Was told to copy/paste over here from my intro. My big boy is Jack, I adopted him in 2011 at approximately 6 years old. A couple of years ago he lost several pounds really fast and got his diagnosis. He was nice and stable for about 9 months when we had a terrible hypoglycemic episode, stumbling and sniffing and not seeming to recognize that we existed, even after being picked up. At the time I did not have a meter, so I have no idea how low he had gotten. Picked up an AlphaTrak II the next day. He went without insulin for another 6 months before his numbers started to get above 100 again. Since then I've been testing him regularly (though not writing anything down, bad me) and he was doing great. The past couple of months however, the way he's responding to the insulin has changed. His curves are much longer and seem to have their nadir around +12, for weeks on end his glucose at that point was in the low 100 range. The vet changed his dose to once a day and each time it's been upped his next curve seems to be higher! She has me do a curve at home two weeks after changing his dose, and I'm getting increasingly antsy about this whole situation. I feel like the "depot" just isn't filling at all at this point and they're not comfortable sending him back to the standard 2x/day routine. Probably doesn't help my anxiety about this that I'm waiting on a call from them about his most recent curve, which was seriously high even for him.
Welcome to you and Jack ! He is gorgeous !!! Folks with great experience and wisdom will be along shortly to answer your questions and give you direction . Sorry you and Jack are going thru this but this Board is exactly where you both need to be !!
I'll leave it to more experienced members to give dosing suggestions. Tagging @Wendy&Neko who has had experience with late nadirs. You can start by reading this about the depot and Lantus: http://www.felinediabetes.com/FDMB/threads/what-is-the-insulin-depot.150/
Hello and welcome. Glad you found us. Start off by reading the Sticky Notes on the top of this forum, if you haven't already. You are right to feel anxious. The way your vet is dosing isn't anything we would do. It's better to find a slightly lower dose that you can shoot twice a day. The insulin isn't lasting 24 hours in Jack. It seldom does, except on really itty bitty doses. How would you feel about following one of our dosing methods here, and us helping you with dosing, instead of the vet? Since he's still getting dry food, you'd follow the Start Low Go Slow Method. By the way, I don't think this is a late nadir situation, just the insulin lasting about 12 hours, then pooping out and up he goes until the AM. As for food, what else have you tried with him? Depending where you live, there might be some lower carb dry food options which would help his blood sugars. We even had one person try freeze dried raw food successfully with her kibble addict. Getting to a low carb diet will really help.
I've read through the stickies - that's a lot of information to sort through! I'll probably be referring back to them often until I can get it all to sink in. I'm still waiting on the vet's call, so I'll push for returning to 2x as this really hasn't been working. I'd tentatively be willing to start trying the Start Low Go Slow method, depending on how much the vet is willing to work with me on this. Food wise, we've gone through so many different kinds of canned wet low carb. He's good for a few cans of each flavor, then starts refusing to eat them. The dry is the high protein blue wilderness grain free stuff, which I'd run into as a suggestion for low-carb dry food options. I can occasionally find the Tiki Cat high protein dry, and can mix the two for him successfully. He eats less than a half cup of dry per day, mostly just the wet. If I don't have it out, however, he tends to become a vaccuum cleaner for his wet and then promptly vomits everything up due to eating too fast. I think he's got food insecurity from his first six years without us, he's always been this way. I'll check out the freeze dried raw, no harm in giving it a shot!
I agree with Wendy above - it's important to get him into a carb free diet - which Blue Wilderness, although grain-free, isn't carb free. The one's I've seen that say 'grain-free' contain 'healthy-carbohydrates' of berries, carrots, etc. None of which help diabetic cats. Your vet is also incorrect about dosing him once a day with Lantus. Lantus lasts hours in kitties and requires twice a day dosing - as previously mentioned. Vets are often incorrect about things to do with feline diabetes - I'm sure it's not intentional, it's just that they haven't had time to learn all there is to know about FD. Welcome to the forum! It's the best place ever to get all the information you'll need to help your kitty feel better! And to get those high BG's down. Read the stickies and ask plenty of questions
Try spreading it out on a plate - only a small amount at a time. For dry food - you can order Dr. Elsey's and/or Young Again (although YA can make their poop stinky/runny in some cats)...
Welcome! Jack is luscious and beautiful. Even after reading all the stickies, I still refer to them quite a bit. Tons of info, yes! I have managed to work pretty well with my vet after showing him success on my own by home testing, etc. (after getting help here). My vet has also mentioned one shot a day, but only after getting down to miniscule dosing. Still not sure about that, but we aren't there yet anyway. ETA: My vet has lots of schooling/ training about FD, but not a lot of hands on experience it would seem.
I had the same issue and this helped a lot: https://www.amazon.com/gp/product/B001NJ4PV2/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1 Hope this link works. Welcome!
Looking at Jack's spreadsheet, I had the same thought as Wendy -- you can't get the duration needed from once a day dosing. I hate to point this out but the Blue Buffalo grain free dry food is approximately 38% carb. It's probably what's driving Jack's numbers up. A different option is ZiwiPeak. They have freeze dried food that is low carb and may be similar to kibble.
