Finally home testing - need help

Hi Everyone! My cat Chauncy was diagnosed with diabetes a little over two years ago. According to the fructosamine testing performed by the vet's office, he was pretty well regulated on his Lantus dose of 2.0 units twice per day. Since I did not start home testing until a few days ago, I have no idea what his typical glucose levels look like.

Everything was going okay until he suddenly lost all interest in his Purina DM dry food. I switched him over to Fancy Feast classic pates. I've known since the very beginning that low carb wet food was way better for him, but I didn't think he would eat it since he is somewhat picky and doesn't even like cat treats. And I knew that I'd have to start home testing if I was going to make a diet change like that. Luckily, the whole transition was a lot easier than I thought it would be.

So, he is now loving his new food and I'm home testing like a pro. (Well almost!) I made the mistake of giving him his full 2 unit dose on his first day back on insulin. At that point, he had missed 3 prior doses since he was not eating enough. I knew that switching to wet food could drastically reduce his insulin needs, but I freaked out and gave it to him anyway. I was worried since I had to skip the 3 doses. ..the possibility of diabetic keto acidosis and losing regulation is always in the back of my mind. Anyway, I did some spot tests yesterday and saw that he was down to 65 in the middle of the night. This was after receiving both of his 2 unit doses that day. I am working on getting the proper spreadsheets together, but here is what I've seen so far.

Saturday 7/18: About 20 minutes after PM insulin shot: 139 bg
Almost 8 hours later: 65 bg

Sunday: Not giving insulin until I figure out what to do...
7:28 am (1 hour later than I'd normally shoot): 74 bg
12:36 pm: 134 bg
2:10 pm: 168 bg

I will not be home this evening...will test again when I return around 9pm. Also should note that he eats throughout the day...I've never been able to get him to eat an entire meal at once.

So...my question is - where do I go from here? Do a glucose curve even though he's not on insulin? Start insulin again tomorrow or wait another day? And where would i even start again. 0.5 units?

Thanks in advance for all of your help! Oh - forgot to mention that im using the Relion Confirm meter. Thanks!

 

Changing the food to lower carb wet food can reduce the glucose 100-200 mg/dL and reduce the insulin dose 1-2 units.
For safety, you don't want him going below 50 mg/dL on a human glucometer and 68 mg/dL on a pet glucometer.
He stayed above 50 mg/dL, so that's good.
If you are concerned and this is the same dose you have been giving, you might cut it in half for a while until you get accustomed to his numbers on insulin and your ability to keep him safe.

 

Is he now eating OK?

 

Yes, he's eating two three ounce cans per day. He has a slightly larger than average frame and weighs about 18 lbs. His vet would like to see him get down to 15 or 16 lbs. He's 13 years old and not very active.

 

Thanks BJM. My fear is that he may have even gone lower than 65 since I've read that some cats hit their nadir at the 6 hour mark? I should've done a full curve but I was still trying to get the hang of home testing.

 

The nadir can and does move around, so yes, he might have gone lower.

Maybe cut to 1.5 units dose you've been using.

 

Thanks for your help! I am going to start him again tomorrow and check his glucose every two hours. I'll be working from home for the next two weeks so I'll be able to keep a close eye on him.

 

Hi @AllieCat,
It's great that you've started home-testing! It took me several months to works up the nerve too but now I can't imagine not doing it.
Regarding the food, it's totally fine to let Chauncy graze throughout the day. It's likely better for him that eating a large amount all at once.
Keep us posted on how he's doing on the new dose. You can always ask for dosing advice on the Lantus page too.

Joan