1. FDMB will be updated soon. PLEASE save this web address: https://www.limestonemedia.com/feline/FDMB/ -- this will be the backup during the transition. It should be just an hour or two. See the "Announcements" section for more info.

? Questions on Feeding plan for NPH insulin cat

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Becky and Gray-Gray, Jan 2, 2020.

  1. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    Hello, I am new here and have reached out to this forum after an unsuccessful year and a half of battling feline diabetes following my vets instructions. Having done my research I have found out that the Hills W/D kibble which has been prescribed to me since August 2018 has not been working because it’s high carbs. My kitty depends on blood glucose curves every couple months and we still cannot get her sugar levels under 400. After reading about low carb diets I am actively seeking information on Glucose Meters. I would like to begin finding a low carb food for my kitty but before doing so I need to purchase and practice using a meter before beginning my transition to a low carb-canned food diet. I live in the USA, and have read that the Relion Glucose Meter from Walmart was a great cost effective meter to buy. I also read that lancets around 28-31 gauge were optimal to use. I’m not too concerned about the lancet as as I about finding a good Glucose Meter. I would LOVE recommendations with any feedback please to provide me with what meter you are using and why you recommend it.Thank you in advance!
     
    Last edited: Jan 2, 2020
    Jennifer R. likes this.
  2. Amy and Socks

    Amy and Socks Member

    Joined:
    Sep 30, 2019
    Hi- and welcome! I use the AlphaTrak (pet meter), because that's what I started with, but am working on getting myself to switch to the ReliOn Prime. The human meters are definitely cheaper, especially strips. The AlphaTrak are about $1 per strip versus ~$0.18 per strip for the ReliOn. Most people on the forum use the human meters, and it really doesn't matter which meter you choose. The one thing I would recommend is checking the sample size needed. The smaller, the better. The Alpha requires 0.3ml and the ReliOn requires 0.5ml. I think there are some human meters that need a good bit more. Since you can go through a lot of strips, strip price and sample size seem to be the best factors to consider. I'm sure you'll get lots of feedback from others with their recommendations as well. Good luck! :)
     
  3. Panic

    Panic Well-Known Member

    Joined:
    Apr 10, 2019
    Hi there, welcome to FDMB!

    I use the ReLion Prime meter (there is the Confirm and Micro as well but if I understand correctly they are being discontinued) and can't recommend it enough. A lot of people are concerned about the blood drop size but I don't notice a big enough difference personally when I went from Alphatrak to ReLion for it to bother me any. I love that it's easily accessible (Walmart is everywhere in the US!) so there's no panicking to wait on restock.

    As for the lancets, you kind of need them to draw blood. :woot: The lancets/lancing device don't have to match the meter you use but I also just get the ReLion kind. Start at 26 gauge. The lancing device is what's optional; many people here prefer to "free-hand" and poke, either for more control or their kitties are afraid of the clicking noise the lancing device makes when it fires. Others like myself are more comfortable using the device.
     
    Becky and Gray-Gray likes this.
  4. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    Thank you so much Amy and Socks! Great information!:)
     
  5. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    Thank you so much Panic! Excellent info about the discontinuation of the Confirm and Micro! :cat:
     
  6. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    One last question, when I read the meter do I simply just look at the number shown or do I need to multiply it by a specific number since it’s a kitty and not a human? Thank you!
     
  7. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    One last question, when I read the meter do I simply just look at the number shown or do I need to multiply it by a specific number since it’s a kitty and not a human? Thank you!
     
  8. Panic

    Panic Well-Known Member

    Joined:
    Apr 10, 2019
    Nope! There's no conversion between human vs pet meters, human meters read cat blood lower than what it actually is but there's no correlation between the two. The nice thing is here on the site everything is in regards to human meters anyway. So 50-120 on a human meter for a cat is considered non-diabetic range.
     
    Jennifer R. likes this.
  9. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    :nailbiting::nailbiting::nailbiting::nailbiting::nailbiting::nailbiting::nailbiting:
    Hi Panic, I just went to the Walmart Pharmacy and they don’t have a ReliOn Prime. They have:
    (1) ReliOn Premier ($14.98)
    (2) ReliOn Premier Blue ($18.98)
    (3) ReliOn Premier Classic ($9.00)

    I’m not sure which one to get :banghead:
     
    Jennifer R. likes this.
  10. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    I found it! ReliOn Prime!!! Thank you for your help!!!!
     
  11. Chloe007

    Chloe007 Member

    Joined:
    Oct 27, 2019
    When I first started I definitely needed a meter with the smallest sample size, but I didn't want to make the commitment to a meter with expensive strips. So I went on Amazon and found the Advocate Pet Meter for $17, it came with 25 strips and lancets (the lancet size which I believe was 21g, is a huge overkill...but it helped me learn so there's that, however you could probably just buy 26g from the store). The AT2 meter is $50, so I didn't want to spend that knowing I'd eventually move onto something cheaper (the advocate meter also runs close to $1/strip). By the time I was done with those strips, I went out and bought a Relion Prime which takes a larger sample size, but by then my kitty's ears had learned to bleed and it wasn't an issue.

    Just an idea if you need to practice with something easier but will eventually want to move onto a cheaper human meter once you get the hang of things. I really think that pet meter helped me learn how to test, so it was worth the $17 for that reason alone before I moved on to a human meter. With the small sample size strips and the large lancet, I never once struggled to get blood. I wouldn't recommend using the lancets that come with that meter for long though, my boys ears were looking pretty rough by the end of the week.
     
    Becky and Gray-Gray likes this.
  12. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    You guys I am so excited!!!! I went out and bought the ReliOn Prime and couldn’t wait to come home and use it:)! It took me only two tries as the first strip for some reason didn’t record:stop:! I think it seems high, 479, but I am trying out some low carb food for the first time and wanted to see if the food affects her sugar levels.... So I just fed her a 3 oz can of Fancy Feast Pate (low carb and recommended). She scarfed it down!!! I will retest her sugar levels to see what they are again soon.... Im thinking 30 minutes :confused: I’m afraid to wait tooo long to test because this is my first go at different food and self checking before administering insulin. Wish me luck :nailbiting:!
     
    Last edited: Jan 2, 2020
    Jennifer R. and Marje and Gracie like this.
  13. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    How's it going?
     
  14. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    I think it’s going pretty good. Within the past 24 hours I have purchased a meter, switched to low carb food, began testing sugar for the first time, and have my glucose spreadsheet up and running ‼️Thank you! I estimated for the first time this morning my own dosing of insulin due to a lower sugar reading on Gray-Gray’s AMPS. I’m sure this is because I’ve switched her from Hill’s W/D to Fancy Feast Classic Pate. So far the morning insulin dose seems to be working out, but I’m super scared of any hypo episodes ‼️ I’m nervous going into my PMPS sugar reading on how to dose her insulin if it drops lower than this mornings AMPS. I actually hope it stays the same so I can use the same dose of insulin...
     
    Marje and Gracie and Panic like this.
  15. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    You have done an awful lot in 1 day. What insulin are you using?

    Switching my Wink from the Hill's W/D to low carb Fancy Feast Classic pate style foods, dropped his BG numbers like a rock and I had to keep dropping the insulin dose down pretty rapidly.

    No information in your signature. 2 things that would really help us.

    Signature info so we have some info with everyone of yours posts. How to instructions for signature are here.
    A spreadsheet that you then attach to your signature (it's read only for us). How to instructions for the spreadsheet are here. There are a couple of people that set up spreadsheets for folks. If you have a problem getting it set up, I'll tag them to come help you.

    What all that stuff on the spreadsheet means explained here.
     
    Jennifer R. and Si am cat mom like this.
  16. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    Wh
    thanks for the heads up in the signature and profile info! I tried to add information in the best I could however I don’t know what DX, TR, SLGS, IAA, Acro, or Crushings mean...
     
    Jennifer R. likes this.
  17. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    DX is diagnosis date
    TR and SLGS are the 2 dosing and management protocols used for Lantus insulin and sometimes Levimir insulin.
    TR means tight regulation, being agressive with the insulin doses, many more BG tests, reacting quicker for dose changes.
    SLGS means start low and go slow. Start with a low dose of insulin, fewer BG tests but still pre-shot and mid-cycle tests, week between dosing changes, go slowly with any changes.
    IAA is insulin resistant antibodies so my require higher doses. Special testing my your vet sent to a lab to see this.
    Acro is acromegaly, a pituitary gland tumor that may require very high insulin doses and other treatment. Special testing sent to a lab at Michigan State to verify this.
    Cushings is another disease in cats with too much production of the hormone cortisol. Again, special testing. Very fragile skin that rips easily is one sign.
     
  18. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    Thank you so much :bighug:
     
  19. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    The spreadsheet link in your signature isn't working. It wants me to try logging into your google account. So something isn't quite right.

    I'm tagging @Marje and Gracie to see if she can fix it for you. She does this all the time for people.
     
    Becky and Gray-Gray likes this.
  20. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    I deleted it, rewrote it, and reattached it.... maybe that helped?:D
     
  21. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    That worked! Able to see Gray-Gray's SS, in view only mode which is exactly how it should be for anyone but the owner of the document.
     
    Becky and Gray-Gray likes this.
  22. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    I took a recommendation from somebody To drop her down to 0.5units with the diet change to allow for the Hills W/D kibble to work her way out of her system. I find it REMARKABLE how much her sugar levels have dropped with the diet change and so little insulin! Previously on 3.5 units and Hills she was always in the 300-400 range and hardly dipped into the 200’s when she had her glucose curve with the vet. Just with three days into the diet change and dropping her insulin to 0.5units I’m getting LOWsugar levels ‼️ I can’t believe it! Oh goodness me I’m praying for remission in our future ‼️
     
  23. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Yes, that diet change from Hill's W/D to low carb wet food worked for my daibetic cat too. The hardest part was getting him to realize that wet food was good for him and getting him to eat it.

    The other change that really helped was getting Wink on one of the longer duration insulins. He got lantus.
     
  24. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    You’ve done a great job, however, that spreadsheet is one used by some of the FB groups and has some issues associated with it (e.g. it crashes when trying to view it from within FDMB, the info regarding normal numbers on the AT and hypos is wrong). Therefore, we don’t use it here and ask that our members use our spreadsheet.

    If you scroll back to post 15 above, Deb has linked the instructions for our spreadsheet. I am happy to do it for you and transfer all your data to it if you send me a private message. To send me a PM, please click on “Marje and Gracie” to the left and then “start a conversation”. But....it’s very important you get the correct SS. If numbers drop and we can’t get the SS to stay open long enough to see what’s going on, we aren’t going to be able to help you.

    Thank you!
     
  25. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    @Marje and Gracie I have one question.
    (1) What is my sugar number that I need to have to NOT give a Novolin insulin shot after her meal?

    (2) Also I’m seeing mixed reviews about what time I need to wait after feeding meal to give insulin shot with Novolin?

    Thank you in advance
     
  26. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Generally for new members without data, and using Novolin, the no shoot number is below 250. Novolin is usually given an hour after feeding when the BG is rising.

    Here is a very helpful post on using Novolin.
     
  27. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    Wow, I had no idea I had to wait an hour. I have always administered Novolin upon completion of the meal:facepalm: bc that’s what vet told me. Do I time the hour from when she began eating or from the time she finished eating? Thank you :)

    EDITED: ALSO HOW DOES THIS AFFECT my +1,+2,+3 etc. if I feed at 5:33pm and shoot at 6:30pm, will my +1 be 7:30pm?
     
    Last edited: Jan 5, 2020
  28. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    I would shoot one hour after she is done eating so the food is completely in her. Novolin can onset very fast so you want to be sure food is already on board.

    Your +1 is one hour after you shoot. All of the “+” numbers refer to hours since last shot.

    It’s also looking to me like she needs a bit more insulin unless you are feeding any dry. I don’t know if the Hills w/d you were giving is dry or canned and if you’ve totally finished it. If she is completely on low carb canned food and her w/d was dry, we should give her a couple more cycles to be sure dry is out of her system. If she was not on dry and you stopped the canned w/d a day or more ago, she could likely use 0.75u twice a day if you are there to test.
     
    Last edited: Jan 5, 2020
  29. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    Hmmm, so on my log I put times above the +1, and logged my test when a shot1 hour after her meal bc I wanted to see how much her sugar increases from her meal before I gave her the 0.5 units.... so technically she has two PMPS..... idk how to account for pre-meal test and post-meal test and post-shot then.... If you look at my SS you’ll see what I’m talking about.

    I go back to work tomorrow and will not be home to test Monday-Friday until I return home. Thankfully her meal timer came in the amazon delivery today, so I can program two meals a day after I leave for work.

    I was free feeding her hills w/d kibble. She was eating ~2 cups dry AND 1/2 can wet each day up until I began the spreadsheet. I noticed her sugar spiked up when I rewarded her with two“temptations” treats after her test the other day and also spiked today after she snuck out on the patio and ate a patch of grass. I will no longer allow for either of those mistakes to happen. Other than that she’s been strictly on FF Pate.

    I think maybe another day or two one the 0.5units she regulates? What do you think?

    EDIT/UPDATE: Ok so I went into the SS and added an xtra row below to account for the second test and adjusted the +2 according to time insulin was given @6:30pm, so my +2 is at 8:30pm.
     
    Last edited: Jan 5, 2020
    Reason for edit: Update info with details
  30. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    If you are testing one hour before her shot and then feeding right then and testing again before you give the shot (I don’t know if you are doing this part or not but generally you want to be sure her BG is rising before you shoot), then the 5:30 test would be in the +11 column and the test before you actually shoot at 6:30 would be in the AMPS and PMPS column.

    If you aren’t testing again right before you shoot, then the way you have it is fine.
     
  31. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    Thank you so much, I left yesterday the way I had it but have changed it based on what you said for this evening today.
     
    Marje and Gracie likes this.
  32. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Thank you!
     
  33. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    I am starting to think your right after another two cycles here w/d kibble should be out of her system and I should increase her from 0.5u to 0.75u. I’m scared to bc I’m not home to test her during the day. Do you think I can begin this tomorrow for her PM meal?
     
  34. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    My experience with a cat going from the W/d dry (kibble) to Fancy Feast pates was that the BG's dropped dramatically, BUT I did not decrease the insulin dose during the food transition as you did (and a different insulin), so the situation is not the same. Food change took longer for me since Wink did not take to the wet food like Gray-Gray did. You were lucky that he loved the Fancy Feast!

    If you are not home to test during the day, and you are scared to do the dose increase, yes waiting to do the dose increase until the PM cycle is fine. Remember, you hold the needle, you know your cat better than we do, you are the ultimate decision maker.

    You did drop the insulin dose down during the food transition to be safe. You did change to feeding and waiting an hour before the insulin shot which is especially important since you are using Novolin N, one of the quick acting insulins. You have absolutely wonder detailed remarks on your SS so we can see what is happening and how things are going. Love the detail! Thank you!

    You went out and got a glucometer so you could home test. You're testing before every shot. You are testing during both AM and PM dosing cycles when you are home to do that. You've changed your cat to a low carb wet food.

    You've done ALL the right things is what I'm saying.

    Hoping to see Gray-Gray constantly improving. Congratulations on all your hard work to get your kitty feeling better.
     
  35. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Forgot to make some suggestions about treats. Maybe you have already seen this information if you have been reading other posts. Avoid anything with grains (corn, corn starch, wheat, soy, rice, flour for example), no veggies (peas, potatoes, sweet potatoes, tapioca for example).

    Keep those Temptations treats in your hypo kit. (You did make up a hypos kit, just in case I hope?)

    You want to find a treat that is only meat. Some people use freeze dried treats but be warned that too many can sometimes constipate a cat. You can cook up any type of meat at home (chicken, beef, fish, pork), cut into small pieces and freeze until needed. Ham and luncheon meats and hot dogs tend to be salty but little bits may be ok. You can use a bit of the low carb canned food as a treat. Some cats like cheese or a bit of egg. Try to stay small, the size of a piece of corn for a testing treat.

    A small snack (think 1 teaspoon) size is a good amount early in the cycle. Novolin N does NOT usually have a long duration in cats (6-8 hours is typical), so you don't want to be feeding much past +3 or +4 with Novolin N.
     
  36. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    Ok so I am currently feeding Gray-Gray 6 - 3oz can of FF Classic Pate a day :eek:. One can before her shot, one can at ~ +3, and one can at ~ +6. I am also repeating this in the evening too. She devours her food. She would eat more if I put it out. I would wait until +4 to give her a snack but she wants it sooner.... what should I do?
     
  37. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Oh my! 18 oz of food a day! Before I can give a good answer to your question, I'd like some more info about her weight.

    1. Is Gray-Gray at her ideal weight? Too thin? Too heavy? One way to assess this is to see if you can feel her ribs. Is her spine showing or ribs showing through her skin? Or you can look on Google and look at one of those Body Condition Score charts, like they have in your vet's office. Here is one example of how to assess your cat's body condition.

    2. Do you have an idea of her weight now? If you have a scale, hold her in your arms, check the weight, let her down, subtract your weight from the first total.

    3. Is she a large breed cat, like a Maine coon cat or another large breed?
    4. Is she a small framed cat ( I have a tiny 7.5 lb kitty, very small frame), medium framed, large, or extra large?
    5. Does your vet think she is a good weight for her body frame size?

    Cat's with unregulated BG levels are often very, very hungry.
     
  38. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    I would say that Gray-Gray is an average sized cat. She isn’t a large breed, just a typical average house-cat. She is nicely proportioned, not skinny, not chunky. I think she looks normal. She is an average frame, weighed 8.4 pounds at her glucose curve last month on 12/14/19, and the vet wasn’t concerned about her weight. Prior to diabetes she was FAT, then the summer of 2018 I went away for 5 weeks and had a my boyfriend (at that time) watch her for me. Upon returning from my trip she looked anorexic, severely dehydrated, had diarrhea, and was walking on the hind feet flat footed loosing nerve function. The vet saved her by giving her an IV solution to give her body fluids and that is when the vet diagnosed her (August 2018) with diabetes. Since then she has gained weight to a nice size as she is currently and has never returned to her pre-diagnosed chubby kitty size.

    I agree that upping her insulin looks like a good idea based on her SS, tonight at my PM meal I’ll up her to 0.75u, and will monitor her sugar every couple hours. My question is,
    (1) how often should I feed her? Keep it at +3 and +6?
    (2) how much should I feed her?

    I have noticed that her stool has turned grayish in color and after reading about cat stool I believe that means she is eating too much:nailbiting:.... so I had a feeling I would need to decrease her food intake, but should I both up the insulin AND decrease the food consumption simultaneously?

    what do you think?
     
  39. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    My first choice for now would be to suggest you increase the insulin dose. Food change is complete, let's increase the dose slightly to the 0.75U of insulin and see how she does.
    Would you add Gray-Gray's weight to both your signature and the SS so we can see it? Please.

    Change only one thing at a time. If you up the dose AND decrease the amount of food, it's much harder (impossible) to know what change made the difference. Same with changing the timing of when you feed. When you switched to low carb food, we had you lower the insulin dose at the same time, to prevent a possible hypo episode. So, there is an exception to every rule.

    I might change the timing of when you feed. With the short acting Novolin N insulin you are using, feeding past the middle of the cycle will simply raise the BG levels that much faster.

    Novolin N (any NPH insulin) is difficult to use to get a cat regulated. As long as a cat is unregulated, they can not use their food properly and will always be hungry. Even at his most unregulated, my Wink only ate 10-11 oz of food, and he was more like 11-12 pounds for his ideal weight.

    You don't want Gray-Gray to lose too much weight, like she did back in 2018. Sounds like your vet thinks the current 8.4 is an ideal weight for your kitty.

    You might want to talk to your vet about a different insulin. (Not Vetsulin/Caninsulin - made for dogs). Better insulins for cats are Prozinc, Lantus, Levimir.

    "Color: A happy, healthy body produces chocolate brown stool. This color comes from bile, a fluid released from the gallbladder to help digest food, and bilirubin, a pigment in the bile. Though some variation in color is normal, certain color changes always catch our attention. Bright red streaks may indicate bleeding low in the GI tract, while tarry black or maroon stools can be caused by bleeding in the stomach or small intestines. Clay-colored or pale yellow stools can be caused by problems with the liver, gallbladder or pancreas. Any significant deviation from the chocolate brown color that persists for more than one or two stools is cause for concern. An exception would be color changes that reflect the pet’s diet, such as kibble containing food coloring that results in flecks of color."

    Fancy Feast canned food does not change the stool color in my experience. I think at least a call to your vet to ask about the gray colored stool is in order. Maybe a vet visit too.
     
  40. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    p.s. If your vet asks you why you changed the food from Hill's W/d tell her "Did you know the W/d dry is 37% carbs, the W/d wet is 25% carbs? AAHA Diabetes Management Guidelines 2018 recommend high protein >= 40% and 12% carb foods for cats."

    Tell her that the Fancy Feast classic pates you are feeding now are higher in protein and lower in carb then the food she had you feeding your cat.

    Then point her to the 2018 AAHA Diabetes Management Guidelines, here.

    Feeding Guidelines here.


    Point her to the ISFM Diabetes Consensus Guidelines for Cats here. Came out in 2015, vet journal published, Journal of Feline Medicine and Surgery (2015) 17, 235–250

    "Knowledge is power" as the saying goes.
     
    Becky and Gray-Gray likes this.
  41. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    thank you so much, this is all just wonderful information. I am going to up her to 0.75u tonight and monitor ever hour or every other hour. I am also going to continue to feed at 5:30, 8:30, & 11:30 even though I’m shooting an hour after at 6:30. She spiked this morning and I think that may have been bc I pushed her evening meals back to 5:30, 9:30, & 12:30 last night to accommodate for shooting an hour after her 5:30 meal. She didn’t take kindly to it. Let’s see how this pans out...

    Do you think the stool color can wait a cycle or two to see if these changes make any difference?

    (p.s. what color is “clay color”?)
     
  42. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Clay is gray. Think of the color of most cat litters that are made of clay. Maybe not the exact same shade, but think of that same 'tone'.

    Yes, let's see if the stool color improves. Could be partly from the diet change.

    I like to research and find some of the latest treatment and ideas on feline diabetes. Can be heavy going trying to read some of those vet journal articles, but worth it to me.

    EDIT: with the Novolin N insulin, You always want to test pre-shot. Because of that 1 hr you need to wait after feeding, you might think about a test again before the actual shot but after the food has had time to start being digested, since with the NPH insulins you want there to be food on board. That way you can see that the BG did not go down too much to give the insulin. NO shoot threshold should be 250 with the NPH insulins, at least at first.

    Sounds like you are doing a testing curve, by testing every hour or every 2 hours.
     
    Last edited: Jan 7, 2020
  43. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    Based on the research you read and shared I think I’m finally doing it correctly.

    well, considering I’m modifying insulin tonight, don’t you think more data is better? My mind is thinking this is the only way to truly see how the 0.75u influences her sugar? I’m a data driven individual. I like numbers and this chart and it’s data is truly amazingly helpful ‼️Do you think such a dosage change should warrant a curve?
     
  44. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    No, a curve on this dosage change is not warranted. Wait a few days to see how this dose is doing and maybe think of doing a curve on the weekend. If you don't work weekends that is.

    I like data too. Worked in the computer field for many years. Although,some of that data is harder to retrieve from the way back mind memory archives.
     
  45. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    Ok you know more than me, I’ll wait until Saturday to curve :). Thank you :bighug:‼️
     
  46. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    @Marje and Gracie

    is there a way to compare the fat content of Hills W/D kibble to Fancy Feast Classic (no particular flavor as I bought all flavors and have been using them all). Since I have switch Gray-Gray’s diet her stool has been transitioning to a gray color, various shades of gray. I am starting to think that the fat content of the Fancy Feast may be too high for her? She is not showing ANY other symptoms of lethargy, pain, discomfort. I am starting to think that b/c she is eating SO MUCH fancy feast every day (6 - 3 oz cans) to regulate her sugars bc she’s hungry that she may also be consuming too much fat.

    when on Hills W/D she was consuming 1/2 can wet and ~2cups dry every day. Currently on Fancy Feast Classic she is consuming 3 - 3 oz cans in 1st am cycle (5:30, ~8:30food timer, ~11:30 food timer) and also 3-3 oz cans in her 2nd pm cycle at same feeding times.

    Last night for her pm meals she ate Seafood food & Cod Sole Shrimp. This morning right now I hav Salmon and shrimp feast & Seafood. On the food list I see those flavors have 50%, 56%, & 52%. For the fat. This morning her stool was a bit more grey than last night. This pm once I come home from work I’d like to compare her stool to see it again. If has increasingly turned more grey throughout this entire food transition and insulin drop.

    What are your thought on the fat content with the food change? I’m starting to worry about this being a fatty liver if this fat is too high bc she’s eating so much.

    edit: I see tiki cat has lower fat, Petco sells that and I can pick some up on the way home from work. What are your thoughts switching to tiki cat?
     
    Last edited: Jan 8, 2020
  47. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Take a look at Dr. Lisa’s food charts that we use here. They are a little dated but I doubt that Hill’s or FF has changed their formulas that much. You’ll see the fat content is not that much different depending on what you select (some of them are more fat as you pointed out). It could be the difference in ingredients. The w/d could have more fillers which make her fill fuller so she has to eat more FF. What you want to focus on is keeping her calories stable at an amount that keeps her weight stable. You can do this by weighing her, feeding her for one week, then weighing again and seeing if her calories need to go up or down (very small increments in either way). Dr. Lisa has a ton of information on her site that will help you about nutrition and how to calculate calorie needs, etc. She is a feline veterinary nutrionist who also posts on this forum.

    Fatty liver in cats occurs from cats who don’t eat enough calories over time or become anorexic. Cats have very different metabolism then people so if you are thinking “ketogeneis” as in people where they eat alot of fat and less carbs, it’s different for cats. They are obligate carnivores and so are geared to eat higher protein, moderate fat, less carbs.

    I’m not really so familiar with many commercial cat food brands anymore as I feed a raw prey model diet to my two cats. Alot of members use Tiki cat; I am not a proponent for cats ever eating fish and they have alot of fish varieties. Having said that, Gray-Gray is YOUR cat and I am a strict proponent of each person’s right to feed their cat as they see fit and for what they deem is best for them.

    Bottom line: I doubt there is any issue with the fat between w/d and FF. It’s more likely ingredients. If she likes FF, isn’t gaining weight that she doesn’t need to, she has no symptoms of anything, then give it a few days and see if her stools get back to a regular color. It takes a minimum of 3-4 days for a food to completely no longer be in the digestive system.

    Edited to add: I’m sorry but i don’t remember why w/d was prescribed to her in Aug 2018. For the diabetes after it was dx while you were away?
     
    Last edited: Jan 8, 2020
  48. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    Thank you for all of the information and your opinion! It is much appreciated. The W/D was prescribed once she was diagnosed with diabetes after I returned in August 2018.

    I did roughly calculate that she was eating ~340 Calories of W/D before switching to fancy feast. So this evening I am decreasing her consumption from 6-3oz cans a day (~525 Calories) down to 4-3oz cans a day (~340 Calories). All honestly I have no idea how much to feed her. My vet always said feed her how ever much she’ll eat and that I should never have a hungry kitty.

    I truely hope this helps her sugar and stool color .

    EDIT: after rereading what you wrote I’ve decided to leave the seafood cans in the cupboard and only choose to feed the poultry and beef flavors. Maybe this could be the ingredient in the diet change causing the problem. WD that’s she had been eating is chicken and liver in the ingredients panel , no seafood listed. Maybe introducing the new seafood ingredient could be the problem in addition to having been feeding her too many Calories. I hope this works
     
    Last edited: Jan 8, 2020
    Marje and Gracie likes this.
  49. Marje and Gracie

    Marje and Gracie Senior Member Moderator

    Joined:
    May 30, 2010
    Interesting advice from your vet. You might want to read this post about feeding diabetic kitties as much as they want. But even for non diabetic kitties, you shouldn’t judge by whether they are hungry but on what is the ideal weight and what amount of calories keeps them there. That part is like humans :)

    As an example, my little girl (and she is tiny) Livia, eats 2 oz of balanced raw every day. This keeps her weight right where it needs to be. I don’t really know how many calories that might be; we determined it by slowly decreasing her from 6 oz a day as a baby to 2 oz as she became adult by weighing her weekly and knowing that at a year her weight should stabilize. She often acts hungry and I asked our vet about it. She said, “Her weight is perfect so as long as she’s not gaining or losing, her food amount is perfect; after all, I’m hungry all the time, too, but if I ate all the time I was hungry, I’d be a blimp”. Love my vet :smuggrin::smuggrin::smuggrin::smuggrin:

    I have a cat scale and continue to weigh my cats weekly. Her weight has been stable for a very long time, as has my male cat’s weight (he’s bigger, gets more food, and is satiated with his allotted food). If Liv seems really hungry, we give her a small piece or two of freeze dried chicken treats and that does the trick.

    ETA: And as Deb says....we play to distract her.
     
    Last edited: Jan 9, 2020
  50. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    More stress on arthritic knees and joints if you are carrying around more weight. More stress on all our body organs and increased risk for so many diseases for us humans (and our pets). For me, it was easy to decide to eat better for my health. Still hungry a lot, but that is part of life and living.

    I have weighed my cats for years. I had a bakers scale that weighed up to 17 pounds, good for monitoring even my heaviest kitty when my vet said "He could stand to lose a couple of pounds". And again when the vet said "He could stand to lose a couple more pounds". So from 16 down to 12 pounds was good for him, took us about a year to do that. And he was hungry ALL the TIME and let me know it. But he was healthier for it.

    You can also weigh yourself on a human type scale, with kitty in your arms, put cat down, weigh yourself, subtract numbers from each other to get approximate weight for your cat.

    Your vet should at least be able to tell you if your cat is a good weight or is too skinny or needs to lose a pound or two, like my vet did.

    Sometimes our cats think or have learned that if we are in the kitchen, they get food. So they keep asking for more food and what they might really like is some more attention. Try substituting things like brushing or some head scritches and such for food. Or interactive play time. I know when my girl Dancer "rushes like a herd of elephants" down the stairs after dinner that it is play time. Stop what ever I'm doing and get out the fishing pole toy for some interactive play fun. Play time!!!

    My little girl is not a 'lap kitty' most of the time, but she likes to be in the same room I'm in. So if I forget and close my home office door, she'll start up with her little squeaky meow and I'll let her in and she'll curl up on the cat bed nearby and sleep, contented to be near me. Close enough for her to be happy. Not looking for food because she meowed. She has taught her servant to read her body language and meows over the years, and respond correctly.

    My point after being that long winded is keep your kitty happy with play and attention and getting her to/keeping her at her normal weight can all help with the diabetes.
     
    Becky and Gray-Gray likes this.
  51. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    Thank you @Deb & Wink and @Marje and Gracie so much for the information‼️ It is challenging for me to read her behavior but I am trying to respond with more affection during our interaction instead of it being just about getting the needle poke and food.

    I have decreased her food consumption Wednesday from one 3oz can three times in am and three times in pm to weighing out her meals on a food scale. Her first am meal is 2oz(5:30am), wait 1 hour shot, second am meal 2 oz(8:30am), then third am meal 1 7/8 oz(11:30am). I repeat the cycle in evening. I know you said Novolin hits hard so I was giving her a bigger 5:30 meal to up the sugar. I was contemplating in decreasing her 8:30 meal down to 1 7/8oz similar to her 11:30 meal but wanted your opinion. i was starting to think about maybe only doing 1 big meal and 2 Or 3 little snacks since the Novolin wears off fast? I would love your thoughts on that idea.

    Also I upped her insulin today from 0.75u to 1.0 u. I haven’t been home during day all week to monitor in am, but her pm SS seemed like it was a good idea. I will monitor her closely today to see how the unit modification affects her SS.
     
    Marje and Gracie likes this.
  52. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Ok, will keep my eye out for your posts Becky. Tag me or change the heading on your post title and put HELP at the beginning to get more eyes on your post. Only need to do that if Gray-Gray drops really low, I'd say under 100 and no answer to your post. If Gray-Gray drops under 50 with Novolin, we'd really worry and then change your thread/post title to 911 to get more help.

    Gray-Gray has never been down in those green numbers, below 100, but there is always a first time.

    The Novolin just doesn't have the duration a cat needs. That's the biggest problem with it. Have you ever thought about using a different insulin? No idea what your budget is like, but there are ways to get other insulins at lower costs.

    p.s.Marje and Gracie are on vacation. So I'll be trying to help you over the next week or so. Very few people here with NPH experience. I'll tag @Larry and Kitties to see if he has any ideas, and get some extra help. He's a vet tech, has had a lot of diabetic kitties and may have some NPH insulin experience to lend here.
     
    Becky and Gray-Gray likes this.
  53. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    Thank you! In the event I might have an emergency how do I change the post title?
     
  54. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Meant to comment on feeding food ideas.

    We know that Gray-Gray needs to lose weight, but want to keep here safe with the fast acting Novolin which onsets quickly.

    12 OZ total food intake right now.

    Biggest meal before insulin is a good idea. Let's stick with the 6 oz each cycle for now spread out during the cycle into 3 meals , one big one, two smaller snack size. How about 1 can (3oz) of FF at 1 hour before her pre-shot test. Then 2 snacks of 1/2 a can each (1.5 oz each snack). That would be the 6 oz Gray-Gray is eating now each cycle, for a total of 12 Oz a day. With how unregulated Gray-Gray's BG levels are now, she can't really use all the food properly.

    You have a timed feeder, so you can use that for the 2 snack size feedings. Do you use the timed feeder for the snacks at night also? A note on your SS made me think you might not be doing that, so that is why I'm asking.

    I'm surprised to see Gray-Gray weighed 8.4 pounds at the vet but 11.4 on your scale at home. 3 pounds is a huge weight gain for 3 weeks. Does she have heart disease or other medicals problems? Would you please weigh her again?
     
  55. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    You as the post creator can go to the very top of the post. Over on the right side of the screen you will see the words "Thread Tools" with a little drop down arrow. Click on that arrow and you will see "Edit Title". A black box opens with the old title there, change it and put HELP NOW or a real, life threatening emergency (cat seizing, comatose) put 911 at the beginning. Then click on "Save Changes".

    You could make a tiny change now, to test and see how it works. Maybe change the title from "Glucose Meter Advice" to "Questions on Feeding plan for NPH insulin cat".

    You will also see in that title in the black window, an area to the far left of your post title that says (no prefix). Using the drop down arrow you can change that to the ? mark icon. Try that too.
     
    Becky and Gray-Gray likes this.
  56. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    I just reweighed her on my bathroom scale and she is 10.8pounds. She has a glucose curve scheduled in one week, so I will have them reweigh her on their scale and compare.

    I was not using food timer in pm, maybe I should start using it. Moving forward I like your recommendation of feeding 3, 1.5, 1.5oz. I already fed Gray-Gray her 5:30 Preshot meal at 2oz this morning. She will be receiving her 8:30 snack shortly in 20 minutes. I’m not sure how many ounces to feed her for each snack during this am cycle since I’m in the middle of the unit change and dose transition.
     
  57. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Don't change the amount of food for this cycle. You can work on that later.

    Using the timed feeder in the PM means Gray-Gray might not wake you up at night.

    For your next vet visit, if he asks you why you changed the food, do you have your reasons ready?
    Maybe print a copy of the 2018 AAHA Diabetes Management Guidelines and show him those. I've attached the PDF version here, so you can open it in Adobe Acrobat and read it yourself. And print a copy if you can.

    Or visit the AAHA (American Animal Hospital Association) website here to look at it on-line.

    Basically, for cats - good insulin such as Lantus, Levimir, Prozinc; low carb (<12%)canned food; home testing. NPH and Vetsulin are good for dogs, but not for cats because of poor duration.
     
    Becky and Gray-Gray likes this.
  58. Becky and Gray-Gray

    Becky and Gray-Gray Member

    Joined:
    Jan 2, 2020
    I read through the 2018 AAHA Diabetes Management Guidelines and it’s sounds like Lantus is the best option and the Novolin I’m on is the worst option. I am going to share this with my vet. If money wasn’t a factor, would you agree that Lantus is a better choice versus Levimir? If I am going to make a switch I want to switch to the best choice for my kitty.

    Side note, everything seems good so far with the dose change this morning :) Thank you :bighug:
     
  59. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    If money is not an issue, yes the lantus or levimir are better options than Novolin. See suggestions on how to cost save further down in this post.

    Yes, Novolin is just about the worst option for a diabetic cat. Duration, lasting a full 12 hour cycle, is just not there and most people work so they can not dose 3 times a day, every 8 hours. I worked to guide a couple of people trying that method years ago. But it's really difficult for folks to live their lives and take care of all their responsibilities without that extra burden, of testing and shots 3 times a day. In my opinion the NPH insulins don't work well and I am a bit sad to see that vets still think it's an ok insulin for cats. Dogs yes, cats no. The only thing it has going for it is the lower cost, but even that is going up rapidly in the US.

    Lantus and levimir are both good insulins for cats. Deciding between the 2 is often a personal decision and thinking about things like what your work schedule is like and when the testing needs to be done, if your cat is a high dose cat (over 6 Units) Levimir stings less with the injection. Some cats do better on one than the other. Some vets do not like to use medications "off-label" and that is what any vet that will prescribe either of these 2 insulins is doing. They do it with a lot of other medications also. You'll need to see if your vet will give you a prescription first. Some vets have never used lantus or levimir and reluctant to prescribe them.

    There are people here that have used and can help you with either lantus or levimir. I think a lot more people choose the lantus because there is a scientific protocol established, but please don't use that as a deciding factor.

    I'm going to ask you to read one more document. This is from over in the ISG (insulin support group) over in the Lantus/Levimir forum. To help you see if you think lantus or levimir might be a good choice for you and your cat. Maybe read through a couple of posts from members over there. It's very busy, and full of terminology you might not know yet. Don't get overwhelmed, please. Any decision does not have to be made right now. Gray-Gray is safe on Novolin for now, you are feeding good food, you are home testing. Think it over. Ask more questions.

    The Basics: New to the Group? Start here!

    Availability of either lantus or levimr is pretty widespread in the US but there are VERY expensive here. You don't live very close to the Mexican border, but if you lived around San Diego I'd say go to a pharmacy across the border. The other option that people use here is to order from Canada, Mark's Marine Pharmacy. Linking you to a post on that here. Something else for you to read.

    You need a prescription from your vet first. Lots of folks here that live in the US use that pharmacy. Member Chris & China found that several years ago.

    Yeah!!!
     
    Becky and Gray-Gray likes this.

Share This Page