Just got back from the Vet...

It was the way he was meowing before I got the result of 2.0 that had me worried, maybe it was just that he was really hungry. Honestly, I haven't been able to truly relax yet, I'm so worried that he's somehow going to go hypo again, seeing him have a seizure was terrifying and heartbreaking. I'll get some more of the medium carb Fancy Feast today and a couple cans of the higher carb FF Gravy Lovers from a previous post, I'll save that for his bedtime meals and see if that helps. I'll feed him a larger meals and/or more often, I don't want him to get chubby but it does seem like he has more energy these days so he might be burning the calories off quicker.

Thanks for the reassurance and the "gold star" for the spreadsheet!

 

So maybe a can and a half of fancy feast?

 

There is a condition called insulinoma which can cause low blood sugar. The condition is common in dogs and even more common in ferrets, but extremely rare in cats.

The only other causes of hypoglycemia I could find are listed here:

Insulinoma in Dogs, Cat, and Ferrets: Confirming the Diagnosis
by Dr. Mark E. Peterson (well known Veterinary Endocrinologist)



We have had cats come off insulin with blood glucose numbers in the 30s and 40s on meters calibrated for humans, but if you're concerned you might want to initiate a discussion with a competent vet/endocrinologist.



EDITED TO ADD: I'm not trying to scare you. I doubt there's anything to worry about, but we're not vets and you should have all the information you need to take care of Barry.

 

Wanted to give you all an update and let you know that Barry has been doing really well, his numbers are staying quite steady in the low range!! He's happy and acting like a normal cat his age - meaning he naps, plays with the other cats if they let him, runs around, plays with toys and loves to cuddle.
I picked up our brand new AlphaTrak meter on the 26th and returned the one they had loaned to us, that evening Barry's reading was pretty low, a 1.9, which had me concerned but he seemed normal. The next day when I tested I realized that I hadn't coded the new machine to the number on the container of test strips, so I fixed that and the test came back as 7.7! I was worried that we had made the same mistake with the loaner meter, especially because we'd been using it with human strips, but when I tested him in the afternoon he was at 3.6 and then in the evening he was at 2.7, so back to "normal", at least for him. Not sure what would've caused the spike to 7.7, it was about 3 hours after he ate, if that could have anything to do with it. Speaking of food, we've been feeding him mainly medium carb wet food, such as the Fancy Feast "Grilled"; Friskies Chef's Dinner and Turkey & Giblets; and the PC brand in the Beef, Turkey & Giblets and Chicken Dinner flavours. I found a helpful article on calculating carb percentages in wet food and if I did the math correctly all of those foods are in the 10.5% - 11.5% range. We occasionally feed him the Fancy Feast Pate but they're lower carb (4.5% by my math) and his BG tends to be a bit lower after feeding him those. I've done some reading here in the forum and it seems he's one of those cats that needs a bit of carbs to stay level. I've made a point of reading labels before buying any new wet food and I try to make sure that the only grain ingredient is rice, I've avoided anything which contains wheat gluten, soy flour, corn meal, etc. because they all seem to be high carb and I don't want to risk getting his numbers up too high. Also, I don't test him before breakfast most mornings because my husband feeds him when he gets up for work. Oftentimes I test when there's been a long interval since his last meal, up to 6 or 7 hours if possible, but I've also tested at 3 or 4 hours to make sure he's not riding a roller coaster of BG.
If there's anything you think I should change or any other advice I would be glad to hear it! Thanks again for all of your help!

 

Thanks so much for the update. So glad to hear Barry is doing well. I wouldn't be concerned about a reading of 7.7 on the AT meter. He might have seen a bird out the window and got worked up or any number of other "exciting" things could have occurred just around when you took that test. Barry must be at or close to 10 days without insulin now so that is very encouraging. Go Barry!

I am really curious as to when Barry was diagnosed and started on insulin? What was that diagnosis based on (bloodwork , urine test, fructosamine)? Had Barry ever been given any steroids? His remission seemed to happen so very suddenly without even a complete diet change.

Some cats do well with very low carb food while others seem to fair better with a little higher carb load but I would try to stick to food under 10% carbs.

Keep testing a couple of times a day until he has been off insulin for 14 days and then you can declare him in remission. Fingers and paws crossed as the count down continues.

 

He was diagnosed in January with blood work and a fructosamine test, we had noticed that he drank a lot of water and urinated often, which was why our vet ran the tests. We changed his diet then to diabetic kibble but didn't start him on insulin right away, we hoped his diabetes would be able to be managed with diet alone, that was due more to our reluctance to start insulin, not our vet's. In mid February he went in to ketoacidosis and was kept in the clinic on IV overnight, we started him on insulin then, I'm not sure how to word the measurement but I think it was 2 "mls" of Lantus twice daily. It was 2 lines on the needles we used. There was never any steroids. We didn't grasp at first that we had to time feedings and measure his food, etc. so he wound up with ketones again in March but it wasn't as serious, he stayed overnight again though. Our vet explained better about how much and when to feed him and he was doing much better after that, up until his hypo.
I'm willing to admit that I should've done more research and tried to better understand diabetes right from the start, which I feel guilty about. I didn't think it was as dangerous and complicated as it is.

 

There is no need for you to feel guilty at all! Do not beat yourself up! You took Barry to the vet when you identified a potential problem, got a diagnosis and started some treatment by changing his diet to what the vet recommended. Unfortunately there is no "diabetic" kibble but the majority of vets have been brain washed into thinking there is by the marketing ploys of Purina, Royal Canin and Hills. Had the vet recommended low carb wet food in the beginning, perhaps Barry would have gone into remission much sooner and avoided the ketones. I'm betting your vet didn't recommend home testing before each shot along with some mid cycle tests to see how low the dose of insulin was taking Barry when you started the insulin in February either. That too seems to be something that many vets do not deem necessary. Had he done so, you would have identified the low BG levels before Barry went into a full hypoglycemic episode.

What I'm driving at is that vets can be great with many ailments but it is all too common that vets are not well versed in diabetes. They get very little training about diabetes in school and many have stuck with their old ways although treatment has evolved over the years. Vets treat many species and can't be expected to know it all and most don't treat that many diabetic cats. So while your vet may have been great with other pet illnesses, I think he/she dropped the ball here!

So with Barry closing in on 14 consecutive days without insulin, it's almost time to celebrate. Going forward, you should continue to test Barry once a week for several weeks and then at a minimum of once a month. Once a diabetic, always a diabetic so don't reintroduce any kibble or high carb foods and test Barry regularly so you will catch any ongoing BG elevation quickly and can get him back on insulin right away to avoid any further episodes with ketones which can be as life threatening as hypoglycemia if not more so.

Go Barry!

 

Are you through your trial yet? I am late to the thread but wanted to throw in mine and Shaak's support!

 

I've just updated Barry's spreadsheet and I think he's made it through 14 days!!! If I start counting from May 21st, which was the day he was hypo (the evening of the 20th was his last dose of insulin), then yesterday was day 14!!! The highest number I got that whole time was 7.7 but his average was much lower than that. He's been hovering around 4 for the last few days with a surprising 4.8 this morning before he ate, which was about 9 hours post food.

Since I'm now a member of the "vampire club" I think it will be hard for me to suddenly only test him once per week but I'll try to wean myself off lol. When would be the best time to test him - morning? Evening? Within a few hours of eating or as long as possible after eating? He seems to be doing quite well with 4 meals per day and I think we can easily manage that even when I heal up and go back to work.

I'm so grateful for all of your help. Linda (@MrWorfMen's Mom ), you, in particular, have been a superstar of support and advice and I'm sure that if Barry could talk he would say thank you as well. He's now such a happy little guy and hopefully he'll only have to put up with the occasional ear-prick to make sure he's ok!

 

YAHOOOO! Barry is ! YIPPEE! Even my little Menace is celebrating with you.

As for ongoing testing, it really doesn't matter when you test Barry as long as you know when he last ate. If any reading seems higher than expected or his usual, then get one when he hasn't had food for awhile just to be sure. It's amazing how excited they can get just seeing a bird or squirrel out the window!

That was quite the ride you took with Barry and I'm glad I was able to help in some small way. He is one lucky kitty to have such dedicated pet parents! I wish Barry, Matt and you a long, happy, healthy future! for you and scritches for Barry!

 

Thank you Linda and Menace All the best to you and all your fur babies!!