High Readings

My ten year old cat was recently diagnosed with diabetes...his readings were ranging from 500-700 or more.....it has been a few months and the past month I have switched to low carb wet food as well...his readings are now in the high 300's. He is on Prozinc 6 units - 2x per day.......
Seems like his glucose levels should be lower.....does anyone know anything about inulin resistance?? Does this sound like the case ??? Or is this normal to give such high amounts.....???

I am so new to all of this....any information will be appreciated!

 

Hello there and welcome. 6u does sound like a bit of insulin but it would be good to rule out other things first before thinking insulin resistance.

It will help us help you better if you can put together a profile and get set up with a spreadsheet [and get them linked in your signature]. Instructions for this can be found in the stickies in the tech support forum here:
viewforum.php?f=6
Generally, the more detailed you can be in your profile the better.

What kind of food specifically are you feeding? Hopefully you are testing [at home] before every shot? How did you get up to 6u - did your vet recommend to give 6u or was that what you ended up at yourself?

I'm sure others will be along shortly to ask more questions. You've come to the right place. :smile:

 

Good morning!

6u is often considered a relatively high dose, does he have any other health issues/medications? Some do have to give a higher dose, but its usually related to other medical problems/medications. Has he had a checkup at the vet to make sure fd is his only issue?

I'm sure you have already done so, but just in case, please read up on hypos:

http://www.felinediabetes.com/FDMB/viewtopic.php?f=3&t=8038

Do you free-feed? (leave food out all day for them to graze on) Many here do, to make sure if they go to low, they have something to eat and bring them back up.

I saw on your other post that you were wondering about different readings on various meters. I assume this means you are hometesting, which is great! How often are you testing? Have you checked his nadirs (low point in the cycle, usually around +5, +6, or +7) to see how low he is going. This is helpful info to have because you will know what his curve looks like, and can adjust the dosage based on this.

Great job on switching to low carb food!

btw-what's your kitty's name?

 

Thank you everyone! My kitty's name is Oreo...I actually started him out with one unit of insulin when we found out he was diabetic and every few weeks I did a curve (per vet) and she kept saying go up one more unit after each curve that I have done....so thats where I am at....actually I was up to 7 units per the vet..but since then - I have already switched to the low carb food (I actually have him on the ff wheat gluten free wet food - sometimes I get the generic publix brand but the ingredients are basically the same I make sure it is wheat gluten free) anyway, changing his food has brought the readings down a little bit on its own...so I have gradually decreased. Two days ago, Oreo's glucose reading in the am was 390 I gave 5 units and then I did the next reading (twelve hours later) and it was 86 - I even retested to make sure it was right since it has NEVER been this low....so no insulin that night. The next morning the reading was 410 so I gave 6 units....then the night time was 186 so no nighttime insulin again.

For the past few days I have been playing it by ear figuring out the dosage....I am not sure its right....but the vet said any reading 200 or under..do not give insulin....and since the morning readings are not as high as they once were (but yet still pretty high) I am coming up with what I think might be okay......I know this is probably not the best thing to do...however, Iwont be home all day to do another curve until this monday. After I do the curve I will call the vet and give the numbers and see what she thinks....and i will probably post the numbers on this forum for advice as well since I have learned more on this forum than I do from Oreo's vet!

Since I have switched to this type of food -Oreo has gained some weight back because he went from 22 lbs to 9 lbs..I am not sure what he weights exactly right now but you cant see any bones and he looks great!!!! I try to have food out for him at all times but he basically eats it all and leaves none....if I refill it - he just eats it all again. Should I just keep putting it out ???? He also is not peeing and pooping thru out the house...which he started to do.....he is going in his litter box and the quantity is no where near where it was which is another relief ) and he is not drinking tons of water which he also was doing. He seems so much healthier so I am feeling very positive. However, I really need to figure out what dosage Oreo should be on.....just seems like it is not consistant at all - is this normal??????

any advice would help!!!

 

I also wanted to add that he was diagnosed with urinary tract infections at a very early age..so he was on a special urinary dry food diet (which probably was a big factor in him becoming diabetic now)

The vet said to worry about the diabetes for now.....

The only thing that i know of thats wrong with him now is the diabetes and of course the urinary problem.

Should I have them do more testing to see if there is anything else wrong???? Not sure I can really afford a whole bunch more of testings....but if it is necessary....????

 

This is my quick response, I may have more for you tomorrow.

Likely the the food is a problem. It is not OK to guess at the food such as it seems you may be doing with the Publix generic. There are ways to get the exact nutritional contents from the manufacturer. Here are the instructions for that:
http://binkyspage.tripod.com/foodfaq.html
If doing that is not up your alley then I would search for other foods Oreo will eat that are on J&B's list that are below 9% carbs. http://binkyspage.tripod.com/canfood.html . And of course no dry food. Some of the The Fancy Feast flavors are popular as well as the Wellness grain free flavors, and if your cat will eat them Merrick makes a few excellent flavors that are grain free and very well balanced. The Fancy Feast ones tend to be high in phosphorous which is generally considered bad for CRF/CKD. I'm not sure what the goal of the urinary diet your vet suggested though, it might have been to alter the urinary PH and not lower the P??? I don't know.

As far as the Urinary diet - what food exactly is that? What are the objectives of the urinary diet? Perhaps similar might be accomplished though a commercial diet that Oreo likes that is also good for diabetes. Otherwise there are options like prepping your own to match the requirements. I have not heard for a cat needing a urinary diet because of a UTI but then I don't know everything? Maybe some others here have some input on that.

As for the weight: ideally cats [just as humans] should be fairly slim. Weight can be a big factor in DM with cats just as with humans. Dr. Lisa has some good writing on the topic here:
http://www.catinfo.org/feline_obesity.htm
I would suggest reading her whole site.

I have a way to calculate how much your cat should eat. The spreadsheet is here:
https://spreadsheets.google.com/ccc?key ... nhPTXBEUUE
you would have to save it to your own computer and use it there or upload it into your own google docs. Otherwise you can tell me how much your kitty weighs now and the activity level [indoor or outdoor] and if the kitty really needs to gain weight or is fine where he is and I can do it for you. But if your cat is unregulated then they need food. Free feeding [or the closest approximate] is the best when using longer acting insulins like PZI. If you are unable to free feed because your cat needs caloric restriction then there are timed feeders some use here. Otherwise, I add water to H's canned food to help it not dry out and get the crusties, some here freeze the wet food in ice cube trays.

Thank you for detailing a little more about your kitty. Again, if you could get that spreadsheet going and the profile set up as detailed in the tech support forum it would really help others here give you the best advice. :smile: For specific dosing advice the spreadsheet is important.

 

I have 2 cats with UTD who eat a special dry food, Hills feline CD. One of the cats was recently diagnosed as diabetic. I posted about it on the Diabetes board. Someone else on there has cats on the special diet too.

 

One other thing I forgot to mention is that UTI [or any infection or inflammation - dental issues are common too] can play havoc with your numbers. They can also bring cats that were in remission out of remission.

UTD and UTI are different things as far as I know. Maybe they are related?

 

I'm just catching up on posts, so hopefully my comments are still relevant.

I would recommend that you lower the dose. 86 is a perfect # for a nadir (for many cats that is around 5-7 hours after a shot), but is really low for a PS. You want the PS to be 150 or higher (200 is a good no-shoot til you have a little more experience, so I'd stay with that for now). If the PSs are coming in below 150, you generally would want to reduce the dose so you can stay on a schedule with regular shots. 186 is really a perfect PS, but I agree that giving the dose you are on that PS is risky, so I'm glad you skipped that shot.

If you have some mid-cycle data, +6 hours after shot or so, that will help you see how the dose is working. If nadirs are lower than 50 or 60 you should immediately reduce the dose. If nadirs are above 100, the dose may be too low, though I would probably want to see some spot tests over a couple days to be sure before raising the dose, especially with the dose you are at.

Personally though, I would lower it to something more like 4u and collect a little more data to help you evaluate things.

 

Thanks for all the great advice!! On Monday, I do not have to go to work so I will be able to monitor Oreo's readings throughout the day. I think I will go to 4 units if insulin is needed until Monday!

Does anyone know the content of the Publix canned wet cat food??? I get the box with 24 3 oz cans.....It looked to me like it was the same as the FF but maybe just because I noticed no wheat gluten...hmmm...This is all so confusing...its hard to measure all this stuff when it does not give me amounts. This can of Liver & Chicken says (crude protein-11%, crude fat- 5%, crude fiber - 1.5%, moisture max -78%, ash max- 2.5%, tuarine 0.5%

Thats all it says!!! I guess I will hit the pet store on Monday as well, or just go back to the FF ones that are on the list.

As for the Urinary Diet - it was science diet - but I cant remember which kind.....( i happen to be pregnant right now and I cant remember anything!!!!) It was a dry food.....he ate that for so many years.....and gained all kinds of weight too...then for a while the vet would have me alternate the science diet one with the science diet w/d - to help control his weight or mix it together. His urinary infections used to be so bad he would bleed....so she said he would always need to be on a special diet......but now he is diabetic!! UGGGH!

I appreciate all the advice and input! Thanks so much!

 

I don't think anyone here knows the content of the Publix generic? You can try searching this forum or search the old forum too. Publix should take back any uneaten food.

The numbers on the can are called the "guaranteed analysis" and they aren't worth the powder to blow them to hell. What you need are the "as fed" or "dry matter" analysis which are tougher to come by. Except for Innova foods, this takes contacting the manufacturer and asking for the goods. The instructions for this are in the link I posted.

Just because the ingredients are similar [or even exactly the same] does not mean the ratios they are combined in in the food are going to be the same.

One thing I've seen folks here do is print out Janet & Binky's list and take it with you to the Pet Food store. This should help you too in your temporarily memory challenge state. :smile:

Urinary issues can be aggravated by dry food alone! Do read the catinfo.org site.

 

Thanks! I will take the leftover publix food back today. I will also print out that list to take with me to the pet store! This is all so confusing - but I am headed in the right direction!

Thanks for all the useful information. It is greatly appreciated!

This morning Oreo's glucose reading was 286.......It has never been that low in the morning...WOO-HOO!!!!! It is a good day so far!

 

They are related. Cats that have UTD ( Urinary tract disease ) are just more prone to have UTI ( Urinary tract infection ). The food keeps it under control. Some say it makes cats gain weight though, although recently the manufacturers have reduced the fat.

 

I also wanted to mention that generally if you get a PS that is too low to give insulin, you can retest and shoot once it is high enough. In most cases that is better than skipping a shot altogether. Depending on the #, you might try retesting in an hour or so and see where it is. If it is headed up and is close to 200, might as well go ahead and shoot. Then with the next shot if you have to shoot an hour early, that is usually fine if the # is high enough. If you are shooting early you might want to reduce the dose a bit, although I probably wouldn't bother if the PS is already high at a +11.

 

The Urinary food did actually keep Oreo's infections under control although he really did pack on the pounds...he is a large domestic shorthair but he went up to 22 lbs.....since he is diabetic (which is only a few months) I have only been trying to regulate the diabetes....the vet said not to worry about the urinary at this time...although she did recommed science diet/wd (DRY).......but i am not going to go with that...it is not helping the diabetes.


That also sounds like a good idea to retest if his readings are good and give him a shot when they get higher ....seems like when I skip altogether is when the next reading is through the roof. Say the reading is a little over 200....how much insulin should I be giving him? Do I do 4 units or go even lower...???

Thank you!!

 

You don't necessarily need to reduce the dose when the PS is lower, it really depends on the cat, and what you can tell from the data you have collected. If you are shooting at say +13, the effect of the insulin will be reduced, so in general terms I would shoot a full dose even on a 200 PS if you are shooting late. By full dose though I mean a dose that you know works well - I think 5 or 6u is probably too much, but it may be that he really does need that much. You can lower more than 4u certainly if you want. It's hard to say really without more data though. You don't want to reduce too far and lose any progress you have made since you are getting some good #s, but at the same time you don't want to be overdosing.

Have you set up a spreadsheet with the data you have so far? That will help people give you the best advice. If you haven't already looked into it, there are instructions over on the Tech forum.