Hello from Riker's (overwhelmed) mom

Hello All,

Riker is my 8yo fixed male cat. He's super sweet, good natured, and loves giving head bonks. He was diagnosed as diabetic on 12/18/18. I immediately started doing all the research I could about feline diabetes and the best ways to care for him. I found multiple forums and groups, including this FDMB on Facebook....but I have to admit: I got a little confused! I've been posting in the Diabetic Cat International forum (and looking at their dosing charts) while interacting with you all on Facebook. *shakes head* I know it's important to stick with one group for consistent advice, so I'm starting over here with this introduction.

Riker was diagnosed after I noticed him drinking tons of water (with some outside the litter box accidents) and constantly asking for food. Despite the eating, he was losing weight -- shoulder blades and spine were suddenly noticeable when I pet him.

The vet put him on an initial dose of 3 units of Vetsulin 2x a day and also recommended a switch to a low carb diet. Because I didn't have a glucometer at home yet, I was worried that this dose recommendation was too high. I never gave him more than 2u while dosing blind.

I removed all dry food immediately, but it took me about a week to realize the Friskies pate I was feeding was about 13% dry matter carbs. On 12/26/2018 I switched him to Purina Pro Plan True Nature Chicken and Liver. Which I believe is under 5% dry matter carbs. (I used this calculator). I've been dosing him right after he eats. Is this bad? He has had no problem going to wet food only, but does ask for "snacks" throughout the day. Because he's slightly underweight (he was 10lbs at diagnosis) I allow him to have small meals of wet food, and sometimes plain cooked chicken throughout the day.

We started home BG testing on 12/23/2018 using an AlphaTrak 2 meter. I was just trying to get the most accurate meter, though now I've learned that I set myself up for extra expense on test strips. I've since learned that FreeStyle Insulinx strips can be substituted with the AlphaTrak 2. If true, that could save me some money.

BG testing was slow going at first, both Riker and his ears resisted! But we are in a good rhythm of testing 3x a day: AMPS, +6 and PMPS. Unfortunately, I am shooting with U40s and have been following the Vetsulin dose scale from that other forum. Fortunately, I have been home with Riker all day every day since the Friday before Christmas, and haven't noticed any behavior that would suggest an overdose. He's actually been pretty normal -- jumping up on the counter, grooming, lying in the sun -- with the exception of asking for extra food.

(Scale I've been using)
Imperial BG……….Metric BG………..Dose of insulin
151-170………….……..8.3-9.4……………….0.25u
171-185……………….9.5-10.2……………….0.50u
186-200……………..10.3-11.1……………….0.75u
201-220……………..11.2-12.2……………….1.00u
221-250……………..12.3-13.8……………….1.25u
251-290……………..13.9-16.1……………….1.50u
291-350……………..16.2-19.4……………….1.75u
351-410……………..19.5-22.7……………….2.00u
411-450……………..22.8-25.0……………….2.25u
451-500……………..25.1-27.8……………….2.50u

He went back to the vet on 12/26/2018 for a BG check. He tested 288 at +4. I explained that I had started home testing and referenced past numbers. The vet again said Riker's dose should be 3units 2x daily, but congratulated us for being so vigilant.

Here is his BG spreadsheet so far: https://docs.google.com/spreadsheets/d/1WTLPRrfYUQpYNXl4S-lPNqfZ7wpgm13qC2YW2gBIHa0/edit?usp=sharing

I'm concerned by the AMPS days in the high 400s. And the fact that he doesn't seem to be coming down very low in the middle (with the exception of that very first test). Edit: Of course right after I post this he tested 77 at +5. Siiiigh.

Everyday I become more confused and unsure! My head is swirling with everything I've read and all the variables. I just really want to get him regulated.

Questions:
-Anything I'm not doing that I should, or vice versa?
-Any advice on what these numbers mean with regard to dosing/insulin effect?
-Does FDMB have a dosing scale for Vetsulin?
-Should I be feeding in the middle of the night to avoid these high AMPS numbers? I have an auto feeder I could use.
-Yesterday and today, I've noticed his breath smelling bad. Not sweet/fruity, but kind of foul. Is this bad? Or could it be because of the new food?

Thank you so much in advance. -Beth

 

Welcome Beth
I have no experience with Vetsulin. I suggest posting in the forum for Vetsulin for more help there.
With the 77 you just tested, I would test again at +6 (or even sooner) since he seems to be coming down pretty fast and furious. With an Alpha Trak meter, that take action number is 68 or below and then feed him some higher carb food until he gets back up over 68 or even into the 80s before you back off on the carbs.
If you didn't feed him at +5, I would do so now.

 

Hi Dyana,

Yes I did feed immediately after the +5 reading. I just tested him at +6:15 and he was 159 so I think we're ok. (He's currently playing with the cotton ball I use after the prick!) And yeah, I'll copy over my questions to the Vetsulin forum. Thanks for letting me know the take action number!

 

Welcome Beth, you will get excellent advice here for your sweet baby.

Spreadsheet and everything, wow! You are well on your way and the group here will help you tweak things to help your kitty. And since he is on Vetsulin that board will be your best bet for specific dosing, etc.

Honestly it is very apparent from a lot of people’s experiences here that vets do not always give the best advice on diabetes management. Good to be safe and question something if it makes you uncomfortable. The people here have been dealing with this a long time and tend to err on the side of caution, which not all vets do.

 

Absolutely! Mixing methods will make you cray-cray!

 

Welcome