1. Are you getting a server error? It should be solved. Email webmaster@felinediabetes.com if you're still having trouble!

? 4u Lantus - 400+ GC for 2 months, vet increasing dose 1U at time- toofast?

Discussion in 'Lantus / Basaglar (glargine) and Levemir (detemir)' started by Jim (NJ), Jul 21, 2019.

  1. Jim (NJ)

    Jim (NJ) Member

    Joined:
    Jul 21, 2019
    Hello All,

    I was grateful to find this amazing forum this weekend. My boy Rocky was diagnosed with diabetes about 2 months ago when he went to have dental work performed. They postponed his dental when his blood glucose levels were in the 600's and the vet started him on Lantus 2u twice a day with Royal Canin Glycobalance wet & dry food. We started out with 2 portioned meals a day after being able to free graze for all his life so it was a big change but he adapted pretty well, just always seemed hungry. I brought him back into the vet every 2 weeks to have a fructose test done and each time his levels were around 450+. He was bumped up to 3u after his 1st test on 2u for 2 weeks then after a month bumped up to 4u. We switched him to 4 meals now (1/3 wet can + 1/4 cup dry for the 2 meals with his shots, 1/8 cup dry for his in between meals) We got his last test back on Friday 7/19 and his numbers were still 440.

    I finally picked up a AT2 to test him at home over this weekend and a bit perplexed by his numbers. I went today to pickup ketone testing strips after reading about them here but the vet never mentioned anything about ketones when he had his urine taken twice because of possible UTI's. So Im hoping they come back negative but shocked to just now only find out the concerns with them and knowing his levels have been 400+ for at least the past 2 months. I am waiting to try to get a urine sample from him now, but wanted to ask for some help. I am using the lantus pens so I can only increase dosage by full #'s not .5, I am going to up him to 5u for the next 3 days and test to see how he responds. I just want to ask others opinions as I'm not sure I am interpreting the results properly. Thank you soo much <3

    *EDIT* Just tested 3 Walgreen Ketone strips and they barley changed the color if at all to tan, indicating negative/trace 0mg - 5mg. So that is a great relief! Now to just get his numbers down
     
    Last edited: Jul 21, 2019
    Tanya and Ducia likes this.
  2. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    Please set your spreadsheet to 'public' so we can look at it.

    Please also rush to your nearest Walmart or local pharmacy and buy some U100 syringes. I buy Relion (it's a Walmart only brand) 31 gauge, 15/64's (very very short needle) You do not need to shoot your cat with the pens and agree they only shoot in 1 or 1/2 unit increments - might be too much of an increase for your cat too soon! On FDMB the recommendation is to increase only by .25 or .5 in high dose cats... Doesn't sound like ketones are an issue right now, so you have time to purchase appropriate syringes.

    You can also look at the human test meters while you're there - we used a Relion meter and strips for a long time - Alpha Trak strips are very expensive - and we're all very comfortable here with the human meter readings..

    If you haven't done so already, read the stickie on 'starting out...' at the top of this forum...there should be a list there of supplies to help get you started...

    Welcome to the forum! It's a great place to get help and support for you and your kittieh :)
     
    Tanya and Ducia likes this.
  3. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    Hi Jim and Rocky. You will get more responses from more experienced members than I, but I wanted to welcome you.

    Diet might be contributing to the higher BG numbers. It is recommended to feed low carb wet food under 10% carbs. The Royal Canin Glycobalance canned food is at 14%, and dry (except for a very few varieties) are always too high in carbs.
    There is a great feline nutrition website you might want to visit: www.catinfo.org which also has sort-able food chart showing fat/protein/phosphorus/carbs/calories.

    Many of us feed Fancy Feast Classics and Friskies pates, they are all under 10% carbs. Transitioning should be done after you are testing because eliminating high carb food can significantly lower the blood sugar and you will want to be able to track that.
    http://www.felinediabetes.com/FDMB/threads/transitioning-your-cat-from-dry-to-wet-food.956/

    It is also recommended to feed smaller more frequent meals to diabetic cats, especially unregulated cats, because unregulated cats aren't able to utilize food as well, and they are hungry. You can use a timed auto-feeder, there are many varieties, some are two portion feeders, some are five portion feeders, if you are not able to be in the home to offer more frequent meals. Alternately freeze wet food in ice cube trays, and leave foodcicles out to thaw and be consumed.

    Regarding getting a urine sample some members use a long handled spoon (or some low sided cup or lid) and slip the spoon bowl under kitty's bum and catch fresh urine to test. Some have used a piece of plastic wrap in the place kitty "usually" pees in the box and test the fresh urine. Others have had to use clean fish gravel or lentils in the box instead of litter in order to get that sample. Just be sure to use fresh urine to get a reliable test result.
     
    Sue and Luci likes this.
  4. Krystina & Nelli

    Krystina & Nelli Well-Known Member

    Joined:
    Jul 4, 2018
    I have a suggestion for you - to get some skilled veteran eyes on you.-
    Put a ? In your title. You’ll find it in drop down at beginning of title (make sense :eek:)... then state something like this...Vet increasing dose by 1U at time- too fast?
    That’s a good one ;)
    Have to run out- will check in later :)
     
  5. Idjit's mom

    Idjit's mom Well-Known Member

    Joined:
    Apr 3, 2018
    Please hold off on increasing the dose Jim, that's a very big dose, and sometimes too much insulin can look like not enough. If you read the information at the top of this forum, a starting dose is usually 1 Unit and increases are done at 0.25 or at most 0.5 Units.

    You can use the syringes to get the Lantus from the pens http://www.felinediabetes.com/FDMB/...info-proper-handling-drawing-fine-dosing.151/

    It may be that you are shooting a big dose, then Rocky's body reacts by dropping very low, then the liver tries to recover by releasing hormones and glycogen..which shoot the BG back up. It's a nasty cycle you don't want Rocky having to tolerate.

    Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high: (possibly contributing to your kitty's high BG at the high dose he's on)
    BG goes low OR lower than usual OR drops too quickly.
    Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
    Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
    These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
    Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
    Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.

    It's time to reevaluate the dosing and I am going to tag some more experienced members to help out
    @JeffJ
    @Judy and Boomer
    @Sienne and Gabby (GA)
    @Bobbie And Bubba
    @Wendy&Neko
     
  6. Jim (NJ)

    Jim (NJ) Member

    Joined:
    Jul 21, 2019
    Thanks all the for quick replys & suggestions. SS should be public now with testing from the past 48 hours. Before he was diagnosed with diabetes, I used to feed him Blue Buffalo weight control dry food free graze and twice a day he would get Hartz delectables or fancy feast packets which he loved. He will be soo happy if he could have his packets again as he doesn't really care for the royal canin wet food, but loves the dry. The only reason I switched was due to vets recommendation which when he was younger went to science diet for weight control and didnt lose a pound. I switched him myself to Blue Buffalo and he did way better with it. I will dig deeper into the nutrition site provided, what a great resource!

    Also I have been paying $80 a lantus pen and found out about mark marine for $165 a 5 pack which is a huge help to me. I picked up the petsafe smart feeder a month ago and it has worked wonders on feeding his 1pm/1am (1/8 dry cup) when we are not available. I am going to look if we can find him a better dry for those small meals we are working/sleeping then feed him only wet for the preshot meals. Sounds like cutting out as much of the dry as u can is the way to go. He loves tuna, chicken, beef so he would have no problems going back to them. Happy Kitty he will be :)

    I am trying to absorb the abundance of info here & have read a good amount of posts all weekend. Its just so much great wealth to take in at one time and I wanted to get a post regarding specific info to Rocky. Thank you all for your support & warm welcoming :)

    *EDIT* We gave him a 5u shot tonight a 7pm but will go back to 4u until more feedback is provided. I just did his PMPS +2 @ 499 and will do the +4/+6 then bed.
     
    Last edited: Jul 21, 2019
  7. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    Kudos to you Jim for the spreadsheet, the testing, and ramping up your knowledge.:)

    - Yes, Marks Marine has much better prices. The "supply closet" subforum, also has providers. I bought multiple times from Alan Hamman there.
    - I stayed on Alphatrak the whole time with Leo, and got Freestyle Lite strips from Ebay.
    - There is no great dry food for diabetic cats. Really, a low carb wet food is the way to go. Diet plays a significant portion in diabetes mgmt.

    I would not change the dose yet. Please strongly consider the removal of all dry kibble type food. Then we can look at a week's worth of data. If Rocky is actually in those high numbers with a low carb wet food, then dosage increase will help him.

    Long term we can't have Rocky in the high numbers. Neuropathy will likely occur (do a fdmb search on it).

    cheers,
    JeffJ
     
    Tanya and Ducia and Idjit's mom like this.
  8. Sue and Luci

    Sue and Luci Well-Known Member

    Joined:
    Nov 3, 2017
    The only dry I’ve found that was 0 carbs is from Young Again- be sure to click on the Zero carb formulas for food and/treats..
    Dr. Elseys has low carb - best bet is to try to feed as much wet food as possible using the dry for only fill in when you can’t be there... more moisture =better for kitty..

    Watch him closely tonight since you gave 5 u.. that’s a lot...

    We’ll see you new thread tomorrow
     
    JeffJ likes this.
  9. Krystina & Nelli

    Krystina & Nelli Well-Known Member

    Joined:
    Jul 4, 2018
    Thanks @Idjit's mom :bighug:
     
  10. Krystina & Nelli

    Krystina & Nelli Well-Known Member

    Joined:
    Jul 4, 2018
    :)
     
  11. Krystina & Nelli

    Krystina & Nelli Well-Known Member

    Joined:
    Jul 4, 2018
  12. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Welcome to the group!

    Did your vet give you any explanation for how he (or she) decided on Rocky's dose? The most widely available protocol for Lantus (or Levemir) is the Tight Regulation Protocol which has been published in a leading veterinary journal. Using the TR method, the initial dose is based on weight: initial dose = 0.25 x ideal weight in kilograms. However, TR is only recommended if your cat is eating a low carb, canned food diet exclusively.

    The alternative method that was developed here is Start Low Go Slow (SLGS). With SLGS, if your cat is still eating dry food, the starting dose is 1.0u.

    Based on what we do here, Rocky is getting a lot of insulin! With either approach to dosing, doses are changed in 0.25u increments. Getting U100 3/10cc syringes that are marked in half unit increments are recommended. A syringe is far more accurate in smaller doses (and that's relative given that Lantus is a human insulin and the doses for people are much, much larger) compared to administering a dose directly from the pen.

    As others have mentioned, the Royal Canin food is very high in carbohydrates. It sounded like you have some concerns over costs. Royal Canin is prescription food and for ta much lower price, you can buy purchase Fancy Feast or Friskies pates which are probably better quality than Royal Canin and very much lower in carbs. They are around 4 - 5% carbs. A low carb food is considered to be below 10%. It is very likely that you will see a significant change in Rocky's numbers if you change him over to a low carb diet. And, dry food is not recommended (at all, ever) mostly because dry food contains ingredients like cellulose (i.e., sawdust). Cats do not have a high thirst drive. Other than a diabetic who generally is drinking and urinating like crazy, most cats do not drink a great deal of water. Cats need the hydration from their food to keep their kidneys healthy. Dry food contains virtually no moisture. Couple the lack of moisture in dry food with diabetes which is hard on a cat's kidneys, dry food is a recipe for disaster on any number of counts.

    Should you change Rocky over to a low carb diet, please be very careful with dosing. His numbers could drop precipitously.

     
    TSP, JeffJ and Idjit's mom like this.
  13. Krystina & Nelli

    Krystina & Nelli Well-Known Member

    Joined:
    Jul 4, 2018
    @Sienne and Gabby (GA) ... do you think Rocky should go down from 5U to 4 in am; waaay too high at 5U so should drop back one full?
    Thanks :)
     
  14. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    There is crucial info in her post about carbs. If you remove dry food and start feeding low carb wet food, then Rocky's insulin demand will likely drop dramatically. 5 units is very high, as most cats get 0.5 - 2.0 units. And in the case of an immediate food change, the high (5U) insulin dose could actually be fatal.
     
    Tanya and Ducia likes this.
  15. Jim (NJ)

    Jim (NJ) Member

    Joined:
    Jul 21, 2019
    She did not state why she started him at 2u when she 1st found his results were 600+. I don't have the paperwork atm but can find out the exact amount of BG for each of the fructose tests. After the intial 2u dose, he stayed on it for 2-3weeks then got his next fructose test and numbers were still high so she bumped him to 3u. After 2 more fructose test and month or so passed he was still 450+ so she went to 4u. He has been on 4u for 3-4 weeks now and she really wanted us to do home test. I have an appointment with a diabetic specialist on 8/1 and she wants to do an ultrasound on his stomach with him. This all came to a head from the testing we did all weekend but its best so we can find out whats going on and fix our guy. My fiance is really upset and a whole lot of emotions as to be expected when its concerning someone whos a family member so I appreciate all the love and support we've gotten so far here.

    I am willing to buy w/e is the best food regardless of the cost for my guy. I was skeptical of royal canin being pushed by the vet when I had a bad experience with science diet pushed by them as well. Im not one to believe everything Im told from doctors/vets, part of the reason it lead me to find all you! :)

    After reading all night, it looks like I am going to order a 4lb young again zero dry bag to try out in the smart feeder when I cant be home. I plan to switch him to fancy feast classics or fancy feast natural in broth. Both were in the single digits for carbs the broth ones had 0! I noticed they make a fancy feast gourmet natural pate in cans but cant find it on the spreadsheet if that's any better than the classic. The broth ones looks the best and most $ but Im not sure, if others can share their feedback. I can pickup the fancy feast tomorrow to replace the wet royal canin and increase the amount of wet portion with his meal shots & cutback to a 1/4 cup of dry with his 7am/pm. Once the young again zero comes I can start replacing dry meals with that and keep an eye on his levels if that sounds like a good plan for the next week while keeping him at 4u. Continue to check what his levels are like on low/no carb food and off the gylco stuff.

    I just did his PMPS +4 @ 425. Rocky appears nothing out of the normal and acting ok so hopefully no harm was done with the 5u but now I know next steps with food plan. We will keep him at 4u for the week with starting to replace his food.

    1st step - Replace royal canin glyco wet with fancy feast & cut back dry from 1/4 to 1/8 cup 7am/pm . Keep 1 am/pm @ 1/8 cup dry.
    * I normally give 1/3 can wet but thought to bump it to 1/2 can since I am cutting back dry food.

    Do step 1 for several days while testing levels until Young Again Zero arrives at end of the week.

    2nd step - Replace 1/4 cup dry at shot meals 7am/pm with 1/4 cup young again zero.
    wait 2-3 days & test
    3rd step - Replace 1/4 cup dry at nonshot meals 1am/pm with 1/4 cup young again zero.
    wait 2-3 days & test
    4th step - Cutout 1/4 dry young again zero with meal shots for more fancy feast wet.
    Test.. test.. test :)

    If we are home for 1pm/1am we can sub in wet but it will mostly be dry so the young again looks perfect, hopefully he likes the taste!
     
    Last edited: Jul 21, 2019
  16. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    Sounds like a good plan Jim. Just be real aware that carb reduction can drastically affect BG. If that dramatic carb reduction is done to Rocky, it could reduce his insulin demand to 1.0 units/dose. We never want to overdose insulin - it can be fatal.

    It may sound like I am harping on this. But on the forum we have dealt with overdosed insulin a lot.
     
  17. Jim (NJ)

    Jim (NJ) Member

    Joined:
    Jul 21, 2019
    PMPS +6 @ 387mg .. Will check back in the morning, goodnight
     
  18. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Hello Jim, and welcome to you and sweet Rocky. Good luck with the food transition plan. Be aware that not all cats like the Young Again and it gives some the runs. If you could possible manage a diet of all low carb wet food or raw eventually, it is much better for kitty. Cats normally aren’t great drinkers and dry food is hard on them. I fed low carb raw food. I used the Petsafe five tray feeder with it. There is a spot below the tray where you can fit a small ice pack that keeps things cool, or you can add an ice cube on top of the food, which will melt and give extra needed water.

    Another thing I don’t think anyone has mentioned, some diabetic cats have secondary endocrine conditions that mean they need more insulin than most cats. My girl had two such conditions, which are referred to by some as high dose conditions. Not all cats with these conditions need high doses, so it's not my favourite phrase.

    Getting some numbers for the next few days,will help us identify whether Rocky is under dose or overdosed. You don’t need to test every two hours if his numbers are staying above 300 by +6. Getting random spot tests can be equally as helpful.

    And lastly, what is the dental work Rocky needed and what is the current plan for it? Bad teeth can keep numbers high and make a cat hard to regulate. The catch 22 is that some vets don’t want to give a dental to an unregulated cat. If your vet is like that, see if there is a veterinary dental specialist you can be referred to. They are comfortable doing dentals for diabetic cats.
     
    Sienne and Gabby (GA) likes this.
  19. Jim (NJ)

    Jim (NJ) Member

    Joined:
    Jul 21, 2019
    Thanks for the suggestion on the Petsafe five tray, I will definitely pick that up.

    Great to hear for the testing as every 2 hours has started to wear on us all after this very long stressful & emotional weekend. I slept downstairs on the floor with Rocky last night to keep an eye on him, everything seemed ok. We will test daily amps/pmps & +6 if that is sufficient for now.

    His dental visit was for a cleaning due to tarter buildup. The vet wanted to postpone the dental cleaning until we treated the diabetis & UTI they discovered. She hasnt mentioned anything regarding rescheduling it and I thought they wouldnt until getting his #'s under control.

    So Im a bit perplexed as we did his amps @ 545, +2 @ 494 so far. We gave him 1/8 cup dry instead of 1/4 but extra royal canin wet this morning. Surprised to see them soo high with the 5u shot last night, I expected lower if anything esp with reduction in 1/4 dry cup this morning. I know we need more data and not sure If Im reading into this correctly but seems like he is bouncing from the high dosage correct? Makes me wonder if the vet starting him at 2u was higher then he needed to begin with. Why I say that is because he had 600+ BG when it was 1st discovered, he had a UTI & was eating standard food & lots of treats since we spoil him :) After 2 weeks on 2u, he dropped to the 400+, but since going to 3u & 4u, its remained in the 400's. It has me thinking the initial drop might have been from eliminating the UTI & changing to portioned meals with glycobalance food, not from the 2u dose. And thats why increasing the dose has seem to do nothing to bring down the fructose test numbers. Sometimes a little bit of knowledge can be a bad things so please correct me if this doesn't sound reasonable as to getting an idea what is going on with him.

    Also, wanted to mention with neuropathy stuff. In the past 14 years Ive owned him, he has never went outside the litter box ever. The past 1.5 months he has had 1x pee & 3x poop outside the box incidents which really concerned us. I picked up a new litter box with lower lip in the front as maybe his arthritis was hurting him getting in/out, but I thought it was more he is just confused or getting old and these things just happen. Seems to make sense if a high dose can cause issues or Im just drawing too many conclusions/lines because I want them to make sense.

    Im going to run out to get the fancy feast classics & naturals in broth, then eliminate the wet rc glyco from tonights meal.
     
  20. Tanya and Ducia

    Tanya and Ducia Well-Known Member

    Joined:
    Feb 25, 2017
    it was noted here that dry stays and affects BG for some time after been removed from feeding entirely.
    Even with reduced amount I am not surprised to see highs.
     
    JeffJ likes this.
  21. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    Agree. It will be hard to regulate him and get lower BGs until the dry carbs are out of his system.

    Neuropathy can get worse. You might search it on fdmb here, it is a common topic. The resolution:
    - regulated BG (ie nadirs at 60-100)
    - Zobaline B12 supplement

    Leo had neuropathy to the point of "the decision". We resolved it per the regimen above. Neuropathy cannot always be reversed, but many kittehs get better. For Leo, it took 3-5 months to resolve.
     
    Penelope and Mačka likes this.
  22. TSP

    TSP Member

    Joined:
    May 30, 2019
    Hi Jim. I just wanted to say welcome. Love the picture :). You are in great hands here! Best of luck with the food transition. Hopefully Rocky will like a few of the new food you picked up & have no issues with them. Hang in there! Another thing you can do with your new feeder is freeze wet food servings if you want to have it open overnight or while you are away during the day (I put a tiny bit of water in with it before I freeze it).
     
    Krystina & Nelli likes this.
  23. Jim (NJ)

    Jim (NJ) Member

    Joined:
    Jul 21, 2019
    I switched Rocky over last night to Fancy feast classic pate and he loved it. I feed him 1x 3oz classic pate can for the preshot, then 1x 2oz tub of the natural chicken in delicate broth for +6. I gave him 1/32 cup of dry with both and he did not seem to care about so little dry.

    Im a bit confused on how many calories he should be getting though. Ive read 18-25 kcal per lb so for him 14lbs the range would be 252 - 350kcal. But since he is considered unregulated for atleast 2 months now, should I be feeding him more like 400-500 kcal? When I calculated what we were feeding him before with wet & dry gylcobalance, it was around 1 cup of dry = 390kcal & 2/3 can of wet = 44kcal but he always seemed hungry. We felt bad when he would cry for food but we thought he had to lose weight due to being diabetic so I feel like we have been starving him knowing the info I do now :(

    Since he is doing so well with wet food, I think I am going to switch him to all wet tomorrow. Please let me know how many kcals he should be getting now, his last pmps was still 487 :( I would love to spoil him with all the wet food he wants to eat but I dont want to do harm to him but since he is cutting out all the carbs, is it ok for the time being? Im soo lost on this one, also I have been taking test every +6 & spot test when I can. Cant wait to see a sub 300 for my guy.

    Today: 400 kcal
    7am - 3oz Fancy Feast Classic chicken & beef pate ( 3% carb & 101 kcal) + 1/32 dry glycobalance (25 kcal)
    1pm - 2oz Fancy Feast Natural chicken & beef in broth (0% carb & 49 kcal) + 1/32 dry glycobalance (25 kcal)
    7pam - 3oz Fancy Feast Classic chicken & beef pate ( 3% carb & 101 kcal) + 1/32 dry glycobalance (25 kcal)
    1am - 2oz Fancy Feast Natural chicken & beef in broth (0% carb & 49 kcal) + 1/32 dry glycobalance (25 kcal)

    Tomorrow: 450 kcal
    7am - 4.5oz Fancy Feast Classic chicken & beef pate ( 3% carb & 150 kcal)
    1pm - 3oz Fancy Feast Natural chicken & beef in broth (0% carb & 75 kcal)
    7pam - 3oz Fancy Feast Classic chicken & beef pate ( 3% carb & 150 kcal)
    1am - 4.5oz Fancy Feast Natural chicken & beef in broth (0% carb & 75 kcal)
     
    Last edited: Jul 23, 2019
    Krystina & Nelli likes this.
  24. Penelope and Mačka

    Penelope and Mačka Well-Known Member

    Joined:
    Jun 13, 2019
    Hi Jim, Funny I had that conversation with my vet yesterday. I was actually shocked by what she told me, and I am not sure it's accurate.
    I asked her about the calorie intake that Macka should get, because he's losing weight. My previous vet told me he should get 200 calories per day. So that's what I was doing, more or less: 2 1/2 cans of FF classic paté.
    The new vet calculated the calories and said that for a normally active cat (he's honestly not), 5.4 kg at the moment (about 12 pounds), he should have 360 calories per day! That's a lot more.
    Someone here told me that the FF kitten formula with chicken and turkey had more calories but still LC.
    Hope this helps!
     
  25. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    Knowledge is a big key to success in diabetes mgmt. Diet is a primary component too. You are doing the right stuff.

    I hope to see lower numbers for Rocky too. Since you just went "whole hawg" on the Fancy Feast transition - please monitor BG closely. His BG could drop a lot. It is great that he likes the new food. Our cats like nearly all the FF classic varieties.

    He is currently "always hungry" because his body is dumping out excess carbs from non-regulated diabetes. With the FF, over time, we can hope that driving hunger will change. It is common what you are seeing. And it is common for the always-hungry symptom to dissipate as Rocky gets his BG regulated.

    You are getting there. Diabetes mgmt takes time and patience.:joyful:
     
  26. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    When Leo was unregulated - during many long periods, I didn't mind seeing a little fat on him. It helped take him through some tough spots. Well, also, it made him even more soft and lovable.:eek::p
     
  27. Krystina & Nelli

    Krystina & Nelli Well-Known Member

    Joined:
    Jul 4, 2018
    :bighug:
     
  28. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Do you have a pet or baby scale? Weighing weekly will tell you if you are feeding the right amount. The vet should be able to give you an ideal weight for Rocky. My Neko was 14 lbs and maintained weight at 200 calories. Multiple smaller meals kept her feeling fuller when in high numbers.
     
  29. Jim (NJ)

    Jim (NJ) Member

    Joined:
    Jul 21, 2019
    I dont have a scale but will pick one up. His ideal weight is 14 lbs but he dropped down to as low as 12 and is currently at 13. I think I will go with 350kcal and see how he does with this. I just dont want him to gorge himself since it just seems like soo much food. I would prefer to feed him less at his +6 then his amps/pmps to make sure he wants to eat those meals but maybe even portions is better?

    Tomorrow: 350 kcal
    7am - 3oz Fancy Feast Classic chicken & beef pate ( 3% carb & 100 kcal)
    1pm - 3oz Fancy Feast Natural chicken & beef in broth (0% carb & 75 kcal)
    7pm - 3oz Fancy Feast Classic chicken & beef pate ( 3% carb & 100 kcal)
    1am - 3oz Fancy Feast Natural chicken & beef in broth (0% carb & 75 kcal)

    or

    Tomorrow: 400 kcal
    7am - 4.5oz Fancy Feast Classic chicken & beef pate ( 3% carb & 150 kcal)
    1pm - 2oz Fancy Feast Natural chicken & beef in broth (0% carb & 50 kcal)
    7pm - 4.5oz Fancy Feast Classic chicken & beef pate ( 3% carb & 150 kcal)
    1am - 2oz Fancy Feast Natural chicken & beef in broth (0% carb & 50 kcal)

    Regarding his possible quick drop in BGs with switching his food, just so I know and can plan/prepare for it. If I get below 300 on an amps/pmps, should I reduce his dosage down from 4u by a .5? I know below 150 is no shot for beginners, so Im just curious how I should be reacting for certain ranges with him & his high dose. Thanks you soo much all, it has been a great help & learning soo much each day!

    Tested tonight for ketones on a urine strip = negative. His pmps +6 @ 349 the lowest we've had so far but not by much. I just got the precision xtra today so I can do blood test for them since I read some issues about the strips. Also ordered all the Purebites flavors and Orijen which I read are like kitty crack. My guy used to love tempations so Im excited for his new rewards for all I put him through :)
     
    Last edited: Jul 24, 2019
    Krystina & Nelli and JeffJ like this.
  30. JeffJ

    JeffJ Well-Known Member

    Joined:
    Jul 7, 2016
    That's a good suggestion. I used the Beurer scale, but there are similar products on amazon.
    Beurer scale
     
  31. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    It is better to feed more in the first part of the cycle, before nadir. After nadir, the effect of the insulin is waning. Carbs added then will slow the insulin action even more, shortening duration and giving you higher preshots.

    Some kitties drop a lot at onset, and for them, a second meal just before onset can help slow the drop. Fast drops can also cause bounces. At this stage, it’s too early to say if Rocky is one of those kitties.

    We reduce dose based on nadirs, not preshots. I wouldn’t reduce if you see a yellow preshot, but you might want to test more that cycle,
     
  32. Jim (NJ)

    Jim (NJ) Member

    Joined:
    Jul 21, 2019
    Thanks for explaining Wendy! Makes alot more sense to me now. Todays amps @ 439, +6 @ 353, pmps @ 377. New lowest pmps by 75 and he was very stressed at this time due to Mom stepping on his tail by accident. I hope this is a good sign that the low carb is starting to drop his GC levels down, looking forward to his +6 tonight. Im just nervous now about overdosing and to know what amount to shot him with for amps if he is dropping rapidly.
     
  33. AEHawkeye

    AEHawkeye Member

    Joined:
    Jul 17, 2019
    Welcome! This group is an amazing resource. My guy just got diagnosed and brought home from the hospital after a hyperglycemia event last week. I couldn’t have figured it out without this group.
     
  34. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Loving the progress on that PMPS.:)

    Just to let you know, +6 may or may not be the best time to test Rocky. It is the typical Lantus nadir time, but most cats hate being predictable. :cat: Random spot checks can tell you more. My girl usually nadired between +7 and +9 on Lantus, but often earlier or later. I have seen some cats nadir at +2. Rocky’s nadir time will become more obvious as his overall numbers get lower.

    In order to maximize sleep (always my goal), might I suggest a +4 tonight. Then if he’s not down much you can catch more sleep. If he is down a lot, then you are catching the drop early and can plan when best to next test.

    A couple other suggestions. On the spreadsheet, it would be helpful to put something like “starting all wet food” in the Remarks column for that day. It is a good idea to track things that might influence blood sugars there so we can tie it to any numbers change.

    Second, on this forum, we usually start a new post each day with a link to the old one. Otherwise the posts look long and intimidating to people just starting to follow Rocky. So maybe start that new post tomorrow.
     
  35. Jim (NJ)

    Jim (NJ) Member

    Joined:
    Jul 21, 2019
    Just did pmps +3 @ 291.. 1st sub 300

    *EDIT* Just saw your latest reply Wendy as I was cheering in joy. I am exhausted from the past few days but was gonna stay up to do his +6 especially after seeing his +3 just now. If you think I should add in any others times or need to closely monitor him let me know. Soo happy to see but its only the start I know
     
    Last edited: Jul 24, 2019
    Dandelion likes this.
  36. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Awesome, doing the happy dance here. :) Maybe another test in a couple hours? Go Rocky!
     
  37. Jim (NJ)

    Jim (NJ) Member

    Joined:
    Jul 21, 2019
    pmps +6 326 :) goodnight all
     

Share This Page