Help For Molly

Created a new thread from High numbers!

 

Hurray! Thanks for doing this, Adrienne.

Aside from not liking the ear pokes, how is Molly feeling and behaving these days? Any word from the vet yet?

 

Molly is feeling great! she has this tower that is three tier with balls on it. She plays with that at least 5 times a day or more. I think she thinks she's hungry? she'll stare at her food dish. I think she's testing me I'll put some dry out on the floor for her to eat. She's gained weight and looks better. She loves laying in front of our fireplace to keep warm
I do worry about her too much, she's a pretty spoiled cat!
No word from the vet, I have a feeling I won't hear from him.

 

You can give her wet food if she’s hungry?

 

Molly is going to be very hungry until she is better regulated, as her little system is just not able to utilize her food properly. More frequently fed small meals is a recommendation for our sugar cats. If you have to be away, you could use a timed feeder or freeze canned food in ice cube trays and leave a cube or two out for her to snack on.

 

Yes, I agree that you could try little snacks of wet food between meals. A timed feeder is great for that.

 

Ok, thank you for the advice. She had her wet food this morning. I only put 1/2 cup of dry in her dish. Gave her a couple of the freeeze dried treats. I find in the evening she’s worse for hunger! She’ll stare me down for food ☹️

 

Just give her a little tablespoon of her wet? For a snack?

 

Yes, that's a good idea for when you're home. It'll get her eating more wet food and maybe less dry. I mention a timed feeder. Many people use then so kitty has snacks through the day or night when they're at work or sleeping. If Molly is your only kitty it would work well for you.

 

I see that you dropped the dose to 2 u this AM. Are you starting the switch to low carb wet food in earnest? Please make sure you get a pre shot test in the evening and one before bed.
@MrWorfMen's Mom and I will rely on those to assess the insulin dosing. It's the only way we'll know what advice to give you in this important stage of the food switch.

 

I started to cut back her dry food. More SO wet maybe I misunderstood what @MrWorfMen's Mom had said? Yes I'll do a preshot after work today. Didn't yesterday wasn't home til late. Start doing one tonight before bed.

 

Here's what @MrWorfMen's Mom said and you're doing it. It's a good plan. I'm sorry if I confused you - I had to review it myself.

Cut the dose back to 2u as soon as you start reducing the dry food amount.
Feed 3/4 cup of dry and continue with the wet SO but give her a bit more of the wet food to make up for the calories you have removed by reducing the dry food allotment.
Maintain that for 2 days. This will allow you to hone your testing skills and allow monitoring to see how the reduction in carbs is affecting Molly.
Then reduce the dry to 1/2 cup daily for a couple of days, again adding in more SO wet to make up for the calories in the 1/4 cup of dry you've taken away.
Repeat until the dry is out of the picture and all Molly is eating is the SO wet.
Then we'll get you to start reducing the amount of SO wet food and replacing it with the Low carb wet food. By this time, I'm sure you will be a testing pro!

 

You are right Adrienne. Cut back on the dry food and give more of the wet food to make up for less dry. Molly still needs her calories but we are changing where she gets them from.
Grab tests when you can so we can track how Molly's BG is being affected by the food change each day.

 

No, you didn't confuse me just thought maybe I read it wrong. I printed off ^^ and put on my fridge. Molly was really hyper this morning, she was literally climbing the walls.

 

Ok Perfect, I noticed she's hungry more and looking for more food. How often can and how many of the dried freeze treats can I give her? I poke on the edge of the year and just a little blood comes out. I use the rice sock. I have to keep going in the ear a little more. Then she really bleeds

 

As you test more, Molly's ears will grow more capillaries and it should get easier to get a sample with one poke most of the time. You are doing everything right. You can try massaging Molly's ear from her head up to where you poked to encourage a blood bead to form. If she suddenly is bleeding a lot, yo umay have hit the vein. Try to poke just outside the vein right along the outer edge of her ear. We've all hit the vein on occasion but it can be messy and cause some bruising.

Right now, you can feed Molly a little more than you normally would. Diabetics cannot process the food they eat efficiently so they tend to be hungry all the time. Giving Molly some extra food to eat as a snack between meals might help calm down her angst for food at shot time.

The freeze dried treats have zero carbs so you can give her a few pieces without any worries. I tend to be pretty liberal with the freeze dried treats with my crew.

 

Give her snacks of S/O wet food if she's really hungry. It might satisfy her more. In the short term it'll be fine carb-wise, calorie-wise, etc. The S/O dry is very likely higher in both carbs and calories. More of the freeze dried treats is fine too.

She'll bleed more if you happen to hit the little vein. Some people have better luck just pressing on the edge of the ear with the lancet and not doing a jabbing poke. Some poke twice very close together and that works better for them. You'll figure out what works best for you. Keeping calm through it all is key though.

 

I just tested her BG still high. Only 3/4 cup of food today increased her wet. I guess I’m expecting a miracle!

 

Keep up the plan. Caution is important. I think you see a significant drop in BG down the line when she's eating only low carb wet fod and freeze dried treats. It takes time to do it safely.

 

The decrease in insulin won’t hurt her?

 

No, because it won't go on for a long time. She should be eating only S/O wet in a week or so. Removing all S/O dry might lower her BG because it's likely even higher in carbs than the wet. If you want to speed up the removal of the dry S/O it shouldn't affect her tummy or be unsafe. You can then introduce fractions of low carb wet sooner while still being cautious.

 

Ok I was talking to my mother. She put the scare in me. About decreasing her dose. She’s looking for more of the dry. She has some left out of the 3/4 cup. But I fed her wet this morning and at 4pm. Plus a little a lunch about a tablespoon.

 

Well, you'll have to think about what you want to do yourself. We'll help any way we can.

 

I’m sticking with the plan. Will she lose weight? She just gained weight back?

 

She should be OK if she eats enough low carb wet food. Also, kitties hang on to weight better when their BG is regulated in lower numbers.

 

Hey, I like that lower PS this AM! And you did great getting a PMPS last night.

 

Me too hopefully the afternoon one won't be high.

 

I still have to feed her a little bit of the wet in the morning. Before I test that's ok right?

 

That's fine. Just feed a bit then test as soon as you can. It generally takes 15 to 20 minutes for food to start affecting BG.

 

Don't worry if it is. The hope is that there'll be a downward trend in BGs over time as the food switch gets accomplished. It's best not to fret over individual numbers.

 

I was thinking of buying some low carb wet today. Giving it to her for treats? where she is looking for more food.

 

OOOOOHHHHH! I love that pink start today!

You could get some low carb wet to give her for snacks and that would allow you to see what flavours Molly likes going forward. It would be good to know what to buy when you are ready to transition her over to the low carb wet for meals.

 

I know I was soo happy to see the pink today I hope the afternoon numbers are not higher. Now where she has had history with urinary crystals. Do I mix the wet with water?

 

Good idea from Linda. Check out Dr. Pierson's chart or just buy some Fancy Feast pate styles. They're good options to try.
https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

You might also try adding a teaspoon of warm water to her wet food so she gets accustomed to that. Increase the amount as she'll tolerate because it really is a good way to hydrate her and keep the bladder flushed.

 

I printed off the fancy feast page of the chart. So I know what to look for when I'm shopping.

 

Why’s her BG high this afternoon?

 

That rise could be a few things. For starters, the depot from the higher dose of Lantus is waning at this point in time and you have only reduced the carbs in Molly's diet by a small amount so far. She could also be bouncing a bit from a lower BG sometime last night or earlier in this cycle. Usual nadir with Lantus would be between 4 and 7 hours post shot but every cat is different. The more data we have, the easier it is to determine what is going on. The reduced dose may cause a bit of a rise temporarily but for safety reasons while you transition to low carb food, it's better for Molly run a bit high than too low.

 

This will take a little while. Don't lose heart!

 

Ok, the vet called and said to raise her insulin to 6 units. Wow that’s high he was away. He left me a voicemail. I’ve noticed she’s not eating as much dry today. I bought the fancy feast and she likes it.

 

I definitely would NOT raise the dose to 6u under any circumstances. First of all, 1u dose changes are too much all at once and can cause you to totally pass over the ideal dose for your kitty. In Molly's case you are changing her diet which will no doubt result in her needing less insulin so an increase now could be dangerous. I would stick with the plan right now and if Molly's BG continues to be high as the transition to low carb food continues, we can re-evaluate the insulin dose.

 

I’m not increasing her dose. Leaving it as is! I just pray that we. Can get her BG down!

 

Just curious why her BG is higher in the evening than in the morning?

 

Without more info during the cycles it's hard to say. It could be that Molly is dropping more during the day cycle than we know about. Is it possible to get a test earlier in the day cycle? That might offer a clue. I'm thinking sometime between +4 and +7 instead of at +9 would be helpful. It would also be veyr helpful if you could get another test at night like right before you go to bed for instance. The more readings we can get over time at different times, the easier it gets to guess/know what is going on. Every cat is different.

 

Where are you now in the dry food reduction scheme?

 

@MrWorfMen's Mom I think the daytime +9 is because of a suggestion I made to Adrienne to get a test as she comes in the door from work because other earlier tests can't be done on work days. It would be a good idea to get some +4 to +7 tests on the weekend.

 

I thought that might be the case but thought I'd put it out there. The "in the door" test is helpful too!

 

The last two night now I've been testing before bedtime. I usually test in the afternoon it's on the spreadsheet

 

Today is 1/2 c of food ( Dry) and more wet and I tried the fancy feast as treats.

 

That's great! I think you forgot to put those numbers on your SS.

 

Is she coping?

 

Do you give Molly her shot right before you go to bed? I see you have taken a pre-shot test but I am suggesting another test at night after that just before bedtime. Or maybe as Kris suggests you didn't put them on the SS yet?

 

You can't see the numbers?

 

She's looking for more food.

 

There's two there one from last night and the night before. I test her around 8pm. Two hours after shot

 

No evening numbers show when I click on your SS link. Strange.

 

Maybe I'm posting it in the wrong spot?

 

I don't see them either. I know there were some problems Marje was looking into but I thought it had to do with colour coding......not numbers being "invisible" to others.

 

Ok well her numbers are 23.3 in the evening 2 hours after shot. Her BG this morning was 18.1 same as yesterday. The afternoon is 26

 

It's only the +2 in the evenings I can't see. Maybe try entering those again?

 

Ok I entered them can you see them now? @Kris & Teasel

 

Ok I can see them but it appears you moved what we thought were pre-shot tests over to the +2 slot which suggests you've only taken once test at night.

We suggest you always get a pre-shot test so you know it's safe to give Molly insulin and then take another test before bed every night so you get some data and you can see if Molly is dropping a lot and take action before turning in for the night. So if you give Molly her shot at 6pm you would test around 6 before the shot, and then take another test again +2 or +3 hours later if you go to bed around 8 or 9pm for example.

 

Yes, I see them now. We misunderstood what you meant and thought you'd done PMPSs too. It's early days and you're still working on getting more data but overall her numbers aren't much different on 2 u than they were on 5 u. I can't be certain of course but the removal of quite a bit of the dry food might be having the effect of stabilizing her BG even though the dose is more than 50% less. By that I mean a smaller dose is (almost) accomplishing what a significantly higher dose did when she was eating a cup of dry daily on top of the wet S/O.

I think you can see why we need data to help you through this. We don't want to be guessing too much.

 

Yes, to what @MrWorfMen's Mom said. Those PSs are really important.

 

Ok so maybe I should wait and just do the preshot, not do the in the door shot? it's 2 hours before her shot? The strips are a bit pricey. Or I can go home on my lunch and test then do a preshot?

 

I'm getting frustrated because like you said. Her numbers are the same as when she was on 5 units.

 

Adrienne, both Kris and I used the AT2 meter and know how extremely expensive the strips are. Both of us switched over to a human meter. A human meter works just fine.... it just reads a little lower but we understand those numbers too. It would be better to get a meter that isn't breaking the bank and use it to keep Molly safe and on the path to better health than trying to limit your testing too much because of the expensive strips for the At2 meter. Both of us used the Freestyle Lite meter and you can get the meter free with the purchase of strips by using the coupon at https://myfreestyle.ca/en/products/lite. There are other meters available too with even cheaper strips but they take a larger sample of blood so might make testing a bit more difficult.

The only way to be able to see what is going on and keep Molly safe is to always get a pre-shot test and at least one more test in each morning and night cycle.....4 tests per day minimum.

 

The dry food was no doubt making Molly's need for insulin higher but it is also possible that the 5u dose was too high. Too much insulin can look just like too little and without testing it's hard to make that determination.

 

I pay over $100 now for the strip for 50. How much are the strips for the freestyle? I can do a test on my lunch that would be +5? if that would help more.

 

The strips for the Freestyle meters are a little less than half the cost......I paid about $78 for 100 strips in Walmart here in Toronto. The other bonus is there is no sales tax on the human strips!
Any tests you can get are helpful and being able to get them at different times in the cycles helps too as it fills in the puzzle a bit better.

 

Ok I filled out the form for the coupon, But I haven't received an email. I'm going to go home at 10am to test her. Another hour from now!

 

You can ask at the pharmacy. Some of them will say you get a free meter when you buy your first box of 10 strips - no coupon needed.

Re cost of strips: I believe I mentioned back at the start that I buy my Freestyle Lite strips at Shoppers Drug Mart for 20% discount on Seniors' Day (every Thursday here in Ontario). Yes, Shoppers is more expensive overall but I end up paying $72 for 100 strips and by collecting the store's Optimum Points (which you get with strip and lancet purchases as well as other stuff) I've often been able to get the strips almost free by cashing in points. Seniors' Day is for anyone 55 and older so if you have a parent, relative or older friend they might agree to buy the strips for you. I've never had an issue with pharmacy staff balking at selling them to me and I've said more than once it's for my cat.

 

I tested her +4 it was 24.3 so my guess is she staying at that all day half the night. She doesn't eat during the night. So her food must be the cause of the high BG during the day?

 

The high BG during the day is probably related to the high carb food (she still gets some dry and the wet S/O is high in carbs) as well as the dose she's on. It's likely a little low for the type of food she's eating.

 

Ok, I fed her the fancy feast when I was home earlier. I put some water in with it. I see she's not eating as much dry today. I only put in 1/2 c and there is still some in her dish? What I thought about doing is. Give her SO in the morning, then the fancy feast for lunch and supper. Or is that too soon? to switch?

 

You could try that. Some kitties tolerate a food switch easier than others. You could also try mixing half S/O and half FF. It seems she likes wet food if she left behind a little dry.

 

I did her pre shot tonight.

 

Another pink pre-shot.......YEAH! Good job!

 

A yellow one this morning @MrWorfMen's Mom @Kris & Teasel

 

!!! I'm SO glad to see this! And it's great you got a PS last night. I hope you're beginning to feel a bit more confident about the testing and what you're doing with Molly's food and dosing.

 

I am feeling more confident. I grabbed the bull by the horns so to speak. I had to tell some people that it's my cat. I'm going to do what I think is best for her! But I still have a few questions
1. My husband mentioned diabetic dry food? Isn't the dry better for her teeth?
2. What BG do we want to see her at? I think the vet said 7 does that sound right?
3. What happens if I get a BG that I'm not sure about? preshot?

 

Loving that AMPS! You're doing great Adrienne. I'll bet that yellow made you smile this morning! A little sunshine to start your day!

 

I was SO happy to see the AMPS this morning. It did make me smile and yes a little sunshine to start my day

 

There is absolutely no truth to dry food being better for kitty's teeth. So called "diabetic" food is no better than the readily available store brands and in many cases, the ingredients are IMHO inferior. Our cats are natural carnivores and don't need or crave the corn and other fillers found in most prescription diets. A lo carb wet diet is by far the best even for non-diabetic cats as it more closely mimics what their diet would be in the wild.

On your meter, normal BG would be 3.9 to 8.3. Vets usually aim for slightly higher BG than we are able to work toward but it's up to you how aggressive you want to be in pursuing lower numbers. Many people aim for a bit higher to start with (your vet's 7 being fine) and as kitty's numbers improve they are able to slowly lower their goal numbers a bit.

If you get a BG that you are unsure about (whether to give insulin or not), you can post here for assistance. There is usually someone around who can lend a hand. Just put a "?" in your title with something like " dosing help needed" or "do I shoot" ......just something to indicate you have a question about dosing.
Right now, I would suggest asking for help for any BG under 225 especially while completing the transition to a completely low carb diet. Once the transition is done, that number can, as you are comfortable, be lowered.

 

This is a good balanced article written by a vet: https://www.catster.com/lifestyle/wet-dry-cat-health-canned-food-kibble-cats-ask-a-vet. I would say that for diabetic cats who tend to be dehydrated because they pee more wet food promotes good hydration and adding extra water to it is a bonus. It's also good for cats who have or have had urinary issues (like Molly and Teasel). I have read about the correlation between hyperthyroidism and canned food before but you have to deal with the immediate concerns rather than focus on a hypothetical. In our case it's diabetes and wet food is definitely better for that. It was the first thing my vet told me about feeding Teasel after his FD diagnosis.

 

Will Molly's numbers (BG) continue to go down? Thanks for helping me and having patience with me lol. I'm happy that I found this message board. If I didn't Molly would still be on the same food and probably on 6 units.

 

Molly's numbers may continue to go down more. Every cat is different. Some see a dramatic change from the food transition and others only a little change. It really depends on how carb sensitive the cat is. Molly is seeing a nice steady drop in her pre-shot numbers which is exactly what we hoped to see. It can take a bit of time for all the carbs to leave the system and for BG numbers to settle completely even once the diet is totally low carb. I am delighted to see the progress she is making so far.

 

Don't worry, Adrienne. Linda and I are keeping a close eye on things.

 

Thanks Ladies

 

Don't worry about that black tonight. She might have dropped lower than usual last night and this is a rebound. Remember - it's the trends over days that matter, not individual numbers.

 

Dropped as in really low? She ate some dry too, I thought maybe that had something to do with it?

 

Even that yellow pre-shot this morning is somewhat foreign to Molly right now so that could have caused her to bounce. It's one number and we can't fixate on that.....the overall pattern is looking better.

 

So nothing to worry about?

 

That's right.....nothing to worry about. BG is forever changing and you are going to see ups and downs like this but it's the overall picture that tells you if progress is being made and Molly is definitely making progress.

 

@MrWorfMen's Mom and @Kris & Teasel her AMPS is 4.4 I don’t giver her any insulin correct? Why the big jump from last night til now?

 

Definitely no insulin this AM. We usually suggest an immediate retest when you get a number that's very different in case it was a wonky strip. Have you fed her yet? I'd bite the bullet and test again.

 

Yes, she’s been fed and is playing. Freaked me out this morning. So test her again? Why the drop?

 

If that 4.4 is a valid number it tells us that the food change is having a dramatic effect and that the 2 u dose *might* be too high. We need more data to be sure. Unfortunately now that your'e getting some action you have to test more so we can give you proper guidance. It doesn't mean testing hourly but you might have to do a few in the middle part of the cycle between +3 and +8 or so. Are you off today?

 

This can happen when you're at a dose that is finally having an effect. You don't have much data from earlier so we can't be sure. It *seems* that the insulin dose wasn't doing much then even with the increases to high levels. That was very likely due to the high carb food she was eating, especially the kibble. She might also have dropped low periodically and bounced (rebounded) high but, again, with no data we can't be certain.

It's stressful when you finally get some action from the insulin. It's what you want though and we can help. We'll definitely err on the side of caution. Where exactly are you in the food transition? Exactly how much dry does she have access to? What proportion of her wet food is S/O versus Fancy Feast. Sorry for all the questions but this will help @MrWorfMen's Mom and I decide on dosing.

 

Ok I’m going to test her here in a few minutes. I am off today. But will be gone for 4 hours this afternoon.

 

Her BG was 6.4 so her 4.4 was accurate.