? It's a breakthrough!!!! Wilbur is letting me test!

Discussion in 'Feline Health - (The Main Forum)' started by johnt, Feb 3, 2018.

  1. johnt

    johnt Member

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    Feb 14, 2016
    I've been on this forum several times asking for help, telling people he refused to let me test him...

    I suspected he had too much insulin one day and I thought 'heck with it' i'm doing it again for the umpteenth time.

    I was able to position him right (it's easiest to wake him when he's napping. i don't do it when he's hard asleep). for the FIRST TIME he allowed me to prick his ear. I'll admit it took a couple pokes to get it but I got it! And now I'm to the point i usually get it the first try.

    Since then i've got him to finally let me test. he still struggles sometimes but it's very minimal, and after i get the sample i put the tester down while it counts down and give hi m tons of attention, and I can tell he really likes it.

    I also don't just run in to test. I position the strip almost all the way in, but just enough out to not activate. When it's time I push it in and while it's going through the motions i start petting. after a few seconds now he lets me. sometimes he still fights me, but in the last four days I've gotten a successful test. not one failure.

    ANyway, i've been averaging about 5 tests per day, but i want to slow that down some. I need to get a feel for his levels.

    I was definitely correct. When i started testing him I immediately cut him back 50%. Now I've got things under control i was looking for a blank spreadsheet you guys use. I used excel with a generic list.

    I'd like to post my results but first I'd like to find the template again on Google Docs so i can fill mine out.

    Can someone point me to that empty one?

    Thank you! and I'm SOOOOO much happier now. no more stressing if he doesn't eat on my schedule for injections. no more wondering how he is.

    No more runs to the vet to check him. no more glucose curves or fructosamines.

    I feel like I've been liberated!
     
  2. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
  3. johnt

    johnt Member

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    Feb 14, 2016
    Perfect. Thank you.

    I'm surprised at the spread of the results I'm getting but at least now I can a handle on his trends.

    Thanks again!
     
  4. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Such great news!!!
     
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  5. johnt

    johnt Member

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    Feb 14, 2016
    I know it's a bit silly to be thrilled about this, but it's the first time in 6 years of testing that I can track it (i think it's 6 years).

    I'm a bit surprised at my results.

    I'm giving him VetSulin. Should I bet posting in that forum to go over his testing cycles? or is there a generic forum i should use?
     
  6. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    You can write here in the main health forum or in the vetsulin forum.
     
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  7. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    Once you get the spreadsheet filled out, add a link to it in your spreadsheet
     
  8. johnt

    johnt Member

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    Feb 14, 2016
    I've got a question about the spreadsheet.

    i finally got enough energy to do this (long story, had serious sleep problems).

    I'm looking at the google spreadsheet and my own, wow, much different.

    I don't know what the "AMPS" column is for and I assume "U" is for units dosed of insulin?

    Wait, I see AMPS and PMPS, what does the "PS" stand for? i assume it's am/pm

    The other issue is dosage. Wilbur has gone up substantially in frequency now. I'm worried. It seems his VetSulin is only lasting for about 8 hours and he's going way too high. So i need to figure that out. but it's causing my dosage times to not fit correctly in the spreadsheet. is that OK?
     
  9. johnt

    johnt Member

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    Feb 14, 2016
    Last edited: Feb 5, 2018
  10. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    This will help:
    http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

    This is a whole new world now that you're testing his BG at home and will be logging the data on the spreadsheet. How did you determine the lack of duration of the Vetsulin without testing? Are you relying only on how he looks or behaves? Vet testing?

    I strongly recommend you go with 12 /12 dosing for at least a week while you get used to this new way of doing things. Log all your BG test results on the spreadsheet and ask for help here to interpret them and decide on how to dose going forward. Here's the basic testing routine we recommend:

    Here's how to approach finding the good dose range:
    1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
    2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
    3. do extra tests on days off to fill in the response picture
    4. if indicated by consistently high numbers on your SS, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
    5. post here for advice whenever you're confused or unsure of what to do.
    As you can see it's very methodical in order to gather the most meaningful data and make safe dosing decisions.

    I just had a look at the data you posted and you're right - the numbers are erratic,. The goal right now is to see if you can't settle him down by sticking with one dose AM and PM for several days, follow the testing routine I described above and log the data on the spreadsheet we use. It looks to me that some days you've given insulin only once and other days three times. Is this correct? If so that can be causing some of the crazy ups and downs you're seeing. I strongly recommend that you read this information about Vetsulin. It was put together by members here who are very knowledgeable about this insulin:
    http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/

    Re what dose to give: why not start again with 4 units twice a day as close to 12 hours apart as you can manage. You've jumped from 3 u to over 6 u and have dosed as little as once a day and up to 3 times a day. You need to simplify everything ASAP and gather the necessary data that allows good dosing decisions.

    I also see that he gets some dry food too. If you can wean him onto low carb wet food only you might see better progress with his BG.
     
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  11. johnt

    johnt Member

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    Feb 14, 2016
    OK i read through this, I'm just unsure how I can only dose him once every 12 hours if it's starting to rise over 300 after only 8 hours. That's really the only question i have left.

    FYI i am reading that document several times and understand the 8-12 hours.
     
    Last edited: Feb 5, 2018
  12. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    OK, let's start with this:
    upload_2018-2-5_16-36-0.png

    This is a typical BG curve for Vetsulin given to cats. It's taken from the Vetsulin web page. Notice the dosing - twice a day at 12 hour intervals. Notice how the BG starts high, drops to its lowest value (the nadir) about half way between doses and then rises to a level similar to where it started. The nadir is about 50% of the beginning and end of cycle levels. This is an ideal curve. Most of the time a cat's actual curve will deviate from this for a variety of reasons.


    Here's a curve showing insulin resistance, ie., the cat's BG stays high because he's not responding to the insulin properly. One common reason for that is the high BG has impaired the ability of the cells to respond to insulin. The high BG can happen if a dose is too low but also if it's too high (causing "bouncing") - more on that later:
    upload_2018-2-5_16-43-23.png



    Here's a curve showing lack of duration of the insulin. At this point you can't be sure that's what's going on with your kitty:

    upload_2018-2-5_16-45-0.png

    Here's a curve that shows the rebound effect that can happen if the BG drops too low or too fast. It doesn't even have to be too low, just lower than usual:

    upload_2018-2-5_16-46-29.png

    There's a lot of great info on the Vetsulin website:
    http://www.vetsulin.com/vet/Cats_Monitoring_About.aspx

    I agree with this if you're using an pet meter. If a human meter, we'd say 200. Vetsulin has the ability to drop BG hard and fast and you need enough "room" at the start for the nadir to not be too low. Ideally a nadir in the range of 90 to 110 is what you want.

    There's much greater immediate danger in BG falling too low than there is in it being high as long as the highs aren't a constant day in and day out. Highs within a cycle that also has a good low aren't a problem.

    Giving insulin every 12 hours is the easiest routine to follow in the long term. You can't chase the BG and dose when it rises above 300 because your dose schedule will be erratic and the danger of overdosing is higher. The single most common cause of seizures in a diabetic cat is hypoglycemia NOT high BG. I have no idea how that 10 u dose was arrived at but I can say it's dangerously high. There are a few medical conditions that can cause a cat to need a high dose of insulin but most who don't have these conditions will need on average 1 to 3 units twice a day. There are a few that will creep up to about 4 or 5 units twice a day.

    On the face of it seems your cat has likely been overdosed and that's probably the reason for the seizures. We can't possibly know what those huge doses were doing without seeing a spreadsheet of data but my best guess is repeated episodes of hypoglycemia.

    Maybe, maybe not. If the Vetsulin isn't lasting long enough that might be true. It's also possible that he dropped fast or low or lower than usual in the hours before that late afternoon test and he's "bouncing" as we call it - rebound hyperglycemia like that graph above.

    Correct me if I'm wrong but this sounds as though you'd dose before the 12 hours were up if the BG had already risen to 250 within a cycle. We wouldn't recommend doing that. Rather, stick to 12/12 dosing, test as per the outline I gave you in my previous post, log the data on the spreadsheet we use here, collect data for several cycles at a dose then evaluate to decide if the dose needs to change. The only exception is if you test and get a BG under 50 if you're using a human meter to test (under 68 on a pet meter). That's an immediate dose reduction. If several days' data shows nadire lower than 90 but higher than 50 a reduction might also be needed to give you that cushion of safety that kitties on Vetsulin need.

    Again, you seem to be under the impression that the high numbers are the ones to worry about. In the longer term, yes, but in the short term no. It's the very high insulin dose that likely has caused symptomatic hypoglycemia (seizures) that is the immediate danger.

    Here's an explanation of bouncing (AKA rebound hyerglycemia):
    1. BG goes low OR lower than usual OR drops too quickly.
    2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
    3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
    4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
    5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
    6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
    7. Many vets have little/no understanding of the bouncing phenomenon.
    So, in summary, here's what we would recommend that you do now that you're testing:
    1. Do your testing strategically according to that schedule I gave you above. Try to show when those extra doses were given on a day where you did that.
    2. Set up the spreadsheet we use here and enter any/all data you have since you've begun testing.
    3. Go back to 12/12 dosing right way
    4. Drop the dose to 4 u right way. If it's too low we can advise on how to raise it quickly but safely.
    5. If the 4 u dose isn't dropping him too low at nadir, keep it for at least 3 or 4 days to get a set of baseline data as a reference.
    Does this seem workable to you? Questions? We're here to help.
     
    Last edited: Feb 5, 2018
  13. johnt

    johnt Member

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    Feb 14, 2016
    I had a long response all written out but Wilbur stepped on my keyboard when i had it all selected and it deleted it all :) He's good for that.

    Anyway, I'm holding. it's not easy since right now i'm +11 and it's 389 but i'll wait.

    Since I'm posting about him here's him a couple hours ago being spoiled

    [​IMG]
     
  14. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

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    Jul 19, 2011
    Oh HUGE Yard Dance!!! That's wonderful news on the testing!
     
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  15. johnt

    johnt Member

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    Feb 14, 2016
    Here's a question.

    Since my testing was erratic as i started on the 30th, the times don't fit in the chart well because they're based on just am/pm dosing.

    Should I just start charting where I am now since i started doing 12 hour intervals yesterday?
     
  16. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    By all means start there if that's easier for you. I'm glad you'll be using the spreadsheet because it'll make it easier for us to give our input if you have a question. :)

    I see your spreadsheet with a few BGs on it. I think you might have accidentally entered that blue 182 at +4 in the wrong box. Also check the dates - tomorrow is o2/07/2018. That blue number is pretty good. Stick with 4.5 u for a couple of days.

    Another useful bit of info to include: if you could add what meter you're using to your "signature" (the light grey text under your posts) that would help us to assess your spreadsheet better. It's especially important that we know whether you're using a human or a pet meter.
     
  17. johnt

    johnt Member

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    Feb 14, 2016
    OK I'll do that. Not sure what you meant about wrong entry though. Did I do this wrong?

    I stabilized him at 9am/9pm I gave him a test last night at 10PM but I had already given him a shot, then went to bed. i've been sick so i way overslept Then a dose of 4.5 and 9am this morning with the reading at that time. and i tested him just a bit ago, so i rounded up and put it at +4

    If I'm doing that wrong let me know. the dates should be accurate, no?

    I'm using a old tester because the strips are expensive for me. TRUEtrack human meter. I use it, know it's old, but strips are $16.00 for 100 so it's reasonable. It uses the old coded tabs and takes 10 seconds to read, but I don't really care about that. is that OK?

    EDIT:
    Wait I think i see. I started charting when I gave him the shot last night. So he's only had one test since then. I figured i might as well just start there

    EDIT 2.
    nevermind i see it. i'll fix it when i get home
     
    Last edited: Feb 6, 2018
  18. PussCatPrince

    PussCatPrince Well-Known Member

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    Nov 25, 2017
    and you have been :D Well done you. It's not easy is it but you have got there. :cat:
     
  19. johnt

    johnt Member

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    Feb 14, 2016
    well thank you!

    Here's my stress though.

    I'm told to wait to 12 hours. how do i do that now? 9.5 hours post and he's at 456. I shouldn't worry that he could go into a seizure? This is normally where I'd give him some.

    look at sheet for today. it's scary!~ it's been driving me nuts.

    I wouldn't worry so much but he's had several seizures in the past (over 2.5 years ago)

    EDIT: see this is why I say he's showing that top bad curve.

    take a look at his chart. I don't even see how it's possible to drop 300 points in one hour.

    this just doesn't look right to me and leaves me stumped

    this makes me think this is what's happening. Doesn't this mean I'm giving him too much? shouldn't I see it much lower in the early hours?

    [​IMG]
     
    Last edited: Feb 6, 2018
  20. johnt

    johnt Member

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    Feb 14, 2016
    Since I'm new to this I need some help (if you don't mind)

    Looking at your chart, I don't understand what this mean?

    chart.png

    I'm trying to understand how to correctly fill this out.
     
  21. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    No, a high number won't cause a seizure. A very low number ( well below 50 on a human meter) could cause one. I looked at your numbers and they are strange. The pink and reds seem out of place. Did he eat some high carb food around +6 or +7? Other high carb contraband? Are you sure your meter is working correctly and the test strips are well before their expiry date? You could try to test your own blood sugar to see if it falls in the normal range, assuming you're not diabetic yourself.
    You don't have enough data yet to know what's really going on. We'd like to see at least three or four days of data while you're following a structured testing routine and keeping the same dose on a 12/12 schedule before making any assessment of what needs to happen next. If his BG at the 12 hour mark (just before his next dose) is still low-ish (mid to high 100s) post here for advice.

    Re the spreadsheet entries above that you don't understand: if BG tests are done close together (eg. 15 minutes apart) both results can be entered in the same cell on the spreadsheet. An example of what the notation means is "at +4.5 hours after the shot the BG was 90".

    Please take some deep breaths and try not to panic. I know you had some frightening experiences when your vet recommended a scary high dose and you weren't testing at home. Everything we recommend here from testing on a schedule, being methodical, keeping a spreadsheet, etc. is aimed at preventing these situations from happening.
     
    Last edited: Feb 6, 2018
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  22. johnt

    johnt Member

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    Feb 14, 2016
    boy this is just so bizarre. my last vet told me the seizures were due to the glucose going very high. They said it was 550 when i took him in right after the last one. They were always happening around +9 but like I was saying, this was back when I was only giving him 4u am 2u PM

    that's the only reason I was worried about it. The seizures stopped completely when I moved to 10/10 @12.

    I have two of these meters, and test them on myself and even others. the numbers all look right. that's what seems so strange. I even have a new 'one touch' meter and the numbers vary sometimes 15 digits but are close enough to understand trends.

    Also, the strips are good until 7-13-2019 according to the tube

    I'm going to get a different kind of tester. But can you tell me how often I should be testing? right now i'm worried I'm testing him too often and he'll get irritated, but i want to get as much data as you need.

    Sorry for my exasperation, my old vet had me so scared to let it get that high.
     
    Last edited: Feb 6, 2018
  23. Kris & Teasel

    Kris & Teasel Well-Known Member

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    There are many unregulated cats here who have occasional numbers so high the meter won't give a numerical result, just a "HI" reading. What can happen if the cat is in high numbers day in and day out is that they can develop ketones in their blood and if that's left untreated it can develop into a serious complication called diabetic ketoacidosis. The symptoms for that aren't seizures but lethargy, lack of appetite, etc. It's possible that your cat's BG dropped extremely low on one of those occasions, triggered an episode of hypoglycemic seizuring and by the time you got him to the vet his BG had rebounded very high. Only speculation on my part ...

    Your meters are likely OK. I'll ask again: did he eat some high carb wet food or kibble in the +6 or +7 time frame? Those numbers look like a carb spike.
     
  24. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    When is his pre shot test before his evening dose due?
     
  25. johnt

    johnt Member

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    Feb 14, 2016
    Oh i'm sorry. He didn't eat anything out of the ordinary. He does eat dry food. Hills Prescription Diet W/D but i know dry is bad. He just grazes.

    Problem is i have 3 cats and it is so difficult to manage feeding them separately. so i just put all the cats on that for their dry.

    Wilbur also gets some of the meow mix simple servings tuna with salmon or tuna with shrimp twice per day. He would eat tuna in water any time if I fed him that.

    But I see no difference in his eating during that last time.

    Finally, his dose is due in about 20 minutes. I'll test him then and see if I can hold off a few to dose him again.

    This makes me so angry at that last vet. they told me so many incorrect things.

    also, again let me know how often i should test him tomorrow so i can get enough, but not do too much
     
  26. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Here's the testing routine I described above in an earlier post:
    1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
    2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
    3. do extra tests on days off to fill in the response picture
    4. if indicated by consistently high numbers on your SS, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
    5. post here for advice whenever you're confused or unsure of what to do.
    It's important to withhold food at least 2 hours before your AM and PM pre shot tests. You need to know what the BG is without the influence of food that can raise it. This is needed so you can judge whether it's safe to give insulin. Until you have more data collected on your spreadsheet, you shouldn't give insulin if he's below 200 on a human meter. If it's right on the margin post here for advice. As you get to know Wilbur's responses to Vetsulin better (by testing and keeping your spreadsheet up to date) you might be able to lower the "no shot" number a little.

    Re feeding three cats: have you given any thought to switching all three to low carb wet food? feeding them in separate rooms on a set schedule?
     
  27. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    If you're at home during the day and while you're working on building a clearer picture of Wilbur's BG levels try this:
    • pre shot test AM and PM - essential! (no food 2 hours before each)
    • two tests somewhere in the middle part of the cycle but vary them day to day - eg. +3 and +6 one day, +4 and +7 another day, +5 and +8 on yet another day
    • one before bed test every day.
    The goal is to get a scattering of BG tests that build up a profile over time. You're looking for overall patterns and have to ignore odd-looking numbers unless they're dangerously low. Don't panic at any high numbers you get!
     
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  28. johnt

    johnt Member

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    Feb 14, 2016
    OH i'm sorry, i thought you meant a different testing than those for the first time span. I apologize.

    I just tested him now and he's at 343 that's what doesn't make sense. but i'll give him his typical 4.5 right now and tomorrow I'll test him only once mid cycle each time but before both dosage times.

    Sorry

    EDIT: you replied while I was typing. Ok i'll do that. i'll give him his 4.5 now.

    i don't know how well he'll enjoy withholding food 2 hours prior but I'll figure it out

    And yes i'm home during the day. I work from home
     
    Last edited: Feb 6, 2018
  29. Kris & Teasel

    Kris & Teasel Well-Known Member

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    OK. That 343 is certainly high enough to give him the same dose. Numbers will only make sense once you've built up enough of a data base on your spreadsheet. I know Wilbur was diagnosed a while ago but you're only now beginning a structured monitoring program so it's almost like his diagnosis was a week ago.

    Keep this dose for now because there's nothing in the data you have so far to indicate it's too high.

    Check your dates column on your spreadsheet: you have two dates of 02/06/2018. Might be confusing later on.
     
  30. johnt

    johnt Member

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    Feb 14, 2016
    I can't believe this. I completely misunderstood that chart and how to fill it out.

    I will correct it and get it squared up before I go to bed. it'll be corrected in the morning.
     
  31. Kris & Teasel

    Kris & Teasel Well-Known Member

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    If you feel like poking him once more tonight, get a +2 test. Those can often give a hint of what the rest of the cycle will be like. If the +2 is the same or higher that the pre shot test there won't be much happening in the cycle - ie., business as usual. If the +2 is quite a bit lower, say 50+ points, it can be a sign that the nadir might be lower than previous cycles.

    Important: did he have food shortly before the pre shot test of 343?
     
  32. Kris & Teasel

    Kris & Teasel Well-Known Member

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  33. johnt

    johnt Member

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    Feb 14, 2016
    i can test him +2
    yes I did fee him. I never dose without him eating. ever

    I expect the +2 to be close to the 343 but we'll see.

    as to the other question, i was just looking at the chart wrong, i thought I start over now, i just need to go to the right. same row, for the PM side. I get it.

    dates should be right
     
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  34. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    To clarify, the sequence is:
    1. take all food away for 2 hours before the pre insulin BG test
    2. test BG
    3. feed
    4. wait 20-30 minutes for food to hit bloodstream (because Vetsulin goes to work quickly)
    5. give insulin shot.
     
  35. StephG

    StephG Well-Known Member

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    Sep 8, 2016
    Kris, you're on your A game! Just stopping by to lend some support. My cat is one of those unregulated cats that have spent months above 400 or 500! He has never had a seizure. Kris has given you excellent guidance. Congrats on home testing! I'm shocked at the 10 unit dose he was on! My cat is a high dose cat but he started at 1 unit and increased very slowly in dose. His old vet prescribed 7 units and it would have killed him if we didn't find FDMB.
    Chuck had a similar issue with the dose not working long enough and getting back up onto the 400/500 range for every shot. Once his body has a chance to settle down you might see him level out a little. I think you're in good hands here!
     
  36. johnt

    johnt Member

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    Feb 14, 2016
    Correct. that's the sequence I did.

    +2 after the shot was as expected. 353.

    I think part of my issue might be misunderstanding and something I did not mention.

    when i had him on with the other vet they were prescription ProZinc. in Oct 2016 I moved, and selected a new Vet which told me he owned a diabetic cat and he preferred Vetsulin. I didn't care, but I did remember that ProZinc took awhile to take affect (at least that's what they told me). I wasn't told that Vetsulin is different than that so i didn't know it was fast acting.

    Anyway, he's about the same at +2 as he was pre shot. I have to go to bed now so i'll test him again when I get back up.


    See there is so much I keep hearing from my previous vets, new vet, then forums. I was explicitly told that the 12 seizures Wilbur had were due to high glucose levels. For 6 years I thought that's what the problem was, so once it started getting over 450 I began to panic. it was so hard on him.

    Once I get here i learn the truth, it was the opposite. LOW sugar that likely caused it.

    that's all. I've been frantic and he still doesn't like all this testing stuff. But now i have a process and i'll stick to it and get this sorted. it just floors me how his insulin can go from 438, in one hour read 130 and in the next hour go to 450. So it's very confusing for me.

    Had I realized it was LOW sugar that was causing his seizures, not HIGH, none of this panic i've had for years would have been there.
     
  37. PussCatPrince

    PussCatPrince Well-Known Member

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    Nov 25, 2017
    Thank you @Kris & Teasel .

    Sorry @johnt . I didn't see your post before I left home. I had to go and collect Tyler from the vet clinic.

    My cat Tyler is on Lanctus , not Vetsulin .

    You've been given excellent guidance by Kris & Teasel. It is very hard but you are in safe hands here and together with this you can work with your vet to help your cat.
     
  38. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    I hate to throw a screw in the works and make you any more confused or worried than you already are, but both high and low blood glucose can cause seizures.

    They are more common due to low BG, but very high numbers can cause seizures too

    http://catguide.com/seizures-in-cats/
     
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  39. StephG

    StephG Well-Known Member

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    Sep 8, 2016
    I had a hard time wrapping my head around this in the beginning. Sometimes even now!!
     
  40. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    I think the most plausible explanation is the 130 was a bad test strip.

    Anytime you get a number that's that out of whack, test again.
     
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  41. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    I wonder what the actual incidence of this is. Very low BG is a far more likely culprit for seizures than high BG - based on all the evidence from members here who have logged very high BGs (blacks on a SS) with no reports of this.
     
  42. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Here's a good summary:
    http://veterinaryteam.dvm360.com/managing-complications-diabetic-cats?id=&sk=&date=& &pageID=3
    One factor you can control that can help reduce complications - along with giving the proper amount of insulin of course - is to make sure Wilbur is well hydrated. Drinking water helps but many cats don't drink enough on their own. That's where feeding canned wet food is best and you can add more water to every wet food meal to make a sort of stew. Dehydration is always a problem with diabetic cats because they're always losing water because of excess urination. Any sort of dry food in the diet makes the problem worse.
     
    Last edited: Feb 7, 2018
  43. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Did the vet use the label "hyperglycemic hyperosmolar syndrome" (HHS) for the seizure episodes when Wilbur had them? Was he hospitalized for intensive care treatment with these episodes? I ask because this can be a rare complication of diabetes. Like most of the complications of diabetes good control of BG, good hydration, etc. are really important.
     
  44. Rachel

    Rachel Well-Known Member

    Joined:
    Aug 25, 2013
    Hi John and Wilbur! I see Kris has given you excellent info already, but I thought I'd pop in too. :) Prozinc is a gentler insulin that Vetsulin usually, but that doesn't mean Vetsulin is bad. We haven't seen as good results from it here, but there have been kitties who've done great on it and even gone into remission. We have a saying: the best insulin is the one that works for your cat. I do think your absolute best bet is to stick with the consistent dosing for several days and let's see what happens...and if you do get a strange number for a test, you can do an immediate retest just to be sure. Those wonky tests can come from bad strips, not enough blood, too much blood, etc.

    I don't think I've ever seen a high number be the cause of a seizure. Not saying it can NEVER happen, but I wouldn't worry about it really since it seems like SUCH an unlikely occurrence.

    BTW, CONGRATS on the home testing! Just to be sure, do you give a special treat after a test? Gypsy would come running for her tests and when I poked she'd often make an irritated meow at me, but she'd sit still and let me because she knew something yummy was forthcoming. :)
     
  45. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    "See there is so much I keep hearing from my previous vets, new vet, then forums. I was explicitly told that the 12 seizures Wilbur had were due to high glucose levels. For 6 years I thought that's what the problem was, so once it started getting over 450 I began to panic. it was so hard on him."

    Can you explain exactly what was said/diagnosed at the time of these episodes? The advice we give here is based on what we see with the vast number of members’ cats. If your cat was diagnosed with something like episodes of hyperglycemic hyperosmolar syndrome or another rare condition we need to know that. In a case like that we, as non veterinary experts, wouldn’t be able to give the usual guidance. Has Wilbur been seen by a veterinary specialist like one in internal medicine or endocrinology?

    We want to help but we need clear information about what has happened in the past. You also mentioned in a recent post that he’s been on ProZinc before Vetsulin. It would be helpful to know why the insulin was changed.
     
    Last edited: Feb 7, 2018
  46. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Thanks for this @Chris & China. This highlights the strengths of a peer reviewed forum. :) That got me researching what might cause seizures from hyperglycemia. What came up was a rare complication of diabetes called hyperglycemic hyperosmolar syndrome. It's a "cousin" to DKA but less common and seizures are *sometimes* part of how it shows.
     
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  47. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I'm sorry that you'll have an onslaught of posts to wade through this AM but I'm trying hard to get a clear picture of Wilbur's issues. We do our very best to give good advice here but it can only be as good as the information we've been given and it's limited by what we see in the vast majority of cats whose owners post here. We aren't vets, just people who live FD day in and day out. If we never see an uncommon condition/complication it won't be part of the advice we give. That's why we rely so heavily on the owner to convey important information to us.

    If you could answer these questions it would help:
    1. Did Wilbur start off as a high dose cat or did the dose creep up over time according to vet's instructions?
    2. Did he start on ProZinc originally or another insulin?
    3. Has he had problems with seizures right from the start after his diagnosis?
    4. Did any of your vets give a name to the cause of the seizures?
    5. If the goal of treatment was to get his BG down into safe levels was one of the longer acting insulins like Lantus or Levemir ever suggested? These often work better at keeping numbers low and flat.
    6. Does Wilbur have any other health issues or medications?
    7. Do you have any older vet reports from the seizure visits that might give details about what the vet thought was the cause? Just saying hyperglycemia isn't really enough. In your position I'd call my vet and ask specifically what the diagnosis was.
    I realize that all this will take away that feeling of relief you had when I focused on low numbers potentially causing seizures. At this point I have no idea if I'm barking up the wrong tree with this hyperosmolar syndrome thing but it warrants attention.
     
  48. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I've gone back and read all your previous threads here on FDMB to try to piece together a better picture. In a very early thread you said that Wilbur had a diagnosis of epilepsy two years before his diabetes diagnosis. Can you clarify this for us? Also early on you described a visit to the vet where you were trying to convince her his seizures were epilepsy and not due to high BG. Later on, that idea appears to have changed to high BG being the cause. Again, could you explain this a little more?

    Re Wilbur's weight: you've said in other posts that you know he needs to lose weight. I can tell you from personal experience that the single best way to accomplish that is to feed only wet low carb food. My diabetic cat's brother was a little over weight so I switched him to the same low carb wet as Teasel gets and he lost over 2 lbs in a year.
     
  49. johnt

    johnt Member

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    Feb 14, 2016
    Ugh, the forum doesn't send notices if you are sent a notice, and there are more replies before you visit the first notice. This is not bad, I love Xenforo and as someone that's a security/programming/web development person this is by far the best option, however it also keeps me from noticing.

    this will be long, REALLY long. But i'll start at the beginning. keep in mind, i have Huntington's disease which affects my memory greatly so i might miss timelines. but i documented as much as i could.
    I'm writing this up now. it will take awhile to fit everything in. i'll go from beginning of the problems up to now.
     
  50. johnt

    johnt Member

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    Feb 14, 2016
    Thank you. The vet was who told me she thought his seizures were from high glucose. the told me they were from the diabetes at first.

    Mind you, I'm rather confident they had little experience with it, and now after finding a helpful vet it makes me realize just how little concern they had for Wilbur, or me. it's ok now though
     
  51. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    Ugh, the forum doesn't send notices if you are sent a notice, and there are more replies before you visit the first notice. This is not bad, I love Xenforo and as someone that's a security/programming/web development person this is by far the best option, however it also keeps me from noticing.

    this will be long, REALLY long. But i'll start at the beginning. keep in mind, i have Huntington's disease which affects my memory greatly so i might miss time lines. but i documented as much as i could.



    Honestly i don't believe my previous vet may have had a lot of information about feline diabetes. That may sound rude, but from what I've learned since it seems that way.

    This will take a bit.

    Wilbur started having seizures when he was about 2. Back then I didn't know they were seizures I thought he was choking. they were very infrequent. maybe twice in a couple years.

    After talking to a friend that's also my family doctor she told me it sounded like a seizure, not choking. Recommending I take him to the vet. i was asking her about it at the time because Wilbur was very sick and I was unsure what to do.

    I took Wilbur to a vet at one point because he was lethargic, couldn't pee etc. When I took him in he had what I figured, a UTI. However, while there the doctor told me that he has diabetes (this was about 6 years ago). She ended up setting me up with this 'pen' to administer insulin. I believe he was about 4 then. his glucose was 400 when they tested him (i think)

    I took him to that vet because when this happened I was not near an emergency clinic (lived in a small town then). I went to the place that opened first because I was afraid he was on his way out. I honestly don't remember the dosage then bvut it was tiny

    A few days later I took him to my normal vet. They told me that they prescribe ProZinc there, and that's what I should start him on.

    Upon their advice I started him on 2u every 12 hours. Things were fine for a while but a few months later he had another seizure at around 10pm. After getting through it, about 8 hours later he had another. I took him to the regular vet when that happened.

    She told me she was unsure what it was, but suspected he might be epileptic. To monitor him and let her know if it happens again. I did, over and over and she kept telling me he might have epilepsy, that he shouldn't have had a seizure one hour after I dosed him with ProZinc at his 2u for PM dose. She told me the seizures wouldn't kill him, to just make sure he's safe when they happen.

    Mind you, the seizures weren't really times specifically to the dosing. Except the last one. I also did not know how ProZinc worked. I thought if I gave him a shot it should work right then. The last seizure he had was again once at night and another about 8 hours later.

    I honestly don't remember how the raise in dose happened, but i know i took him in for a curve and when i picked him up they raised me to 10u/10u. I asked if they were sure, they said yes. Somewhere before this they put him on the phenobarbital saying he had epilepsy but i don't remember them ever doing a test for it.

    i stayed the course for a couple years. Now it's oct 2016 and I'm moving my mother to Arizona to be close to her family. She's not well, losing eye sight so I moved her in to care for her (divorced). Obviously my cats came with me. Wilbur had stayed at 10u/10u that whole time (couple years)

    Also, after each of the seizures I took him in for, they said his blood sugar was over 500 when tested. Although most times the seizures had happened 8 hours before i could get in since they were at night and they were closed

    I found a new vet here. They were very nice, and receptive. the doctor did what felt like a very thorough exam. When complete, he first told me he didn't believe Wilbur had epilepsy. He also said 10u was a LOT. but he didn't want to adjust too much. he took him to 9u/9u.

    Over the next month I weaned Wilbur off Phenobarbital. I took him back in and he was in good shape. Sometimes I could test him but it wasn't often. he was very difficult. Wilbur has been off Phenobarbital since approx dec 2016

    Also at the new vet I told them I was on a very limited budget, and giving Wilbur 10u twice a day meant a vial of ProZinc would last me just about 3 weeks. It was $120 per vial and at this point It's expensive. he told me they prefer Vetsulin and it would be about half the cost. He said it should be fine to switch him so i did.

    At some point he lowered me to 8. So that's what I did. i could sometimes test him when he was zonked out and I could sneak up. he had to be in a very deep sleep. those were normally around +6 to +8.

    I called the vet because the readings seemed too low to me. Many times it would be under a hundred. Sometimes in the 90s, one time as low as 63. He then lowered me to 8u/8u

    When he got sick again was about Jan 30. I was afraid maybe he had too much insulin to i tried to test him and suddenly it worked. he fought in a little and i'm not very good at hitting the sweet spot yet so it takes a couple tries most times. Sometimes i get it first shot.

    From then on is when i started testing through the day, using that old spreadsheet. I immediately took him down to 4.5 because his numbers were low. they've since climbed. but when i called the vet back is when he told me to keep him at 4.5 and make sure he was over 200 before dosing him .

    that's where I'm at today.

    PS. Wilbur is difficult to feed. both in specific food, and timing. he eats VERY frequently, usually somewhat small amounts. I'd say he eats about every 30 to 60 minutes. then at night he'll go several hours without eating.

    over time he started gaining weight. he stopped roaming around and playing in the last year. He started getting fatter then.

    When i took him in august this year he weighted 25.4 pounds. When I took him back a few days ago he was 26. so he gained about .5 pounds over about 4 months.

    But i have a VERY hard time with food. Partly because I have 3 rescues, they all live together. they all eat together and they all graze. Wilbur gets a wet simple servings (Meow Mix) maybe 4 times per day now because I'm trying to get him off so much dry food. But he doesn't really eat it. he licks it to death but leaves almost all the meat. I used to grind up his meow mix pate at 1/1 water/food. But suddenly he stopped wanting it, and that was over. I started using the wet food as a treat to make sure I could feed him prior to dosing. I have never injected him without knowing he's eaten first.

    I spend a lot of time dealing with him, but i get frustrated after awhile because everything is a challenge

    So that's probably written very badly, and I apologize. I'm also ADD and it's very difficult to sit that long :)
     
  52. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Thank you for this. It helps me to understand what has happened and where you are now. Given your description of the timing of Wilbur’s seizures - ie., several hours before the vet saw him - it seems to fit the situation we see here often of a high insulin dose causing the BG to dive low followed by significant rebound hyperglycemia. I can’t be certain but that’s a common scenario.

    I suggest you follow the testing routine we recommend at least for today and tomorrow. Keep your SS updated so anyone who checks can see where he is. Hold the 4.5 u dose both AM and PM. The goal is to settle things down and get used to a structured testing/dosing schedule.

    Keep a close eye on Wilbur’s clinical signs and post if you see anything strange or concerning.

    I’m sorry all this has been so hard for so long. Do as much as you can with wet food, extra water for good hydration and so on.
     
  53. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    How about a +4 and a +6 today to fill in those gaps. On the face of it the pink and red look like inflated rebound numbers from the earlier yellow and blue. That late afternoon blue yesterday really seems out of place so I’m ignoring it.
     
  54. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    @Kris & Teasel I'm going to get a +6 for sure. I actually came back to post to let you know, I want to give him a bit of a break today. i tested him 8 times yesterday and he's starting to get nervous when i come back in. Also I'm under the weather today myself.
    +4 is in one hour and I'm beat, need to take a break.

    I thought I'd get him a +6 then a +10 if that's ok. then tomorrow start more regular, evenly spaced


    Also, i should add. I know that was a lot of stuff to read. But it might be unclear. Wilbur had the seizures during the time i was dosing 2/2 and 2/4. once they instructed to raise to to 10/10 2.5 years ago he hasn't had another.
     
  55. johnt

    johnt Member

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    Feb 14, 2016
    FYI i definitely agree on the blue tests. they seem like anomalies and don't fit the trend.

    also a correction. I'm not going to edit the post. it was when he was four taht he was diagnosed. he's been diabetic for 6 years and he's 10 now.

    also this probably doesn't matter but when i was using the original vet she said he had cataracts in both eyes
     
    Last edited: Feb 7, 2018
  56. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    So, maybe it's possible that on those low doses his BG was so high it severely dehydrated him leading to seizure activity. Hydration is essential! Think of dry food like a sponge that soaks up water from their tissues. Yes, I know you've had trouble getting him to eat wet food. Have you ever tried adding extra water to low carb wet food and putting it a blender to make a thick soup that might be more palatable to him?

    Re dosing: there's a heck of a lot of doses between 2/2, 2/4 and 10/10. You said you saw evidence of low BG and that's why you decided to lower his dose by 50% yourself.

    I still think the solution for Wilbur involves a good testing routine to guide proper dosing and more efforts to gets wet food into him.
     
  57. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    Hi Kris, I got the +4 and it was 86. I poked the other ear with a different lancet+strip, 79

    so yikes

    And yes, that was a lot of doses. that was before I talked to you and understood how this all worked.

    I am going to be charting him regularly now. I would bet, based on what i was seeing, his bg will be 350+ in 2 hours

    Finally, what lancet size do you recommend? i'm using a 30 gauge that i bought a while back. is that too big?
     
    Last edited: Feb 7, 2018
  58. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Hurray!! It's great that you thought to double check with a second test. Those two numbers are essentially the same as far as BG level goes. If you can possibly convince him to tolerate a +6 test that would be very helpful, then you can leave him alone until his evening pre shot test (remember: no food for 2 hours before that one).

    He's still well above the "take action" (with a small food snack) BG of 50 on a human meter. Leave him alone to graze or whatever he likes to do so we can see how this dose plays out with no interference. You need this baseline to learn his patterns.

    Great job! :)
     
  59. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Don't panic if he's lower at +6. There are things you can easily do to prop him up. I have no idea if that'll be the case - just giving a heads up.
     
  60. johnt

    johnt Member

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    Feb 14, 2016
    I have a tiny jar of Karo i keep at my desk just 'in case'. I c an't bother him again right now, he got very fussy on #2 as it was.
     
  61. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    Well, would you look at that???

    I have been lurking on this thread for a while and was going to pop my head in to say "hi" and to second Kris' recommendations on getting a testing, but while I'm here, wow! Hitting green!

    Small disagreement: in this situation I'd test earlier, like +5, and I'd give him a little low-carb snack now if he's amenable (not time for Karo yet, but it's good to have it at the ready!). I'm suggesting an earlier test just in case he's got a lot of momentum working on that drop from 443 to 86. And then, yes, he's likely going to zoom upwards from here and be super-high by PMPS. So it goes!
     
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  62. johnt

    johnt Member

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    Feb 14, 2016
    Hi there. Thank you.

    I'm going to give him some time and when he settles into his bed for a nap i'll test again.

    FYI when it was low I did give him some of the 'treats' to assist.
     
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  63. johnt

    johnt Member

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    Feb 14, 2016
    Oh, honestly, before, when i was getting a test every few days, this was happening at about time too. I just didn't know all that I do now.
     
  64. Nan & Amber

    Nan & Amber Well-Known Member

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    Mar 19, 2016
    Sounds good! (it's important to stay on the good side of your patient and not annoy him :D )

    On the lancets: the smaller the number the bigger the lancet. Usually we say new people start with the biggest lancet they can get, 26 or 28, easier to get blood. As the ears "learn to bleed" you can go smaller, down to the really thin ones, 33. If the 30's are working, great! If you find you have to make multiple pokes or work really hard to get the blood drop out, you might want to move to 26 or 28 for a little while.
     
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  65. johnt

    johnt Member

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    Feb 14, 2016
    Thank you @Nan & Amber

    I'm ok with this, the problem I have is sometimes it bleeds really fast, other times it's normal and simple. I am fairly sure I've poked my thumb at least twice as much as his ear.
     
  66. johnt

    johnt Member

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    Feb 14, 2016
    Well great. he's been hiding from me all day. i finally got it but he's hiding from me now, and i could see it coming.

    great
     
  67. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    This looks like classic bouncing high into reds after having those lovely dark greens today. Vetsulin often gives a very deep curve like this - it's the nature of the insulin's action. Those dark greens are what we focus on to assess the dose. Ideally with Vetsulin you want a nadir in the 90 to 110 range. Those high 80s are OK but tell us that 4.5 u is almost on the edge of too high a dose. Don't change it yet though. You need a couple more days at the 4.5 u dose to know for sure. He still needs to settle after previous erratic dosing times.

    For tomorrow: aim for the important AM/PM pre shot tests and try to get a +5 and a +7. Try to be as relaxed and matter of fact as you can around the whole testing procedure. Your stress will make Wilbur more stressed.
     
  68. johnt

    johnt Member

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    Feb 14, 2016
    ok. one question. how was he still alive when I was doing 10/10?
     
  69. Kris & Teasel

    Kris & Teasel Well-Known Member

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    That's a really good question. I can't imagine giving that high a dose to a cat that doesn't have one of the high dose medical conditions like acromegaly or autoinsulin antibodies. Unless his insulin needs were higher then and have dropped significantly for some unknown reason, I think he was just lucky that his physiologic compensation processes (that cause what we call bouncing) were in good working order. You weren't testing then so you have no idea what those huge doses were doing to his BG.
     
  70. johnt

    johnt Member

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    Oh i know. I'm so much more relaxed now, yet more stressed too. when i get better at testing it'll relax. but since i'm not going to test him 10 times a day he should calm down.

    I'll keep this going.

    I can't thank you enough for the help. i meant to say that several times
     
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  71. Kris & Teasel

    Kris & Teasel Well-Known Member

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    The minimum number of tests a day that will give you a general idea of how he's doing is three: AM/PM pre shot tests and one more in the +4 to +7 range. You can try adding a fourth at your bed time. If you move that middle test around day to day you'll get a good sampling of data to show how a dose is working. You don't routinely have to do nearly as many tests as you did yesterday. Once in a while you might want to do a full curve at a dose but the scattered tests are generally easier to accomplish and give good information over time. Think of them as pieces in a jig saw puzzle.
     
  72. johnt

    johnt Member

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    OK. my thought was I need those +4 - +7 on both cycles. so i only need to do them on one or the other? Should I rotate them? Moving them around won't be a problem. i don't want him to start hiding when i'm coming anyway.

    poor chunk has gone through a few rough days.
     
  73. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    No, you don't need them both cycles. In the daytime, you can do one test (between the AM/PM pre shot tests) and vary it from about +4 to +7 over a few days. Do two if you feel ambitious and Wilbur is OK with it. The routine evening test we recommend is one before you go to bed. If you want to be more strategic, get a +2 in the evening to see what his plans might be. If the +2 is much lower, set an alarm for a test near +4 or +5 because a low +2 can be a sign of a bigger drop to come.

    You're still getting used to this testing routine and building it into Wilbur's day as well so aim for those three basic tests for now. Of course, you'll need to increase that if his BG needs to be monitored more because it's getting low.

    Work on getting more water into him. Try that pureeing wet food with extra water trick.
     
  74. johnt

    johnt Member

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    Boy he drinks a TON of water. I keep filling the cup full of ice again, and i have two of those big baking dishes I fill up with ice then water.

    he frequently lays by the cup like the pic i posted during the day.

    me backing off a bit will calm him down. i'm glad to know i just need to do it 3 times per day
     
  75. Kris & Teasel

    Kris & Teasel Well-Known Member

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    OK. It seems he has the water drinking covered. Part of the problem as I mentioned a few posts back is that dry food actually dehydrates them so the less he eats of that the better. He's already dehydrated because of diabetes.

    Yes, I hope a reduced testing schedule will help. You have to stick to it though because that's what all the dosing decisions are based on.
     
  76. johnt

    johnt Member

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    Understood.

    Should I move him off the dry treats completely and just use the simple servings? those are small wet packets that he licks. It would take me awhile to get him off the treats but if needed I think I could.
     
  77. Kris & Teasel

    Kris & Teasel Well-Known Member

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    When you say dry treats do you mean regular kibble or things like Temptations (very high carb!)? He has to eat but the more low carb wet food the better, the less kibble the better. Do as much as you can.
     
  78. johnt

    johnt Member

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    yes the temptations. I'll wean him off of them again
     
  79. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Some people here refer to them as donuts for cats. ;) There are freeze dried plain meat only treats in pet stores that are good to use as treats. One brand is Pure Bites. Wilbur needs a treat before and after every BG test. I keep Temptations on hand to boost my cat’s BG when he dives too low. You can use them for that.
     
  80. johnt

    johnt Member

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    Feb 14, 2016
    That's what I was hoping for the temptations. the problem is when he was young that's all he would eat. so i likely am the reason he got diabetes, i had no idea.

    Anyway, yes I want to get him off the temptations unless he drops down real low.

    he's so tuned in to those things, he stops eating them when they get old. even sealing them every time he will wait till i open a new bag then crush them. So since they're all about .50 per /oz I stopped getting big ones and buy the smallest I can.

    Anyway, done for the night, i'll start up in the morning

    Than k you for the patience.
     
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  81. FurBabiesMama

    FurBabiesMama Well-Known Member

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  82. Kris & Teasel

    Kris & Teasel Well-Known Member

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  83. Kris & Teasel

    Kris & Teasel Well-Known Member

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    How is Wilbur this morning?
     
  84. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    yes you've been a Godsend, believe me.

    Wilbur is good. I woke up about an hour ago and tested himv (331 @ +10). He's due for a dose in 30 minutes.

    I'll check him again at +5

    Also, is there a preferred time of day that's best or just when h wakes up in the morning?
     
  85. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Another idea for treats: you can roast or poach a plain chicken breast, cut it into tiny bite-size pieces, freeze the bulk and leave out a day's amount at a time. Easy to do and economical.
     
  86. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    That +10 doesn't count as his AM pre shot test. Make sure he doesn't eat anything for the 2 hours before each pre shot test. I know I sound like a broken record but that's important.

    Test again at what is his +12 time - that's your pre shot test. Post it here right away. My guess is the 4.5 u will be OK but I'd like to see the BG test number.
     
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  87. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    After this AM business is dealt with, getting a +5 today is good. Give it a few more days and this whole routine will be second nature. :)
     
  88. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Just saw that 348 pre shot and the 4.5 u dose. Good. If you've forgotten the no food for 2 hours before the pre shot test, no problem. Aim to get that in place going forward. Give Wilbur a pokey break until +5.
     
  89. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    Yes. i gasve him the shot and we did the 'no food' 2 hours pre. He was sleeping. This is why i changed him when i started the chart back to 9am/9pm. that seems to fit his schedule. I prefer him to be at 5am/5pm to fit mine, but that's ok.

    I also saw @FurBabiesMama say how horribly high the carbs are in Hills Prescription Diet. See that old vet got me on that saying it was good. Well it's not, and it's expensive (well to me). It's $65.00 for a 16lb bag.

    The problem is I need something all 3 will eat. Still looking. I was going to try that 'young again' food. Wilbur LOVED that when they sent samples, but this was before I could test him and they told me they wouldn't sell it to me unless I was testing. I think it might be hyperbole but i'm not sure. are you familiar with that? This is the food i was looking at but I don't know that I could afford those prices. $56 for an 8lb bag? seriously?

    screenshot-www.youngagainpetfood.com-2018.02.08-09-16-37.png
     

    Attached Files:

  90. FurBabiesMama

    FurBabiesMama Well-Known Member

    Joined:
    Jul 6, 2017
    If you could get them all on a low-carb wet food, that would be the best option. There are lower priced ones available. If you must have dry food, the Zero Mature Health is as low carb as you are going to get. That company is very 'dramatic' about their product which I do not like and just ignore. If you buy into their 'propaganda', it is the best food to ever exist and must be the only food your cats ever eat and will cure their diabetes! :rolleyes: My girls like it, and I add a few kibbles, usually crushed, as a food topper. Occasionally, I use it as a treat for Mia. She is really a little kibble junkie. :)

    Update: I should add that if you change to low-carb food, you will have to be very careful because that can drop a cats glucose level quite a bit, so you want to monitor very closely.
     
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  91. FurBabiesMama

    FurBabiesMama Well-Known Member

    Joined:
    Jul 6, 2017
    One more thing about Young Again. Notice how high the calories are. Your Hill's food has 280 kcal/cup while the YA has 596 kcal/cup. So, they should not eat as much of the YA which makes the cost better than it seems.
     
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  92. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    i did see that, and I agree about the hyperbole. i mentioned it. For me it was the carrbs.

    But they do claim on their site that your cats will eat much less of it so it's comparable. however that's hyperbole as well.

    I know that wilbur LOVED it as a treat. so i am hoping to maybe swap it out as a treat instead of the temptations that are awful

    I'll look at the one you mention above when I'm back in my office.

    Thanks!
     
  93. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    oh also, i can't swap them to wet. Tinker and Pickle are strange. they both do fine grazing but are awful trying to feed on schedules. Tinker is the worst, she's so picky the best I can get is for her to 'sometimes' like a wet food to death. She won't eat it. she'll just lick the sauce off. but even then it's very difficult to find one she'll like, and then the little monster gets tired of it.

    Im trying to find a balance though
     
  94. Nan & Amber

    Nan & Amber Well-Known Member

    Joined:
    Mar 19, 2016
    Another dry that I think has acceptable carbs (supposedly; I haven't kept up with reports from folks that have tried it) is Dr. Elsey's Clean Protein kibbles. They're available on Chewy.com. Also pretty pricey, but might be another option for your picky eaters.
     
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  95. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    Yes, the chicken is 5% and the salmon is 8% (if I remember right).....I got some for my civvies (one of who has always missed her "crunchies") .....China sneaked a few and it didn't do anything bad to her BG
     
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  96. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    i buy the hills prescription diet on Chewy using auto ship. I'm familiar with them.

    It says 42.29 for a 6 lb bag, I wonder if it's possible to get bigger?

    I also wonder if there is a sample or really small bad (2lb was the smallest I saw). I would need to try them all and see if they like it (it would have to be salmon i'm sure).

    Maybe i'll order the $14 small bag and try that
     
  97. FurBabiesMama

    FurBabiesMama Well-Known Member

    Joined:
    Jul 6, 2017
    It took a little while for me to transition my girls to wet; they had eaten dry their entire lives. It also required going through several different foods before finding what they would consistently eat. I feed them four times a day (every 6 hours) and whatever they don't eat at meal time remains out for them to graze on until the next meal or until two hours before Mia's pre-shot glucose test.
     
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  98. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    You can call Dr. Elsey's....they'll send you samples
     
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  99. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    Got him a +5 @ 319

    He's getting sketchy around me, he squirted out and ran a little but he came back around and was then fine.

    I got him just now and i got a great shot, no flinch, first try etc and he didn't notice. if I can keep getting that he'll be fine.

    So your advice is to get a +7 tomorrow? should I do it during the day cycle like I did this +5?
     
  100. johnt

    johnt Member

    Joined:
    Feb 14, 2016
    Oh fantastic! I'll do that. Maybe lightning will strike and they'll all swap. I got very lucky (well not now that I know the truth) with them all moving to the Hills, but once i find the right stuff to feed them i just have to cross my fingers and hope the agree.
     
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