don't forget that these companies are the same companies who have sickened and killed our pets, over and over again, by using sub-par ingredients, insufficient supplementation, and most recently, rat poison. If our government has no agency in charge of making sure these claims are accurate, who should hold them accountable? Veterinarians should hold them accountable. You're the people who sell it to us, the people who trust you.

From Hills:
While there is no cure for diabetes mellitus, veterinarians recognize it can be controlled with insulin, exercise and proper nutrition. Fiber is key in managing the disease because moderate to high-levels of fiber lower insulin requirements and blood glucose levels. Fiber also makes the body more responsive to insulin.

Really? How so? What does fiber do to make a cat's body more responsive to insulin? Before everyone gets excited, let's remember that cats are not omnivores, so the rules of human and canine diabetic management do not apply.

From Purina about their DM product:
This very high-protein and low-carbohydrate diet fits a cat's unique metabolism.

Thank goodness, they know what kind of diet we should feed. Let's check out Purina DM's ingredient list.
Dry food:
Poultry by-product meal (JUNK), soy protein isolate (CARB), corn gluten meal (CARB), soy flakes (CARB), animal fat preserved with mixed-tocopherols (form of Vitamin E) (srsly?) corn starch (CARB)
Ok that was revolting. 4 of the top 6 ingredients are carbs.. and the 5th one is preservative-filled animal fat? How can you say this is low carb?

Maybe their wet food is better:
Liver (organ), water, beef, corn gluten meal (CARB), trout, fish meal (JUNK), animal fat preserved with mixed-tocopherols (form of Vitamin E), wheat flour (CARB), soy protein isolate (CARB), powdered cellulose (TREE)
Liver should never be the primary ingredient in any cat food. Water is the 2nd ingredient? Even the cheapest grocery store brand doesn't do that. Guess what cellulose is? SAWDUST. I don't even want to get into how they came up with adding that.

Hills reports their carbohydrate values as being 18% for the dry food, and 2% for the canned food. How can this be with so many carbohydrate ingredients in their food? Well it can be that way because the government has no agency to force them to tell the truth. If all those ingredients were in YOUR food, you would not eat it, so why are people being instructed to feed this to their obligate carnivores?

Let's take a peek at the ingredient list for Fancy Feast Gourmet Chicken Feast, a low carb, high protein food sold at every supermarket in the United States.

Chicken, Chicken broth, Liver, Meat By-products, Fish, Poultry By-products, Natural and artificial flavors, guar gum, potassium chloride, iron oxide, tricalcium phosphate, salt, vitamin supplements (E, A, D3, B12), sodium nitrate (for color retention), thiamin mononitrate (vitamin B1), ferrous sulfate, zinc sulfate.

Hmm.. why does a 50-cent can of food contain better quality ingredients than one manufactured by the very same company and sold to veterinarians to sell to people who shop in grocery stores? You see, Fancy Feast is owned by Ralston-Purina.

So... if I'm not a graduate of vet school, why is my uppity self challenging you? I don't want to have to explain to any more vets why I am feeding my diabetic cats Fancy Feast, Wellness and Nature's Variety. The food recall was the red flag. "Veterinarian brands" were recalled. My own bag of Hills WD was recalled. A $25 bag of cat food was recalled due to sub-par ingredients containing rat poison. Isn't that enough to tell you that these companies do not care about our animals?

Some interesting links:
Dr. Lisa Pierson, DVM
Dr. Jean Hofve, DVM
Dr. Elizabeth Hodgkins, DVM, Esq.
Dr. Debra Zoran, DVM, PhD, DACVIM

Talking to Braille Kitty

I have always prided myself on being able to talk to the animals. I saw Dr. Doolittle when I was a kid and though I have zero recollection of the movie itself, I have practiced talking to all my animals. Growing up on a working dairy farm gave me many animals to talk to, and talk to them I did. I even talked to the chickens, which I thoroughly detested. Life was rough for me, but the animals gave me a gift. They responded to my incessant chatter with lowing moo's, offended bok-bok's and excited squeals.

All this confidence in my ability to talk to the animals was blown to smithereens by one cat. Sammie was an odd kitty, seemingly she was personality-free for a good couple of years after I adopted her. Then one day, my then-husband went to sea, and Sammie emerged from herself. She wanted to cuddle, and play ball, and watch TV upside down on the couch with Jesica and me. I was stupefied. All this talking to Sammie, and apparently I wasn't understanding what she was saying. She didn't like the man I married! Sammie lived a good life after that, because shortly thereafter, I disposed of the man in question. A few years later I met Ronnie, and Sammie fell in love too. A man she liked, well he must be perfect for me.

The revelation that Sammie didn't like my ex sent me back to Square One with my animal communication. I was never blessed with the ability to communicate in other-worldly fashions, so I was forced to hire this talent out. One of them said my cats heard me talking to them, and that they laughed at me. I was not surprised to hear this at all. They ACT like they are laughing at me.

Enter Braille Kitty. Roxanne speaks in Clawsanteeth, an ancient language devised by devious children of Bast to communicate with their idiot owners. I have tried to explain to Miss Roxanne that I do not need to be spoken to with such force, but it has fallen on a laughing kitty's deaf ears. Everything she needs to get across to me is spoken using tiny sharp teeth and four sets of double-pawed claws.

I have marks from head to foot from these chats I've had with Roxie. I bear embarrassingly long ugly red welts which require turtlenecks to conceal. Scratches which itch and burn, puncture wounds in various stages of healing in perfect kitty paw patterns and gashes which seep blood and range from my neck to my knees. She's a tricky one, this kitty. She wants all the attention, chatters away non-stop looking for it, and lures me in with that cute "pet me" look. (I fall for this every time.)

When it's time to eat, I am notified by the biting of the toes, or the nose, if I am asleep. When it's time for me to let her through a closed door, a sharp slash to the hand occurs. Time to play? Any of my flesh is fair game, especially the tender top of the foot flesh. I am not allowed to watch TV without paying attention to her, nor spend too many minutes staring at the computer screen. Explaining to my friends why my hands look like I was assaulted by The Slasher, which they were, is an exercise in lying. There was the Horrible Dishwasher Incident where I was attacked by the silverware caddy. Another day, I fell straight into a vicious rose bush!

One time I tried to make coffee before feeding her. She reminded me that I was remiss by jumping from the floor and implanting every single claw she had deep into my derriere and both thighs, where she hung on for dear life until I detached her. This was no easy feat, she has many claws and I did not wish to enhance the agony by allowing her to reposition herself. I am this cat's slave, and whatever she wants, I do it. Willingly, but in fear.

Roxanne is now about 3 and a half years old or so, and like Sammie, coming into herself a little on the late side. She has been with us a bit over a year now, and she has established her tiny self firmly as the alpha kitty, boss of Niko, Leo and Me. Ronnie is a whole 'nother story. She loves her person, none other than Ronnie, lover of dogs, ignorer of cats. The more he ignored, the more she loved. She has trained him now, and he talks to her as she talks to him. He reaches down to pet her without a thought, and lets her in and out of doors as she follows him around the house. Ronnie has never been the recipient of even a single tooth dent in his flesh.

*sigh* Lost another one.

Sadness and the Sleep-Purr Cure

It's been awhile, hasn't it? Leo has now been with me almost 5 months. After his diagnosis of acromegaly, we had a flurry of vet appointments, a dental, a change of insulin, and a whole lot of mental strain.

The strain is from the fear I think, I know Leo is going to die of his condition, and I don't know from which disease first. Will his heart fail? Will his kidneys fail? Will he get cancer? It's tremendously scary, and even though I consider myself to be optimistic bordering on the ridiculous, I am also a realist.

Realists don't have a lot of fun treating diseases like this, in my experience. Many times, we realists are trying so hard to be optimistic that we fail to see the writing on the wall until one day when it slaps you upside the head, holding a cold and slimy trout. I remember all the hours agonizing over Oscar's numbers, and the day reality set in. Heart failure is not an illness, it's a death sentence with a very firm deadline.

Back to The Present, Leo is a very healthy cat who happens to have acromegaly. He's got all kinds of classic acro signs, like a big pot belly, which serves to make him look cute and too-well-fed. He needs about 30 times the insulin of a "normal" diabetic cat. He's got a giant head that he likes to push against my arm, headbutting his way into my heart. Startlingly beautiful and wise eyes seem to stare almost into your soul, but it seems his vision is faltering. His big snowshoe feet carry his giant body as he lumbers from comfortable sleep spot to comfortable sleep spot. He likes to go outside at night, because bright light bothers him, and he hides under the bed if the Oceana jets are flying too much and it hurts his ears. He eats like a starving horse, drinks like a thirsty horse and sleeps like a drunken man. What a racket he makes with that snoring!

With all the symptoms around me on a daily basis, forcing me to mind my reality, it was really hard to come to terms with the simplest truth. One day, with the big furry boy laying next to me as I tapped away on my laptop, I heard it: Sleep-purring. It occurred to me that Leo always purrs in his sleep when he lays next to me.

Loud and steady, clear and true. My baby is happy. Does anything else matter?

How to Save Money *and* Treat Feline Diabetes

I don't like to spend all my money on my cats, though I would if I had to. Thankfully, diabetes can be managed fairly inexpensively.

So you have sticker shock, a $500 vet bill, a $25 bag of "special diabetic food" and a sad, sick kitty?

Here's my list of what you can scrimp on, and what you can't.

Fructosamine tests and "regulating". Scrimp. You don't need to do this if you are testing blood glucose at home. You can fax or email your testing results to your vet and he/she can work with you on dosing from there. If your vet won't work with you, you need a new vet. Blunt, but true. Fructosamines are a poor substitute and very costly. No need for in-house regulation either, because it simply can't happen. Vet stress causes the cat's blood glucose values to remain abnormally high, and the dose will reflect the stress, rather than the actual need for insulin. It can be dangerous, and a big waste of money.

Food. You can scrimp on this. You can return that bag of WD or MD or those cans to the vet, it has a full money back guarantee. It's overpriced and poor quality, and that money will help you to buy what you need. Use Janet and Binky's list to find canned foods your kitty will eat, and that you can afford. After you get your kitty transitioned and treatment is going well, you can study the best quality foods to feed your kitty. Your kitty basically will eat 6-8oz a day in perfect condition, so you can expect anywhere from roughly $0.50/day with the cheapest food to $1.50/day for some of the premium brands. Yes, the dry food *is* way cheaper per ounce, but if your kitty is getting sicker instead of better, how much are you really saving? For a true slap-the-forehead moment, check out Dr. Lisa's site at catinfo.org

Blood Glucose Meter. You can scrimp on this, Walmart has a good meter called the ReliOn that costs $10. Strips are $46 for 100 strips and that should keep you going for quite some time. Yes, you will use every single one of those strips, they won't go to waste. If you later decide you want a different meter, you're not married to the one you bought. :) Most of us have 8-10 meters. We get them as free samples, or just go out and buy another one to see if we like it. We'll show you how to get them too, just watch Supply Closet. Oh yeah, and you don't need the pet meters. Blood is blood. :)

Ketone strips. Here's how to scrimp on this.. There are two types of urine testing strips, and a blood glucose meter that also tests for ketones. You don't need the meter, it's not better, and the strips are expensive. One of the types of the urine strips only tests for ketones, and the other one tests for glucose spilling into the urine as well as ketones. You don't need to test for glucose because you've already gotten a bg meter. Just get the strips that test for ketones. We often refer to them as Ketostix, but that's a brand name. I think it's perfectly alright to use a generic version if you find them, but the ketostix cost less than $15 per 50 strips. At one strip a day max, that's pretty good. Ketodiastix

Insulin. Don't scrimp on this. Thankfully, you're not married to your insulin either. If you've got one of the less-recommended insulins, you can change to a better one when the vial runs out, or when you get some money together. Do your research, ask around. The petdiabetes wiki has a handy list of the insulins most commonly used/prescribed. PetDiabetes.wiki.com There are ways to save money on even the most costly of them. Nothing bad will happen to your cat during a change to another insulin and there are plenty of people here to help you transition. It's not a lifetime commitment. :)

Refilling your Supplies. Here's where you really start saving money. One of our affiliates is where I buy ALL my stuff, syringes, lancets, meter, strips, even my Tylenol. :D Follow the pink banner at the bottom of every page in the message board of FelineDiabetes.com and it will direct you to our affiliates. Hocks.com is listed there, and if you buy using that link, you'll help the FDMB. :)

How to save money buying insulin.
First start calling around. Get pricing on Lantus and Levemir, a they are both human insulins and NOT available through your vet. Try any wholesale clubs you have, Sam's, BJ's or Costco. Try all the pharmacies, including any grocery store pharmacies. Lantus and Levemir are basically very alike in stability, duration and dosing. Check out the very active Lantus board to see both Levemir and Lantus in action. They are so alike in behavior that you will see both insulins on the same board.

Find out which pharmacies have discount cards, some, such as Rite-Aid have cards that can save 20%. That's a huge savings.

Get your quotes for Lantus and Levemir as this: "5 pack of 3mL cartridges" which are for the pens. You will not need to buy the actual pen, only the cartridges. You will also need to get a quote on syringes. You want u100 syringes, and they should be 30 or 31 gauge, 3/10cc (or .3cc) and you are looking for 1/2 unit markings. These will be difficult to find. We often buy them online, here's where I get mine: Hocks.com

The reason you are requesting the cartridges and not the vials of lantus/levemir is because they both have shortened opened shelf lives. Lantus is somewhere in the vicinity of 28 days, Levemir is in the range of 42 days. The vial is 100mL so that's a large amount of wasted insulin if your vial goes bad. These cartridges, lasting +/- 1 month apiece for a total of roughly 5 months, will run you anywhere from $150-$225 so it's important you price around. Location is a big determination of price, so if you live in a remote area, your costs could be higher.

Canada is also an option. They have L/L available at around $150 for the 5-pack of cartridges with $10 shipping. Here's an interesting thread for you. Canadian Options

There are also FREE non-pharmacy-specific Rx prescription cards listed here: Rx Card Thread

I hope this helps you all to breathe a little, and know there are ways to control the spending.

I must give credit where credit is truly due. Had Janet not been hosting Frugal Feline Diabetes Frugal Feline Diabetes I am not sure what would have happened to me. Thanks Janet, you saved my bank account. :)

This article assumes the reader is aware of felinediabetes.com - if not, come over and join!