New - At-Home Blood Glucose Questions!

Hey everyone,

New to the forum. Just have a few questions.

I have a 10 year old male, neutered boy that was recently diagnosed as diabetic a little less than a month ago. About 2 weeks ago he had a glucose curve done at my veterinarian, and he is on 3 units of Vetsulin twice daily.

I just bought the AlphaTrak 2 to do at home blood glucose tests, and did a fasted BG on him this morning. He had been fasted since 9pm the last night and the last time he had his insulin was 6pm last night.

It read at 551, which is very high, however since it was the first time having his ear pricked at home, and I was getting used to using this specific lancet (usually I have free-handed before, which might be what I have to end up doing) I know stress/excitement could have raised his blood sugar. He was figgiting quite a bit so even with two people lightly restraining him it had proved to really stress him out. I know with cats sometimes it can cause a reading to be even ~200 points off.

I know when he had his curve it stayed between 300-450 in the hospital, which is where he was also apparently quite stressed.

I have some veterinary experience but not a huge amount regarding Feline Diabetes, so my question is more towards my cat's behaviour. He is an easily stressed/excitable cat in general, and I'm wondering if anyone has any tips or similar behaviours with their cats that would prevent them from getting an accurate BG reading every time? I know we're going to have to adjust his units, from my experience he will probably end up being brought up to at least 4 units twice a day, but I'm waiting on my veterinarian to call me back this morning, to see if she wants to me to test after he had in insulin/breakfast or wait and do another fasted BG tomorrow. I just want to be able to give her the most accurate readings since he is still in the beginning stages of his diabetes and I know we have some regulating to do.

He is acting like his normal self, ate all of his food, drank water, peed, and is now half asleep/purring up a storm.

 

Hi, and welcome to FDMB! You have definitely come to the right place for help with managing feline diabetes. Here is a link with loads of good information, tips and tricks for home testing:

http://www.felinediabetes.com/FDMB/...mps-262-3-63-4-53-5-53-10-96-pmps-129.155642/

 

Hi,

I'm not really sure what I should be looking for in that link specifically? Especially since it is under the Lantus sub-forum, and I'm currently on Vetsulin.

 

LOLOL! I am so sorry, I copied the wrong link! Let me try that again.

http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

That should do the trick!

 

Hahaha that's okay, thank you!

Yeah I think my issue was definitely in trying to hold him. I'll try sticking with the lancet after he comfortably sits down somewhere on his own (the next time I do a BG) I think the lancet might be making him nervous to so I might have to free-hand if all still doesn't go very smoothly.

 

Hello and welcome. My cat started out on vetinsulin from mar 9-28 then switched to lantus because his numbers were to erratic. Started out on 2units the first week then 3 units then second which he crashed on twice. Also lantus has a higher rate of remission with diabetes. From what I have learned on this forum lantus is a lot better than vetinsulin. you normally test before you give the morning injection then another test about 6 hours later then another before the evening injecion and then another 2-3 hours after. Also you may want to setup your spreadsheet so you can get the numbers going from the start. Also what diet are you feeding? the alpha trak is going to be expensive to do a lot of testing with. As for the lancing device i take the cap off but leave the lancet in so i have a better grip and poke that way.

 

I always free handed the lancets until just very recently, when I decided to try the lancing device just to see how well or not it worked. In my opinion, the device is okay - better for getting "uniform" pokes, that don't go all the way through the ear, but it has nowhere near the accuracy of free-handing the lancet.

 

Hi,

Yes I've known Lantus to work better for cats because of their high metobolism and Vetsulin does not stay in the body for as long . This is something I want to inquire about as well but I was going to go ahead and give Vetsulin a try, my veterinarian said she starts with Vetsulin and if not successful, moves on to something else.

I tested him at 7am and called my practice, still waiting to hear back from the Dr. as she has been in appointments all morning. Because this reading was likely very inaccurate due to stress, I am wondering if she'll want me to test again at all today or just wait until tomorrow to do another fasted BG.

I feed a high protein/low carb diet, Instinct Raw 1/4 cup in the AM, 1/2 cup in the PM. I have 3 cats in total all on this diet.

Yes the AlphaTrak is extremely expensive for strips and lancets, but I've known mixed reviews about using a human-based GC meter. Money isn't a huge issue for me, but we'll see if he becomes an extremely hard cat to regulate what some other options would be. It says to only use the AlphaTrak lancets, but I'm wondering if I solely free hand it I can purchase a cheaper brand of lancets? The strips on the other hand, to my understanding, would read inaccurately with off-brand strips?

How do I set up the spreadsheet? Should I include even inaccurate readings due to stress?

 

Yeah I've always free handed previously (not my own cats) and it worked well, helped achieve the premium spot to poke with more accuracy. The lancing device seems bulky and awkward.

 

spreadsheet instructions
include all your readings and you can add notes as well.
Once you start gathering information from this forum you are probably going to run into the problem of your vet disagreeing with a lot of it. Unfortunately most vets have not studied feline diabetes enough. A lot of us have horror stories from trying to work with are vets.

 

you can get relion lancets at walmart for $1.48 for 100

 

I'm just really curious to what his number is at right now but I don't know if I should wait for her to call back or not.

 

testing him isnt going to hurt anything.

 

Awesome!

Are they over the counter?

 

True. I'll give it go right now.

 

yes they are where the meters and strips all that stuff is together near the pharmacy

 

So I just tested him (3 hours since pre-shot test) and it is down to 350. Dr. called me back soon after and she said despite him possibly being stressed, even if his BG was in the low-to-mid 400 (without the stress) that's still too high. She said to up his dose to 4 units twice daily and then when I do another fasted BG on Friday morning to call her.

I will create my timeline tonight, my laptop is about do die!

 

Hi and Welcome! I don't use vetsulin so no advice from me on that, but I do use the Alpha Trak 2 meter. I have been testing my kitty in the paw pads for a few days to give his ears a break and am using the Lancet device for this. I bought the Relion 26 gauge lancets for alternate sites from Walmart, 200 for less than $2 and they work fine in the AT2 lancet device. I freehand when testing ears.

 

I originally wanted to try on his pads but first lancet barely drew enough blood, and I wasted a strip. I will definitely attempt to rotate though, I don't want to bang up his ears too much!

I will definitely purchase the lancets from Wal-Mart! Any alternatives to the strips or are those the only option?

 

Some on here use the Freestyle Lite strips made by the same company but for a human meter. I have yet to try them with the AT2 but those that use them say that the don't see but a small difference in the numbers, from 5 to 10. I plan to try them eventually when I go broke buying the AT2 Strips, LOL! I worried about testing on the paw pads too, but I have found that I like it a lot. What works for me is to warm his pad up for longer than the ear before sticking. I don't think Shoes actually feels the stick at all. He never flinches. Then when I see the tiny blood drop, I squeeze gently the pad to get a little more blood from it. I think Shoes likes being cradled on his back like a baby too. Good luck whichever way you go! Testing is so important, as I am sure you know!

 

What gauge lancet are you using? Sometimes it's helpful to use a smaller gauge, 26 - 28 (numbers go "backwards",e.g., 30 is smaller than 28) until ears "learn" to bleed. And you would definitely need them to test paw pads.

I started on Vetsulin, using the Alphatrak to test. I might have used the AT 10 times before I switched to a human meter, lol. A lot of people here use the Relion meters from Walmart, they are accurate and much less expensive to use. There is a difference in readings from human to pet meters, but as long as you know the correct paramaters it's no big deal.

My cat was on Vetsulin for about 9 months and did very well on it, but it is harder on kitty and difficult to regulate with. Most people also seem to find that they don't get a full 12-hour duration with Vetsulin, although I did not experience this. We switched to Lantus about a month ago, and I wish I had been able to switch sooner, after seeing how incredibly well my guy is doing on it!

You don't need your vet's permission to test. You can test anytime you want. In the early days of diagnosis, especially, the more you test the better picture you will get of how your cat is responding to treatment. It is really helpful, both to you and to us, if you can set up and fill out our spreadsheet. It will be one of your best tools for coping with your kitty's diabetes, enabling you to see patterns and events that you might otherwise miss or not see the significance of. It helps us to be able to view it when you have questions or are looking for advice.

Could you please tell us your kitty's name, and a little bit about him? You can tell us your name, as well, if you'd like, but if you prefer not to that's okay, too. If you click on your name as it appears in the dark blue bar at the top of the page it will open a drop-down box with other options, one of which is Signature; it's very helpful to put any pertinent info in your signature, such as what your kitty's name is, his age, date of Dx, what type of insulin he is on, what he eats, etc. This also helps give us information at a quick glance, in case you need help. And just browse the site, there is a lot of great information contained herein! You can also take a look at other spreadsheets, to get an idea of how they work, just click on the link in a signature to view it. Happy browsing!

 

Hi!

I'm using the AlphaTrak 2 28 gauge lancet. His ears bled without issue, I just found it much easier to do it by hand than use the lancer.

I saw several of the Relion meters on Wal-Mart, do you know specifically which type is commonly used? Is there something for reference regarding the difference/conversion between human/pet meters?

I of course would like to keep the cost down, but if he's going to be one of those hard to regulate type cats, I'm concerned with getting the most accurate reading as possible. Since I already bought the AlphaTrak 2 I feel like I might as well use it or it's a waste but in the long run I would definitely save money by using a human meter...

If the 4 units she switched him to today don't show any progress by next week, I will discuss the possibility of switching to a more cat-friendly insulin such as Lantus.

My name is Erica! I will update my spreadsheet here in a bit, and my signature.

 

The favorite meters around here are the Relion Confirm or Micro from WalMart...they take the tiniest sample size and are affordable at $35.88 per 100 for the strips

We are big into home testing here, so most of us can't afford to use the AT...especially if you're testing as much as we do! I test China 6-8 times a day (more if she's running low) so that would be over $250 a month in just strips if I was using the AT

The only "official" comparison number we have is that 50 on a human meter = 68 on the AT

All of our protocols here are written in human numbers because that's what most people can afford and it's just what was used when the protocols were developed.

ALL meters, including the AT are allowed to have up to a 20% variance by the FDA, so even if you use the same drop of blood in the same meter, you can get up to 20% difference in each test

 

Freestyle lancets are identical to the Alphatrak ones and therefore fit the Alphatrak lancing device perfectly. Don't know about the US but the Freestyle lancets are w-a-y cheaper over here in the UK. Have a look on ebay or Amazon to see what the prices are like.

If you just want to freehand with the lancet alone then I'm sure that you'd be able to find other lancets of appropriate gauge online even cheaper than the Freestyle ones.


Mogs
.

 

Thank you!

So would that translate to the AT to always being 18 points higher than the read on a human meter? Or would it increase as you went up, like... 51 on the human meter would be 69, 52 would be 70, etc?

So overall would you say to put the AT aside and purchase a human meter? Or wait and see if he's a hard to regulate/needs constant BG testing in comparison to how much other cats may require?

 

I'll take a look for sure!

 

I am quoting another member here (thank you, MrWorfMen'sMom!):
"The comparison between the AT meter and the human meter is not directly linear or a percentage difference. While we think the difference between the two meters at low ranges is somewhere between 30% and 40%, we do not have definitive information regarding what the differences are at moderate or high ranges of numbers. This is largely because at moderate and higher numbers, the difference really doesn't matter so not much scientific information is available. Different things can also influence what number you get.....for instance, were your tests done with the same drop of blood? And then of course there is the allowed FDA variance of both human and pet meters of up to 20% so there are a lot of factors coming into play here."

As Chris & China say, most of us here do use human meters. The conversion of numbers from the AT to a human meter is not particularly important, it's more important to know what the numbers (on either meter) mean. Numbers below 50 on a human meter are falling into hypoglycemic range; on an AT meter that would be numbers below 68. And high is high on either meter, lol. There is no hard and fast rule for comparing the numbers from a pet meter to a human meter, except that 50/68.

EDIT: I could never afford to do all the testing I do if I was still using my AT! Feel free to take a look at my spreadsheet, and you will see what I mean!

 

Will do, thank you. I will update mine later tonight.

 

That's a great explanation....another way to think of it is to think of thermometers.....as long as you understand the scale, you understand the numbers you're getting

Once you learn what to look for, both are accurate. On human meters, anything below 50 is your "time to act" to bring their blood glucose up....on the AT, it's below 68

Our spreadsheet is another great example of why we don't use the AT....at over $1 per strip, there'd be no way I could afford to test as much as I do and that's a pretty common theme around here.....even if you can afford them, the tendency is to conserve them as much as possible, where with the human strips, it's only about .30 cents so it's no big deal

I'd suggest getting the human meter and just learning from the beginning what those numbers mean. Keep the AT as a backup meter, but don't try to compare them...you'll just drive yourself crazy....lol

 

Welcome, Erica!

There are a few things here I wanted to address.

First, what version of Intinct Raw are you feeding? There is a version that is just freeze dried meat, and ok for diabetics (although, I would feed it sparingly because it is moisture depleted), but there is another version (Raw boost) that is a mix of dry kibble and freeze dried meat. This is not diabetic safe (it includes alfalfa meal), and if you're feeding this it may present problems regulating your cat. If your cat will eat canned food we usually recommend that you just ditch the kibble completely for diabetic (and really all) cats--not only is it usually too high in carbs, it is also dehydrating and causes chronic kidney and urinary tract issues. There's a great website here that explains why. If your cat refuses to eat canned food, there's also some tips for transitioning to canned food there that are super helpful. If your cat refuses to eat canned food, there are a couple dry foods that are low enough in carbs for diabetics that you can feed while you work on transitioning-but I would still keep working on the switch. Even those foods still present problems with regulation in some cats and still have the same issues with kidney disease and urinary tract disease that all dry food has. You'll want to make sure you're testing when you do the switch to low carb canned (if you're feeding the "raw boost" and not the raw freeze dried which is already low carb), because removing kibble from the diet can cause dramatic drops in blood sugar levels, and reduce his insulin need.

If you have switched to a low carb diet, and your cat isn't well regulated on Vetsulin within 4-6 weeks, I would definitely switch to a slower acting insulin like Lantus or Levemir. Studies show that there is a window of remission with long acting insulins, and the sooner you start on one the better your odds are. 80+% of cats that start on it within 6 months go into remission, while very few cats that start after 6 months reach remission.

You don't have to worry about your home test readings to be influenced by stress, because your cat isn't going to be stressed long enough for it to affect the test. The reason why vet testing is inaccurate because of stress is because the cat is getting stressed in the car on the way there, and the office, and by the strangeness of new space and people and the smell of other animals. At home, these factors are not in play. Your cat may seem a little stressed (he's likely more annoyed than stressed), but it's not going to be enough to raise his blood sugar significantly, unlike a vet office visit which is very traumatic for many cats.

 

Hello and welcome.

I was an AT user, but the cost did convert me to the relion micro. Since I'm somewhat number phobic ( they jump around on me) I basically go by the color ranges on the spreadsheet. The green zone means wake up, pay attention, and step up the testing.

You will find what works for you. Just keep asking questions.

 

Yesterday, I got 3 boxes of 100 strips each, with good expiration dates, from ebay for under $33.00, total!!!

 

Hi there!

I feed him Instinct Duck & Turkey kibble, not the raw boost or the completely raw freeze dried bits. All 3 of my cats are on this formula, they were all previously on Natural Balance Reduced Calorie. I'm not opposed to switching to a different protein but I would like to stick with this brand, they seem to really enjoy it. I like to keep them on filler-free diets in general so cost is not an issue, so with that being said I'm not a fan of Fancy Feast etc. Carter will not eat wet food in any extent, he won't even eat something like tuna or chicken as a bribe or treat (pre-diabetes). He loves dry food, and eats all of his portion at each feeding. My other cats like wet food but I've never been a fan of wet food as a primary diet in because of how it effects their oral hygiene. I had my oldest (non-diabetic) on a dry food/wet food type diet when he was younger (he's now 12) but I had to give him so many dentals (in addition to routine oral care, water additives, etc) due to the plaque and tarter build up I decided to eliminate it from the primary diet and he's only ever gotten it as a treat here and there.

I can always pick up a can since he's on this new food and see what he does but I really highly doubt he will eat it, even if it's portion/mixed with the dry.

I definitely will speak to my veterinarian about switching to Lantus, I know in a week or two she wanted to due a Fructosamine test anyways.

He seems fine now stress-wise I think it was that first initial test that stressed him out but it's good to know that can't affect the test much.

 

Yeah I totally understand. I will likely make the switch as well, I'm sure. I just want to see how well this 4 units of Vetsulin works over the remainder of the week and if not, I'll probably be making a stop at Wal-Mart.

 

Oh wow!! That definitely seems a lot more cost effective. Why is the AT2 Tracker so expensive to maintain? Is it the only animal GC meter on the market?

 

Unfortunately, the kibble you're currently feeding will keep his blood sugar high and present problems with regulation. This is a great website that explains why you should not feed any kibble, especially to a diabetic: http://catinfo.org/. I strongly urge you to check out the tips for transitioning dry addicts to canned. The most common impediment people usually have with transitioning is that they don't feed the canned food frequently enough, in smaller meals. Cats have metabolisms twice as fast as people's or dogs, so you want to feed at least 4x a day, if you can. You can freeze portions of canned food to leave out overnight or while you're at work, or set them in autofeeders if that works better. If you need some dry food in the meantime while you're trying to transition, Young Again Zero is only about 5% carbs. However, I would only use this food as a temporary measure and continue to try and transition to canned. Even the lowest carb dry foods still can present problems with regulation because they are high glycemic due to the manufacturing process. Also, diabetic cats have extra strain on their kidneys, so it's best to keep them as hydrated as possible. Because dry food is dehydrating to cats, it causes kidney problems.

Dry food does nothing to help with dental health, and wet food does nothing to hurt it. I'm not sure how that myth began, but there's absolutely no studies that back it up. Studies have shown that oral hygiene is mostly determined by genetics in cats--and any problems they have will be independent of whether you feed them dry food. I just adopted a cat from the shelter last year who is only a year old and needs a dental already--and he was eating dry food the whole time he was at the shelter. He just lost the genetic lottery when it comes to his teeth.

There are a lot of good, filler free canned options for diabetics! There's a food chart here that breaks down many commercial foods into their protein, fat, and carb values. Bandit eats Weruva and Wellness Core canned, neither or which have fillers or byproducts.

Just an FYI, a fructosamine is completely useless outside of diagnosis and a waste of money. Home testing gives a much more complete and accurate picture of how insulin is working in your cat. A fructosamine will only give you an average BG over the course of several weeks, which is pointless because a cat can experience a range of highs and lows throughout the day, espeically if the cat is unregulated. Bandit has been diabetic for over 7 years, and he's never had a fructosamine (he was diagnosed with blood tests and a urinalysis).

If you give your cat a diabetic safe treat after every test (successful or not), it helps quite a bit! Also, cats can sense if you're nervous or upset, and they act accordingly. It seems silly, but adjusting your attitude from "Oh, poor kitty! I'm so sorry I'm hurting you!" to "You're getting this test, cat, whether you like it or not because we need it to save your life!" can work wonders. The attitude change made a world of difference when I was learning! Keep in mind as well that the pokes don't hurt the cat at all--they have less nerve endings in the tips of their ears than people do in their fingers. They just don't like that you're nervous and doing something new and strange to them. If you relax, make it part of their routine and give treats, they accept it. Bandit used to fight me tooth and claw, and now he comes running to me when he hears the meter beep on, sits at my feet, and starts purring.

 

Hi,

I thought I saw Instinct/Nature's Variety on a list of acceptable foods, though? I saw a link somewhere on this site but I can't find it.
Does that mean he can't have Instinct wet canned food (if can even get him to eat it) either? Like the whole brand will keep his blood sugar unregulated?

I literally (like two days ago) just bought a huge bag of it so should go ahead and purchase another type of dry this week to give Carter while I try to transition and then feed my other boys the Instinct? Are their other filler-free foods you'd recommend you besides Wellness Core wet? Are their other types of dry food with low carb content you can think of that are sold in-store or on chewy.com? I live in small town in Alabama so there are few options for good quality pet food unless you purchase online and that means I couldn't switch him over immediately because I'd have to wait on delivery in regards to dry.

In regard to the Fructosamine test, is this something that I would straight up decline then? I don't want my doctor to feel as if I'm challenging her in any way as we have a good report at our veterinary hospital but I don't really know how she'd respond if I saw a bunch of people on the nternet said this or that is a waste of money, haha! But I am aware how veterinary hospital the kickbacks and "money-making" visits that can be implemented for clients.

I had no issue actually taking blood from him all. He was a little figgity but I think I was trying to hold him in place too much, he did much better thereafter when I just pricked him casually without making a big deal about it. I was more concerned with how much stress can produce an inaccurate reading but now I know that's only really relevant on a more drawn-out scale.

 

Show-off!


.

 

No, the Instinct canned is fine. It's all low carb (it's on the list of canned foods posted below). It's just the dry that is problematic. I honestly don't know if the Instinct Kibble is low enough in carbs for a diabetic cat. Their old dry formula was listed at 7% carbs back in 2007/2008, but they've changed their formula since then. It's probably better than most dry (I'm not seeing anything that screams high carb in the ingredients), and probably ok if you want to keep feeding it while you try to transition him off it. As I mentioned, even the lower carb dry foods (including the Young Again) can cause problems with regulation, and all dry foods contribute to kidney and urinary tract disease in cats. I found it easiest to just get rid of all the dry in my house, rather than try to not feed it to one cat and give it to the others. And the others also reap the health benefits of the canned diet.

There are a TON of different premium canned foods you can feed without fillers. Weruva, Wellness, EVO, BFF, Tiki Cat, Wild Calling, Instinct--these are few I can think of off the top of my head. There's a food chart on the catinfo site that gives you a breakdown of the protein, fat, and carb content of many different commercial canned foods. Just pick any one that you like the ingredients for that is less than 10% (preferably below 8%) carbs.

I understand not wanting to challenge your vet--it's hard to find a vet that you have a good rapport with and will work well with you. However, many vets may not be up to date with current feline diabetes treatment, so you may have to educate them a little. Bandit had a good vet when he was diagnosed, but she was awful with her dosing advice. His current vet at Cornell is the only one I've not had to educate in regards to his diabetes in some way! I've attached an article that you can print out and bring to your vet. Under Fructosamine, it states

"Using fructosamine to guide insulin-dosing decisions is not recommended because it is not an accurate guide to recent blood glucose concentrations. Blood glucose
monitoring, ideally at home by the owner using a glucometer, is preferred."

If you feel really uncomfortable challenging your vet this stage in the game, maybe do the fructosamine to make your vet happy, and save the challenge for the next time they ask for one when you are more experienced? But if the cost of the fructosamine is something that will impede your ability to buy a good low carb food or home test strips, then I would challenge it, period. Vets are not usually bad vets, they just don't have all the information. If your vet is willing to read the information you give them and work with you on what you want to do, then stick with them. If they refuse to recommend good treatment practices despite current studies and recommendations, then it's time for a new vet, unfortunately.

This is GREAT! Winning the struggle of wills with your cat is half the battle with home testing.

 

Ah I just found that food list again, I was hoping to save you the trouble of typing everything out but you beat me to it! Haha!

Thank you so much for taking your time out to explain everything further. I just want to get him solid and regulated and I know that takes time when switching foods and adjusting insulin doses and brands.

I obviously misread about the Instinct because for some reason I was thinking the dry food was what was being referenced but it was the canned.

He really likes the Instinct so maybe he will really liked the canned food version. I noticed when I fed my other cats a wet food treat last week he seemed interested in what they were eating but I shewed him away because I didn't want him eating a bunch of different foods when we were just starting out insulin. He had never been interested in wet food before (since we had him and before we adopted him according to his old "owners") so I don't know if he would have sniffed it or ate it but it's a start... I'll pick up a few cans of those brands tomorrow and see what I can do for him.

I have a lot of dry food in the house right now so I'll probably let my other two boys finish it off and then adapt all three to the same diet again.

Do you know how much Fructosamine tests usually run? I know the first curve we got done in hospital was $25 (which she said the first one she would prefer to do in hospital but felt more comfortable if we could test at home thereafter) so I feel like she wouldn't be offended but maybe she just wants to do the one Fructosamine test in hospital during the beginning stages just for her notes? I'm not sure, I will have to discuss with her further.

 

Bandit's never had one done, so I'm not sure how much they run. I hope maybe one of the other members could comment on that? When I switched vets way back in 2010, they wanted to do a fructosamine on Bandit that I vetoed (I was home testing 3-8 times a day so there was no reason for one), I think they quoted me $150? I have no idea if I'm remembering that correctly or if that is still a standard price for one.

Edit: I just did a quick internet search and I think I am remembering that wrong...I'm seeing about $50-$70 on average for one?

 

Update: we went to the store tonight and got three different brands of canned food - Instinct, Merrick (I saw that on the list) and Wellness Core. Didn't have any of the other brands at Petco or Petsmart,

Tried with about 1/4 can of Instinct and he actually ate most of it after some hesitation and some looks of "are you serious?" From the looks of it, he licked up most of the liquid first and then ate 75% of the solid portion. Didn't finish all of it, but it's a start! I gave him some Instinct dry in addition because he really didn't eat a whole lot of the wet food for his calorie intake.

I will try the same thing again with the Wellness Core tomorrow and see if that gets a better response.

Thankfully Petco said they would exchange my full, unopened bag of dry Instinct for canned food, so I basically just have the last bit of my current bag and then I can switch everyone over to canned.

Does anyone recommend the best places to buy the canned foods in cases? Like the most price effective? As far as I know most of the pet food stores closest to me do not sell by the case...

 

Chewy.com is about the best for price/shipping/choice but you can order most foods from Amazon too (as far as online places)

 

You can get the cheaper canned foods at walmart or costcos like fancy feast classics, 9lives patetes,sheba perfect portions in cases and coupons are posted for those to on forum.

 

Yeah I'm comparing prices now. I guess it will depend on which canned food we settle on too.

 

Does anyone know the carbs in Fromm canned wet? I can't find it anywhere but I found this article where it was mentioned.

I feed my dog Fromm and I really like the brand if that was acceptable brand for Carter but I'm not sure.

 

If your in the chewy site checkout the ziwipeak brand. Smokey likes it better than nature variety, he stopped eating it after a week. I didn't like nature variety because of how dry it is.

 

Okay I will!

My only issue is I would ideally like to find something he likes and then order the large quanitiy and it's hard to due that around here because I'm limited to trying brands at Petsmart and Petco. There is a place called Hollywood Feed about 30 minutes away that sell a lot more premium and holistic foods but I don't think they sell half the options they have on Chewy.com. I have to go there soon to buy some more Fromm dog food so I thought I'd buy Fromm canned for the cats (1 can to try) but I am totally stumped on the carb content.

 

The chicken, duck & salmon numbers are listed, so I assume their other flavors are too

https://frommfamily.com/products/four-star/cat/can/chicken-duck-and-salmon-pate/technical-analysis/

Looks like As fed is 6.27% and Dry Matter is 30.59

Right now my brain isn't working and I can't remember for sure which number is more important, but hopefully others will chime in and help

 

Welcome!
Here is another picture of the sweet spot... it helped me tons-(I was aiming for the vein at first)

 

Ah you're a life saver, I went to that page but obviously missed that other tab.

Yeah I'd like to know too. I assumed Dry Matter applied to the dry formulas so I have a lot of learning to do haha!

 

Looks like the 6.27% is the important one, so since it's below 10%, it should be OK

From the Food chart on Dr. Lisa's website

2) Carbohydrates: This is an important area of consideration – especially for diabetic patients. Unfortunately, this macronutrient is not actually measured in a lab. Instead, it is calculated by subtraction. In other words, we add up the moisture + protein + fat + fber + ash and subtract that value from 100% leaving us with the carbohydrate fraction. However, any error in those Big Five values will result in an error (usually an overage) in the carbohydrate value. Stated another way: The carb values noted below are probably higher than they actually are. Even a value of 10% carbs could actually be closer to 0% carbs. Therefore, stick with the directive to stay below 10% carbohydrates but do NOT get caught up in whether a diet says 10%...or 5%....or 0%. Take it one step further and read the label. For example, if you do not see any grains, peas, potatoes, “starch,” or vegetables on the label, even if it is listed as 10% carbs, chances are that it is much lower.

 

Just a quick note... If you're changing the diet please make sure you're testing and lowering the dose as needed! Eliminating the dry food can cause big drops in BG, and he's on a pretty hefty dose of Vetsulin. The same dose of insulin can cause a dangerous hypoglycemic incident once the dry is removed.

 

Great. Thank you!

 

Yes absolutely! I am only just trying him on a 1/2 3oz can(s) to see how he likes it but I am still feeding him the dry as of right now until we find the wet food he likes the most hopefully by the end of the week.

Should I test a lot (more than 3x a day) at this point since I still have the dry in his diet?

I am suppose to call my vet with a fasted BG on Friday morning so I didn't know if I should wait, tell her about the diet change, get the okay from her regarding the insulin dose?

 

There's no such thing as too much data when it comes to insulin and our sugarcats. We always test before shooting, and then if at all possible during the AM cycle get at least one test between +5 and +7 and then on the PM cycle get at least a "before bed" test (since most cats go lower at night)

It's really important that you start keeping track of his numbers on our spreadsheet (Instructions on getting the FDMB spreadsheet) It's a very important tool here and we'll want to see how he's been doing before giving much in the way of dose advice in the future.

As for your vet, I'd REALLY try to get a better insulin like Lantus, Levemir or ProZinc for Carter. A good insulin can make the world of difference in his chances of possible remission or regulation

 

Can you explain to me the +5 + 7 etc? I have looked over the spreadsheet but I haven't been able to create one yet because I've been swamped with school finals, immigration forms, and I share my laptop with my spouse who has been applying for jobs. I'm off tomorrow though so I will have time to create it.

So essentially I should be testing around 3 times a day unless he really starts to fluculate?

I also need to go to Wal-Mart this weekend and look at the Relion meter.

I would like to get him on Lantus but I'm not sure how to bring that up or request that, especially if she wants to stay on Vetsulin for a few more weeks? Like how do I suggest what I want without sounding like I'm telling her how to do her job?

 

We use the "+" system here because we're from all over the world....it just refers to how many hours since the last shot...so +5 is 5 hours after the shot, +7 is 7 hours after the shot....all the way up to +11 and then it starts over

If you can get 4 tests a day, it's even better...we do the PS (Pre-shot) tests just to make sure they're high enough to give insulin at all.....the mid-cycle tests tell us more about how low they're going which is the most important part of the sugardance

I had to find a new vet to get Lantus, but what I'd suggest if you like your vet otherwise is to tell her the truth...that you've been researching feline diabetes and found that Lantus is one of the best insulins for cats and would she be willing to let you use it instead? There's a published protocol on using Lantus you might want to send her in advance of your visit for her to look at too. The link to the protocol most of us use in in this sticky from the Lantus Forum

 

Gotcha.

Was your veternarian just not comfortable with that insulin? Or was is more of a money-making thing?

I do like my vet otherwise, everyone knows us up there, our dog boards there whenever we go out of town, they are pretty familiar with our all of our 4 pets. I'm from Canada but I live in the US with a Green Card so this was my first veterinarian in the US. It is a small town, a lot of the alternative veternarians around here are... questionable. Not personable. "Country" if you will.

I'm wondering if when I speak to her on Friday and let her know about his numbers I can casually bring up Lantus as an alternative. I'm just curious as to why Vetsulin would be the first insulin she would put him on if not many cats can successfully use that insulin but she did mention something about Vetsulin being one of her favourite insulins...

 

My original vet said "insulin is a hassle and if we can keep her in the 300's she should live a few more months".....I never did like him much, but that was the last straw. I was "lucky" that I had a night to research before making any decisions, and almost every Google search I did landed me here, so I spent a lot of time reading and knew how I wanted to treat her....and giving up wasn't even close to what I had in mind!!!

So I spent the next week or so calling around to find a vet that was willing to give me a script for Lantus and we're still here almost 3 years later and China's doing GREAT. We don't even see a vet for her diabetes.....I listen to the people here who have years of real life experience when it comes to making dose changes. When I do have to take her for a dental or when she had an URI last fall, I just tell them she's on x.x units of lantus and her blood glucose numbers run from 50-120 most of the time and that's pretty much the end of that conversation. When they DO feel like they need to say something (last time it was that she should be eating the D/M food), I just smile, nod, say "I'll consider that" and leave to come home and continue what's been working so well for us all this time.

If you live close to Canada, you could just hop across the border and buy Lantus from any human pharmacy...it's OTC in Canada!

 

Mostly we hear that because they see a lot of diabetic dogs...and Vetsulin IS good for dogs....just not for cats. But a lot of vets treat their cat patients like small dogs instead of learning more about a cat's metabolism and how longer acting, gentler insulins are better choices

 

Did finding another vet mean brining the cat in to have more bloodwork etc done or could they just faxed your files over to the new clinic?

That's awful, I can't imagine a vet treating diabetes like a death sentence.

Ah I wish I lived close to Canada haha unfortunately I live in Alabama. But I am immigrating my spouse back to Canada within the next year.

 

I just picked my original bloodwork up from vet #1....YOU pay for them, they are yours, not the vets. To prevent a big confrontation, I just told them I wanted copies to keep in a folder at home

Then I hit the phone book and started calling around. I'd ask them to have the vet call me back because I wanted to discuss how they treat their diabetic cats (these calls usually happen after office hours). Ask things like "what kind of food do you recommend?, is there a particular insulin you like to start with? Are you willing to try a different insulin? How have your previous patients done? Have you ever had one go into remission?"....questions like that can give you a good idea if another vet will be a "good fit" for you and Carter

And if they're "too busy" to call you back, that's important information too....cross them off and move on to the next one!

 

Yeah I'm not exactly good at confrontation. Hopefully she says switching won't be an issue... I'd like to stay in their good graces because they are all super sweet and friendly, my dog boards their often and they have an excellent boarding faciliity and an off-leash dog park which is unheard of anywhere else in this small town. I also want to use them as a veterinary reference for when we move in regards to renting a place etc to show we provide all the necessary and annual care for our animals.

I mean I could always stay with them but get another veterinarian to give me a script for Lantus and then order online? I had no idea Lantus was OTC in Canada.

 

Here's a link to the AAHA guidlines that you can print and bring to your vet:https://www.aaha.org/professional/resources/diabetes_management.aspx. Point out to your vet where it says (under insulin therapy in the cat) "The insulin preparations with the appropriate duration of action in most diabetic cats are glargine (U-100) [Lantus] or the veterinary-approved human protamine zinc insulin" and "This panel does not recommend the veterinary-approved porcine zinc (lente) insulin suspension [Vetsulin] as the initial treatment for the cat, because its duration of action is short and control of clinical signs is poor." When I get back to my computer, I also have another, more recent article you can print that goes into more detail about dosing and remission rates that I'll post here for you. Most of the time, the wrong treatment gets recommended not because the vet is bad--they just don't know the correct treatment guidelines for cats and need the right information. If your vet still insists on a different treatment path after reading the articles, then it's time to find a new vet.

Even vets that get some things right can be off about other things. When Bandit was diagnosed back in 2009, all of these guidelines were still very new, but his vet was very forceful told me I had to home test (and that human meters were fine), handed me a list of low carb, commercial canned foods in different price ranges, and gave me a script for Lantus. All good things, except her dosing recommendations were WAY off because she had two diabetic dogs, and adjusted Bandit's dose like a dog, in whole unit raises and only having me shoot once a day. I found this site and read the current research and dosing protocols, and when I confronted her with the correct published dosing protocol, she insisted that her protocol was better because she had great success with it in all her dogs. *facepalm* Because she wouldn't work with me, I switched to a vet that knew much less than her about the correct treatment, but was willing to read and follow the material I brought her, and we had a great relationship for many years until I had to switch vets again last year when Bandit started having health issues her practice didn't have the ability to diagnose (immune-mediated myelofibrosis, unrelated to his diabetes), and he now has to see an internal medicine specialist at Cornell. Fortunately, Bandit's new vet is very knowledgeable about feline diabetes and advocates the exact same treatment we do here, so no arguments were needed with him! However, I still bring my younger cat to the other vet--we established a very good relationship over the years and we always have a good rapport, even if we disagree on something.

 

Well, luckily I spoke with her today and she has no problem if I wanted to switch to Lantus. She mentioned ProZinc(?) is also good but didn't know enough about Levamir.

She said the reason she starts out with Vetsulin is because of the price affordability. She said she had another cat the didn't adjust to Vetsulin as well either and the owners just today decided to try Lantus. This is a small Alabama town where most people don't give a crap about their animals so she probably lives in that mindset that anyone with a diabetic cat, who lives here, is probably poor and wanting the cheapest method available. I'm not rich but price isn't an issue, especially if I can buy it from Canada for 1/3 of the price..

I told her I was going to look around at prices and get back to her regarding the script.

 

I see Chris already gave you the links to Mark's Marine for the Lantus, which is great! If you get a 5 pack of pens it is around $170, but they will last you a year or more (working out to be around $14 a month, which is actually cheaper than Vetsulin, I believe). And when you consider that Lantus is very effective in cats and Vetsulin not so much, Lantus is by far the better bargain. I really hope the price for Lantus comes down in the US next year when their patent expires. It was only (and I can't believe I'm saying only, it seemed so expensive to me at the time!) $110 for a vial and $233 for a pack of pens in the US in 2009.

 

Well hopefully if your vet is willing to work with you on using Marks, they'll start recommending it for their other patients as well!

I know my vet was amazed at how much cheaper it was! Around here, a 5 pack of pens is over $500....compared to $149.99 plus $25 shipping from Marks is the difference between China being on Lantus and being on nothing...and you can see how great she's doing!

 

Oh wow! Yeah the Vetsulin was $50 for a 10ml bottle.

How do they last that long? What's the expiry usually range around?

 

I don't see why she wouldn't be. I had mentioned wanting to purchase Vetsulon (previously) online and she had no issues with providing or faxing a script to an online company.

 

The pens last until the expiration date on the box...usually at least 2 years away. You just keep them in the refrigerator, take one out long enough to draw the dose into the syringe and put it back

 

Just so you're ready....you pull the cap off the pen and inside there's a rubber stopper just like a vial. You just insert a regular insulin syringe and pull out the correct dose. You do NOT use the special needles that humans use with the pens.

 

Awesome, I was wondering how the pens worked!

That's great how the expiration date. I wonder why it different so much between a vile of Lantus and the Lantus pens?

 

If handled properly, a pen can last 3-6 months once opened (unopened they last about 2 years). I've never gotten more than 3 months of life from a pen but others here have, and even at 2-3 months per pen that's still 12-15 months of insulin.

Once your Lantus arrives, check out the stickies in the Lantus forum for proper handling! The two big things to extend the life is to keep it refrigerated, and don't shoot insulin back into the pen when drawing the dose (you take more insulin than needed into the syringe and shoot the excess into the sink). The lubricant from the syringes makes it go bad faster if it gets into the vial/pen.

 

The price or the amount of time it lasts?

 

I guess both haha!

 

Well a vial around here is a little over $300 and holds 1000 units....5 pens is a total of 1500 units for about $500 so they're comparable

The reason the vials aren't recommended for most cats is because most cats need less than 2 units of insulin twice a day, so a vial would have to last at least 250 days for you to use 1000 units.....but even if it's taken perfect care of, the insulin is going to poop out at 4-6 months, so you end up throwing half of it away

Each pen holds 300 units and the entire 5 pack is good usually for at least 2 years....they're used like "mini-vials" that last longer because of the way they're packaged and handled

The vials are fine IF you have a cat on high doses, but generally, you end up throwing too much of them away

 

Just a note for tomorrow....this thread is getting really long, so best to start a new one tomorrow so you don't get "lost in the shuffle"