Going away/Tigger not eating well

Hi all,
I am still in the process of regulating my newly diagnosed cat. We've been at it since May and are just now seeing better results.

A few things about Tigger: we switched him from free feeding dry Hills Z/D to wet Z/D twice a day. He has skin allergies that is why he is on z/d and we have decreased his prednisolone because it was interfearing with regulating him. So he's on 2.5 mg prednisolone every other day now (recent change). He was recently upped to 5 units of Vetsulin twice a day because glucose curves warranted it. He has not been eating well so I tried switching his food to Natural Balance Venison or Duck and I went too fast, now he is not eating much even after switching back to the z/d. I get a half a can in him by feeding him off my finger, then I give his shot. His numbers have been lower since upping to 5 units, boardering on too low (130 or so at 12 hours after feeding, right before giving insulin and food again.

We are going away this weekend and the pet sitter will be feeding him and injecting him. She will not be following him around to ensure he eats before injecting him and I'm very worried about him having a hypo emergency over the weekend when no one is there.

I guess my question is this: if he only eats a quater of a can and gets the 5 units, is that enough food to "cover" the administration of the Vetsulin? Of course a conversation with the vet is in order but I won't be talking to her until Thursday because we are doing another curve tomorrow at home.
Thanks for any input. I'm so glad to have found you!
Stephanie (and Tigger)

 

Hi Stephanie and Tigger,
5.0U is an awfully high dose for just a few months. It sounds like you are home testing? Will pet sitter be testing his BG before insulin? What meter are you using?

 

Hi,
He has been raised to that because he hasn't adequetly responded at lower doses probably because of the prednisolone. The most recent curve was done by me at home after his prednisolone dose was decreased. Raising it to 5 units was a result of the curve results that stayed steady all day in the 300's.

The pet sitter will not be testing prior to administration. I am wondering if it is not wise to lower the dose just while we're away and get busy regulating when we get back?

I am using the Advocate Pet Test meter.
Stephanie

 

Ok so pet meter is used. Were his doses increased by whole units? What was his starting dose? If you are able to do curves at home, why have one done at the clinic where his numbers are more likely to be stressed influenced? Has he ever had ketones? Do you only feed Z/D? What is his meal schedule? (twice a day or multiple?) Sorry for so many questions .
Would you be willing to setup a Spreadsheet (SS) and fill it in with the data you have? Majority of us won't be comfortable making a dose suggestion for going away without knowing his BG history. Safety first .

Spreadsheet template: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
Understanding SS: http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/
And Signature setup, will also be where SS link goes: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

So for pet sitter dose, all I can really say right now is yes to a lowered dose. If you're open to sharing his data, we can be more specific as to what that dose might be

 

Hi,
Yes, he was raised by whole units.

We did two curves at the vet and suspected they were high because of stress. That's why I got the meter and started doing them at home. We do one again tomorrow at home.

He's been eating/getting insulin in the morning, then again 12 hours later. His appetite was not great on the wet Z/D, that's why I tried switching the food. I wish I hadn't tried. I went too fast and he wouldn't eat it. I believe it is better quality food so when we get back, I will try to switch again, this time doing it much slower by mixing it with the z/d.

I do not have the numbers here but before upping the dose to 5 units and when he was on 5mg prednisolone every other day, his numbers were in the 400's consistantly thru the day. When we cut the prednisolone to 2.5 every other day, they dropped down to the 300's consistantly thru the day. That determined he was not "Somogyi'ing out" as the vet put it. That's when we upped the dose, then I attempted to switch food.

I just want to get him thru the weekend without me. I cannot ask the pet sitter to test, follow him around to make sure he eats, or to mix food.

Since going on the insulin (1 unit twice a day to start), his drinking and peeing have decreased considerably and he is putting on weight. He was obese but lost weight before his diagnosis. He is 12lbs now after gaining 2 back.
Thank you for your help, I don't mind the questions
Stephanie

 

Why is he on the steroid?

 

Skin/food allergies.

 

I don't have dosing advice but I do have experience with the prednisolone. Jones has gone down the scale and back up again for IBD issues.

The one thing I noticed is that it is easier to get the numbers more consistent and to help regulate the BG's is to give the prednisolone every day. And to try to time the prednisolone onset with the insulin onset. I was doing the every other day dosing and I noticed he would go low on the off steroid day and super high on steroid day. On top of that the low would sometimes cause him to bounce and have high numbers for a cycle which further mudded the waters as his body didn't know what normal was any more.

Is it possible to give 1.25mg every day vs. the 2.5 every other day? The caveat is that you will need to test because the dose Tigger is on is a larger dose and you may find you can lower the dose with this type of change. At least I did.

Did you discuss with your vet trying a different steroid? Something that is less likely to affect BG's?


For Jones (which will not be the same as your kitty) I give the 2.5 mg of prednisolone at the same time as the insulin as the prednisolone starts it onset at about +2 hours after his insulin injection which also onsets about then. Jones is on Lantus/Glargine for insulin which is long lasting so his nadir (lowest point in the insulin cycle) is about the same time as peak of the steroid. Trying to offset opposing forces.

 

Maybe ground up some of the Z/D dry that you may have left and stir into some Z/D wet. Not optimum for carb values but is just the weekend and you can keep him safe with higher BG's and then get back on track when you get back.

Hopefully some more experienced eyes will be along soon.

 

Thank you for the input Tracey. Something to think about with the pred. for sure.

 

Hey Stephanie, just saw your post on Signature info. Just stick with the basic information for your Signature, not a ton of detail. Peek around the forum to look at other's. Ideally, you'll want to include:

1. Kitty's name
2. Dx date (diagnosis date)
3. Any other health concerns
4. Insulin type
5. Meter type
6. Other medications
7. Diet
8. Time zone

 

Thanks!