Advice please - skeptical of vet

Discussion in 'Feline Health - (The Main Forum)' started by Matthew Brennan, May 22, 2017.

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  1. Matthew Brennan

    Matthew Brennan Member

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    May 22, 2017
    Hey folks,

    Would appreciate any advice as I am looking to home test my cat. He is 15, and about a year ago was diagnosed diabetic. His symptoms where a bad coat, drinking a lot and always hungry.

    After a lot of vet appointments they "got it under control". Currently I give him 4 units of caninsulin twice a day. However, his symptoms still remain, bad coat, drinking a lot etc. The vet tell me though his levels are "fine".

    Id love to believe them but I dont. For that reason I would like to start home testing, but im out of my depth. What do I need (meter wise) to start, and how do I test him and use the results to alter the units of caninsulin he gets.

    Any and all advice would be great! Thanks!
     
  2. Shenandoah

    Shenandoah Member

    Joined:
    Nov 25, 2015
    Welcome! Sorry you had to find us under these circumstances, but don't worry, this is a great place to learn!

    There are some great resources on the main page for home testing at
    http://www.felinediabetes.com/bg-home-test.htm
    and http://www.felinediabetes.com/bg-test.htm

    It looks a bit overwhelming at first, but feel free to ask any questions as you go along. There are many very experienced people here to help.

    Pretty much any glucose monitor will do. If you're in the US, a lot of us use the Relion confirm or Relion micro (from Walmart). There are other options available from Walgreens, CVS, etc. There's a pet specific one, the AlphaTrack, but the strips are more expensive so most people here don't use it. There are some conversions between the numbers of a human reader vs a pet reader, but most of what you'll read on this site is based on using a human reader.
    But since you're using Caninsulin, I'm guessing you might be located in a different country? If so, let us know where you are and someone can probably recommend a meter you can find nearby.

    Testing is nerve wracking in the beginning, but it's pretty straightforward. You just need a meter, test strips, and lancets (some people also use the lancet gun, some of us just poke freehand).
    You make a small poke in your kitty's ear, and then put the test strip against it. In a few seconds the reader will spit out the current blood glucose level. There are a lot of tips in the pages I linked above about how to be more successful, and how to make it a more pleasant experience for both you and your cat. Or ask here if you run into any issues. We've all been overwhelmed at first, so you can get a lot of advice on how to work through any part of it you struggle with.

    Home testing is a great idea. It's the only way to truly know what's going on with your cat, as the numbers change constantly throughout the day, and numbers read at a vet's office may not reflect those at home due to stress (increases BG levels).

    Once you are testing, be sure to check out the Caninsulin specific forum at http://www.felinediabetes.com/FDMB/forums/caninsulin-vetsulin-and-n-nph.19/
    They can give the best advice about working with your specific insulin, and how to adjust the dosage.
     
  3. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    Setting up your Signature and getting your Spreadsheet up for sharing can allow experienced members to help you get your kitty's numbers under better control too. Not mandatory but highly recommended ;)
     
  4. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    4 units is a fairly large dose.... More than most cats ever need.... I would be nervous dosing that much without careful testing, so I'm glad you are going to try it.

    I use an Alphatrak pet meter, but the strips are pricy.... If cost is a concern, many on here use a Walmart relion micro or confirm human meter. Testing is fairly simple... You can watch how I do it on the video in my signature.


    What you'll want to buy is the meter,
    About 100 test strips
    A box of 28 gauge lancets
    Cotton rounds
    And neosporin ointment with pain relief


    Once you start testing set up a spreadsheet and we can advise on dosing.
     
  5. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    Welcome, and good for you for taking control of your kitty's health! Your story is a common one around here, sad to say. I don't know why, but many vets seem to think that pet owners just won't be willing to put in the time to properly care for a diabetic pet, and as a result they take a very limited approach.

    You'll soon find that home testing your cat's glucose is a really powerful tool for getting control of his diabetes and (hopefully) get him feeling better. It feels awkward at first, but soon becomes second nature for both of you. Most important tip: always follow up test attempts (successful or otherwise!) with a treat. My cat has been in remission for a year so I only test her occasionally, but all I have to do is walk by the spot where we do our tests and she will go running over there eagerly!

    Last thing: I agree with Janet about the dose. Very glad you are testing!
     
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  6. Matthew Brennan

    Matthew Brennan Member

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    May 22, 2017
  7. Matthew Brennan

    Matthew Brennan Member

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    May 22, 2017
    Last question! Once you do the curve, how often do you test the blood glucose?
     
  8. Shenandoah

    Shenandoah Member

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    Nov 25, 2015
    I'll let someone else answer on the meter, since I'm not familiar with UK equipment.

    For testing, you want to do periodic curves, test before every shot to make sure they're in a range that's safe to shoot, and as much possible test close to nadir (the time when the blood glucose drops the lowest in between shots - will vary based on type of insulin and your specific cat, but after doing a couple curves you should know when that occurs. The caninsulin forum can give you an estimate of where to expect it).

    Test any time you see suspicious behavior (possible hypo).

    Then a lot of people throw in random other tests whenever they can. The more data you have, the easier it is to figure out correct dosing.
     
  9. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    See if you can find a meter that takes a 0.3 blood sample. This one requires 0.6 which is large for a cat.
     
  10. Yong

    Yong Well-Known Member

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    Jan 11, 2017
    Most important tests are daily AMPS and PMPS (morning/evening pre-shot tests) to make sure they are safe to give current dose :). I'll tag some of our UK members to see which meters they use. Only Elizabeth and Bertie had hers listed: One Touch Ultra but @Diana&Tom and @Anthony Morgan are also UK. One of my Prozinc buddies is in Scotland, she uses Bayer Contour XT meter @Blair & Freya :cat:

    Matthew, please check out the links in my previous post on setting up your Signature when you have a moment ;)
     
  11. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Hi Matthew! Sorry I'm a bit late to this. You're in the right place to treat your kitty for FD, that's for sure. What's your kitty's name and where are you in the UK? There aren't a lot of us on this board but we always try to help with "local knowledge" as much as we can so keep asking questions. It is sometimes a good idea to write UK in the title of a thread, if you're asking for specific UK-based info - foods as well as meters and any other equipment - otherwise the advice you'll get is the same from everywhere.

    You ask specifically about meters. The One Touch Ultra is good and reliable, and additional strips are readily available on ebay (don't pay full price at the chemist or you will soon bankrupt yourself!). Members here also like the Code-free (from Amazon) which I've read is easy to use and is good for getting more strips (the main cost you will incur when testing). You'll also need a supply of lancets.

    Once you have your meter, you can practise on yourself a few times to get the hang of it - it really is just a knack and you'll be fine, but keep coming here and asking any questions you may need.

    As far as a curve is concerned - a full curve is every two hours of a 12-hour cycle, but whilst you're still practising the knack, you might just want to take pre-shot (before insulin) tests, otherwise it can get quite stressful for you and kitty! With Caninsulin, an insulin with a fairly quick "onset", it is interesting to note the blood glucose drops in the early part of the cycle, and then about halfway through to try to identify a "nadir" (lowest point). Once you start to collect data and keep a spreadsheet, we can look at how the insulin is working and discuss an adjustment if necessary. Four units is a high dose and it doesn't sound from what you say that your kitty is regulated (whatever the vet says) so depending on your data, it may be worth reducing the dose and seeing if that makes an improvement.

    The other thing that can help is food. What are you feeding? The ideal for diabetics (and all cats come to that) is a good quality low-carb wet food. If your kitty currently eats dry, switching to wet may drop BGs, BUT you should be home-testing to make sure numbers don't drop TOO much... on 4u it is quite possible that numbers could go too low with a lower-carb diet. @Elizabeth and Bertie has a link on her signature that can help with foods and she is also a very experienced member who may have something to add about meters as well.

    Good luck and keep us informed!

    Diana
     
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  12. Matthew Brennan

    Matthew Brennan Member

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    May 22, 2017
    Great info guy thanks. I am in Northern Ireland.

    Basically the vet upped his dosage fairly quickly from 1unit, 2 unit .. until we hit 4. He did have an "episode" about 6months ago where he took a fit/siezure - which was highly unpleasant for him and me. He has seemed fine since, but the past few weeks very hungry and thirsty. I suspect the vet will simply up his dosage again - so time to take control of it myself and treat him correctly!

    A big issue (maybe) is he will only eat chicken. He will not eat cat foot, or dry food. This is not a favourite food thing, he simply will not eat cat food. And he cant really eat dry food as he hasnt very many teeth left. So its just cooked chicken he eats.

    Any thoughts about chicken diet and his diabeties. He is fed 9am, 2pm and 9pm. Sometimes around dinner time too if he is looking.
     
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  13. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    Well, kudos to you Matthew for taking the initiative! We are delighted here when we see new people being pro-active and wanting to do the very best for their cats! You will get as much help as you need.

    It sounds as if the vet has raised insulin dose too quickly. You would usually start at 1u and give it a couple of weeks to see what effect that has, and if numbers aren't budging much, work up in maybe 0.5u increments until you find a dose that does what you want. It MAY be that 4u is ok, but it also MAY not be... we don't know until you start testing. I am guessing that the vet is going by the results of sporadic fructosamine tests, which simply give an average of a cat's BGs over a period of time... not ideal at all, as there may be some very high and very low numbers in there which is not a sign of a regulated cat. (Vets, it has to be said, are not all experts on FD... they have very little training on it and tend to go by the rule book which is not really appropriate with a disease like FD. But luckily it is manageable at home.)

    So first, get a meter. I think I'd give the Code-Free a go, in your shoes.

    As for diet - chicken is certainly better than dry food, but the problem is that it is not a "complete" food in itself... it doesn't contain some of the nutrients cats need. I'm not an expert on this but I think there are supplements you can get... I will tag another of our UK members, @Marlena , who is very good on this subject!
     
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  14. Marvin's Mom - Nat

    Marvin's Mom - Nat Well-Known Member

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    Apr 10, 2017
    Hello Matthew, I am new so will leave the advice to those with more experience. I think it's great that you are you want to take charge of this. This forum is excellent, and the people are great. You will get a lot of advice, and sometimes may feel overwhelmed, all cats are different and you know your cat best. just remember that. Hugs and wishing you both the best.
     
  15. Marvin's Mom - Nat

    Marvin's Mom - Nat Well-Known Member

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    Apr 10, 2017
  16. Blair & Freya

    Blair & Freya Member

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    Mar 19, 2017
    Yeah, I use the Contour XT, which takes the Contour Next strips. There's no coding. When I looked, the strips seemed cheaper than the Accu-Chek ones that a lot of people use, and I order them online -- whether from Amazon (in a bind, as it's more expensive that way) or from reputable eBay sellers (which is much cheaper).

    I saw the CodeFree mentioned, but I guess I was a bit skeptical of it. I've heard good things about the One Touch Ultra, though.
     
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  17. Matthew Brennan

    Matthew Brennan Member

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    May 22, 2017
    Contour XT purchased. I guess when I do a full day curve and show you guys, you will be able to help me going forward.

    On the food front. Can anyone recommend a supplement to make sure he is getting all the nutrition he needs? (Although, he's 15 and only ever ate chicken, so that's not my main concern).
     
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  18. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    @Marlena
     
  19. Tanya and Ducia

    Tanya and Ducia Well-Known Member

    Joined:
    Feb 25, 2017
    Hello Matthew, welcome!
    There are some members who used to serve home made raw food using the premix supplement from THIS site. @Wendy&Neko
    I believe is one of those members and maybe she can help you further with the issue. The site says that supplements are ok for the cooked food, too but I'd make some more research and wait to get more responses re:cooked food supplement.

    THIS blog by renowned US vet/cat nutrition guru has lot of info on feeding kitties properly. It's very informative good read - cooked v. raw and also in the recipe section there is list of all supplements necessary to make cat's food complete/balance at home.

    I am very glad to hear that you are starting home testings - no more hypo events for your kitty! (What's his name?)
     
  20. Anthony Morgan

    Anthony Morgan Member

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    Feb 16, 2017
    Hi Matthew,
    Sorry I am late in responding and I see you now have a meter. I am in the UK and my cat is on 1.0 u of Can insulin twice a day.
    I bought the Alphatrak 2 from my vets. It was over £100 and the testing strips are over £80 for 50.
    I have found them on line at Animed for half that price. But the meter does work well and will read from the tiniest sample.
    Shelley had a hypo earlier this year and her BG levels are constantly changing so I have a problem knowing how much to inject.
    Just thought I would make contact and would be happy to exchange information on the subject.
    Kind regards, Anthony
     
  21. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    My kitty got up to 5 units of Caninsulin - some cats need larger doses of insulin than others. Home testing the blood sugars will tell you whether 4 units is a good dose or not.

    Tanya gave you a link to one website that sells premixes for cooked food. Alnutrin is another that offers low carb premixes for either cooked or raw chicken. Both FoodFurLife and Alnutrin are in the US. TC Feline is another premix, that is sold from Germany to other parts of Europe. But their produce is primarily for raw food. Dr. Lisa Pierson has a page on making cat food, and you can make your own premix with that recipe.
     
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  22. Matthew Brennan

    Matthew Brennan Member

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    May 22, 2017
    Yeah, Timmy (my cat) is fairly large, so I can kinda see why the dosage may be so high.

    However, his night hunger and his bad coat gives me cause for concern. The Bayer supplier said there was a delay, so went ahead and ordered the AlphaTrak - the expense doesnt bother me so much. Will wait for delivery, do a 24hour test and report back!
     
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  23. Anthony Morgan

    Anthony Morgan Member

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    Feb 16, 2017
    Matthew, thanks, I will be interested to see how it goes.
    My cat Shelley is not very agile and fairly compliant so getting the blood samples is not too bad.
    Hope it goes OK!
     
  24. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    Sounds like you are on top of things!

    Testing is going to get you the information you need about Timmy's dose and its appropriateness for him. It can be tough to figure out when you've already been giving insulin for a while and have an established dose, though, so please do post when you get some numbers-- we're always happy to help try to sort these things out!

    It can take a little while to get "up and running" with testing, so on the first few days I'd focus on just getting pre-shot numbers plus (if you can) a test about 3 or 4 hours after the shot to see how it's going. I don't know how long it's going to take to get the meter, but in the meantime you might want to practice the pokes so that both you and Timmy will be used to the process.

    Another thing to keep in mind: don't expect the patterns from any one day to give you the answer about the appropriateness of a dose. What you'll be seeing over a given day is not just the reaction to that day's insulin dose, but also (possibly) the aftereffects of what happened to blood glucose on previous days. Most importantly, there is a phenomenon we call "bouncing", in which a cat's body reacts to low BG on one day by releasing a bunch of glucose into the blood and raising BG, sometimes by hundreds of points. This phenomenon can last up to three days, so if you happen to be testing on a "bounce" day, you'll be getting an incomplete picture.

    The "bouncing" phenomenon is also why the clinical signs you're seeing (eating, drinking, poor coat), which on the surface look like the effects of a too-low dose, could actually be from a too-high dose-- if the dose is too high, the cat will be spending a lot of time in bounces with high BG and all that comes with it. Really, it could go either way, though (too high or too low)-- the best way to tell is from testing, it's such a good thing that you are going to start doing that!
     
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  25. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Just got the machine and ran a test.

    Alphatrak(US) read 97mg/dl about 3 hours after his shot.

    Where can I find information about these numbers and what is a good range?

    Thanks
     
  26. Anthony Morgan

    Anthony Morgan Member

    Joined:
    Feb 16, 2017
    Hi Matthew,
    You might find this link useful;
    http://petdiabetes.wikia.com/wiki/Blood_sugar_guidelines

    I use the UK number system which I am more familiar with.
    I think 97 is about 5.3. That is in the right area but wouldn't want to drop much lower depending upon when your cats nadir is. With Shelley it is around 4 hours but can be up to 6.
    With Shelley I would encourage her to eat something at 4 hours just to keep the BG up a little.
    Hope this helps but I am not an expert.
    Anthony

    PS . I was advised to use the ? Icon in my post title if I was asking a question. Might help with more responses but I think it is just quiet on here at the moment.
     
    Last edited: May 25, 2017
    Reason for edit: PS
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  27. Matthew Brennan

    Matthew Brennan Member

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    May 22, 2017
    Just done one 2 hours later and its now 295. Did 2 tests to confirm (295 and 297). Surely thats weird?
     
  28. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    Well, you're doing an amazing job to be testing with zilch fusss, Matthew. "Just ran a test..." - we hardly ever hear that from a newbie to testing so well done!

    OK so to convert US numbers into numbers the rest of the world uses, divide by 18. And to convert world numbers to US ones, multiply by 18. If you have time, because this is a global (albeit mainly US board), you can use both numbers in your posts, so maybe stick to one version first and put the other in brackets. Be consistent if you can.

    97 at +3 is a good number *in itself* but lowish for early in the cycle, as Anthony says. The higher number at +5 would either suggest that the insulin has all been used up, or it might be a food spike, or the cat is "bouncing", ie reacting to too high a dose.

    A clearer picture/pattern might emerge after a few days of testing, and we can see whether this was an unusual reaction or in fact quite a common one. Cats do vary a lot, anything can happen!
     
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  29. Matthew Brennan

    Matthew Brennan Member

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    May 22, 2017
    Awesome advice as always guys. Doing every 2 hours now for the next 24 hours. He usually sleeps all day, and meows for food all night - so I am really interested to find out how his levels fluctuate during the night! Will keep you all posted.
     
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  30. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    Just checking in-- looks like you're getting great input from others here! I'll just add a couple things: first, I think the "normal non-diabetic cat" range is usually given as something like 70-150mg/dL on the AT2. So as Diana says, that 97 is a great number, just maybe a little low for being early in the cycle. Once you get a bit more data under your belt we'll better know what a number like that means for your kitty, but if you start dipping below 100 early again, one thing you can do is give him a little snack of low-carb food. That can help to slow down any dives, which also helps to reduce bouncing.

    Second: yeah, that 297 is a little extreme, but not an impossible bounce (especially with the AT2, which runs higher than the human meters a lot of us use). If it is a bounce, he's likely going to stay high for the rest of the day, but we'll see!

    Great job testing!
     
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  31. Matthew Brennan

    Matthew Brennan Member

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    May 22, 2017
    Levels have went 97 - 297 - 524 - 568 (and yes I checked the calibration).

    So it looks like his caninsulin is wearing off too quickly throughout the 12 hours? I guess once he gets his 4units in a few hours time, the resulting few tests will tell a story.
     
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  32. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    Yes, it will be interesting to see how the evening cycle goes, but for right now, wowza, it sure looks like Timmy is not only not getting good duration from the caninsulin, but that he is a champion bouncer!
     
  33. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    Looks like it, yes... and although we've been saying that 4u is a high dose, it's always possible that your cat does need higher than average doses. There are some conditions that might present in that way. Or yes, he could be bouncing.

    Yes, the more data you get the better. Could you give us the results in this format:

    AMPS (morning pre-shot) - xx (bg number)
    +2 - xx
    +4 - xx
    +6 - xx
    +8 - xx
    +10 - xx
    PMPS (evening pre-shot) - xx

    That's a curve at a glance and enables us to see quickly what's going on. If you can give both world and US numbers as I explained earlier, so much the better. This will soon be second nature!
     
  34. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Im just spouting numbers as I record them for now. By 12 tomorrow I will have a full 24 hour curve done, that will tell all.

    Forgive the lack of knowledge on that subject. My thinking is that if he is ging from 97 to high 500's over the course of 12 hours that the dose of insulin is wearing off too quickly? Is that not correct?

    Secondly, can someone explain bouncing to me, and the causes for it?
     
  35. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    This is a VERY steep ascent you're seeing and it would suggest that the insulin is wearing off quickly. Caninsulin has what's called a fast onset - it starts working quickly - but not a very good duration. It's very common to see numbers rise after the first half of the cycle, but this is very steep. Your poor kitty won't be feeling too great with these fluctuations.

    So he MAY be a big gulper of insulin.

    OR he could be bouncing. If a cat is given too much insulin, the body may try to counteract that as a defence mechanism against going too low (hypo) and this can result in higher numbers than would be seen if the "correct" dose was given. I'm not very good at explaining this but that's the simple version.

    Have you read any of the other threads on this forum with similar queries in the heading? That might give you some insight.
     
  36. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    Yes, indeed-- I sent off a quick post just now, but Diana is exactly right, we can't assume that this big climb is due to a bounce. He could just be one of those cats that needs a lot of insulin. It's likely going to take more than one day of readings to help sort this out.

    We speak of readings in terms of "+" times-- number of hours that have passed since the most recent shot. You mentioned the first two readings were taking 3 and 5 hours post-shot, so assuming you're going every two hours, here's what I have so far in this notation:

    +3 97
    +5 297
    +7 524
    +9 528

    If those times are wrong let me know and I'll correct them. We find it helpful to use this notation because we have people all over the world, in a lot of different time zones!
     
  37. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Spot on Nan, those times are correct. Thank you. I think im filling out the spreadsheet correct too. Timmy is just about to have his PM 4units insulin, so going to do a pre shot test, then one in two hours etc.

    Quick question. Would a higher dose of insulin stabalize his glucose over the 12 hours. Or would it be a case of moving to a shot every 6 hours? Im still learning, but surely if you increase the units to increase the length of time it lasts, you are also increasing the initial "hit" of insulin and could push him into low blood glucose?
     
  38. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    Ah yes, I can see your spreadsheet! Either I missed it before or that is new, either way it looks great!

    Those are really tough questions to answer, but I'll tackle the second one first. I don't know of anyone who does every-6hr dosing in a home situation-- unless you have a lot of help and/or are some kind of superhuman who doesn't need sleep, the schedule would be absolutely brutal. I have heard of every-8hr dosing, but it's not something we currently do around here (no direct expertise at present). It's also a brutal schedule. If it turns out that Timmy is consistently getting a too-short duration out of the caninsulin, before considering either of these schedules I think a better option would be looking into switching to a longer-acting insulin like ProZinc, Lantus, or Levemir.

    Back to the first question: is there a caninsulin dose that's going to work for Timmy to keep his glucose in a better range for most of the day? The answer to that is, we don't know yet (we don't even know yet whether that "good" dose is likely to be higher or lower than his current one), but it is possible-- we've had some cats do quite well on short-acting insulins, even occasionally going into remission. The short duration of caninsulin makes things harder, but it's not impossible. You'll be fighting against his body's tendency to shoot up (as he did this afternoon), but on the other hand, the more time he spends in "normal" numbers, the more used to those numbers his body will get and the more chances his pancreas has to do some healing. It becomes a virtuous cycle-- the more time in the normal numbers, the easier it is to get him and keep him in those normal numbers. He's been diabetic for a while, which makes it harder, but if you can get that healing process started, good things can happen!
     
  39. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Higher doses don't necessarily mean longer duration, they may mean steeper drops which as you say might cause hypo. But higher doses MAY last longer also. The whole thing about FD is that every cat is different and there is no one formula that applies to every cat, nor one formula that applies to any one cat every day. This is called a "dance" and it will certainly keep you on your toes.

    There is no one protocol that suggests dosing every six hours... Caninsulin is usually doses twice a day at evenly spaced intervals. But when you are more experienced you could if necessary look at sliding scale dosing which would mean regular testing and giving a variable dose depending on the BG.

    If after a while you aren't getting good results you can talk to your vet about switching to a longer lasting insulin. Not all insulins suit all cats.

    There is a lot to learn but you can pick up a lot from reading all over this site.
     
  40. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Just looked at your ss, Matthew... that last number you got is worrying, it's almost off the scale. Some meters may give you a reading of HI in such an instance.
    These numbers today definitely show that Timmy is not regulated so where your vet got that from is a mystery. These very high numbers are almost undoubtedly what is causing the poor coat condition and hunger.
    Have you had Timmy checked out for any other conditions that might be causing these high BGs? Infection can do that, or teeth problems. I think if it was me I'd be challenging the vet with these numbers and asking him to justify what I think you said he called "fine". If it helps you to know - quite a few people here change their vets after being on this board for a short time, to one who actually knows what they're dealing with in FD.
     
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  41. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    He does have a cold at the minute if that would affect it, although his number was low (97) earlier in the day. Anxiously waiting to do him post insulin shot here in an hour or so to see what it is at.
     
  42. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    Yes, this next test may give some important clues.

    I agree. I'm thinking the vet's assessment might just be based on a spot-check in the office in midday (when Timmy might be in the 100-300 range, based on today's numbers). Lots of vets consider anything in the 200's "regulated", whatever else is happening with the cat :banghead:.
     
  43. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    Took a peek at the spreadsheet, and it looks like Timmy is dropping a lot-- from 602 at pre-shot, to 273 at +2 and 153 at +4.

    If you haven't done so already, please make sure Timmy has a little snack-- low carb food for now, and not too much (just a snack)-- to try to slow him down. If his evening cycle is like his morning, he's about to reverse course and shoot to the moon, but I'm not comfortable with the current downward trajectory and don't want to take any chances.

    With this, and knowing that it is still early days, I'm leaning more towards the "too much insulin" hypothesis. We didn't know where he started when he hit the 97 this morning, but now we have seen him have a very strong reaction to insulin. It's not that he isn't getting enough to bring his numbers down-- he clearly is.

    I'm not experienced enough with Caninsulin/Vetsulin to make any specific dosing suggestions, and I'm interested to hear the opinions of those who do have more experience, but just based on what we've seen today I would be inclined to try a dose reduction tomorrow morning, even if he's back to being sky-high at pre-shot.

    So glad you are testing now!!!!
     
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  44. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    Important addendum: if you do end up reducing the insulin dose, definitely also start testing for ketones (a good thing to do with a diabetic cat regardless). The last thing you want to do is trigger a DKA (very very serious-- and expensive-- health crisis). Especially since he currently has a cold-- the "recipe" for ketones is: not enough insulin + not eating/drinking + an infection or other systemic stress, so if you reduce insulin you potentially have two out of three going.
     
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  45. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Alright guys, as you can see from the spreadsheet, a full day has been done. Here is his morning and nightime curves.

    [​IMG]

    [​IMG]

    He has 4 units this morning again. I just wanted to see how it went during the day again to back up yesterdays results.

    Do you guys think I should start by lowering the dosage? If so but how much, half a unit?
     
  46. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Well, these curves are very typical of Caninsulin's action... steep drops and steep rises. We really need to work out how to smooth things out somewhat so the curve is gentler. It is very difficult to say how much to reduce the dose... a reduction might just mean that the climb starts earlier in the cycle because the insulin is used up faster. This is very much trial and error. Sometimes we suggest going back to a starting dose of 1 or maybe 2 units, just to start over and work from that basis. But with high pre-shots like you're getting that might not do much. I think I'd be inclined to try 3u for today and see what that does... keep a note of numbers and we can discuss again. BTW when you are changing a dose it is better to stick to it for a few days to allow the cat's body to get used to it... too many dose changes too quickly just confuses the picture.

    I'm off to work now but will check in later, and our friends over the pond will be around in a few hours too.
     
  47. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    There are people who have done 3 shots a day such as @cashy ... It would require a lot of monitoring and is hard for most to be home that often, but it is an option. So you would take the total units and divide it by three... So you might do 2.5 every 8 hours
     
  48. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    Have been doing some more thinking about these patterns, and what I'm struck by most is how well-behaved those curves are-- they really do look like "classic" Caninsulin curves, just on the extreme end of range across the day. In a way, this is really good-- it makes Timmy's patterns more clear and easier to interpret than they otherwise might be. It's really just duration of the shot and range of BG numbers experienced that are the problems. No wonder Timmy is still showing poor clinical signs-- he's not only spending lots of time in (very) high numbers, being yanked around like that every day has got to feel really yucky.

    I defer to the experts like Diana on how to adjust Caninsulin to try to get a flatter curve (I simply don't have any experience with this), but I'll put a plug in here for the longer-acting insulins like Lantus as another option to explore in the future if that proves difficult. Lantus isn't as good at bringing high numbers down, but it is better at keeping low numbers low and (eventually) producing very flat curves. I'm hopeful that there will be a "good" Caninsulin dose for Timmy, but if not, there are other options.

    Glad you just posted this, Janet. I was thinking about this as well, after seeing these curves. The thing is, the 3x/day dosing is just so hard on the caregiver-- I could see doing it for a limited time (recovery from DKA, or perhaps for a cat you had hopes could be bumped into remission quickly), but as a long-term dosing strategy it would be really rough. It definitely is one way to "fix" the short duration issue, though, and that does seem to be a big problem, if not the big problem, here.
     
  49. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Just testing today again, his "low" doesnt seem to be going anywhere near 97. I think testing for a few more days before making any changes might be wise, to get a more "average" daily pattern.

    3x a day injections is no issues for me - I work from home (if that is indeed the cure to stability).
     
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  50. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Matthew, you might have to be prepared for the long haul here... all our suggestions are only that, starting points to collect data, from which point it becomes easier to see what the insulin is doing etc. So if one suggestion doesn't work, we try another, etc etc until we start to get somewhere and can fine-tune. I hope this makes sense?

    Dosing with Caninsulin is tricky in some ways and ok in others... because it does have a fast onset (ie gets to work quickly), it is often used up quickly (short duration), leaving the second half of the cycle without much if any insulin in the cat at all. (FYI - Caninsulin is actually designed to work in dogs, not cats... cats' metabolism is different which means that some cats don't do too well on this insulin. But here in the UK it is prescribed first, so worth giving it your best shot.) So in that sense, it's not easy to work with because we need to cover as much of the 12-hour cycle as possible. But on the plus side, it's an "in and out" insulin - once it's gone, used up, that's it, it's pretty much out of the cat's system which usually makes it safe to dose again when numbers start to rise at an appropriate point in the cycle. Eight-hour dosing is probably ideal for a lot of cats on Caninsulin, but as Nan has said, it's hard work for the care-giver and needs a lot of commitment on an ongoing basis.

    Nan, I'm not really an expert on Caninsulin at all, I just know from my own experience, and that of many others on this board over my ten-year membership of FDMB, how tricky it can be to get that gentle "smile" of a curve rather than the big "grin" that Timmy demonstrates so graphically above. I thought about it too before my earlier post today - some people would recommend going back to 1u but I just can't see that doing much at all with such high pre-shots. If the pre-shot numbers were lower, we could suggest a lower dose, but readings verging on HI need to be brought down as quickly and safely as possible.

    So as I've been saying, it really is trial and error at the moment, until we start to see these high numbers budging. You could try shooting a token dose when numbers are very clearly on the rise, but I couldn't recommend that to someone just starting out home-testing and without more data.

    If, further down the line, you can't get better numbers for Timmy on Caninsulin, there would probably be a case of asking the vet for a longer-lasting insulin.

    FD is a marathon, not a sprint!
     
  51. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    Trust me, Diana, you are more of an expert than I am! I've never used Caninsulin, and I haven't been around long enough to see a lot of examples of dosing strategies for this insulin. Beyond the very basics of short-term safety (that 97 yesterday worried me!), I am hesitant to make suggestions on longer-term strategy.

    Matthew, I think it's a really good plan to keep collecting data for a while. You are monitoring, so you'll be able to keep Timmy safe, and you'll gain a lot of good information about what is going on with him. You're doing great!
     
  52. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Here is a foody question.

    I usually feed him "sliced chicken", prebought from Tesco. Its always been his favourite over say - a cut up chicken breast. Just checking the packaging, I see it contains 0.3g of sugar per 100grams.

    Is feeding him this bad? Should I be just using plain chicken breast or is 0.3g per 100g an insignificant amount?
     
  53. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    Pretty sure you're OK with that. We usually go by %calories from carbs, and try to keep it under 10%. Can't do the calculation without all of the macronutrient data, but I cannot imagine how you could get above 10% with 0.3g per 100g!
     
  54. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Thanks guys, the help and knowledge so far on here has been amazing. His levels havent come close to 97 today, curious as to why they where so low yesterday. A few days testing should tell the real story.
     
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  55. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    his preshot yesterday was probably lower.
     
  56. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    His green and blue numbers from yesterday are probably causing some bouncing. I do have to wonder if his unbalanced diet is playing a part. Timmy just eats plain Chicken, correct?

    Written by Kris & Teasel:
    Here's how bouncing works:
    1. BG goes low OR lower than usual OR drops too quickly.
    2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
    3. 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.
    4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
    5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
    6. 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.
    7. Many vets have little/no understanding of the bouncing phenomenon.
     
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  57. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Burning through my strips, and dont get the next delivery of them until Tuesday doh - so 2 hours testing it off. Its going to be preshot +6 testing for the next few days.

    Timmy just eats plain chicken yes. I tend to feed him small amounts when he is looking these days. 3 times a day and I find he is very hungry between feeds. In terms of working out if he is bouncing or not, should I keep him on the same dose for a few days and monitor?
     
  58. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    He's hungry for at least 1 reason, the other is just my suspicion.
    1. Uncontrolled diabetes. His body is literally starving and not able to properly absorb nutrients from food.
    *Just my opinion* 2. He's not really getting proper nutrients anyway even when his diabetes gets under better control.

    Usually with bouncing you want to hold the dose, unless there's an obvious need to change it. Like being much lower for pre-shot. Since you were recommended to lower to 3.0U, hold that dose.

    If I offended you in anyway about his diet it is not my intention, and I tried to say it as politely as I can, then you can feel free to ask that I not respond to your postings anymore. :) I am aware I can be a little bold at times.
     
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  59. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Yong is right, uncontrolled diabetes does make a cat hungry all the time. Feeding three times a day may not be sufficient - many people leave food out pretty much all the time to allow their cat to graze. And as I think I said yesterday, chicken on its own is not a "complete" diet so ideally I would think about adding in some good-quality commercial cat food that does contain essential nutrients. The best I've found, and the nearest to what we recognise as flakes of cooked chicken, is the Sainsbury's Delicious range... if you can get hold of that (it is sold in boxes of six pouches) you can mix a little with some of Timmy's preferred plain chicken at each meal and try to get him used to that so he is at least getting a more balanced diet.

    It's a shame you're running out of strips as that means the plan to monitor / collect data isn't going to be quite the same. You could really do with some tests in the early part of the cycle. Do you know any human diabetics with a meter (and strips) that you could borrow for the weekend? A human meter reads slightly differently to a pet one but you would at least have an approximate idea of what's going on.

    As Yong also says, feel free to disregard what any of us say if you wish... We all have our own opinions based on personal experiences and learning, but at the end of the day we have to do what feels right for our own cats. Trust your gut. What we all have in common is a wish for a better quality of life for all the kitties whose owners come to this board looking for support, but if you're not comfortable with what any of us are suggesting, that's fine. You're on a steep learning curve but you have great commitment and that's half the battle. Anyway, if you could keep your ss up to date we will be able to see what's going on.
     
  60. Sharon14

    Sharon14 Well-Known Member

    Joined:
    Aug 16, 2015
    Yong is right, if all you're feeding is cooked chicken without proper supplements, Timmy is not getting all the nutrients he needs to be healthy. If you're doing this temporarily because that's all he'll eat, then you need to start offering and even assist feeding him some proper food, that contains all the vitamins and minerals that cats need, such as taurine.
     
  61. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Are there any powders or oils available to add to food to allow him to get the nutrients needed? If he even smells or sees anything in his chicken that is not the chicken he knows and loves, he will walk away from it and not eat it.
     
  62. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Try offering fancy feast purely. (You can probably find it cheaper in the store). Fancy Feast Appetizers Natural White Meat Chicken Cat Food, 2-Ounce Pouch, Pack of 10 https://www.amazon.com/dp/B005OPQKN2/ref=cm_sw_r_cp_api_LrukzbQAJ8Z4B

    Maybe a product like this could be used to add to the food. Call the company and talk to them.... They have excellent costumer service.
    http://www.youngagainpetfood.com/phone/carnivoreraw-with-calcium.html
     
  63. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Matthew is in the UK.
    I have asked one of our UK members who is knowledgeable about supplements etc to look in.
     
  64. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    AHHH ok. Forgot about that. Maybe he can find something similar.
     
  65. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Worst case of he tastes supplements and won't eat, maybe you can get a caplet of a vitamin of some sort in him.
     
  66. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Great news. Went and bought a "cat supplement paste" today which has all the vitamins and nutrients he needs in it, but I also bought some "chicken breast" flavoured cat food flakes.. and he loves it. So hopefully the paste wont be required. If he keeps eating this new cat food then that should definitely help his diet.
     
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  67. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Very glad to hear you've found a new food that Timmy likes, Matthew. What brand is it? Is it definitely a complete food and not a complementary food? Just to be sure... there are so many cat foods available these days! Hopefully it is complete and Timmy will certainly be getting better nutrition. You can still give him pieces of cooked chicken as snacks or treats after BG tests (try to do that).

    I'm concerned though to see the high numbers during Timmy's cycle today and have just asked someone I know who is very experienced in these things but doesn't come to the board much... she feels it's possible that these high numbers are bounces. We've mentioned this as a possibility on this thread as well as the possibility of Timmy being a big gulper. As you've been giving Timmy 4u for a while now and recent tests show that it's not his ideal dose, I really would consider dropping the dose now and see if that helps. If you try 3u you should still see a drop but perhaps less of a climb, so that might give us a clue. No guarantees. But it could be a step in the right direction. 3u would still be a higher than average dose for most cats and may or may not be right for Timmy. A lower dose might be better... but we don't know without more data... nobody knows. As I keep saying (sorry) it's trial and error.
     
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  68. Marlena

    Marlena Well-Known Member

    Joined:
    Nov 25, 2015
    Dear Matthew!
    Your kitty's health really depends on what you feed him.
    Cats requirements for certain nutrients are vital and you just won't get your kitty healthy without fixing his food.
    I'm not quite clear what you have been feeding your cat all his life so if you don't mind please give me more information.
    From what I have read so far it seems that you kitty eats plain chicken (not cat food) and now you are trying to add some flakes or paste to his diet. Please correct me and clarify.
    If I may suggest could you please purchase wet quality cat food which says on a packet that it is a complete one. You can find those made from chicken but there are other wonderful meats in those as well and I think it would be a good idea to try different meats as feeding just chicken is not balance and a lot of cats are actually allergic to it.
    There is a lot of information on this board about feline nutrition and it is paramount that you try to follow that as whatever you do to treat your kitty and you are a good dad that you are helping with his diabetes but your kitty is in real danger if he eats unbalanced diet.
    Have you discussed Timmy's diet with your vet?
    I would like to make food suggestion for you:
    1. there is a list of foods for diabetic kitties in the UK
    2. I like Natures Menu Country Hunter - google it, it is available in pet shops but it is not cheap
    3. make your own
    Please don't just settle on the fact that Timmy only likes chicken! I have seen many people who seemed to be so adamant that their kitty would only eat so and so but after our suggestion to try different things they managed to transition their cats to healthy foods. There are ways of doing so and we are here to guide you, just let us know that you are ready!
    Does Timmy go out at all?
    Cats eat mice and birds (and rabbits often). This is their natural food and they have in it everything they need. Can you see how far away from it is a piece of chicken? Good feline food manufacturers try to copy that nutritional profile of species appropriate diet and it makes sense to feed your cat like that.
    I have made a mistake of feeding my baby cat home made unbalanced diet and he got very sick. It was a long time ago, I'm glad I wised up!
    Now I have a dog (Rottweiler/GS cross) and my kitty Rocky and I've been feeding them species appropriate diet for many years. It is a homemade raw feeding including bones and it is a very expensive way of feeding because the dog is big and active and his food intake is huge - about 1.5 kg of meat a day. I'm not suggesting that you need to do that, there are other ways but I'm just giving you options if you're interested.
    You said that you work from home so I suspect you're very computer literate and you could do you own research on proper feline nutrition and equipped with this knowledge you will sail through feeding your kitty properly.
    I hope I got you interested in the subject, just ask us any questions.
    Other members will be able to give you more detailed information with regards to what's available in commercially prepared foods.
    On the subject of insulin I would suggest that you change Timmy to Prozinc - you could discuss this with your vet. But it is a subject for another post - it requires more discussion.
    Sending best regards to you and chin scratches for Timmy.
    Marlena and Rocky:cat::cat::cat:
     
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  69. Marlena

    Marlena Well-Known Member

    Joined:
    Nov 25, 2015
    Diana, I'm pretty sure that we are seeing bounces here as Timmy drops from very high numbers to low (for him) numbers. Unfortunately Vetsulin works like that, I had the same with Rocky. After that we can see very high flat curves which look like insulin is not working. I would change to a different insulin asap.
     
  70. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Great responses here from Marlena, Matthew - I think the consensus now is that Timmy is bouncing. As we've briefly discussed here, Caninsulin can be tricky to dose because of the way it is utilised in cats. My suggestion as before is to decrease the dose and see the effects of that, and yes, discuss other insulin options with your vet asap. You could spend weeks and months fighting a losing battle and Timmy really does need to get out of those horrible high numbers asap.
    See what your vet says and if he/she disagrees, just show them your spreadsheet which speaks for itself.
     
  71. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Have you put any more thought into trying 2-2.5 units every 8 hours?
     
  72. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Hey guys, can I just again thank everyone for taking the time to give such great help and advice.

    Timmy has always ate chicken or tuna his whole life. This is either just cooked chicken, or tuna chunks. This was discussed with the vet (which now has a serious question mark above their head) and was told it was absolutely fine. When he was diagnosed a year ago with diabeties, and his coat didnt improve after he was "normalized - according to the vet", they gave me an omega 3 oil to add to this food. I do add this regularily.

    The food I found yesterday is a "wet" cat food. This is it:
    https://www.pet-supermarket.co.uk/A...xIOPrQu_b1d7SIoFyzPod2QfMi8VDznDuUGgK_3vD_BwE

    I also found this:
    https://www.amazon.co.uk/Vets-Best-Multi-System-Support-Cats/dp/B01GZTQPNA - although I tried hidinga bit in his food, and he ate everything but the paste!

    Unfortunately after today, I am out of strips to Tuesday. A complete oversight at my end - as a few strips displayed error and had to be discarded. So tomorrow I wont be able to monitor at all. However, I am back on it with a box of 300 from Tuesday onward.

    His starting point before injection time was much lower today, so I agree with the bouncing theory. I gave him 3 units today and will continue with that, and monitor for a few days and hopefully that helps. Will also get a vet appointment booked asap, although am looking for a better vet to be honest. I have lost all faith with my current one. I had another poor fellow who developed an ear tumour, which was removed. A year later he started looking unhappy one week, took him to the same vet and was told after a few days of testing all was well - he died of heart failure 2 nights later. I also have another beautiful cat, who suffered a stroke but made a full recovery. I should become a vet myself with all these patients! ha :)

    Anyway, I am keen to get Timmy down to green numbers quickly, so to recap.

    1. Keep him eating this better food.
    2. Lower insulin to 3units and monitor.
    3. Get a vet appointment and discuss trying a different insulin.

    Is their anything else I should be doing?

    Oh, one final point. I have read online that FreeStyle Lite strips work with the AlphaTrak2 memter - anyone has experience with this?
     
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  73. Marlena

    Marlena Well-Known Member

    Joined:
    Nov 25, 2015
    Matthew!
    I have look at Timmy's SS.
    The first line showed green number and then you had lots of black ones.
    When kitty goes down to green number suddenly his liver would try to compensate to save his life and would throw glucose which would than be seen as a black number. This is a classic bounce as we call it. Insulin dose should be LOWERED for few cycles to see what happens. When body stops panicking the levels of glucose should level up. I think we can see it happening already today as you lowered the dose and you seeing better numbers.
    You can always start increasing the dose of insulin if you have more data. What we advocate here is to start with lower dose and go higher if you need to.
    Let's wait and see.
    Good luck.
     
  74. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Thanks Marlena. Im annoyed I wont be able to track him tomorrow. But Tuesday on I will be doing 2 - 3 hours tests for a few days to track his levels.

    I should be ok keeping him down at 3units tomorrow even if I cant track until Tuesday?
     
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  75. Marlena

    Marlena Well-Known Member

    Joined:
    Nov 25, 2015
    Matthew!
    I use FF lite test strips with A Trak and they work so well and are half the price of ATr test strips! They read very similarly. When buying them at a pharmacy you can try to negotiate the price. They cost about £27, you might be able to find them cheaper somewhere.
    We have a list of approved commercial cat food but I would have to ask another member to find it for you.
    So I understand that you will try different feeding for Timmy, is that right? You forgot to tell me if Timmy is indoor only cat, please clarify.
    Change of vet is paramount.
    Sorry about my brief and slightly chaotic post but I'm in a hurry at the moment.
    Congrats on your commitment to Timmy, you've got a heart of gold!
     
  76. Marlena

    Marlena Well-Known Member

    Joined:
    Nov 25, 2015
  77. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Good to see you taking all this seriously, Matthew. There's a lot to take in but it does fall into place after a while. I agree - you need a new vet. Maybe ring around a couple of local practices and ask if any of the vets have a special interest in FD... it's not exactly likely, but some more on-the-ball vets do take it upon themselves to research more than what they get told at vet school, ie precious little.

    OK, food... the Applaws you bought for Timmy is probably an improvement on plain chicken or tuna, but if you look at the description it says "complementary". This means not complete, but complementary or secondary to a "complete" food. It's fine to carry on feeding if he likes it, but ideally you do want a complete food containing all the nutrients that are essential to good health. Timmy may have done ok so far on chicken and tuna, but as he gets older you do need to get the essential vitamins etc into him. So, carry on looking for "complete" foods. As I recommended before, one of the best is Sainsbury's Delicious range - it really does look like chicken should, and contains all the nutrients needed. If you're not near a Sainsbury's do you know someone who could pick up some boxes for you - or order online of course.

    As for dosing, it is so hard to say, but I'd keep to the 3u and then start testing again asap. It may be that the 3u is still too high and you might need to try 2u or even 1u, but there isn't much point doing that until you're testing again. It will be very interesting to see how he responds to a few days of a lower dose. Meanwhile, just keep a close eye on him of course - be aware of any unusual symptoms.

    Great job!
     
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  78. Marlena

    Marlena Well-Known Member

    Joined:
    Nov 25, 2015
    Matthew,
    there is always a pharmacy open every day even on holidays (short hours). Supermarkets are open and they have pharmacies in them and most pharmacies stock Freedom Freestyle test strips so please try to buy them asap as you should monitor your kitty.
    I'm not sure what dose of insulin you should use but 3 units might still be too much.
     
  79. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    I would not recommend giving 3 or 4u of Caninsulin or monkeying with the dose without monitoring. You can use the Freestyle strips in the AT2 meter and while the readings won't be as accurate as they would be with the batch tested AT2 strips using the right code for the AT2 strios, they would still be in the ballpark. There are at least 5 cat codes on the AT2 meter and the different codes will give very slightly different results but a number of people use the FS strips and are quite happy with them.
    I suggest if you want to go that route at least to tide you over till Tuesday, to go get them before you run out of AT2 strips and do a comparison by dual testing on the same drop of blood to see how different the readings are. Leave the AT2 meter set to the cat code you are currently using. That will give you a baseline to work with.
     
  80. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Thanks guys. Will grab some of the Delicious range tomorrow and see how he likes it.

    Timmy used to be an out door cat, however these days he is very very much an indoor cat.

    I have rang some local pharmacies already, and non seem to have the Freestyle strips. They all seem to only have accu-check strips?
     
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  81. Marlena

    Marlena Well-Known Member

    Joined:
    Nov 25, 2015
    I so agree with Diana!
    If you like Matthew I will find you a good vet in your area but you need to tell me where you live, you could do that in a private message so nobody else would get that information.
     
  82. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Ignore that last message. Sainsburys pharmacy do them- off to get some!

    I live in Ballymena, Northern Ireland. (Not to worried about private messaging you that :) )

    Thanks!
     
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  83. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Hi again - just looked at the Applaws range... it's the PATE version you need to seek out, it's a complete food which is what you're after. Maybe try that and the Sainsbury's one.

    Re dose... yes, 3u might still be too much, the reason I was suggesting that is that Timmy is used to 4u (with no testing data) and if the dose goes much lower he may still be up in the high 600s simply because of what he is used to. It really is a tough call. We've seen people drop to a lower dose when the cat is bouncing and getting little variance from the numbers at the higher dose. In an ideal world you would start out at 1u and increase by half-unit increments every few days until you reach a point where pre-shot numbers aren't so high as to justify a highish dose. Have a think about this and go with your instinct.
     
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  84. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Are they open though Matthew? Sunday trading hours...?
     
  85. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Freedom strips bought. Just did a back to back test. Alphatrak was 549, Freedom was 583.

    How should I go about the different, just work with it. Or subtract 40ish off any Freedom strip test?
     
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  86. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    It's within the variance. You could get readings like that from two different alphatrak strips from the same drop.
     
  87. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Great news to have strips!! not familiar with how to compare, but if you can't get a definitive answer just use the numbers you get as a good guideline.
    Anyway, now you can test again more frequently. Just seen your latest number.. it looks as if the drop of 1u isn't making much difference in terms of bounce effect. Although it's not ideal to chop and change too often, you may have to reduce the dose again and see it that reduces the bounce... perhaps try 2.5 or even 2u tonight but what do other members think? Starting over at 1u or 1.5u could also be a plan... soooo hard to say and it is as always all down to the individual cat.
     
  88. Marlena

    Marlena Well-Known Member

    Joined:
    Nov 25, 2015
    Well done!
    These readings are very similar, ignore the difference. You could take the number which is in between (566).
     
  89. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    It's common for the FS strips to read roughly 5-10% higher than the AT2 strips so the difference depends on the specific reading and you won't ever know what that difference is given there is meter variance involved too. I'd make a note on your spreadsheet in the comments or otherwise to indicate use of FS strips and just work with the numbers as they are.
     
  90. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Hi Matthew
    Just had a look at Timmy's latest numbers... the 3u doesn't seem to have made any appreciable difference and he has a very high number again this morning. I see that you've given 2u today so let's hope that helps... it may well bring numbers down to start with, as the other doses have done, but maybe not rise quite so high in the latter part of the cycle... only time will tell, but if you're around today and able to do a few tests that would be very useful.

    If the 2u doesn't show a different pattern today, I'd stick with it for another day or two. Perceived wisdom seems to be, when reducing doses to counteract suspected bouncing, to decrease the dose by 20-50% for two or three days, and monitor. Another school of thought is to start over at 1u, keep to that for a few days and gradually increase if necessary.

    It's so hard to figure out what's going on here... it may take time, and meanwhile I think a new vet might be in order. It may be that the initial 1u dose wasn't given enough time to work before it was raised... if it were me I would definitely be looking for a vet with more experience in FD, or at the very least one who specialises in feline health (some vets are more experienced with dogs or other small animals, for example). It may be an idea to take Timmy for a check-up - you mentioned that he had a cold, or what is probably medically termed a respiratory tract infection, amd that could well be raising his BGs as well.

    Keep us posted.
     
  91. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Honestly since you said you can manage it, I would try the 3 times a day 8 hour approach. I'd try it for the week and see what happens.
     
  92. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Trying him on 2units today. If that doesnt work will start 3 times a day. What units should I be giving him if I go 3 times a day? 2.5/3?
     
  93. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    I would do 2.5 three times a day to start
     
    Last edited: May 29, 2017
  94. Marlena

    Marlena Well-Known Member

    Joined:
    Nov 25, 2015
    I would try few cycles (3 days - 6 cycles) on 2 units twice a day because if kitty bounces it takes at least 2 days to "clear" the bounce. If after those few days you still have high numbers you can increase the dose or try 3 times a day dosing but I would like to see more data on how Timmy reacts to insulin.
     
  95. Marlena

    Marlena Well-Known Member

    Joined:
    Nov 25, 2015
    Matthew,
    I forgot to mention something very important:
    have you read about insulin you are using, do you know how it works?
    also I think you should be posting on vetsulin/Caninsulin forum.
    The thing you are looking for when you do a curve is a gentle curve like a bottom lip shape not a deep valley shape and the lowest point of the curve should be less then 50% of your starting BG so if you have BG of 600 the lowest point should be no less than 300. So this is what you should aim at first. If your numbers is 600 and kitty goes into 200 range although it is still not a very low number your cat's liver will try to compensate for the very steep drop and you will have a very high number again.
    So you could see bounces for sometime which is stressful for the kitty. Things are complicated even more when you use insulin like Vetsulin/Caninsulin because you will see big drops in 2 hours and than 5-6 hours after injection as it is insulin composed of two different types of insulin: one very quick acting and one longer acting. It might be very risky to use it every 8 hours.
    Another very important thing: have you managed to sort out Timmy's diet? It is important that he eats something at injection times and at expected nadirs.
     
  96. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    There's a lot going on here, a lot of options. I'd like to see what happens over the 2u cycle... so far the drop isn't as dramatic as on higher doses, and with this lower dose, bg may now either shoot right up or stay around that level for longer because there may be less of a bounce... I think it's a matter of taking each cycle as it comes, and sticking with one dose for two or three days if possible to get a clearer picture.
    Matthew, you could also post on the C/V forum where you did last week, or maybe go over there and add a link to this thread. The more experienced eyes you get on this the better.
     
  97. Matthew Brennan

    Matthew Brennan Member

    Joined:
    May 22, 2017
    Going to keep Timmy on a dosage of 2U for a few days as recommended and see how the bg looks. The BG hasnt come down so far today, curious to see how high it goes back up too.
     
  98. Diana&Tom

    Diana&Tom Well-Known Member

    Joined:
    Dec 29, 2009
    Yes - let us know when you get a +6.
     
  99. srk4cats

    srk4cats Well-Known Member

    Joined:
    Jan 19, 2017
     
  100. srk4cats

    srk4cats Well-Known Member

    Joined:
    Jan 19, 2017
    Chicken is good, but mice are even better. Why don't cat food companies make their food from mice?
     
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