Feeding and Dosage question

Oliver has been on ProZinc for a week now and I haven't seen much improvement. On Wednesday we started trying to switch him from Dry to Wet and it has been somewhat successful. He is 17 lbs and the vet said we need to get him to around 14lbs so we have been trying to feed him on a 400 cal diet to help with that. My biggest questions is how much is considered a meal to be able to give the insulin? We were doing a half a can of wet in the morning and for the most part he did well eating almost all of it and once it was gone I would give him the insulin. If he didn't eat all of it we would get him to eat some dry to make sure he had enough in his system. We also have been leaving out small amounts of dry food for him to graze on during the day and overnight to make sure he is getting his full calorie intake and because he would just sit and meow at us if we didn't. We tried doing a whole can of food, but he just wouldn't eat it all and it was then hard to tell how many calories he has eaten. Any feedback would be appreciated.

We are starting to home test, but haven't made it habit everyday yet.
8/11- PM 307 (lowest reading yet)
8/13- PM 340 ( highest since DX, but was a little later than normal)

 

Grats on first home tests! It will be a habit in no time and part of your routine . 400 calories a day seems awful high for trying to get a kitty to lose weight, in my opinion. I calculated 260 calories per day at most for an ideal weight of 14 lbs . Just a general formula used, so it doesn't factor in things like energy levels, activity, physiology, etc. With Prozinc, since it's a lower onset insulin he should be ok with like 1oz of food or two nice tablespoons of food so half of a half big can (5.5oz) is roughly 1.4 oz of food . You could make catfoodsicles to leave out for snacks later. Freeze portions of wet food and then leave out.

Honestly, cutting the DM dry with my boy helped significantly but you'll want to establish your home testing routine, daily, before doing this, just to be safe . If Oliver absolutely loves his dry food there are 2 better options available in the U.S. only, online. Both companies will send you samples too!

Young Again Zero / Zero Mature
Dr. Elsey's Clean Protein Chicken

HERE is the Spreadsheet (SS) link since you are starting to home test now. Feel free to post any additional questions or if I've confused you. Post is slightly rushed since I'm leaving for work

 

This is helpful! I was worried half a can wasn't enough to give him the insulin. I am waiting on the vet to call so I can update her now that we are 7 days into this. I was just hoping I would notice some sort of change in him or more so than what I have seen. Sometimes he looks completely out of it and other times hes kind of playful. I have looked into the other dry food, but we literally had just bought the food and with all the vet bills we can't afford to not use it. Even though it's a higher carb content it's still better than what he was eating. I know cutting it out completely would be the best option, but i'm 7 months pregnant and don't have the emotional stability to listen to him whine so it's been nice to give him a little here and there. I have thought about leaving out the food, but we have a dog who can get on Oliver's food table, so we have been playing around with the idea of a gate that Oliver can get under, but Bear (40lbs) can't get over. I have a spreadsheet, but I haven't figured out how to add it to my signature.

Quick example. Last night we took a reading later than normal compared to his morning dose (I also gave some treats throughout the day..my bad I know) it was 340 we then put out the half can of food, he ate all but maybe a spoonful and then just laid down and looked blank if that makes sense which has been a somewhat normal sometimes he lays down a bathes after eating. Me being the worrier I am thought he hadn't eaten enough so I gave him 1/4 cup of dry and and housed it (made me feel better). This was all in probably a 30 min span. Then this morning like clockwork he woke me up at 6:15am ready for food, bright eyed and ready to go. I fed him 1/4 of the dry bc I didn't want to mess with the wet after worrying about amount the night before and is ate it all, gave him his dose and he was laying around while I got ready. I didn't get a reading bc it was already time for him to eat/get insulin and I I wasn't awake enough to properly handle him and what not.

 

Oh my goodness! I can't imagine doing this when 7 months pregnant. Kudos to you!

Give him some time to get back to normal. I know we all want to see the change right away, but he didn't become diabetic overnight...he won't get regulated overnight either.

We can definitely help you with figuring out good dosing if you'd like!

 

PS I believe to get the SS in your signature, you just copy and paste the link. It doesn't have to say Oliver's SS or anything...it can just be the link. I think to make it say Oliver's SS, you do the following:

• Copy the link from your Google doc for the SS
• In your Signature, type out whatever you want it to say (Oliver's SS or whatever)
• Highlight those words and click the little link button in the toolbar above (looks like a chain link fence a bit...7 over from the right on my screen)
• Paste the link from your Google doc in there and click Insert.

That should make the words a clickable link. Let me know if any of that doesn't make sense or doesn't work and we'll get it working!

 

Thank you!! It's been very hard on me emotionally. I got him as a kitten when I was 18 and he has literally been with me through all my ups and downs of adulthood so to see my baby sick absolutely breaks my heart. Not to mention then I feel guilty that I'm. Not focusing on the other baby. The Vet upped his dose to 1.5 and said that the half can of food is plenty so I'm less worried and he seems to like it so we are going to give it more time. I will definitely frequent these boards until I get him on the mend. It's such a great resource!

 

We can help you to help your kitty.

 

Thanks for this. I think I got it set up now

 

Great job getting the spreadsheet linked in your signature! It doesn't look like the sharing is set correctly yet though. When I click on the link, it says I have to request permission. In the top right corner of your spreadsheet there should be a blue "share" button. Click on that and select "anyone with the link can view". Then we should be able to see it.

 

Try it now and let me know!

 

I can see it now.

 

Great job! We can see it now.

Okay, ready for the next steps?

In order to get him on the mend, we need to see his blood glucose (BG) before each shot. So you'll want to test, then feed, then give the shot - in that order. We also need to see what mid-cycle numbers you can get. Especially any tests you can get between +5 and +7 (the usual nadir for most cats. Nadir = lowest BG during the cycle). That means between five and seven hours after the time when you gave the shot. Since we all live in different time zones, we tell time in hours since the shot, instead of what time the clock says. (If I'm telling you things you already know, please forgive me - I'm not sure how much you've had time to read so far).

If you work during the day, which many of us do, you can get those mid-cycle numbers on weekends or in the evenings/at night.

It's the difference between the pre-shot BG and the nadir BG that tell you if the dose is too high, too low, or just right. So the occasional tests that you've been getting are a great start, but to safely adjust the dose and help Oliver start feeling better, you'll need to collect more data. If testing is a struggle right now, please let us know what's making it difficult and we can try to help. We've all gone through our own struggles in getting all of this figured out and have lots of little tricks we've learned along the way that might help.

Testing at home will give you much more accurate information than you will get from blood tests at the vet. The reason for that is that cats get stressed at the vet, and their BG goes up much higher than it is at home. So the vet's numbers will often look like he's in far worse shape than he really is. Vets then often recommend raising the dose on falsely high numbers, resulting in overdosing the cat. I would recommend holding off on blood work at the vet until you've got a better body of at-home data that can be used to make dosing decisions. It will be much safer for Oliver to use the more accurate data you'll get while he's relaxed in his own environment.

I know that's a lot. Please ask whatever questions you have, as often as you have them. There is so much to learn at the beginning of this journey, and we are all here to help.

 

Oh, I also just noticed that you're using an AlphaTrak. Those test strips can get quite expensive, especially if you're testing regularly. Most of us use a human meter, and the protocols here are based on human meter numbers. The test strips are also much much cheaper. If you're interested in switching, we can make some recommendations. If you want to stick with the AT2, that's totally fine as well. Another option is that several people on here use the human glucometer for daily tests, and then do occasional curves at home with the AT2 in order to communicate more clearly with their vet. Again, we can support whichever option you prefer, I just wanted to make sure you know that it's completely fine to use a human meter.

 

Thank you for this information! I know we need to test more, but it's hard for me to do that to him which is why we haven't. It's a two person job also at the moment and it works well when my husband does it and I hold Oliver. I think the only time we could get a +5 or +7 is on the weekends as I physically can't stay up long enough for that at night and get up and function in the AM (almost 8 months pregnant).

 

We literally just bought the AT2 so I think we will just stick with it even though it's pricey.

 

Oh my! Forgot that you were pregnant. Any data you can get is good data, so on weekdays if you can try to get a before bed test...even if it's +2, that's fine. At the beginning, all data is helpful. I used to only get mid cycles during the weekends and if I..er...happened to wake up during the night. I'd get other tests just when I could to help.

We'd be happy to help you get the testing routine down so it isn't as upsetting for either of you. Most of our cats come running at test time now...eve though they didn't at first! They really do get used to it and it doesn't hurt much since they have fewer nerve endings in their ears. If you let us know some about your test routine, we'd be happy to help. I know it'll be easier for you if it's less traumatic all round!

 

Your kitty is very handsome! Kudos to you for taking on home testing. I agree with Rachels' advice to do what you can for now. You have a lot on your plate - with more to come soon!

 

Thank you for saying that! I feel like sometimes you get shamed here for not testing all the time and we just aren't there yet. I think those that have been doing this a while forget what it's like in the beginning and that it's more of an adjustment for us humans vs felines. I don't know that we have a routine yet, but we are getting there.

 

Thank you! I call him handsome all the time and my husband just looks at me and shakes his head, lol.

 

Yes, this is a very data-centric place and many members test A LOT. I truly understand that feeling of pressure to test more from comments here and when looking at others' spreadsheets. At the start you have to build your skills and then move on to getting a data base of BG patterns to use as reference. Once you have that down then you'll find what works best for you and also keeps your kitty safe from hypos. I'm a big promoter of the happy medium myself!

 

I have to tag @Waheeda because Oliver kind of reminds me of her boy, Jebat .

Don't be too hard on yourself Kris (Oliver's Mum), you are trying and that's important. I didn't test the first week because I was looking at meter's and then when I made my choice, I injured myself and could barely move to give my boy his shots. Had to ask the neighbour to come over, pick him up so I could administer the shot at standing level. When I wasn't dosing off from the pain, it's amazing how exhausting being in pain can be , I was pretty much starring at Maury lol. Once that was over, I established my routine, still a rough start as I wasn't a morning person and slowly started becoming a data junkie . It helped me feel a little less anxious because I knew what his BG was. I honestly hated shooting blindly. So hang in there, you'll get better at it too . You can ALWAYS ask us questions or for any tips

 

Yes, Oliver does look like my Jebat! And we call him handsome too. He's a proud cat who walks with his tail vertically up.
Take it easy Oliver's mum. After you get the hang of testing, it will become easier and a routine. Don't be surprise when you become a serial poker one day .

 

We definitely don't want you to feel in any way shamed for not testing more! Remember when looking at our spreadsheets, many of us became data junkies over time. Most of us get more tests than necessary because...well...we just WANT to. It's really not necessary to test as much as a lot of us do. We DO always promote home testing and sometimes we might ask you to get a test in at a certain time, but if you can't for whatever reason, just let us know. We really are just asking usually and we'll tell you why...or if we don't just ask us why!

Please don't get upset if we forget that you can't test in the middle of the night or anything. We have a hard time keeping people straight at first...usually over time we recall your specific circumstances, but it takes some time!

And definitely don't be hard on yourself. You're doing what you can, and that's all anyone can ask!

 

I was able to test over this past weekend and compared to the numbers from the previous weekend I don't understand what is happening. We switched to all wet this weekend and he probably ate close to two cans each day, half at meal times and then I left the rest out for grazing a couple hours after insulin and then would pick it up 2 hours before PM test. I know we need him to lose weight, but am I feeding him too much. I thought with removing dry I would see some improvement, but so far nothing. I am down to 3 test strips until I can order more on Friday so I was saving them in the even the vet ups his dose.

Thoughts?

Friskies Pate- all flavors

 

Hmmm...so you switched to the wet this weekend? I'd give it a few more days to see if it improves his numbers. It can bring them down immediately, but ECID (every cat is different)...and maybe Oliver just needs some adjustment!

He is staying pretty high...and those midcycles you've been able to get (thank you for those! they help) tell us that it's probably not bouncing. It's possible he goes lower later, but with those purple +5s, I think it's unlikely. My guess is that he's just in high numbers right now...no particular reason. Like I said, it may be that he needs a few days for the food change to take effect. Hopefully that's it and he goes down some...if not, we can look at changing the dose to help bring him down.

How are YOU doing with everything?

 

Thanks for the feedback. I was unable to test this morning as he woke me up about 2.5 hours before breakfast whining so I gave him 1/4 a can and knew it would probably screw the number. I plan to test tonight after I get home from work. His bowl is usually empty when I get home so I am not as worried that he ate recently. We did weigh him yesterday and we think he has lost a little weight based on us weighing ourselves and then with him. The vet said he needed to get down to about 13-14 lbs from 17. I think that might be too low as he already seems less flabby if that's possible.

I am doing okay. I go through spurts of being SUPER emotional and upset that my baby is still sick and then other days I am just going with the flow. I also suffer from anxiety so I just have to remind myself that this is the right thing for him. He still purrs at me and gets semi-playful from time to time so I know he is still in there. I think acceptance is the hardest part and then adjusting to the schedule and routine.

Our vet is back today from a conference so I will be updating her and getting her recommendation on whether to up the dose or stay the course. She didn't recommend we switch to all wet food so I am hoping she sees it as a positive change. I will update everyone once I hear back from her!

 

We are upping the dose to 2.5 in the hopes it's his magic number!

 

Good luck with new dose! Are you also testing for ketones weekly? Just to be safe while he's in higher numbers

 

No, that's something the vet hasn't mentioned at all. Before all this started we thought he had a tumor on his tail, when we switched his food the bump got smaller so they are thinking it was a fatty bump, but we were getting ready to do a biopsy and a dental cleaning. When I check in with her next week I am going to see if that something we should go ahead and do and then do another round of bloodwork. What do you think? He doesn't go to the bathroom much now being on all wet food and doesn't seem to be getting sick or anything and has a healthy appetite.

 

It's just something I was recommended to start when I joined here. I worry about DKA and other things

 

I have anxiety so I have to keep my worrying to a minimum or else I would go crazy. Not to mention high blood pressure which isn't good for the little girl I'm growing. If we don't see some improvement after this week of upping the dose or something changes for the worse in his habits I will look into that.

 

DKA isn't likely to happen, but it DOES happen. I'd say it's not something to worry about at all, but just something to check for. Usually, DKA comes from not enough insulin, not enough food, and an infection. So if he's eating and seems all right, I would just try to get a ketone test in when you can for peace of mind. However...any chance hubby could do it? I don't know a lot about it, but I know you aren't supposed to clean litter boxes when pregnant (I think) and I KNOW you don't want to be crouching down trying to catch cat pee when 8 months along!!!

Seriously, though, I have bad anxiety too and I find that what calms me most is to know things are going well. I do know it's harder when your hormones are involved but just take a deep breath and remind yourself you're not alone! If you need to vent, cry, or just rant for a bit, we're here! You do what you can and your boy will be okay. Remember that he's more than just a number...if he seems okay, he probably is okay.

 

Here are some ways to get a urine sample for a ketone test:

• put the end of the test strip right in his urine stream as he's peeing
• slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
• put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.

Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.

 

That is correct I haven't been able to change the litter box since February and I can't say I am mad about it! My husband on the other hand can't wait to not have to do it every 2 days! It is getting harder and harder to bend down and I usually regret it after I do it. We will look into this after we see what his numbers are like and if his behavior changes. The thought of trying to get a urine sample right now just for piece of mind sounds exhausting. Lol. I am going to test before bed tonight to see what this dose does to him at +4 and this one day this weekend we are going to do another 4 day reading. If he seems to be going into the lower range we will start testing pre-shot more regularly.

Last night he was more social than he has been and I don't think it was because he was hungry like normal. He played a little bit with his favorite toys and begged for treats which he used to to nightly, but hasn't for some time now.

The only issue we are running into is he is waking us up at about 4:15am hungry. We leave out 1/2 can before we go to bed say 10 or 10:30 and it's gone when I go to check it after he gets me up. There is no way to sleep with him meowing in hunger and I am not going to shut him in a room until 6am breakfast, so I have been giving him 1/4 can to nibble on until then. Since I haven't been testing in the AM this hasn't been an issue. We are also concerned that our dog might be getting on Oliver's little table where his food is. We are getting a gate with a cat door today to see if maybe that is the issue.

*sigh* this marathon is making me tired, but looking forward to a 3 day weekend!

 

Thanks, this will come in handy if it's something we need to do! TBD for now!

 

These are important things to keep note of too
And Maury has his own spoon as well, it's labeled his and sits on the litter box.