Spaceys diet, BS and insulin questions

Discussion in 'Feline Health - (Welcome & Main Forum)' started by spacey, Aug 7, 2010.

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  1. spacey

    spacey Member

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    Aug 1, 2010
    I have a few more questions re Spacey, if I may. He went to my vet last Monday for regulation with blood sugars over 500. Spacey came home Thursday with blood sugars in the 150 range. He is on 4 units ProZinc at 8 a.m. and 4 units at 8 p.m. He is on Science diet WD canned and dry. My vet was not very specific about how much I should feed Spacey. So I feed about 1/3 can WD when Spacey gets his shots and about 1/8 can plus dry WD a few hours later. I have started 3 blood sugar tests per day, 1 before each shot and 1 around midnight. Spaceys bs was 309 yesterday before 8 p.m. shot and 55 at midnight. This morning before his 8 a.m. shot his bs read HI on the glucometer, so I'm assuming the bs was over 500. I panicked last night when his bs was 55 and let him eat some of my other cats canned KD, as this is all I could get him to eat. Now this morning his bs was way too high. I am confused about how much I should be feeding Spacey, and is it OK when his bs is low to feed him anything he will eat if he refuses the WD? My vet said Spacey could free feed the WD all the time, but to take it away about 5 hours before shot times so Spacey will be hungry at those times. Last but not least, lol Is it OK if I have to prick Spaceys ear several times each time to get blood. I hate doing that, but I am adament about getting enough blood for accurate bs readings. I just don't want to ruin his ears, hopefully I will get better with this over time. Any suggestions Spacey and I (my name is Lori, btw) would appreciate.
     
  2. Hillary & Maui (GA)

    Hillary & Maui (GA) Well-Known Member

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    Dec 28, 2009
    Lori

    Welcome to the group. First off, you aren't doing your cat any favors feeding the WD. If you look at Janet & binky's food chart you will see that it's higher in carbs than most commercially purchased foods and it's not necessarily made with quality ingredients.

    http://www.felinediabetes.com/diabetic-cat-diets.htm

    Also, feeding dry food of any kind, isn't good for cats. The best thing to do is get your cat off dry food and look for low carb (10% or less) canned foods. You can get fancy feast, friskies, etc. and won't break your bank.

    Check out Dr. Lisa's site - she explains why dry food is not a good option for cats.

    http://www.catinfo.org/

    You can return the prescription food - the vet has to refund the money, it's all guaranteed - you can just tell the vet the cat won't eat it.

    How did you arrive at 4 units? We typically recommend starting at 1 unit or even 0.50 unit of any insulin and gradually move up or down the dosing scale in .25 or .50 increments.

    You are getting rebound and it's very possible that 4 units is too much for your cat. Now you may need to give 4 units, but it's done gradually and with testing data. I recommend that you start over and give 1 unit.

    Since you are home testing, I recommend getting in more than three tests, so you can get a better idea of what is going on. Also, I recommend that you start a spreadsheet and attach it to your signature.

    viewtopic.php?f=6&t=18207

    And when you can, set up a profile, it will help us get to know your cat better.

    viewtopic.php?f=6&t=17766

    REgarding how much and when to feed. I leave the wet food out all day and my girls graze as they are hungry. I add water to the food to keep it moist. Others will feed several small meals (mini meals) throughout the day. And that's a good way to keeps the BG's at an even pace.

    A lot of times, by changing the food to low carb, it reduces the need for the high amounts of insulin.

    Read the links and know we are here to help you.
     
  3. spacey

    spacey Member

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    Aug 1, 2010
    Thank you so much, and I will read the links. The vet is the one who set Spaceys insulin doses, as we have had a hard time with him having high blood sugars. Spacey also had struvite crystals and was fed SD for a week before his regulation started. Spacey is also taking antibiotic tablet orbax 22.7 mg once daily for infection. I am suppose to take him back to vet in 9 days. How many bs should I be doing? And yes, I am concerned about 8 units total a day being too much.
     
  4. Kelly & Oscar

    Kelly & Oscar Well-Known Member

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    Feb 17, 2010
    If he was already at 55 only 4 hours after the shot, then I really think 4 units is way too high for him. The lowest point on ProZinc is usually 5-8 hours after the shot. Also, when kitties hit lower numbers that their body hasn't seen in a while, the liver sometimes panics and sends lots of glucose into the system to try to protect itself. This coupled with the higher carb food (which I think was a good thing that you gave it at that number) is probably what lead to the ultra high number you saw this morning. If he were my kitty, I personally would at least take the dose down to 3 units and monitor him closely this evening, and be prepared for possibly decreasing again tomorrow.
     
  5. Hillary & Maui (GA)

    Hillary & Maui (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    I disagree with Kelly and recommend starting over at 1 unit. If 1 unit isn't enough you can always increase the dose. Once shot you can't take back the insulin if you shot too much.

    This is from the lantus board, however, the basic information should be helpful:

    Learn how YOUR kitty is responding to insulin:
    Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose (http://petdiabetes.wikia.com/wiki/Onset)
    Peak/Nadir - the lowest point in the cycle (http://petdiabetes.wikia.com/wiki/Peak)
    Duration - the length of time insulin continues to lower blood glucose (http://petdiabetes.wikia.com/wiki/Duration)
    How to do a Curve (http://petdiabetes.wikia.com/wiki/Curve)

    Example of a typical curve:
    +0 - PreShot number.
    +1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
    +2 - Often similar to the PreShot number.
    +3 - Lower than the PreShot number, onset has started.
    +4 - Lower.
    +5 - Lower.
    +6 - Nadir/Peak (the lowest number of cycle).
    +7 - Surf (hang around the nadir number).
    +8 - Slight rise.
    +9 - Slight rise.
    +10 - Rising.
    +11 - Rising (may dip around +10 or +11).
    +12 - PreShot number.


    Read this about rebound: http://petdiabetes.wikia.com/wiki/Rebound

    Did anyone mention to you about testing for ketones? http://petdiabetes.wikia.com/wiki/Ketones

    It's a simple test that you can do at home. All you need is to purchase ketostix or ketodiastix at the pharmacy (usually with diabetes supplies). And then catch the cat's urine, either while he is going or putting plastic wrap on top of the litter and dipping it into that.

    I suggest testing him as follows:

    preshot

    2 or 3 hours after shot

    5 or 6 hours after shot

    9 or 10 hours after shot

    This will help you to determine when he nadirs and how low he goes and when he starts to rise.

    The carb % in food is a great way to control how low he goes and how quickly he rises. Some cats are more carb sensitive than others and each cat will respond different to varying amounts of carbs.
     
  6. Joanna & Bix (GA)

    Joanna & Bix (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Hi Lori, welcome!

    I would let him eat as much as he wants, and not worry about taking the food up by shot time. With PZI, there's no need to eat a full meal literally at shot time, i.e. to be particularly hungry then. As long as they eat some in the first 4 hours or so of the shot that is usually fine. If you want to continue that, i.e. taking the food up for a few hours, that's ok too, personally I would just leave food out & not worry about it.

    Seeing that 55 at +4 you were absolutely right to feed what you could to get him to eat something, that was a smart move!

    If you continue with the HC food I would probably try something like 2 or 2.5u as the dose, and get some tests in to see how that is going. 1u is usually too low for cats on HC food, and often people make the mistake (like I did with my cat! :oops: ) of dropping the dose too low on HC food, and then not moving it up fast enough when it's clear it's too low. If you drop the dose and aren't seeing decent #s at all, I would raise it back up very quickly. Sometimes if you see a # like 55 it just means the dose is a teensy bit too high, it could be he needs say 3.5u rather than 4u. I would drop it back a little more than that though to get some data & better determine what a good dose is.

    Ideally if you are able to switch him to a low-carb food, then I definitely would go back to 1u with the food change.

    Keep us posted how things are going! Feel free to pop over to the PZI forum if you like & say hi!
     
  7. Laurie and Mr Tinkles

    Laurie and Mr Tinkles Well-Known Member

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    May 9, 2010
    I would cut the dose in half, at least. If you are going to switch to a low carb diet, cut it to 1u. Four units is a high dose for ProZinc, and a cat is not "regulated" in a few days at the vet. It takes a few weeks for the cat to get used to getting insulin, and until then, the numbers tend to stay pretty high. In our case, Tinkles BG was 600 at diagnosis, and he was started on 2u of ProZinc. We saw very little effect in his numbers for the first few weeks, and when we did, it was only down into the 200s. After he settled in on the insulin, his "good" dose was 2.2u. If Spacey is down to 55 (at least, and could have gotten lower!) in a few days, that dose is way too high.

    Better to cut it too much than not enough and be dealing with hypo.
     
  8. spacey

    spacey Member

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    Aug 1, 2010
    Thanks to everyone. I really appreciate the very good advice. I will try and get the spreadsheet set up for Spacey soon. Hillary and Maui, I read the low carb food link that you posted. I was shocked to see that even canned Hills w/d had way more carbs than plain old friskies or fancy feast! In everyones opinion, what is the best low carb food(s), canned and dry? I will primarily be feeding Spacey canned, but like to have a little dry on hand so he can graze on that, plus for a treat. I did lower Spaceys insulin dose last night to 3 units, and his BG was 257 at midnight. But it read HI again Ketones? on the glucometer this morning pre-shot. I would like to get Spacey on low carb food with less insulin. Thanks again to everyone.
     
  9. Laurie and Mr Tinkles

    Laurie and Mr Tinkles Well-Known Member

    Joined:
    May 9, 2010
    It isn't that any one food is "the" best one, the lists are a good guide to choose from. Print them out, take them to the store with you and choose foods that are below 10% carb. I personally look for food that is 4% or below, because my kitty is pretty carb sensitive. You will have to experiment to find what your cat likes and agrees with him. Many people use Fancy Feast, Wellness, Friskies. I use Special Kitty and Sophisticat.

    As for dry food, there really isn't any dry food that is "good" for diabetic cats. I would eliminate it, but you want to transition gradually, and watch for changes in BG while you do it. The BG numbers will get lower if you get rid of the dry, and you want to be testing so you can lower the insulin dose...he will need less insulin without the dry and HC wet food. You can use wet food for grazing, just add some water to it and leave it out. You can also add water to the wet and freeze it in an ice cube tray, then put out cubes to defrost slowly to have fresh food available later in the day or night. I do both, and it works very well.

    For treats, freeze dried chicken is great, they LOVE it and it's low carb. You can find it in Petsmart (and other places I'm sure) in the dog treat aisle, look for one that says it is only one ingredient...chicken. Break it into smaller pieces for treats, or crush it and sprinkle on top of food to get a finicky cat to eat. I also use boiled chicken breast as a treat for testing, cut into little pieces.

    Does your meter test for ketones? Some do, and some just prompt you to test for ketones when the BG reading is high. If you are not testing for ketones, you need to start doing that ASAP. You can get ketostix at any pharmacy, if you don't see them in the diabetes care section then ask for them at the pharmacy counter. You need to stick the strip in the cat's urine stream if you can catch him in the act. If not, put a piece of saran wrap over the area he likes to pee in and test from the puddle after he goes. If you still can't catch him, there are other ways to do it....post and we will give you other ideas. It is important to know if he has ketones, that can become a very serious emergency situation, so you want to catch it early if possible. It also would affect dosing decisions...cats with ketones need to be more aggressively dosed. I have no experience with that, but there are many here that do.
     
  10. Hillary & Maui (GA)

    Hillary & Maui (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    What Laurie said.

    I feed my girls a buffet of:

    friskies special diet (lower phosphorus than regular friskies)
    nature's logic (special ordered from local specialty pet store
    and homemade raw food (make it myself, yup I have a grinder and everything)

    If you need to feed dry food, then go with the lower carbs ones and those are typically EVO or Wellness Core. Like Laurie said, removing the dry completely is best. However, it's not always possible and does take time. Maui was easy, my other two were the problem when I did the switch. It took time, but more than one year later, they don't get any dry food.

    Laurie suggested freeze dried chicken as a treat - great idea. Here is where I order from and ounce for ounce it's the best price:

    http://www.kingwholesale.com/Shopping/i ... fm?id=5994 - while this shows a dog, don't tell your cat, just break it up into smaller pieces

    http://wholesalesupplementstore.com/liv ... reats.html - this is the "premium" freeze dried treat and the cheapest place to get it

    you can also boil or bake chicken, purchase a rotisserie chicken and share it (being careful not to give the skin with the flavorings on it), even deli meat and cheese can be used as treats.
     
  11. spacey

    spacey Member

    Joined:
    Aug 1, 2010
    I called my vet and he said to experiment on Spaceys evening dose, due to the low BG Friday night midnight. I put Spacey on 3 units last night and his BG has been high all day. I guess I will give him 4 units tonight and see what happens. Another question--If I take Spacey off the w/d and feed him friskies special diet canned only, and lower his dose to 1 unit in a.m. and 1 unit at p.m. and work up from there, should I start this with his BG so high? My vet said to keep him on 4 units in a.m. and lower or raise Spaceys p.m. shot. And he implied I should keep Spacey on the w/d. So I am really confused as to what to do. Also, does it matter when I drop his insulin first, in the a.m. or p.m.? I'm kinda skeptical about my vet, as I had asked if I would have to do daily BG at home, and they told me no. But on the phone he acted like it was a good idea. Maybe he thought I couldn't at first, or something. Thankful for any advice.
     
  12. Joanna & Bix (GA)

    Joanna & Bix (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Just for reference, when my cat was on a lower carb dry food he needed about 4 units (and wasn't regulated), vs. when I switched him to canned, he went down to about 1.5 units during the switch.

    There are varying approaches, and you are right to be concerned about dropping the dose too fast too soon. If you are able to test frequently to monitor you can step the dose down more gradually - for instance if one day you feed 3/4 of the old food and 1/4 new food, you might reduce the dose by 1/4, rather than jumping down to 1u.

    Often we recommend people just drop down to 1u because that is a lot simpler, especially when someone is new to testing, or working full-time and can't really monitor. For most cats, changing the food makes a dramatic difference in the #s, so if you want to reduce the dose more gradually, you will want to be able to spot test in the first half of every cycle to be sure the dose isn't too high. If you change the foods gradually the #s will likely come down gradually - if you change the food all at once (which can be hard on their digestive tract, but sometimes is the only option), you may see a dramatic change in the #s within the first day or two.

    I would keep the dose steady between AM & PM. When you change the dose around, it makes it a lot harder to interpret the data to see how the dose is working. If you are staying with this food, I would probably try 3.5u rather than going back to 4 - the 4 looked a bit too strong to me.
     
  13. RuthV

    RuthV Member

    Joined:
    Jul 15, 2010
    you can also boil or bake chicken, purchase a rotisserie chicken and share it (being careful not to give the skin with the flavorings on it), even deli meat and cheese can be used as treats.[/quote]

    ________________________________________________

    I haul out my Ron Popeil dehydrator, place some small,thin slices of cooked chicken on it ( I simmer it first), and it no time I have nice dry chicken 'jerky' which I then chop up fine. Joey LOVES the stuff and I use it in place of his light afternoon meal.
     
  14. spacey

    spacey Member

    Joined:
    Aug 1, 2010
    I thought I would give an update on Spacey. I started feeding him friskies special diet (ocean whitefish, canned) because it has only 3 carbs. About 1/3 can at shot times and 1/3 can a few hours later, then small amounts if he acts hungry. He is still on 4 units at 8:30 a.m. and 3.5 units at 8:30 p.m. Since I started the friskies last night and took away the w/d, his bloodsugars have been as follows- over 500 before 8:30 p.m. shot last night, 340 at midnight, 499 before 8:30 a.m shot today, 195 at 1:30 p.m. today, 431 before 8:30 p.m. shot tonight, and 465 at midnight tonight. He has only had the friskies special diet. I am wondering if I should raise his p.m. shot back to 4 units. I must be doing something wrong. The vet mentioned the other day raising him to 5 units, but should I do that with Spacey on the friskies? The vet thinks I'm feeding Spacey the WD. Also, I tried to set up Spaceys spreadsheet, but since I am accessing the internet on a Wii, I couldn't. I'll try to get my son to do it on his computer soon. Lori
     
  15. Jen & Squeak

    Jen & Squeak Well-Known Member

    Joined:
    Dec 28, 2009
    I think you need to stop jumping around with the dose and let the food change have a bit of time to take effect. And I think you need to test his urine for ketones (a side effect if there is insufficient food/insufficient insulin/infection). We've no clue how much insulin he really needs and to find this out you need to be more methodical and scientific...I know it is tough going against your vet and getting conflicting advice but your vet did you no help (although likely thought they were ) by trying to regulate at the clinic and giving you some of the crappiest food out there.

    Take a deep breath and just let things settle a bit...is my opinion anyways ;-)
     
  16. Joanna & Bix (GA)

    Joanna & Bix (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    I would give the same dose AM & PM, otherwise it is really confusing to know what dose is working.

    I would also try a slightly lower dose. I know the PSs are high and scary, but you got a good drop yesterday, and a steep drop can contribute to the PS being higher than it would otherwise. It can take a couple days for the higher carb food to really clear their system, and then the #s can drop a lot and this dose could be dangerously high. Right now the #s look ok, nothing that is scary low, so that is good. I would just be really cautious over the next few days as his system adjusts to the lower carb food. I'm thinking that a lower dose might soften the curve a bit, and that might help the PSs come down a bit.

    If it were me, I would try a lower dose, keep it even between AM & PM, and give it a few days to settle out (lowering the dose further if I saw #s that are too low of course). If the #s are high overall then I would raise back up a bit. If you are getting a drop though that is around 50-60% from PS to nadir, I wouldn't raise the dose further, at least not without letting it settle out for a few days, and collecting some data to see how it is going. It looks like you are getting a drop that is steeper than that. Because of that, and knowing that his BGs have a good chance of coming down on their own over the next few days, that's why I would lower the dose some.

    You aren't doing anything wrong - it is par for the course that the #s aren't what you want, it's a tricky illness!!! It is great that you are getting in some tests to see what is going on, and are able to switch to LC food. It's just a process to get everything sorted out til you have the insulin working the way you want it. It often takes weeks to get things under control, so give yourself a pat on the back for taking the steps that you are to get there!!!
     
  17. spacey

    spacey Member

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    Aug 1, 2010
    Update on Spacey--He went back to the vet today, and all the vet did was one BG test. Spacey is on 3 units A.M. and P.M. and his BGs are still in the upper 400s right before shot times. His peak time afternoon BGs have been in the 100s and 200 today. I have been feeding him the canned friskies special diet. The vet sent some canned Purina DM home today, he said it was low in carbs. So I will check Janets list as well. Thanks for all your help, I will keep you updated. Lori
     
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