Wet Food check please...

Can someone take a quick look at our wet food calcs please?
They are on Dustys SS (linked in sig) on an imaginatively named sheet "Food Data (Wet)".

We had pretty much decided to shift her from the "Royal Canin Digest Sensitive" to the "Natures Menu Adult Cat Food", (as highlighted in a red line and a green line respectively).

BUT now looking at the data again, Asda's (Walmart) own brand "Tiger Cat Pouches Meat in Gravy" look ok too? They are slightly lower protein, total cals, and moisture, but I'm not sure how much a difference on those numbers matters? I was also surprised to see a supermarket "own brand" scoring so well (or at least appearing to me to score well), hence requesting someone else cast an eye over the data.

Thanks!

 

We may have answered our own question, the NM is made with lots of actual meat, whereas the Asda stuff is made with animal "derivatives" and veg proteins.
I imagine that would go someway to explaining the price difference too!

 

Hi, just looked at your Tiger cat meat pouches calculation and that's fine. Does seem to come out at 4% calories from carbs. (Well spotted! I'll add that one to my list of UK foods later.) It appears to have a higher fat content than is typical for a supermarket brand cat food.

I think you're right that the Nature's Menu just has better quality 'named' ingredients.
'Animal derivatives' sounds a bit grim, but isn't necessarily bad. This can, for example, just be the bits of animal carcasses that aren't used for human consumption for whatever reason. The derivatives may also come from a range of animals or fish that we might not normally consume in this country. But there have also been instances of very low grade and even distinctly dodgy material finding its way into pet foods too. As a general rule of thumb, the better the quality of the food, the better the quality of the ingredients.

Eliz

 

Thanks for the reassurance Eliz, much appreciated. I must say the Natures Menu looks like a really meaty 'pate like' chunk, and it does seem to be high quality ( to the extent that Dusty has now completely turned her nose up at the Royal Canin food! )
We are keeping her on the Natures Menu for now as it has higher protein and calories, both of which she could do with, but her brother will be on the Tiger meat.

As an extra point, for "snacks" we also found that both of the following treat sticks work out fairly reasonably in terms of the calcs (they are on the "DRY" sheet in the SS):

Asda Tiger Chicken Cat Treat Sticks (pk 6)
Pets At Home (PAH) Semi moist Treat Sticks (Lamb & Turkey) (pk 10)

Dusty eats either quite happily, but perhaps prefers the Asda Tiger ones.
Her brother Scamp however will reliably vomit if fed the Asda Tiger ones, but will happily munch down the Pets At Home ones!

As they say, ECID!

 

Will have a look at those and see if they can be added to general UK info here.

Just had a look at Dusty's SS, and see that you only have very high numbers there, and a couple of day's worth of data. (Is there data that you haven't put on the SS?) Also, you seem to have been feeding a higher carb food at the time you got those tests, is that correct or have I misread your notes on the SS?

A couple of things...
If you're switching from a higher carb food to a lower carb food it's really important to monitor the blood glucose carefully while doing that. Reducing the carb content of the diet can reduce the blood glucose, sometimes a lot, and the insulin dose may need to be reduced accordingly.
And it can happen that high flat (unmoving) numbers can be caused by too much insulin as well as by too little....

Also, if you're still seeing high numbers then it would be prudent to check Dusty's pee for ketones. Ketones can be extremely dangerous for diabetics.
The test is easy, you just dip the end of a ketone test strip into a drop of pee, time it, and read off the result. You're looking for a 'negative' result. Anything above 'trace' is a reason to contact your vet ASAP.
Crumpling clingfilm loosely over the litter tray is often a good way to catch a sample. Pee gets trapped in the creases, and you only need a tiny amount.
Be aware though that not all ketones are picked up by the test strips, so, it's also good to be aware of how Dusty's breath smells, especially if she seems unwell or off her food at any point. Her breath should smell like normal cat breath (!). If you detect a fruity 'acetone' smell then that could indicate ketones.

Eliz

 

Hi Eliz,

You are correct with everything you have said above
Dusty's levels were very high, and unfortunately (before coming here) we hadn't realised that the food we were feeding her was relatively high carb too.

We did the two BGCs as shown on her sheet initially and then took those results to our vet when we went for Dusty's checkup on the 2nd October.
The vet's advice was to increase Dusty from 1U to 2U twice a day of Prozinc to try and bring those numbers down. I also mentioned that we were intending to (imminently) change Dusty's food to a low carb food to help correct the BG level.
It was the vet's opinion at the time that doing both would be ok, as actually both changes would take a period of time (they said 10 days?) to really take effect and settle down.
In addition to this Dusty was really suffering with the high BG levels, hind leg weakness that had her slipping and sliding all over any hard floors, and a need for pretty much constant laxitive (2ml of lactulose twice a day). Based on this it was decided we should try and bring the level down fairly quickly (but carefully) to minimise any further damage / problems.

Unfortunately since then we had two events coincide; the first was that between the two BGCs, calibration checks, and the occasional failed test we had all but used all of the AT2 test strips that came in the starter pack so had to order some more, which then unfortunately got damaged in the post, so then we had to source some replacements.
At the same time all the advice we had seen indicated that we should try and transition Dusty across from the RC food to the NM gradually, so we started this just giving a quarter packet of NM along with her RC food to start with. Unfortunately (?) once Dusty got a taste for the NM food she then refused to eat the RC, and would actively pick through her food bowl only eating the NM food. This meant that she then wasn't getting the amount of food that she should have been, which concerned us with it then not (potentially) balancing out the insulin shots, especially with us effectively 'flying blind' due to a lack of test strips. Ultimately we decided that we would have to accelerate the transition of food, and moved her rapidly over to solely NM food.
I understand that this sudden drop in carb levels could have the potential for problems, but with a cat that was refusing to eat the previous food we were left with little choice.

Thankfully there is pretty much always someone in the house around when we expect her nadir to be, and we are all now well learned in the signs of hypog. Thankfully Dusty seems to be improving in general health, as well as things like quality of skin & coat, and is certainly a lot more lively now, and the food is going down well.
My order of Dr's Best B12 arrived today so she had her first two capsules of that this evening, and we now have some test strips (both AT2 and Lifestyle) so we are intending to plot another curve this Saturday to see how things are really going on at the BG level, but outwardly things are looking 'better'

We'll see what the curve looks like on Saturday, then from what you've said if the levels are still high we'll check for Ketones. We don't have any test strips for that, so I'll need to get some of those on order too.
I've just looked over the labs she had done when they diagnosed her, but it looks like they only did blood work, not urine tests, so I don't have any info on the ketones from then either.

Thanks again for your help & interest, and hopefully we will have some better BG figures on Saturday <fingers crossed!>

 

That's really good news. It's great that there's an improvement in clinical signs and demeanour.

Just a note of caution... Something we've seen here time and time again is vets increasing the dose of insulin based on maybe a curve showing high numbers, when in fact the dose was already too high...

We had a truly spectacular example of that a few months ago when a new member joined with a cat in very high blood glucose numbers. At the point where she joined the forum the vet had just increased the dose to 6 units. And the vet was starting to conclude that the cat was 'insulin resistant'.
The member started homestesting straight away, and it almost immediately became apparent that the dose was too high. She reduced the dose substantially planning to work up again from that point. But even the reduced dose was too much. She needed to keep reducing the insulin, and about ten days later the cat was off insulin completely and in remission... Her vet was amazed....
While the situation of vets overdosing cats is not at all uncommon here (sadly), this must be one of the most dramatic examples we've ever seen of this. And the member learning to homestest so promptly almost certainly save the cat's life.

Fortunately, Dusty is on a much smaller dose. But the dose was raised on the basis of a couple of days of high numbers, and while Dusty was on a higher carb diet. Reducing the carb content of the diet can reduce the blood glucose significantly in some cats, and can often mean that the insulin dose needs to be reduced. For that reason we wouldn't recommend increasing the insulin dose at the same time as reducing the carb content of the diet.

It may well be that Dusty does need the higher insulin dose, or even might need more; but it is not really possible to determine that on the basis of the data that you have so far.

Many vets seem to be of the opinion that 'rebound' (or what we commonly call 'bouncing' here) is fairly uncommon, but in fact we find it to be incredibly common here. But then we have the opportunity to see the data from a huge number of cats, while most vets may only deal with a few cases at a time. And the data they mostly see may be from occasional blood glucose curves (or from fructosamine tests). If those curves were done on a day when the cat's blood glucose was in high numbers due to 'bouncing' then the vet might well conclude that the cat needs more insulin....

In a nutshell, bouncing works like this. If the blood glucose drops too low (or sometimes too fast) the body, sensing danger, can release stored glycogen to raise the blood glucose level. It can also release counter-regulatory hormones, the purpose of which is to try to keep the blood glucose level from falling (temporary insulin resistance). The result of this can be high 'flat' (unmoving) blood glucose levels that seem unresponsive to insulin. The effect can last up to a few days in some cats.
The insulin dose doesn't need to be dangerously high for bouncing to occur. Quite often a cat will 'bounce' just because the blood glucose is dropping to a level lower than it has become accustomed to.
Whenever there are high flat numbers bouncing is always a possibility. This is why regular hometesting is so useful: The data from that can usually show whether high numbers are due to too little insulin, or too much.

Really hoping that you see some better numbers from Dusty very soon.
And good luck with Saturday's curve. Do let us know how it goes.

Sorry for long message....

Eliz

 

Just adding my two-penn'orth here and emphasising the need to test at regular intervals now... with the change to a lower-carb food and higher insulin dose, you really don't know what bg numbers are. I'd assume they would still be quite high, given the early data on your spreadsheet, but the food/insulin factors in combination since then could be making a significant difference so even though you're around at nadir to spot any signs of going too low, you do need to be proficient in testing in the event of an emergency (we hope that won't happen, needless to say, but there are certainly no certainties in FD...

So it's good that you've stocked up on strips (it's wise to have more than you need so there are always a good few in reserve) and if it were my cat I'd be getting pre-shot bg data now at least, even before a curve at the weekend. Improvement in clinical signs is always heartening but the peace of mind that comes from knowing that you're shooting a safe dose every time is what will get you on track to determining a correct dose... whether higher or lower. Remember, you can always adjust in smaller increments than 1u - it can be easy to skip over a "correct" dose thinking that 1u isn't much - to a cat, it might be 0.5u too much! We just don't know. As you've probably read here, FD is a marathon not a sprint so you have to be prepared for the long haul - but you may be one of the lucky ones and find that the new food and appropriate insulin dose fairly soon after dx gets bg in decent numbers for most of the day, every day. It's trial and error but you certainly seem to be very dedicated and knowledge is power!

 

Hi Eliz, please don't apologise for the long post, its great and very informative

We have been keeping an eye on her for low signs of low BG, but you do raise a good point about a possible 'bounce'.
Hopefully we'll see on Saturday as to whether the figures have come down, gone up (well, we won't see that because we'd be overlimit on the meter!), and whether we have a nice curve, or a line instead.

Chances are we'll be updating the SS just after each test so that we can see how it looks, so the figures should be available "hot off the press" -

 

Much better numbers yesterday.
.

 

Yup, numbers have come down which is good to see

A bit quirky yesterday, not quite sure what happened as the numbers seemed to go "up" after AM and PM shot before then dropping, (resulting in an overall higher curve on Sunday (14th) than we had on the Saturday (13th).
I think we will likely do another curve this coming weekend and see how it looks again...

Initial thought is that she might need a bit more insulin, (no idea how much more though), but then I wasn't sure if the 14th-oct-2018 upward 'flick' after getting the shot was an indication of a bounce reaction (although she also has her food at the same time, so maybe its just that).
Either way, as above, the readings on the 14th seemed strange enough that we'll repeat again the coming weekend.

Probably a silly question, but I assume that both ears would give the same reading? (or at least close enough)?
Everything I know tells me that they should, but so far (to keep as much consistent as possible) we've always used her left ear. Yesterday I noticed it was looking at little bruised /scabby, so I cleaned it all up, but am tempted to move to the right ear for the next curve... Just wanted to make sure it wouldn't cause any issues?

 

Hi Schmill @Schmill,
So nice to see those two lower preshots (both 17.9)!
...I looked in the notes and see that you fed Nature's Menu, where previously you were feeding the Whiskas 7+ meat in gravy? The Whiskas contains cereals, and that might well explain the reduction in numbers when you fed the Nature's Menu?

I did see also see that there seems to be two different sets of data for the Whiskas (on the box as compared to the website - they're radically different), and that 'customer service' confirmed the (lower carb) box info to be correct. Even given that, if your kitty is carb-sensitive the cereal content could well be enough to raise her blood glucose.
Really hoping (fingers crossed/anti-jinx) that a change in diet will bring positive results for your girl.

Eliz

 

Yes, things seem to be improving greatly, especially with Dusty herself, the change in her health, appearance, and general health really is amazing! The "juice" might be inconvenient but it certainly seems to do the job!

She's now on a 50:50 mix of the Natures Menu and the Asda Tiger meat. We found that on just the NM she started to go off it, reduced the amount she was eating, and would try to steal the meaty chunks from her brother's bowl of Asda Tiger meat.
The 50:50 mix seems to go down well, keeps her to her own bowl (mainly!) and as both are low carb all is good.
For now I'd like to think that the extra protein and additional calories that the NM give are helping with her recovery and gradual weight gain, ultimately though I expect she may well end up on straight Asda Tiger meat, since it will be a lot simpler if she and her brother are on the same food, and the Asda food seems to be pretty good.