Questions To Ask Your Vet

So there you are in the vets office, having just discovered you’re taking home a cat who has diabetes - where on earth do you start?

First and foremost you need to build a good working relationship with your vet - hopefully a vet who is interested and committed to helping you. If your vet isn’t helpful and knowledgeable (or at least prepared to learn) - get another vet.

This isn’t the time to be polite and worried about hurting your vet’s feelings - your cat’s health depends on support from your vet. Don’t forget - you pay them for their efforts. If you’re not happy, change vets.

Here’s a list of questions you could ask your vet. No doubt you’ve got plenty of your own to add!

How many diabetic cats are you treating and how are they doing?
If the answer is “none” - my next question would be to ask for a referral to a vet who has had experience with diabetic cats.

Is this ‘just’ diabetes or is there an underlying cause?
What causes diabetes itself is unknown, although latest theories seem to suggest it’s an auto-immune disease. However, some other diseases can cause diabetes. If the underlying cause is treated, it is possible the diabetes will go away. Your vet should check for possible causes.

What do I need to know about diabetes?
At the very least you need to understand the disease and how insulin works. This is one of those cases where knowledge is power. A number of the larger prescription food manufacturers produce leaflets about looking after diabetics, so ask your vet if they have some literature they could give you.

How should I handle insulin?
You need to know how to store it (in the fridge) how to mix it (by gently rolling the bottle, not by shaking it) how long it lasts and how to get new bottles of it. You’ll also need to see how to fill the syringe. Most importantly, your vet will need to show you how to inject it! I did my first injection into Paris with purified water to get the feel of it, after having practised on an orange!

How long does insulin last?
I’ve heard so many suggestions as to how long a bottle of insulin lasts, anything from two weeks to a year! I keep my insulin in the fridge, and buy a new bottle every three months - because it seemed to be a happy medium! Follow your vet’s advice, or if in doubt ring the manufacturer of your insulin.

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What do I do if I think I missed when injecting?
You thought you did it right, but you notice a suspicious bit of damp fur afterwards. You probably missed. Everyone does this, no matter how long they’ve been injecting. You’re wondering if you should inject again, just to be on the safe side. Unless you’re home blood testing and can say for sure that you missed, the answer is When in doubt, DON’T. Do not risk a double-dose and possible hypoglycaemic episode.

What do I do with used syringes?
UK Law prohibits the dumping of syringes in your wheelie bin. They must be disposed of safely which means returning them to your vet, or your local pharmacist.

Where do I get more syringes?
Your vet will supply you with all the syringes you need. However, it’s worth knowing that you can buy syringes from chemists, and they’re cheaper that way too. You can also buy them online. (See the Useful Websites page for information)

How much, how often and what should I be feeding my cat?
Your cat will probably be put on some sort of prescription diet, as it’s important that the food remains constant from day to day. If this is a radical change from your cat’s normal routine you’ll have to take it slowly, otherwise your cat will refuse to eat altogether – not a good thing. Treats are now pretty much off limits, at least to start with. If your cat is used to set meal times you’ll have an easier task on your hands. Having said that, cats are naturally “grazer” eaters and will have about 10-15 small snacks each day. If, like me, you always have food down for your cat, don’t change this. It’s not essential that they only eat at fixed times, it’s just easier.

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What do I do if my cat throws up, or won’t eat?
The answers you’re given will be different depending on whether you’ve given an insulin injection prior to the throwing up or refusing to eat.

What do I do if my cat eats extra food by mistake?
This is a common problem in multi-pet households, or with cats that have charmed your neighbours! You have to be ingenious about separating animals from each other’s food. Again, set feeding times make life easier here, but free-feeders can be accommodated with a bit of thought and sneakiness. If you have a cat who visits many people, a collar and tag with “I am diabetic, don’t feed me!” might help.

What do I do if I have an emergency out of surgery times?
You need an emergency phone number handy because, as I am sure you already know, disasters never happen during vet’s opening hours! Get the emergency number before you need it and stick it up by the phone.

How should I monitor my cat’s condition at home?
You’ll need to keep an eye out for the classic diabetes signs, which could mean your cat isn’t well regulated, or has become unregulated. Conversely, watch for signs of hypoglycaemia. Also, check your cat’s general behaviour, and whether they seem like their normal self. Only you know how you cat normally acts, and any instinct that something isn’t right is probably a good one.

What kind of records should I keep?
Ideally you want your vet to ask you to keep records of food eaten, amount of water being consumed, frequency of urination, results of any blood tests you do - but some of these is better than none. Again, the answer “don’t bother” means it’s time to find another vet.

What is hypoglycaemia?
You want to know what the symptoms are, and how to treat it, and at what point you should be doing an emergency dash to the vet’s office. In simple terms, it’s a dangerously low blood glucose levels. This is life threatening and needs immediate attention. It’s a very good idea to train other humans in the house about all care involved in looking after a diabetic, particularly this bit. See the Associated Conditions page for symptoms and further information.

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What is diabetic ketoacidosis?
Caused by blood sugar levels being too high, it’s also potentially life threatening and needs immediate attention.

How do you feel about home testing?
This relates to both urine testing, but more importantly home blood sugar testing. Despite what some vets think, it is possible for you to blood test your cat. It’s easy and it’s an invaluable tool for monitoring your cat’s condition. I wouldn’t be surprised if your vet hasn’t heard of it, but a vet that condemns it out of hand isn’t going to be much use to you.

I have noticed that this is becoming more and more accepted amongst the veterinary community. The first vet I suggested it to said "oh no it’s not possible" - the last vet I mentioned it to said "cool, it’s less stressful for your cat and the results are more accurate than the ones we get"!

What complications should I be on the lookout for?
Besides the conditions mentioned above, you need to watch for diabetic neuropathy, which is muscle wastage, normally in the hind legs. Be aware that cats that have consistently high blood glucose levels can very quickly develop cystitis. This may sound unimportant but is incredibly distressing and debilitating for your cat - and distressing for you to see. See the Associated Conditions page for further information and treatments. For some reason diabetic dogs are very prone to cataracts and a great number go blind very quickly. It is extremely rare in cats, however it does happen, so keep it in mind.

How does this impact on existing conditions?
If your cat has any pre-existing conditions, you need to know how the illnesses will impact on each other. Particularly, how various medications will affect diabetes and insulin levels - and how diabetes will affect any other complaint your cat might have.

How often do you want to see my cat for checkups?
It’s good idea for your vet to take periodic blood tests to check for other conditions. Diabetes in cats often starts in later life, so it’s a good idea to keep a check on general health. It’s so easy to concentrate on the diabetes alone, forgetting other illnesses may be developing.

Has your cat been Identichipped?
I don’t know if this is an issue or not, but it occurred to me that the chip will be in about the same place as you’re injecting - and I would worry about hitting the chip with the needle! Best have a quick word with your vet about the chip’s location.

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