3/13 Lightning - need BG regulation advice *newbie*

Hello! Lightning and I (Cristina) are new to the forum. Lightning was diagnosed a year ago, and is now 14yo. At first, the vet started him on dry Hills m/d and Vetsulin. As you will see on his SS, we changed food a couple of times, and recently switched to Lantus 2U, 2x/day, while feeding FF turkey/giblets (1 can/3oz) & FF Cod, Sole, Shrimp (1/2 can/1.5oz), twice a day. (no extras, no treats, no dry food) His last BG today was 359 (+3).

There have been a number of symptoms and issues that I can't seem to figure out, no matter what we try. I know that some are now behavioral issues, but I'm hoping if I can finally get him regulated, then I can work on fixing those, too. I should say that I have only been home testing, sporadically, for about 6 mos with a ReliOn Confirm. The vet never really mentioned home testing before, and so for a while I would take him to the vet to get checked once a week. Most of the time, I didn't get the results of those tests. My vet, while they mean well, does not have a lot of diabetic cat experience, mostly just dogs. Lightning seems to be giving the vet a run for their money. I have learned a lot in the past year, however I know I still have much to learn. I'm trying to read through the info on this forum, as much as possible.

Backstory: Right before Lightning was first diagnosed, he began randomly peeing on the kitchen rugs. This went on for a few weeks, until I heard him yowling, and realized he might have a UTI, and that was when the vet diagnosed him. Anyway, from then on, he will not use a litter box, unless he is kenneled. He pees on my kitchen tile floor.

Another bad habit he has developed has been to consistently wake me up 2 hrs early by yowling outside my bedroom door incessantly, to try and get me to feed him. Of course, he doesn't get anything until his designated time at 5AM (but at first he did when he was diagnosed). However, he has recently started to lose weight in the past month or so, down to 9.2lbs today, from 10.8lbs in Feb '18. He was not overweight, so now he is getting bony. On one hand, I'm afraid to give him any more food, because his BG is already high. On the other hand, I tried to increase his FF CSS food for a period of 5 days in Jan '18, to see if it would help his hunger, and nothing improved- he still cried all the time for food. So, I'm not sure what to do about that. A week ago, I started saving a small portion of his evening ration of FF CSS, to give as a snack before bed (So overall ration was the same per day). I can't say it has done any good, but I will continue for now. I have also considered getting a timed feeder to help spread out his food portions, since Lantus is more evenly distributed.

But the biggest of the issues is the fact that his BG is usually in the mid 300's, and rarely below 200. I just recently read on here about over dosing, and how missing the right number of units can show high numbers. I'm afraid that when the vet recommended going from 1 to 2 units in a single day, it could have been too much. At the time, I did not know better.

Now, I am trying to be more precise, with dosing/timing/being a food nazi, to hopefully reduce outside factors as much as possible. I think I will be trying the go slow method, and be more scientific, and not change too much at once than I did in the past. Please, I'm looking for any advice that y'all can give me on if I should maybe lower or raise, or stay, based on his SS. Or, just any general suggestions for a newbie on Lantus. I need my sanity back. This past year has been a beast. Thank you! (sorry for such a long post!)

 

When a cat is unregulated they can eat a ton more then normal. If I were you, since he is losing weight, would feed him more until you get him regulated. Their bodies don't process the food the same way when unregulated and he could be missing out on nutriets.

 

Ok, thank you. I tried before, I just wasn't sure it was the right thing to do for Lightning. I will increase his FF CSS again, and see how that goes. Funny, I think your advice to someone else, is what made me try it in January. haha

 

And I would say you need to up the insulin. He's been at that dose for a while, and he hasn't seen blue numbers since the first or second day.

 

So usually you would keep kitty at same dose for a week, and then do a curve. Check bg every 2 hours for 12 hours. Find the nadir, lowest point, and then reevaluate from there.

 

Ok, I have read that before but I didn't really understand what to do with the numbers, once I got them. I will look more into curves. Thank you.

 

I'm on my cell and hate typing on it! I'll post tomorrow for sure to help out! Hopefully others will drop by, too.

 

Good to see you're starting to test more! The answers to pretty much all your questions will be in the test results.

If at all possible, try to get at least 1 mid-cycle test on the AM cycle as well as the tests you're getting on the PM cycle.

When can you do a curve? That's testing every 2 hours for 12 hours or every 3 hours for 18. (However, if you can get more tests in at different times during both cycles, you may not ever need to do a "formal" curve at all......think of your spreadsheet like it's a puzzle....the more "pieces" you have sprinkled around, the easier it is to figure out the picture)

If you were up to 7U of Vetsulin, you may have gone down too much in dose when you switched to Lantus....We usually take into consideration the dosage you're on when recommending a starting dose for a new insulin.

I'd increase him to 2.25, get those mid-cycle tests in and let's see where he's at in a few days.

I agree too that he probably needs more food....6oz per day really isn't much for a non-regulated diabetic cat. If he's still losing weight, he needs more. As long as it's a low carb food (like the FF), it's fine to feed him more

 

I can do more AM tests this weekend. I will increase to 2.25, and will increase the 1/2 can of FF CSS to 1 can, twice a day. Thank you!

 

Also, just to clarify, he was getting 9oz of FF (3+1.5+3+1.5 or 3 cans), total per day. Starting this AM, I have increased to 12oz of FF/4 cans, total per day. Sorry, if my notes weren't more clear. Thank you!

 

Are you feeding him twice a day or breaking his meals up? It has been advised to feed 3-4 small meals a day. Also, I think, you could probably give your boy some Pure Bites treats if you would like. Most cats love them. They are freeze dried meat. Zero carbs. I give Diamond a few after his tests. Of course the rest of the crew shows up too. Lol

 

I agree with Chris' observations. I'd encourage you to read over the sticky notes at the top of the board -- especially the two notes on the dosing methods we use here. Tight Regulation (TR) and Start Low Go Slow (SLGS). These posts will give you a template for how to approach dosing.

Regardless of which method you opt for, we may want to be attentive to how Lightening is responding. Changing from 7u to 1u is a very large reduction. If your kitty wasn't responding at 7u, he may need a lot more Lantus. The numbers will dictate what your cat needs.

Please let us know if you have questions. We're here to help.

 

For the last week, I've started feeding 2 meals and 1 snack, per day. It's hard to feed during the day, since I work, hence the thought about automatic feeders. Does anyone have experience with feeders, with multiple cats?

 

Hey! I'm back. Do you understand what @Chris & China wrote about dosing and doing the curve? Do you have other questions? Basically you hold on the same dose for a week. Test before meals (no food for 2 hours before meal) and try to get at least 1 test in each cycle. Try to test at different times. So if shot is at 7am & 7pm, always test before shot. Also, try to get a test at say 9am or 1pm or whatever time you get one (or 2). Same for pm cycle. Then on curve day, take a test every 2 hours. Not exactly sure what numbers are recommended, or that yopu want, but I'd say low to mid 100's would be great. So, what you are looking for is the lowest number he gets to on a dose. So if his before his does his bG is 300, but then at 3pm he is 200, that's getting better, but not where you need to be. If you do get a "good" number, then you might be at your right dose. You are going to look at all the data you collected the past week, including the curve day to see what your next step will be.

 

So, if he was in pain, it is possible he has associated the litter box with the pain, and is avoiding it. Cats "do what work" and "avoid what doesn't work", it's pretty simple, really.

Have you tried:

• using a different litterbox?
• using different litter?
• putting it in a different spot?
• adding extra litterboxes?
• putting paper where he usually pees, then cardboard under the paper, trying to inch towards "building" a litterbox around the place where he pees?
• mix and match the above

The yowling should get better with more food. Again, in the spirit of "cats do what works", try and not give food when he's yowling for it, if at all possible.

 

Hello and welcome. A automatic feeder is a life saver. The one that many of us use is called the PetSafe 5. You can put wet food in there. There is a small compartment under the feeder for an ice cube or gel pack, or you can add water/ice cube to the food to keep it safe. Cheaper prices on Amazon or Petsmart - look around for sales. My Neko "owned" the feeder - no way the other cat would get there before her. You can buy feeders that open based on a collar. Tagging @Tracey&Jones cause I think she uses one. The thing about using an autofeeder, Neko's attention went to it instead of bugging me for food.

Some cats need more insulin that others. Neko was up to 5 units of Canisulin (Vetsulin rebranded to sound less dog focussed) and seeing blues in her mid cycle. I switched to Lantus at 1 unit - big mistake. She got up to 8.75 units of Lantus so we wasted quite a bit of time getting back up a better dose. I was my vet's first home testing client too. The best thing you can do now is get what data you can. Some people move shot time up a couple hours so they can get a +2 as they head out the door. Some get home in time for a +10. Either of those will give you and idea what happened during the cycle. Those before bed or night time tests you are starting to get are also good to have.

Have you tried Dr. Elsey's Cat Attract litter or sprinkle on? Or Feliway plug-ins? Both can help with out of box peeing. I presume you have enough litter boxes for the number of cats you have plus 1. If cats are sick, the others might be detecting it an picking on him when he tried using the litter box. He may have developed an aversion. One thing to try is locking him overnight in a bathroom with the litter box so he has to use it but can do so in comfort. Gradually move the litter box to a place you want it to be.

 

Ok, thank you. Yes, I think I'm starting to understand curves, now.

 

Dr. Elsey’s cat attract (red bag) worked great when I had a Mr. Peebody. It’s expensive but did the trick. I only had to use it for a month or so I think.

 

I have tried adding litter boxes, in several different areas. The clumping litter I use now, isn't the same as I used when he stopped, but I haven't tried other textures. I have also tried puppy pads where he pees, and he goes next to it. I thought they would best resemble the soft rugs he started peeing on. The only thing I haven't tried is "resetting" him by confining him in a room/enclosure, for a short period of time, to get him back on track. I felt like if he was still not feeling well, it wouldn't last long.

 

And don't be worried if his numbers go up a little in the next day or so, sometimes that happens as the body adjusts to the new dose

 

Thank you. I did try both the blue and red ones of Dr. Else's but he had no interest.

 

Is he pooping in the litter box?

 

Ok, thank you. I will look up the PetSafe feeder.
I did try the Feliway plug in for about a month, but it didn't really help, as I think there were other factors involved. Around the time he started his bad habit at the end of 2016, we had been raising an 8 month old kitten I found, Atticus. He definitely picked on Lightning, and was rambunctious. The main litter box enclosure we had at the time, previously was Lightning's when he was an only child, but everyone wanted to use that one, even though we other boxes in other areas. Lightning was the only one that didn't want to share, it's quite possible that Atticus attacked him while using it. Sometimes, the other boxes got used, but mostly just that one. Atticus passed suddenly this Jan of FIP, so that is no longer an issue, as our only other cat Leelee is an old-timer, and doesn't bother Lightning. I haven't recently tried to get him to use the box, again. But if I can just get his BG reigned in a bit, so hopefully he starts to feel better, I probably will try again, soon.

 

No, he poops right outside the litter box, on the tile floor. He pretty consistent on that. And I'm thankful he's using the tile floor, and not my nice, wood floors. But it does get old after awhile.

 

Hmm, yeah sounds like he's not too happy about something. Either trying to tell you he doesn't feel well with the diabetes, or maybe he has arthritis? Is he on any meds or supplements for that?

 

I use the Sure Flap feeders. It takes a bit to train the kitties to use it but it is a life saver. It doesn't have planned meals but it does keep other cats out of Jones food and allows him to eat at will. He is a free feeder.

What have you cleaned the spots with?

 

No, he's not on any other meds. Is there a test for arthritis? I know he probably doesn't feel well, but I always attributed it to his diabetes making him feel bad. He doesn't seem in pain, and still jumps on the counter, and when food is involved, you have to watch him like a hawk. Overall, though, he's definitely slowed down a lot, since he started getting sick. It's to the point where he no longer goes after string at all. And catnip is only a little enjoyable. He's more concerned about food. Before, he was almost like a kitten. Now, he mostly just sleeps a lot.

 

I only have hard floors. I used to use that expensive enzyme cleaner but now I use a mixture of water, vinegar and rubbing alcohol in a spray bottle. It did have orange essential oil in it for a fresh scent, until I read that citrus and cedar can make cats sick over time.

 

The ultimate test for arthritis is an x-ray. But even I could feel Neko's arthritis. Often a vet can tell by physical exam.

 

If he's still jumping on counters that's a good sign. Xrays could show arthritis. I knew Rufus had some, but the xrays confirmed it. Yeah, he'll probably sleep a lot until he's regulated

 

Is he declawed by chance? Many cats will develop litter box issues when they are declawed.
I’m sure you probably have checked off all of the things I’m going to list but, just in case...

You have as many litter boxes as you have cats plus one on each level of the house.

If you have covered boxes, have you tried without cover and vise versa.

Scoop daily if not twice a day.

Use unscented litter. Scented litter could make the box unappealing.

Boxes are not near where he eats or drinks.

I’m determined to help you figure this out and solve the problem. I like to think I have a handle on litter box issues. Lol

 

Lol Thank you. No, he's got all kitty claws intact.

Because I haven't pushed to get him back on track lately, I only have two boxes, one is in an enclosure and the other is top-loading. Neither of the boxes are near food or drink.
For awhile, I was using Dr Elsy's ultra unscented, and he still didn't use it. About 6 months ago, I switched to cheaper HEB clumpable scented litter, but it's not a strong perfume like tidy cat, or cheap litters.

Maybe also part of his issue is that for the first 9 years of his life, he was able to go outside to potty because we lived in a quiet, rural area. When we moved in with my spouse 5 yrs ago, he went from being an only cat for Several years, to having to share with another cat and 2 dogs, plus he could no longer go outside because there is more traffic here in the city. He didn't really develop any litter box issues though, until 2016.