12/13 Hogan (First Day) AMPS 360, +3 140, +4 90, +5 115, +7 79, +9 267, +11 423, PMPS 445

OK, just got the first injection done. Hogan was diagnosed last week after I tested him at home on a human meter and the reading was 408. Unfortunately, I had to go out of town the next day and Hogan is an extremely difficult cat. So my vet and I decided to wait until I got back to start his insulin, so my SS numbers until today are unmedicated.

I am going to attempt Tight Regulation. His AMPS number was not fasting. So now I will test at +3, +6, and +9.

I ordered some premixes as I'm going to see if he will eat a raw food diet. I'll probably also pick up a couple of cans of good no-carb wet food and see if he has any interest, though I've tried to transition him to wet food in the past and it was a big fail.

One question: my vet prescribed a starting dose of 3U, but from reading here, I think that's too high and started with 2U. The vet said his ideal weight would be 17 - 18 pounds, which would put the dose at 2U by my calculation. I figured I can always increase the dose if need be since I'll be monitoring closely.

 

Welcome to you and Hogan !! You are in the exact right place for experienced help and guidance . Sit tight and one of our Pros will be getting feedback to you ! Again, a hearty welcome

 

@Kris & Teasel @MrWorfMen's Mom

 

Hi and welcome to FDMB. Kudos for home testing Hogan.

Sounds like you've already done some research and got familiarized with some of the ropes. You've indicated you want to follow TR however that protocol requires kitty to be on a wet/raw diet so right now, as you work on transitioning Hogan to a wet diet, you should plan to follow SLGS. It's a bit less aggressive but works well for many cats. Once you get Hogan onto a wet/raw diet, you can switch over to TR.

Your routine should be to withold food for a period of at least 2 hours before pre-shot testing. This is to ensure that insulin is given only when it is safe to do so based on a non-food influenced BG.

You've indicated the BG (360) today was after food and Hogan has dropped 220 points in 3 hours which is a very significant drop and likely to cause a bounce (higher BG levels). A bounce occurs when kitty's BG drops a lot, drops quickly or drops to levels kitty has become unaccustomed to.

With that significant drop this morning, it may be that the 2 unit dose is a bit too high for Hogan but not knowing his true BG when he got his insulin makes it difficult to say for sure. 2 units is a bit higher than we would normally recommend as a starter dose.
The normal nadir (peak action time) for Lantus is between +4 to +7 hours post shot so Hogan may still drop lower. Not sure how many hours post shot you are now but I would suggest testing again now to see what's he is up to. You do not want him dropping below 68 on your meter.

 

@MrWorfMen's Mom since she is using a human meter she doesn’t want him dropping under 90 since dry food is being fed. That number would also call for a reduction of .25.

Please check again an hour from the last test. To slow things down I would feed a little food. Since you are feeding dry at this point we on,y would suggest SLGS and not TR. Once fully transitioned you can switch.

 

Signature says she is using an AT2. And I know she doesn't "want" him dropping below 90 with SLGS but with that major drop, I wanted to be sure she was aware of the absolute lowest safe number on the AT for now and find out what he is up to at this point before delving into methodology further.

 

Thanks for the detailed replies! I just tested again at +4 and the result was 90. While his AMPS was not fasting, I did test him 2 hours before that when I'm fairly sure he hadn't eaten (but there was food in the bowl, so I could be wrong, and it was 292).

So he's dropping even more on the AT2. From the time of the shot, he did not eat anything, just slept at my feet. Now that I woke him up for the +4 test, he just ate a little bit and is drinking some water now.

Yes, sorry for the confusion, I was using a human meter originally, but ordered the AlphaTrak2 and have been using that.

 

Thanks for clarifying. You mentioned in the post that you tested on a human meter so I thought you had switched to one.

 

Should I test every hour until I see the numbers going up?

 

90 is a great number but it's still early in the cycle so since this is your first day it would be good to get another test at +5. As Elise said, if Hogan goes below 90, he earns a reduction of the dose by 0.25u making your new dose tonight 1.75u. You may want to reduce tonight anyway because with meter variance he might be a bit under or over 90 right now.

 

It certainly wouldn't hurt to get tests until +7 or 8 today. All data is good data.

 

I tested at +5 and it went up to 115. I had to go out so I missed the +6 test. I just did the +7 test and it was 79.

I will test again at +9, unless you think I should try to get +8?

Should I reduce the dose to 1.75 for his PM shot?

 

I think you should be fine. I would reduce to 1.75.

 

Since he is still coming down, let’s see where he is closer to,preshot before deciding his next dose. Can you get and post a +11?

Hello and welcome to you and Hogan by the way. We’ve had a couple people successfully transition their kibble addicts to a freeze dried raw first, which is low carb, then slowly add more water. Out of curiosity, what symptoms led to the diabetes diagnosis?

 

Not that I'm an expert by any means, but I might consider skipping the dose tonight to drain the depot a bit, getting an accurate AM BG not influenced by food and go from there.

Just my two cents.

 

Thanks!

What brand of freeze dried raw should I look for? I just tried making his first batch of raw - ground boneless chicken thighs with the Young Again premix. He licked it but did not eat it. I'll leave it out for a while, but he can be pretty stubborn.

His symptoms were weight loss and increased urination. I came back from a trip and noticed he looked quite a bit thinner. Also when he made a bigger fuss over his water bowl than over his food bowl. So I suspect he's been diabetic for a couple of months now.

He's always been an overweight cat, but it was very difficult to get his weight down, particularly in a multi-cat household with older cats with health problems. They've since passed away, so it's just Hogan and the dog now, so it will be much easier to control what and how much he eats. I'm tracking his weight, it's holding steady at 21 pounds on the nose. I'd like to get him down to about 17 pounds, but I figure I should focus first on getting him to eat the best food possible (wet food or raw diet) and probably his weight will come down in the process.

 

I will read up more on the depot. Could he have a depot effect after just one dose? I really appreciate all of the feedback, it's so helpful.

 

He will only have a tiny bit of a depot after one dose. The numbers you saw earlier were just the result of starting dose being a bit high, and/or a strong initial reaction to insulin, which some cats have. Given the +9 number, he could be bouncing and you should be OK with giving the 1.75 unit dose tonight.

Thanks on the history, just wanted to make sure there were no other complications that might impact dosing decisions.

As for food, Primal makes a freeze dried raw that Is low carb. And yes, just transitioning to low carb food should help,

 

Hi and welcome ...
You might want to check out www.darwinspet.com. They have excellent raw food which they ship, packaged amazing-ly! You can try a generous (two week supply!) for a mere $14. As far as a transition raw diet, I highly recommend.
Nelli had been eating Rad Cat exclusively for 8 years- it’s been hell for us both to find a replacement. If you give Darwin’s a try... Hogan and you might be glad you did

 

Thanks, I will definitely try out both Primal and Darwin's Pet!

I just tested his +11 and it's up to 423. Should I give him 1.75 for his PM shot in one hour?

 

His PMPS was 445. I gave him 1.75U. I'll set my alarm and try to retest at +3 from the PMPS.

 

That's the bounce we were expecting....His body isn't used to being in "normal" numbers, so it reacts like he went too low.

The liver releases stored sugars and hormones to bring them back up quickly. It can take up to 6 cycles for those sugars and hormones to clear the body, so you don't want to increase just because his numbers might be high for a few days.