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Newly diagnosed cat options

Discussion in 'Feline Health - (The Main Forum)' started by jgeeky, Aug 10, 2019.

  1. jgeeky

    jgeeky Member

    Joined:
    Aug 4, 2019
    Greetings all. I made a post in a sub-forum and was encouraged to post here. Our 12-year-old DSH tabby named Ziggy was recently diagnosed as diabetic. While we were on vacation, we were alerted to what appears to be neuropathy. He seems to walk on a much larger surface of the paw and lower leg than normal and his gate is slowed.

    He was tested around 400 BG by the vet, but there was no starvation before the test, so we have no idea how much time lapsed between his last eating (free feed) and the test. As such, he was prescribed 1/2 cup of w/d food twice daily along with 4 units of U40 vetsulin following each meal (which he almost never completes).

    The question I had posted was about what appears to be an illogical combination. W/d food is higher in carbs and in low-quality ingredients (corn is high on the list) than what we normally feed. So, I feel like I'm now feeding him expensive garbage food and combating that by sticking sharps in him twice a day. My first thought was looking at a targeted kibble that is something like 62% protein, 15% fat, 5% fiber, and 10% moisture with no listed carbs (Keto Kibble). I don't understand the relationship completely, but the logic to me is that feeding w/d and injecting insulin is like spraying him with water and toweling him dry when he's dusty. Couldn't I just stop spraying him with water?

    Today, 8/10/19, he was fed at 7:30 AM and received his insulin just after. At around 6:30 PM I measured his BG at 136. My understanding is that vetsulin has an 8-12 hour duration, so this would have likely been near the wear-off period.

    My plan is to feed this new food for a day or two on scheduled feedings and take his BG about an hour after the meal in the HOPE that there is some dream scenario where we can regulate by removing carbs rather than stuffing carbs and stuffing a carb-digesting drug. We are often gone for lengths of time and have family members and friends who are cat lovers babysit our cats. While the number one priority is Ziggy, the secondary priority is also to try to avoid having to figure our how we rearrange our lives unless it's absolutely the best thing.

    When I found this forum and got some initial feedback, I felt less crazy. The ingredients on the w/d food seem like exactly the kinds of things I would to avoid in the past. I also found it strange that Ziggy's BG was taken with out any idea of when his last meal was and the 4 unis of U40 seem risky if he isn't eating the prescribed amount of food.

    Ziggy has always been a massive cat. He never seemed overweight, just generally large. We noticed he looked a little thinner about 8-10 months ago, and he clocked in around 20.5 lbs. Before that, we hadn't weighed him in at least five years when he weight around 22.5 lbs. He is currently at around 18 lbs, and his hind legs feel thin/atrophied. To give some reference for weight and size, I'm 6'5" and when I'm laying on my back, Ziggy likes to straddle my waist with his hind legs (they wrap around me and touch the bed) and drool on my face with his shoulders just under mine.
     
  2. Jerry dutchboy

    Jerry dutchboy Well-Known Member

    Joined:
    Mar 27, 2019
    Hi, glad you found this forum. It is the best place to get Ziggy on the road to better health. I can't comment on the neuropathy as I was lucky not to have experienced it.
    Diet plays a huge role in diabetes and the prescription food is not a good choice for a diabetic cat. I think most people here have been told by the vet to feed this as part of the management and we have all switched to other types of wet food. Most of us feed fancy feast classic pates or friskies pates, readily available and affordable, there is a fabulous food list on the forum by Dr. Pierson that you should check out. Just make sure the carb % is less than 10%.

    We nearly all feed our cats multiple small meals throughout the day, so sticking to twice a day is really not necessary. With Vetsulin ( which is a harsh insulin) it is important however that he eats before the shot.:)
     
  3. CandyH and Catcat

    CandyH and Catcat Well-Known Member

    Joined:
    Apr 23, 2019
    LOL -- sounds like Ziggy may have some Maine Coon or Norwegian Forest Cat genes in his background

    keep reading here -- as it sounds like your vet was setting up a schedule more applicable to a dog than a cat -- my opinion only

    I totally agree, get the carbs out of there, return the unused food to the vet for a refund and say that your cat won't eat it -- your description of it as expensive garbage food is exactly what we've found .. there are far better and less expensive foods for diabetic cats -- FancyFeast classic pates are the most common but there are many others that are possible, be sure to read Dr Pierson's food chart (yellow sticky has the link, up at the top of this forum)

    it makes more sense to test the blood BEFORE feeding, and at least 2 hours after his last meal --

    keep reading here, take a look at the yellow INFO sticky for those new to the site -- covers quite a lot of things we'd like to know to be able to make intelligent comments concerning you and your sugarcat

    you're in for an intensive learning experience, dive in and ask any questions that occur to you, this community is amazing
     
    Last edited: Aug 11, 2019
    Jerry dutchboy likes this.
  4. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    4 Units is a HUGE dose for any cat!! Most cats need less than 2U (although there are some that need more...ECID) but as a starting dose, that's crazy high. I don't know what it is about 4U doses....my vet told me to start at 4 too and China never needed more than 2.75...I would have killed her if I had listened to the vet. I've seen a lot of other members who just joined and their vet said to start at 4 too....I think they must all be reading the same (wrong) book!

    The W/D is garbage....You're totally right in questioning it. I like to say it's like trying to put a fire (diabetes) out while you're still pouring gasoline (carbs) on it....Yes, you can do it if you overwhelm it with water (insulin) but it's a whole lot easier to just stop pouring the gasoline on it!!

    I'd strongly suggest you take the W/D back and get a refund. Use that money to buy yourself a blood glucose meter and some strips. Most of us use the Relion Prime from WalMart. Strips are only $17.88/100

    Start over with feeding a low carb canned food (most of us use Fancy Feast Classics or Friskies pates) and start home testing.

    But...don't change his diet unless you're home testing first....Or at least drop the dose WAY back....I'd start on 1U. It's a whole lot safer to start low and go up as needed than it is to try to save your cat's life when they drop too low.

    Vetsulin isn't usually a great insulin for most cats but some do OK on it. It tends to hit hard and fast and then wear off before it's the next shot time. Better insulins are Lantus, Levemir and Prozinc so keep that in mind if the Vetsulin doesn't seem to work well for Ziggy
     
    Last edited: Aug 10, 2019
  5. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi and welcome to fdmb. This is a great community.

    If you are swapping to a lower carb food, which is recommended for diabetic cats....10% or under carbs, you will need to be testing frequently to ensure that 4 units of Vetsulin is not too much insulin. A starting dose of 4 units of insulin is a lot of insulin. I know your kitty is a large kitty. I am not experienced with vetsulin so I am going to tag @Elizabeth and Bertie and @MrWorfMen's Mom who maybe able to help with dosing.

    Always test before every insulin shot and again during the cycle between +3 to +7 to see how low the dose is taking Ziggy.
    Do you have some higher carb food and some honey or karo at home in case of low numbers?
    Here are two links to how to treat hypos and what you need to treat hypos. I would recommend you print out these two sheets and either put them on the frig or in your hypo tool box
    http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/
    http://www.felinediabetes.com/FDMB/threads/jojo-and-bunnys-hypo-tool-box.2354/

    Keep asking questions!
     
    Chris & China (GA) likes this.
  6. jgeeky

    jgeeky Member

    Joined:
    Aug 4, 2019
    Thank you for the super fast reply. Your post brings up two questions for me, but both exactly on the lines of where I was heading and both solving parts of the riddle.

    1. We have two dogs and two cats. We used to be able to avoid dogs trying to sneak cat food by placing the cat food in a climbing structure. Since Ziggy is now much less sprightly, that isn't really an option. Also, our other cat is the same age and we want to minimize injury. So, ideally, when all four pets are at home and we're at work, we would like to use a timed feeder that opens only during the night while the dogs are in bed and the cats roam the house (about 10 hours of open feeding). Is this schedule something that still seems possible given a better diet?

    2. I have seen a lot here about wet food. It's so strange to me, because I've always thought of wed food as junk food. Our cats have never done anything with wet food other than roll in it, and we only given it to our dogs when we've needing to add supplements. For two very active dogs, the 8-8% protein of wet food seems ultra low. But, it would certainly not be the first belief that I learned was fallacy. My thought with the Keto Kibble was about getting a dry food that was more bowl-stable because of our lifestyle. I though that if the protein, fat, and fiber were high enough, and carbs were low enough (it's claimed to be carb-free but the listed percentages of non-carb ingredients add up to 93.2), it wouldn't matter if the food were wet or dry. My assumption is that wet food isn't really something that could be left out and grazed on, as it would dry up and be both unappetizing and susceptible to food-borne bacteria.

    In the same line of inquiry as question two, do obligate carnivores like cats not need a diet higher in protein? What is the "moisture" and how is passed?
     
  7. jgeeky

    jgeeky Member

    Joined:
    Aug 4, 2019
    Thanks for the reply. My hope was that I would go to a low-to-no carb food while not giving vetsulin and starting regularly testing of BG levels. I think giving ultra low carb and 4-units of vetsulin would probably cause serious issues. But, that does bring up the question of titration. I don't know the carb-to-dose conversion or the impact of a single unit of vetsulin.
     
  8. jgeeky

    jgeeky Member

    Joined:
    Aug 4, 2019
    I can't believe how quickly the replies are coming in. This is really supportive and helpful. I bought the Alphatrak 2 just because it stuck out on Amazon and I saw the use directions on YouTube. I tested on my fingers about 10 times and it's not painful at all. I tested on Ziggy's largest paw pad today since he's used to me touching his paws. It was a total non-issue for him.

    Is there a reason for low carb canned vs low carb dry? I see canned mention here a lot. If canned is the way to go, I'm all in. Is it just because dry food has traditionally been carb rich? Has Keto Kibble been critiqued here much (https://amzn.to/31CfkY1)? It seems to be well under 10% carb. Again, I have no objection to wet food except that I worry about just leaving it out.

    Lastly, you mentioned China started at 2.75. Now that China is on wet food, is there still a need for insulin?
     
  9. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    If you are swapping to a low carb diet, which is best for Ziggy, I agree with what @Chris & China (GA) suggested.
    Go back to 1 unit of insulin, test first to see it is safe to give the dose, feed well before the shot then give the 1 unit. Test during the cycle to see how low the dose it taking Ziggy. Testing is the only way to tell how much insulin you need.
    I also agree that there are other insulins better suited to cats which have a longer duration and have a gentler action.
    Lantus, Levemir and Prozinc.
     
  10. jgeeky

    jgeeky Member

    Joined:
    Aug 4, 2019
    So it's been suggested to drop to 1 unit. If the food is truly ulta-low carb, is there a big risk in feeding, waiting an hour to test bg, and then possibly not giving insulin if the number seems solid?
     
  11. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    I also meant to ask if Ziggy was tested for ketones when he was diagnosed.
    Dry food only has 7 % moisture in it compared to 78% moisture in canned/wet/raw food, and as cats are not good water drinkers, they need lots of moisture in their diet. Most cats that are fed a dry diet are chronically a bit dehydrated which is bad for their kidneys.
     
  12. CandyH and Catcat

    CandyH and Catcat Well-Known Member

    Joined:
    Apr 23, 2019
    only your cat can tell you that -- though his blood glucose measurements -- you'll hear this a lot -- ECID -- every cat is different

    as far as we have been able to tell, there's no carb-to-dose conversion -- it's way way way more complicated than that -- we find the dose that works for our cat AT THE MOMENT by essentially doing a trial-and-error procedure -- feed the food, measure the BG, shoot the insulin, measure the BG, plot these on the spreadsheet, talk with others on the board, read what's worked for someone else, see if it works for you

    if you look at spreadsheets, you will see -- it's anything but cut and dried --- sometimes the effects don't show up for a day or two or three -- meanwhile the cat is trying to regulate himself and not always in the way you'd expect ... and it doesn't happen overnight -- you will hear people saying "it's a marathon not a sprint" -- Vetsulin is, in some ways, a little easier to see the effects it has, however you must be vigilant with it, believe me I know ! which is why my sugarcat is on Lantus now
     
  13. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    You need to test the BG firrst to see it is high enough to give the insulin. Then feed the meal and wait 30 minutes before giving the insulin to let the food get into the system, then give the shot.
    Here is the link to the Vetsulin info
    http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/
     
    Chris & China (GA) likes this.
  14. Sarah&Soph

    Sarah&Soph Member

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    Jun 18, 2019
    Food is a very important part of the big picture of feline diabetes, but just keep in mind that it is not the “cure”. Some cats can go into remission on diet change alone (they are still diabetic, just diet controlled), but many cats require insulin support, either temporarily or more permanently. Zero carb also isn’t always necessarily better than low carb - there’s a sticky about how some cats actually have higher BG on zero carb food than on food that is low carb. Generally under 10% is just fine
     
  15. CandyH and Catcat

    CandyH and Catcat Well-Known Member

    Joined:
    Apr 23, 2019
    go canned -- seriously it makes a huge difference to your cat's systems -- many of us add additional water to the pate, making it almost gravy, and cats lick it up

    some cats are stubborn, they've never seen food that wasn't crunchy nuggets, with luck yours won't be one of those --

    with Vetsulin -- test FIRST, feed at least a snack if not a meal, wait about half an hour, then inject .. because it can start working right away, and the food gives a "cushion" so the blood glucose doesn't drop so dramatically that the cat is in danger of hypoglycemia -- most cats have their nadir on that insulin (when insulin is most active and glucose is lowest) around 3 to 4 hours after the injection -- and for many cats Vetsulin loses its oomph around 10 hours after the shot .. but the next shot isn't due for another couple of hours -- it was developed for dogs, not cats, and their metabolisms are different
     
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  16. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    She wasn't started at 2.75.....I found this message board the first night and was only comfortable starting her at 1U....the highest we ever needed was 2.75

    She had been diabetic for quite awhile before I finally saw enough signs and got her to the vet for diagnosis so she had probably already done too much damage to her pancreas to ever go fully into remission, but she did go OTJ for a short time and she was the most tightly controlled cat here for several years. Feel free to look at her spreadsheet in my signature.

    We used Lantus because it's usually a better insulin

    I lost China on Christmas Eve morning last year, but her spreadsheet can still be an inspiration to others. I am so grateful for the education and support I got here that I stay and "pay it forward".

    If you see "GA" in someone's name, that means their cat has "Gone Ahead" or is a "Guardian Angel"
     
  17. jgeeky

    jgeeky Member

    Joined:
    Aug 4, 2019
    Thank you for the feedback and I apologize for missing the cues in the name. I apologize for the misstep and I'm sorry to hear of China's passing. The pay-it-forward attitude is very much appreciated.
     
  18. jgeeky

    jgeeky Member

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    Aug 4, 2019
    That makes sense. I suppose it's like in humans where under eating can cause the body to hold onto food in short term situations as a starvation reaction.
     
  19. jgeeky

    jgeeky Member

    Joined:
    Aug 4, 2019
    So, for situations where we're gone from the home (as we will in early Sep) and where someone can only come by once per day, how do you think leaving wet food out would fare? Also, is there some tactic about getting cats to eat wet food? Should we start by mixing with the dry? As I mentioned, our cats don't respond at all to wet food.

    Water intake doesn't currently seem to be a problem. We have filtered fountains in a few areas of the house and the cats seem to drink (and urinate) very often. That said, I totally get the logic there and the increased moisture rationale.
     
  20. jgeeky

    jgeeky Member

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    Aug 4, 2019
    I'll have to look back at the write-up. I believe the vet said that the ketone levels we're surprisingly not problematic at all. I don't remember how it was present, just that there wasn't a ketonic issue. I'll post back with more information.
     
    Bron and Sheba (GA) likes this.
  21. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

    Joined:
    Sep 21, 2018
    The walking like a rabbit , or sort of flat footed is neuropathy. I myself and a lot of us here give what's called Zobaline .
    It's pretty expensive 38.90 plus 4.99 shipping for 60 pills.
    It has to be Methylcobalomin. Vit B , it also has folic acid 200 mcg and the
    Vit b is 3 mgs. You would crush it up and mix it in the wet food
    The pic of the Zobaline is under the Vitacost brand sorry about that

    Until someone told me about the same thing , much much cheaper and the same thing
    It's called Vitacost , it's 5 mgs ( 5000 mcgs ) which is ok because the cat will see out what's not needed. The only thing it doesn't have is the folic acid. So I just go to the supermarket and buy folic acid 400 mcgs and cut them in half and crush it up, or if you find 200 mcg use the whole pill. The Vitacost is a capsule so just empty it on the food
    I'll post the pic

    Vitacost Vitamin B-12 Methylcobalamin -- 5000 mcg - 60 Capsule

    [​IMG]
    • Our price: $17.57 for 60

    • And $23.92 for 100
    • A lot of times on the qty of 100 it's buy one get one half off and free shipping
    • Give it once a day, once you get your cats BG regulated his legs should get better with the supplement.
    • My cats legs have gotten much better, and some people's cats legs went back to completely normal. So why not go with the better price with the Vitacost
    • Best of luck with Ziggy










    • [​IMG]
     
  22. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    No apology is necessary. We have our own language here and you're new so there's no way you could know what everything means!!

    Thank you though...she was a very special kitty (but they all are!)

    You're going to find that although you're absolutely sure that you love Ziggy as much as you can possibly love a cat, the relationship you build with your sugarcat goes above and beyond what you can even imagine right now. But it also means that when they're gone, it hurts that much more too.
     
  23. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    Who's going to be giving Ziggy insulin? Insulin needs to be given every 12 hours.

    Most of us add extra water to the canned food which helps get extra water into our cats as well as keeping it from drying out, but a lot of people here also use an auto feeder like the Petsafe 5 that you can program to open up to 5 times to offer a fresh meal.

    There's some good tips in this "Tips on Transitioning" page of Dr. Lisa's website on Feline Nutrition.
     
  24. jgeeky

    jgeeky Member

    Joined:
    Aug 4, 2019
    In looking at your spreadsheet, can you tell me if I'm on track? On 1/9/2016, for example, I see AMPS at 80, then 1.5 units given. Then, 3 hours later, I see a 76, etc. How much time is there between a morning feed and a AMPS measurement? Is the AMPS measurement also pre-feeding or at least before the glucose is potentially in the system? My logic (however likely flawed) would be that if we wanted to see the effects of food on the BG levels, we'd need to see the food reacting with the bloodstream (20-30mins maybe) and then test the impact of the food intake. Maybe that's way off or maybe that delay is implied in the spreadsheet and I'm just very new.

    Similarly, I've read that 80-120 is the ideal range, but I see you've conditional formatted based on 50-99, 100-199, etc. Why that stratification? Again, this is my ignorance at play.
     
  25. jgeeky

    jgeeky Member

    Joined:
    Aug 4, 2019
    Thanks for the input. Is there any risk of adding this to our other cat's (Captain) diet when we need to feed them communally?
     
  26. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Since we used Lantus, it's different than using Vetsulin. With Lantus, it's not so important that they eat a certain amount before shooting. As long as they're willing to eat, they usually have 2-3 hours before the shot "kicks in"

    With Vetsulin, you want to Test, feed, wait 30 minutes and shoot. You test first to make sure they're high enough for insulin at all, then you feed to make sure Ziggy eats a normal sized meal...then you shoot. Vetsulin hits "hard and fast" so it's important to get a good meal on board first.

    I used a human meter (I couldn't afford to test as much as I did using an AlphaTrak with strips that cost $1 each!!)…..On a human meter, normal blood glucose is 50-120....On a pet meter, it's 68-150
     
  27. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Chris I didn't realize you lost China, I'm so very sorry
     
  28. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Sorry I'm not sure
     
  29. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    It will be expensive if you do it like that. You will need to make sure that Ziggy is getting the correct dose. It's just once a day. You can sprinkle it onto Ziggy plate just before eating and make sure he eats all that is on that plate.
     
    Diane Tyler's Mom likes this.
  30. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    Thank you Diane....it was a shock because she showed zero signs of being ill until that morning and then she crashed quickly. She passed on the way to the vet.

    No way to start the holiday, that's for sure!
     
  31. Diane Tyler's Mom

    Diane Tyler's Mom Well-Known Member

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    Sep 21, 2018
    Oh my God Chris, that is so heartbreaking, I am actually tearing up right now, I am a real softie , I can't help it. You are right about starting the holiday. I'm looking at her picture , such a beautiful baby, again I'm so sorry
     
    Chris & China (GA) likes this.
  32. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Hi and welcome to FDMB.

    I agree with the recommendations given regarding dosing. I'd reduce the insulin dose to 1u and definitely be home testing while making the transition to wet food. 4u to start is an extremely high dose and could potentially cause hypoglycemia if carbs are lowered. Until you get some data I would also skip the insulin unless BG is at least 225 to 250 on the AT2 meter. Once you get some data and understand how the insulin is working for Ziggy, you can lower the no shoot threshold a bit but for safety sake especially while transitioning diet, best to err on the side of caution as long as there are no ketones on the picture.

    On the feeding side, even if not mixing a supplement into the food, I would dole out a separate portion of food for Ziggy at shot times to ensure he is getting enough food before giving insulin. It's very important to make sure Ziggy has adequate food on board when the Vetsulin starts working as it can cause swift drops in BG early in the cycle in some cats.
     
  33. Jerry dutchboy

    Jerry dutchboy Well-Known Member

    Joined:
    Mar 27, 2019
    I don't have any experience with multiple animals in house. I just have two cats and have put both of them on the same diet (easy peasy). The feeder is a great idea and some of them have a compartment where you can put an ice block underneath to keep the food fresh.. if this is not an option you could always freeze small portions of the wet food so that it thaws over time for snacks.

    Cats get most of their hydration from their food so dry food is really not great for them. I highly recommend you read Dr. Pierson's food chart on the feline health board as this provides a lot of information regarding diet. Ideal cat food will be >50% animal protein from calories, 20-40% fat from calories, 1-2% carbs from calories and 70% water. Have a read there is much more.:)
     
  34. jgeeky

    jgeeky Member

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    Aug 4, 2019
    Day one of the trial makes me think something is off. We fed Ziggy at around 7am this morning followed by 4 units of U40 vetsulin hoping to change the dosage in the PM. I Fed him at around 7PM with 1/2 cup of the keto dry mixed with fancy feast gravy wet beef. Before eating, his BG was around 75. That seems to confirm that 4 units of vetsulin is too high, but maybe I'm misunderstanding. I prepared 1/2 cup of the aforementioned wed/dry mix for Ziggy and he ate just a little over half of that. He's never been a big single-sitting eater. I just tested his BG and he shows around 55, about 2 hours after eating. It just doesn't seem to add up. I tested via ear and paw pad multiple times. And, at that BG level, wouldn't he seem off? He actually bizarrely normal. Since the BG seemed low to me, I tried giving him some more fancy feast with a little of the w/d mix just to get some carbs in, but he has no interest in food (normal for him). We gave no insulin after his feeding because his BG seemed so low. Am I misunderstanding something here?
     
  35. jgeeky

    jgeeky Member

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    Aug 4, 2019
    just to clarify, when i say wet/dry mix, I mean the keto kibble mixed with fancy feast.
     
  36. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    What type if Meter are you using?
    Yes 73 is too low to shoot. Do I understand you didn’t shoot at the PM shot time?
    If you are using an alphatrak meter the 55 needs high carb food or honey or karo to bring the number up over 68 NOW!
    If using a human Meter you are getting very close to the take action number of 50. I would give some higher carb food now.
    Either way you need to test again in 20 minutes.
    I have to go out and collect children from school but I’ll try and look back in.
     
  37. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    If you are using an alphatrak Meter and he won’t eat rub some honey or karo on his gums now
     
  38. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Just reading back and it looks like you are using an alphatrak meter.

    Please give some honey /karo or high carb food NOW. 55 is too low!! And test again in 20 minutes.

    If the number hasn’t risen to over 68 give more high carb honey or karo and keep testing. Don’t leave and think Ziggy will be ok.
     
    Elizabeth and Bertie likes this.
  39. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
  40. jgeeky

    jgeeky Member

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    Aug 4, 2019
    I’m using an alphatrak 2 but it just doesn’t seem right. That test was over two hours ago and he hasn't changed at all. He is socializing with the dogs and with us in bed. Just tested again and he shows 58. I'm using his paw pad, but I didn't see if there was any difference in glucose level based on test sight. I just lanced my index finger and I show as 130 (I ate some carb-rich foods somewhat recently).
     
  41. jgeeky

    jgeeky Member

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    As stated above, it's been over three hours since his last meal. He isn't interested in food at all, but he's sitting up in bed, being sociable, and letting the dogs groom him. He doesn't seem lethargic at all. I feel like he can't be testing correctly or that maybe there's something I'm doing wrong.
     
  42. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    57 is TOO LOW on the alphatrak. He doesn’t necessarily have to have symptoms of a hypo when he is in those numbers. But he is in hypo territory at the moment.
    Please give some honey/ karo and or high carb food NOW! I can’t stress this enough.
    57 is too low for a cat. He needs to get up over 68 at a minimum.
    If he won’t eat rub honey or karo on his gums.
    Please post when you have gone this. Thanks
     
    Elizabeth and Bertie likes this.
  43. jgeeky

    jgeeky Member

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    Aug 4, 2019
    Giving Karo now. Is it possible for him to be in the 50s and asymptomatic for 3.5 hours? After the Karo do we need to insulin dose?
     
  44. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    If you have tested several times And they are the numbers .. you need to take action now or you are risking Ziggy dropping even lower which is very dangerous.. I can’t stress this enough. He might look ok but he is too low!!
     
  45. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    NO. DONT GIVE ANY INSULIN!!
     
  46. jgeeky

    jgeeky Member

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    Aug 4, 2019
    Just rubbed some karo on his gums. Is there an amount or frequency that is best?
     
  47. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Good, test in 20minutes to see if numbers come up and post the results please, I will be watching for the result
     
  48. jgeeky

    jgeeky Member

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    Aug 4, 2019
    I just messaged you directly. I'll test shortly. We did about a fingertip of Karo on his gums and in his mouth (it wasn't super streamlined).
     
  49. jgeeky

    jgeeky Member

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    Aug 4, 2019
    I'm still watching and waiting to test again. As I'm doing so, am I understanding correctly that maybe the prescribed 4 units of U40 was an overdose that has caught up and the wet-dry mix I gave was under-carbed?
     
  50. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    4 units is definitely to much for him, you need to drop it back to 1 unit. Ziggy needs to be eating lowcarb food and you need to be giving the correct amount of insulin that will work with that.
     
  51. jgeeky

    jgeeky Member

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    Aug 4, 2019
    I read that loud and clear. We gave the vet prescribed food and insulin dose this AM and this evening was the first run with low carb (mixed low carb dry with fancy feast) and gave no vetsulin. It would have been my last thought that it would be too low carb. But, I suppose there was just too much vetsulin, even that long after. Tomorrow am we will feed and then have to be away from the house from 7am until 3pm. My thought is all fancy feast and a 1U of vetsulin IF he eats the wet food by itself. Any recommendation?
     
  52. jgeeky

    jgeeky Member

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    Aug 4, 2019
    It’s been about 24 mins since the karo gum rub and I just tested him at 79. So the big question is what to do tomorrow AM at around 630am when we leave for work. I can give fancy feast and dose 1U but I’m super concerned that if I can fancy feast and keto kibble with no dose and he was in the 50s, what will happen with just fancy feast and 1U? Am I making sense here? If I didn’t dose and gave ultra low carb and there was panic, What happens if I give low carb and low dose?
     
  53. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    First of all you will need to test to see he is high enough to give insulin to in the morning.
    If you read back on this thread you were advised by others who are familiar with Vetsulin to reduce to 1 unit and not give it unless the BG was over 225 or 250 @MrWorfMen's Mom
     
    Last edited: Aug 12, 2019
    Reason for edit: just clarifying point
    Elizabeth and Bertie likes this.
  54. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    79 is good. Test again in 30 minutes to see he is still rising please
     
  55. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    I have to go out again to meet a school bus to pick up another child so will answer your questions when things settle down for me.
     
  56. jgeeky

    jgeeky Member

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    Aug 4, 2019
    To be clear, we’re not ignoring advice. We decided that after this morning we would start trying to follow a new plan as laid out here and abandon the plan given to us by the vet. If you look back, this afternoon I gave low carb food and did not give any vetsulin the food mixture was implemented because Ziggy didn’t seem to care at all for just wet food.

    After feeding the very low carb mixture tonight, Ziggy’s BG was low. I tested just before feeding and he was in the high 40’s (after what we decided would be the last vet-instructed feeding of w/d food and 4u vetsulin). It seemed to be so low that I thought something was wrong with the machine, since he seemed totally normal. I supposed I’m still thinking of diabetic students and family members I’ve seen drop low, but I also had early issues getting readings and had to swap out the stock battery when I received it, so I thought maybe it was just off. In retrospect, it seems the prescribed feeding/dosing plan was just sugar loading and glucose depletion that was bringing Ziggy dangerously low. that’s part of my questioning.

    Ziggys blood sugar was too low. You mentioned giving 1U of vetsulin, but I’m wondering how that wouldn’t still be problematic. To be clear, when I fed low carb this evening, I gave no units of vetsulin. Tomorrow morning I’ll feed just fancy feast. Is 1u too much even then?
     
    Last edited: Aug 12, 2019
  57. jgeeky

    jgeeky Member

    Joined:
    Aug 4, 2019
    I suppose my question was more along the lines of whether or not this evenings results were tainted by this mornings vetsulin dosage.

    To be clear, we only relied on this vet clinic because they’ve been treating our dogs for the last 6 years or so. When this diagnosis came along, the treatment came along, the treatment logic just seemed wrong. But, rejecting it and starting something contrary meant any harm to Ziggy because of that rejection would be our own doing. So, as I alluded to, we decided that we would follow the vet’s orders this morning and start testing based on this forums advice this evening.

    Since 12 hours had passed since the last vetsulin dose, I assumed I could give low carb food and not dose vetsulin at all. It seems to me now that the dose was so high that basically Ziggys body was relying on carb loading from the crap w/d food to maintain and that the vetsulin has dropped him very low over those last 12 hours.

    So, my concern is that we can feed tomorrow around 600am and we have to leave tomorrow around 700am. I’m guessing the best solution is to feed fancy feast and then test, only dosing if he seems high, but I’m worried about time constraints. My hope is that since by tomorrow at 6am he won’t have had insulin in almost 24 hours, he won’t be low before feeding and so we won’t run into tonight’s situation again.
     
    Last edited: Aug 12, 2019
  58. jgeeky

    jgeeky Member

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    Aug 4, 2019
    Just under 1 hour since karo on gums and ziggy is at 106
     
  59. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    BINGO!! 4U is way too high a dose and it was probably the high carb junk you were feeding that kept him from crashing before this.

    If he is below 250 in the morning, do not give him any insulin. It's better that he's too high for a day than too low for a moment.

    If he is above 250 and you're concerned about giving 1U, you could always start a .5 until you get him completely off all the kibble and eating only the low carb canned food as well as getting some testing data to see how he's doing.
     
    Elizabeth and Bertie likes this.
  60. jgeeky

    jgeeky Member

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    Aug 4, 2019
    What’s strange is that we were always feeding him very high protein, high fat, high fiber, and very low carb food. When he was diagnosed and his slightly older sibling was fine, I just assumed it was genetic. When the vet gave us the w/d food and vetsulin it just seem so strange. It was like a human eating healthy and getting diabetes and a doctor saying “the cure is to just eat ice cream and dose insulin accordingly”.

    I also thought it was so strange that the dosage and diagnosis were issued without any reference for when he had last eaten and without any ketone issues.

    It seems like the dry kibble was too low carb as it didn’t have any real ability to counteract the remnants of the vetsulin. Am I wrong there?

    Thanks for all of the help.
     
  61. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Looks like he is on the way back up now. I'd test again in 30 minutes just to be sure as karo wears off.

    Glad to see @Chris & China (GA).. :)

    Moving forward, Chris has given you good advice for the morning.
    There are a couple of things you can do to help us help you.
    If you could add your signature, that would be very helpful as it will give us a lot of information which is often needed in a hurry and it will save having to keep asking you. Here is the link
    http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

    The other thing that would be super helpful and would allow us to give you dosing advice if you need it....is to set up Ziggy spreadsheet. Put in all the tests you have done so far and any moving forward. Be sure to put in the numbers in the 40s and 50s.
    Here's is the link
    http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
     
    Last edited: Aug 12, 2019
    Reason for edit: Added make sure to put in the 40s and 50s numbers in the SS
    Elizabeth and Bertie likes this.
  62. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    which kibble?

    But I think you've got it backwards....if it was W/D, it's very high in carbs....so when the insulin was "working", the high carb kibble kept him from dropping too low.

    Carbohydrates break down into glucose very easily, so by feeding a high carb kibble, there was lots of glucose in his bloodstream so the insulin couldn't counter-act that much glucose

    By changing to a low carb food like Fancy Feast Classics (NOT the "gravy" kind), there's less sugar in the bloodstream in the first place so you don't need as much insulin to work against it.
     
  63. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    Using my fire example from above....if you've got a fire and you pour lots of gasoline (high carb food) on it, it's going to take a lot more water (insulin) to control it.

    By lowering (or stopping) the gasoline, you need a lot less water (insulin) to control it
     
  64. jgeeky

    jgeeky Member

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    Aug 4, 2019
    the kibble is called keto kibble. It’s a supposedly very low carb kibble. It’s advertised as zero carb but the percentages don’t account for about 7% so I’m guessing that’s the carb percentage and there’s some reporting threshold. I bought the gravy fancy feast on amazon as I wasn’t checking closely. But, we live in a large enough city that I can get new stuff tomorrow.
     
  65. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Yes you are correct......it is like treating diabetes with ice cream, giving the w/d food.

    Feline diabetes treatments have advanced and improved in the last 10 or so years and many vets are sadly not up to the latest treatments. And the nutritional information they are taught is taught by the large pet food manufacturers that of course promote their products that are really not all that suitable.
    There are several much better insulins than vetsulin which was originally made for dogs which have a slower metabolism to cats. Lantus, Levemir or Prozinc are much better choices for cats...they are gentler and longer lasting. If I were you, I would be asking to swap to one of those insulins.

    Cats can be diagnosed with diabetes without having ketones.
     
  66. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
  67. jgeeky

    jgeeky Member

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    Aug 4, 2019
    Reading your post from above where you referenced “NOT the gravy kind”, the kibble comment about w/d was my exact thought. I know our communiques are oddly juxtaposed because of the posting delays, but I think you were confirming the equation that the w/d food was so carb rich that basically it was cutting through the vetsulin enough to last until the next w/d feeding. Looking at the fire analogy, the w/d food was like trick birthday candles or ultra hot embers where the douse from the vetsulin would really just keep the carbs at bay.
     
    Chris & China (GA) likes this.
  68. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

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    Feb 21, 2015
    Have you tested again ?
     
  69. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

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    Feb 18, 2015
    4u being a high dose I can see why karo and high carb food was used last night however if there has been no insulin given for 12 hours or more, and BG is sitting in normal range, then no high carb food or karo is needed. Vetsulin is an in and out insulin so any concern about low BG without insulin for over 12 hours is likely not warranted and low carb food should suffice if you are concerned and simply retest to see if kitty is holding normal BG.

    A BG in the high 40s is not dangerous for a cat not on insulin. My girl (in remission) has tested in the 40s on her AT2 meter a few times. Low readings below 68 require immediate action IF there is exogenous insulin on board. That 68 warning number allows for a bit of cushion before hypo is likely to occur.

    My big question is how was your cat diagnosed? Was a fructosamine done or just a BG test in the vet's office?

    How is your cat this morning? What was BG?
     
    CandyH and Catcat likes this.
  70. CandyH and Catcat

    CandyH and Catcat Well-Known Member

    Joined:
    Apr 23, 2019
    still thinking, your vet recommended a dosage much more suited to a dog -- perhaps this vet hasn't had any diabetic cats in the practice before, only diabetic dogs

    glad you found us, listen to the posters above ^ --- seriously they know exactly what they are talking about and they have been shepherding some of us newbies towards success ...
     
  71. jgeeky

    jgeeky Member

    Joined:
    Aug 4, 2019
    This morning I only tested post food because of non-cat related happenings. About 45 minutes afterward he was at 190 and I had to go to work. It was our real first test run with absolutely no insulin (yesterday was like 11 hrs since last insulin). My AT2 test strips got delayed (arriving tomorrow) so I stopped by walmart and picked up an AccuCheck Guide. I know Chris mentioned the ranges are different. It will be nice to have two on hand for caretakers or incidents like today, but I wondered if the AccuCheck Guide was suitable and if all human meters use the same range. It seems like a much solid unit physically and has phone-based logging, which I like.

    I just got home from walmart and I haven't tested Ziggy. I left the laundry pantry open so he was asleep on all of our towels when I got home. Unappreciative twerp.

    My wife was the one who took him to the vet and I don't know if we still have the results. Blood work was done to see if there was an infection of possibility of Lyme disease do to the leg issues (not often cases of lyme here in central California, but the dogs travel a lot). The only information really relayed to us was that his BG was somewhere around 400 and to immediately begin vetsulin + w/d immediately in the hopes of addressing the neuropathy while there was still a chance (though it sounds like maybe B12 and Folic acid for that).

    We have never taken our cats to this vet, just our dogs. Always had good experiences, but like you said and like others have alluded to, they may be inexperienced and looking at antiquated material in this dept.
     
  72. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    All human meter normal BG range is 50-120 whereas the alphatrak 2 meter normal BG range is 68-150.
    The AccuChek is a good Meter. Most of us use human meters here as our dosing methods are based on the human Meter BG numbers. Human meters are also much cheaper to run.

    When testing to see if it is safe to give the shot, the test always needs to be done before food is given otherwise the BG result will be food influenced because BG goes up after eating.

    You are better choosing either the human or the pet meter and generally sticking to the one type of meter otherwise it gets too confusing.
     
    MrWorfMen's Mom likes this.
  73. Gypsy's Parent

    Gypsy's Parent Member

    Joined:
    Jul 24, 2019
    I recommend returning the AT2 and test strips. You'll needlessly go broke purchasing test strips. In two weeks, I've gone through almost 50 test strips and I don't even think I've tested all that much! That would be $50 for test strips alone. I think there's some good info on the internet if not here with a chart of cost of strips and how much blood is required. I haven't had any problems getting enough blood for the ReliOn Prime, but other people have had issues. There are human meters that require less blood but slightly higher cost of test strips.

    You'll want to stick to one or the other so that you can easily look at trends over time in the spread sheet.
     
  74. jgeeky

    jgeeky Member

    Joined:
    Aug 4, 2019
    A little update. We've tried different fancy feast iterations and combinations and Ziggy has zero interest. If it were a dog and not about a blood sugar, I think there MIGHT be some logic in saying "well, he'll get hungry enough". BUT, he seems to really like the keto kibble. His blood sugar has been pretty stabilized for the last few days without a single insulin injection, but we are very much keeping in our minds that this could be part of the honeymoon transition phase.

    We installed a cat door into the office with another circulating, filtered water fountain and a small bowl of keto kibble for snacking. This keeps the dogs out and offers a third fresh water source, as well as a cat den. The dogs love the cats, but the cats still want their seclusion.

    Ziggy's BG was hovering around 115 with the keto kibble, but I worried that we didn't have much ability to check after 7:30am or before 3:30pm. And, after the 40-50 BG scare while we were still giving vetsulin that so many of you very helpfully responded to, I decided to add a little bit of the old kibble this morning, which spiked him up around 250 and then about 6 hours later he returned to around 120. So, lesson learned, I will not be adding that back in. Going to try again tonight after just keto kibble and see how he is maintaining. If we can get BG somewhat stable, I'd like tp start administering the b12/folic acid combo for addressing the neuropathy. I have all the necessary things on hand, I just want to try to stabilize one thing at a time.

    I know it's all a very small snapshot and nothing is regulated, but I will say that he seems more like Ziggy. He's walking around, crying in the middle of the night, and wanting to drool on us: all of the things that perturbed us before but that we're happy to see again. When we were giving w/d and shooting the vetsulin, he seemed zombified. He would have moments of himself, but mostly moments of being prone and staring, even when his name was called.

    We're definitely not ruling out the Fancy Feast and definitely not thinking we're out of the woods. Our other 12-year-old boy, Captain America, seemed to take to the water + ff slurry, even after years of having no interest. He doesn't currently show any signs of health issues, but our plan is to change them both over to a new diet. The two dogs and two cats in the house drink a lot of water from the running fountains, and I hope adding a third fountain will help. But, I really like the idea that wet food will support a reality when they stop showing that interest.
     
  75. jgeeky

    jgeeky Member

    Joined:
    Aug 4, 2019
    One of the things I noticed about BG testing is that the human meters seem to require a larger blood droplet. The AT2 and the strips that come with the unit require only a very small amount. The PetSure brand generic alternative is about half the price, but seems to require about 10-20% more blood. But, the Accucheck seemed to require just enough more blood that I would often get an error. Ziggy does not give a single thought to having his paw pads pricked, but has never liked his ears touched. The AT2 strips are more expensive, but the stress level is much lower for both Ziggy and me. And, if it means no vetsulin or 1 dose of vetsulin instead of 4, doing away with the w/d food, the cost of the strips is negligible.
     
  76. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi thanks for the update.
    Do you think you would be able to set up your signature and spreadsheet? It would make things much easier for helpers and you would get a lot of feedback yourself from the SS. Thanks
    Links are in one of the posts above.
     
  77. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
  78. Sarah&Soph

    Sarah&Soph Member

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    Jun 18, 2019
    Fancy feast is the most recommended food because most cats love it and it’s pretty cheap, but as Bron said it’s certainly not the only option. Any food under 10% carbs on the list she provided will work. Tiki cat and a lot of the weruva kinds are also good, and there’s options that aren’t pate if it’s the texture that he’s maybe not liking about it
     
  79. CandyH and Catcat

    CandyH and Catcat Well-Known Member

    Joined:
    Apr 23, 2019
    one thing you might try is Meow Mix Tender Favorites seafood mixes (tuna/shrimp and salmon/crab) -- they're low carb but shredded in broth, often stocked at Walmart, comparable in price to Fancy Feast

    Catcat does well also on 4Health grain free chicken/whitefish or turkey/giblets (available at Tractor Supply, variety pack is cheaper) and Blue Wilderness grain free chicken, turkey, or salmon (not the "healthy" or "gourmet" versions) -- I got lucky with a seasonal closeout price
     

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