What's the best way to transition from dry food to wet?

I want to make the change in diet from Purina DM to Friskies pate. We're new at this and I'm testing, but not quite sure of when to test to make sure it's a safe transition. Thanks!

 

Can someone help Lois , I'm not sure what to tell her and I'm not understanding what she means when she says she is not quite sure of when to test to make sure it's a safe transition. It looks like she's talking about kibble thanks. I just didn't want her post to get lost

 

I was afraid that changing Jacky's diet from Purina DM to Friskies pate too quickly might cause problems. Not just low bg, but stomach upset.i think I may have a handle on it now. Last night for dinner I gave him 1/6 can of Friskies and a little less DM. I did the same this morning. Tonight I will give more Friskies and continue that until he's only eating Friskies.
Also yesterday when I posted I was frustrated over testing. When I poke him, he meows and jumps like I'm trying to murder him. Then he growls the rest of the time. Not a fun time for either of us.

 

@Idjit's mom
@Sandi & Whisper
can someone maybe answer Lois I'm not sure what to tell her but I do see on her SS
she is not testing through the cycle after giving the insulin and not sure if her dosage
is to high. Or maybe you can tag someone else I thank you. The only reason why
I tagged both of you is because I saw that you had welcomed her
when she joined. I hope you didn't mind

 

Transitioning too quickly can cause stomach upset for sure. Whispy's diet has to be changed over the course of about two weeks or he gets off track, but he had symptoms like IBD when we first adopted him, so that could be why. If you gets vomiting or diarrhea, just slow down the switch.

I have never used your insulin, but Diane is right in being concerned that a change from dry to wet will reduce the need for insulin no matter what kind, and you will need more tests to do that. In general, you should always test before each shot, then I'd suggest sometime between 3-4 hours after your morning shot (if the midnight test was lower than you normally see, then test on the earlier side, like +2 or +3, and if not then maybe +3 Or +4). Then test before the evening shot, and when you go to bed. (Unless some of those tests show low or unexpected numbers, in which case you might need more.) But since I believe Novolin N can hit pretty quickly and hard, someone who uses it may want to shift those testing times earlier -- and you should listen to them instead of me.

I know that you are having trouble when testing, but I'll try to find a good post showing a bunch of tricks. If you don't feel like you can test that much at this point, I would almost be inclined to say that you should reduce your dose a little while removing dry food. Let me see if I can find someone well versed in Novolin for you too. Back in a few.

 

Ok, first you should read this if you haven't already. It is specific to your insulin: http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-novolin-humulin-nph.186097/

Second, I am not positive who to point you to for N insulin., but please read this thread and the second post on it from Linda ( @MrWorfMen's Mom ) because it is discussing the same issue of removing dry food. And Linda if you can redirect to an experienced N user, please do. Thx!

And lastly, try reading through all of this for testing tips and tricks: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

Best of luck to you,
Sandi.

 

@Sandi & Whisper Thank you Sandi for responding Whisper is so adorable, I see how many kitties you have, bless you for taking all of them especially Henry, that sweet boy.
It broke my heart reading about him, thank you for taking him into your home.

 

Lois and @Diane Tyler's Mom, I am so sorry, I didn't see this earlier or I would have responded.

Lois, I have not used Novolin, and had hoped that you would visit again so we could help you with diet, dosing and testing. Novolin is a very fast acting, but not a long lasting insulin for cats. I realize there may be a financial issue to be considered and Novolin is the least expensive insulin you can use for a cat. But there are several other much more suitable ones such as Lantus and Prozinc. It might be worth exploring down the road.

First, you are correct in gradually reducing the dry and increasing the wet. A low carb diet is definitely going to affect blood sugar and you do not want to make the entire change abruptly. Testing Jacky during the cycle between shots is going to tell us how low that Novolin is taking his blood sugar and we can make some judgments about dosage. You are doing more testing today! Good for you and good for Jacky.

Testing, it's a process of practice and patience and here are some wise words that Chris & China (GA) wrote about getting used to the process:
*********************
Here's something I wrote up for others for testing...maybe it'll help you too!

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you.

Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well

For new kitties, using a heavier gauge lancet is also really helpful. A 25-28 gauge lancet pokes a bigger "hole" than a 31-33 gauge lancet does, so look for "Alternate Site testing" lancets that are usually a lower number

Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!

************
Using the cotton ball, pad or folded tissue that you use to back the ear when you poke, fold it over the poke site and compress gently for 10 to 15 seconds is going to help prevent bruising. I use some Equate Pain Relief ointment (like Neosporin only Walmart brand) to help releive discomfort. You can try a cool compress on his ear if he will allow it.

 

Hi Lou no problem, I figured I would just tag you and Sandi since I saw you welcomed her when she joined. Thanks so much. Idjit is such a beautiful boy and I was reading about him and he seems like he's such a character. My Tyler snores up a storm also. I'm so happy that your sweet boy is in remission @Idjit's mom

 

I called my vet today and suffice to say that we will not be on the Novolin N for long.

Thank you so much for the responses. You guys are amazing!

 

What will your kitty be on

 

Diane, Idjit really is a character and definitely boss of the house. We are a couple of old folks that are devoted cat servants, which is just the way Idjit likes it.

 

Definitely take the diet change slowly. I'd start by reducing the kibble by 1/16th cup and make up for that reduction with the Friskies pate. Do that for 2 or 3 days and then reduce by another 1/16 cup. Repeat until the kibble is totally out of the picture. While transitioning, get mid cycle tests every cycle possible to see how low BG is going. The kibble takes longer to get out of the system so making the change slowly will allow you to catch any drop in numbers as a result and dose can then be adjusted accordingly. If you are having trouble testing Jacky, slow the process down a bit more. Some cats are more carb sensitive than others so making the change slowly will prevent GI upset and keep Jacky safe.
If you change to another insulin, you may be able to speed up the transition process a bit but the same principle of doing it incrementally will apply as removing kibble can have a significant lowering effect on BG.

 

I said, Lantus or Levemir. Not sure what they're going to say. My vet wasn't in. I talked to the vet tech.

 

Thank you. That's pretty much what I'm doing, so that's great. The other 2 cats are taking this journey with Jacky and they used to get wet food as a treat every day, so they are kind of used to it. ♡♡

 

My 2 kitty's are also the bosses lol. I always cave in to them. They are brothers.

 

If vet will cooperate they can assist with ordering from Marks Marine Pharmacy in Canada. Less cost, check out the website.
https://rxcanada4less.com/

You will want to get the pens, and use them as mini vials to the last drop. Members use the pens with syringes so that they can fine dose if needed, as we recommend increasing/decreasing doses by 0.25 unit.

Basaglar is very similar to Lantus, is less expensive and is also available from the Canadian pharmacy.

If you don't think vet will cooperate, just get a written Rx and you can send that to Marks Marine Pharmacy.

You can read about the different "depot" insulins in this forum
http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

 

I wouldn't say anything to the vet about planning to order insulin from Canada. It is technically illegal to import medication therefore the vet is not obliged to assist. The vet is required to give you a written prescription if you ask but they can refuse if they know you are ordering from out of country. SO I would just tell the vet you want to shop around for best price and handle ordering yourself. You won't have any problem ordering from Canada because Border security turns a blind eye and lets the insulin in without question.

 

Could you tell me something about the pharmacy in Canada. I saw the website, but I mean how long have people been using that pharmacy? What assurance do you have that the insulin is all it should be. I know people on the Facebook support group get it there. I'm not trying to be difficult. I just need reassurance.
Thank you! ♡♡
Ets...I gave him 2 units of Novolin instead of 3 because I fed him more Friskies wet food this morning. I hope that was the right thing to do. I would like to stop the Novolin until he's completely on the new insulin and on just the wet food How long does it take to get the insulin from Canada once you order it? I would be more than willing to get it locally and pay more to get him started and then order it.

 

Talked to my vet's office. Maybe detected a slight chill. Vet not in. Vet tech is working up the best way for me to proceed and they asked me not to make any more changes until I talked to vet tomorrow morning. I really always just thought they were the best and I feel bad like I'm second guessing them because of Dr. Internet.
The AAHA says on their website that Novolin N is not for cats. The spelled it Novulin N. I did a google search for Novulin N and couldn't come up with anything, so I'm assuming its the same thing.
Edited to say, if you think I'm wrong, please say. Wouldn't you be upset if you read that report. Am I perhaps misunderstanding something? I don't care about being wrong. I just want my sweet kitty to get the best chance at as healthy a life as he can have.

 

Lois, I have not personally ordered from Marks Marine in Canada, but have read many posts about it and from members who have. I have not read one post that was negative. I suggested it because Lantus, Basaglar and Levemir are also used for humans and are excessively expensive in the U.S. It's a way to save money on a product that people need, a product that is effective.

I do not know how long it takes to get the order, and I suggest you start a new thread here on the Main Health forum for information, input and advice. When you do, I will tag some of the members that I know have ordered from Marks Marine to get their attention to your thread.

I would not recommend stopping the Novolin until you get another insulin. Jacky is diabetic and needs treatment, Novolin is not bad, it's just a harsher, shorter acting insulin, but it does some good at bringing down the high blood sugar, even if for a shorter period of time.

The other insulins are recommended because the duration is longer and they are much gentler on the system. It takes a few days to build up the depot..some of the shot you give goes right to work and some gets stored in the fat in the body, so after the depot is in place the body can draw on it through the 12 hour cycle and have a flatter effect. So you do not see any immediate effect on the blood sugar when you start using a depot insulin.

Novolin goes right to work, has a short duration and then peters out..leaving the body to wait until the next injection for the blood sugar lowering effect to happen. At least that's my understanding of how it works.

 

They are probably very good techs and vets, I wouldn't say no to that. The ER vet clinic here with followup from our regular clinic saved Idjit's life a few years ago.
I have learned by reading here that many vets just are not as educated in feline diabetes as we would like.
That's pretty normal....the sad truth is that vets only get 5 hours of diabetes education in school and that covers all types of animals. Once they've graduated and are in practice, they don't have time to stay up to date on the latest treatments for every disease in every type of animal they see. That's why message boards like this are so valuable. Not only do the people here have the time to research for new treatments, they have the day in/day out experience in their own cats so they know what works....and what doesn't!

Novolin wasn't developed for cats, neither was Lantus, Basaglar or Levemir. They were developed for humans, but work on cats' blood sugar. Some members here use Vetusulin (Caninsulin) which which was developed for dogs. Prozinc was developed for cats, but is again an In & Out insulin akin to the Novolin. However, it is not as harsh and has a longer duration than Novolin. It's a choice of effect and duration you are going to make. Some people just can't afford the more expensive insulins and that's why we suggest using a Canadian Pharmacy.

We paid $300 for a vial of Lantus when Idjit was diagnosed. I didn't know any better, I didn't even know there was the option of getting pens and using syringes with the pens to fine dose. The vet just said this is what you need, and here are the prices in your area, where do you want us to call the prescription to? We were still taking in the diagnosis, that we were going to have to learn to test, and inject insulin, change the diet..and asking ourselves, "can we do this, really?"

We are older and on a fixed income, but like you, we wanted Idjit to get the best chance at as healthy a life as he could have. Then, we were fortunate enough to have him go into remission. That bottle sat in my fridge, "just in case" he fell out of remission and it would be there. My safeguard. But we kept it (way) beyond the time that it would be effective and essentially threw $300 away in the garbage.

Becoming educated is not wrong, in my opinion, it's a very good thing. No one here on the board knows everything, that's why we have a peer reviewed board. If someone posts a reply and someone else knows it's incorrect or off the mark, they say so. Or they can provide more detail, and factual or experiential information.

You get to decide and you have to provide the day to day diabetic care to Jacky. You can ask for the prescription to shop around for prices, as MrWorfman'sMom said. You are doing Jacky good by changing his diet to a low carb diet, by testing and possibly saving his life by seeing how low the blood sugar is going, and being concerned about the dose while you are changing his diet. However, I would really like to get other input about decreasing the dose of Novolin yourself without some kind of input/guidance.

This from your post above:
Ets...I gave him 2 units of Novolin instead of 3 because I fed him more Friskies wet food this morning. I hope that was the right thing to do. I would like to stop the Novolin until he's completely on the new insulin and on just the wet food
@MrWorfMen's Mom
@Marje and Gracie

 

I just want to clarify that I wouldn’t call PZ an in/out insulin like Novolin with a longer duration. PZ is a long duration insulin and there is some thought that a dose might extend further than 12 hours. In that case, you would start to see carryover and overlap somewhat resembling a depot insulin to a degree.

In regard to his current dosing and switching insulins. Decreasing the dose by 1u when he’s fairly high is more than I would have recommended reducing by. However, without more tests, we don’t know how low he is going and that’s really the important factor here.

If you are there to test today, I’d try to see how low he’s going and if he’s still high, I’d shoot 2.5u tonight provided you get the PMPS and a +1 or +2 and before bed. Novolin N does allow you to change the dose if you need to from cycle to cycle although, it’s also good to be consistent with the dose if the numbers allow it.

I also would agree with others that stopping Novolin until you put him on another insulin is not a good idea.

Because it’s going to take you a bit of time to get the new insulin (even if you get a prescription and buy it locally, it will be a couple days, likely), then I would focus on getting more tests in. You don’t have to poke the heck out of him but yesterday’s morning cycle was a good example of the testing that would give us an idea of what he’s doing. For the pm cycle, you could get a +1 or +2 and a before bed test.

We base the starting dose of the new insulin on how he is responding to the current one and that’s why it’s important to be able to see how low he might be going before we make a recommendation. If you choose Lantus or Levemir, it usually takes several days for the depot to build until you see changes in the BG.

 

Thank you Marje, I had seen it described as an In & Out type insulin, but now know better. Adding that to my files of information.

 

Thank you so much. I am reading and digesting all the info in your posts!

 

PZ is an in and out insulin; I said it’s not an in and out insulin like Novolin. Subtle difference and I don’t mean to split hairs but there is a difference between the Novolin/Humulin/Vetsulin type insulins and PZ. It’s important to note that my comment was that it can get a nice, long duration with carryover and overlap that “to a degree” can somewhat resemble a depot insulin. Don’t you just love the subtleties of FD

I’ll try to find the information Jill gave me about this. I have so much from her. Hopefully, I can find it and repost it.

What one can do with PZ that is not as desirable to do with the L insulins is change the dose, as needed. Again, consistency helps in both insulins but there is a lot less concern for residual effects if you change the dose from cycle to cycle with PZ than there would be with the L insulins.

 

@Jacky's Mom

Lois, how are you and Jacky doing? Just checking in and hope you and that fine boy are well and happy.

Have you made any decisions about changing insulin yet?

When you have time, give us an update on Jacky, the diet transition and how you are feeling about all this, ok?

 

We are doing ok. We are switching to Lantus, but my vet wanted me to get Jacky totally over to wet food first. I'm feeding him Friskies and Fancy Feast. She also wanted a urine sample first and I got that to her yesterday. So, I'm calling tomorrow to find out where we stand. She said she was willing to work with me.
She wants to get the Lantus from a local pharmacy. Buying pens of Lantus will equal out to about $80 a month and I can live with that. I'll post here with any updates.
Thanks for the concern. ♡

 

Lois, so glad to hear from you and very happy about the decision to use Lantus. Lantus works differently than Novolin and there is valuable information for you at the top of the Lantus Insulin Support Group forum HERE.

This group has some very experienced and knowledgeable members, and is very supportive and responsive. This is where you will ask questions about using Lantus, dosing etc. Has the vet said what dose dose of Lantus she is recommending? Changing Jacky to a low carb wet diet is likely to result in a drop in the blood sugar, and you will want to be testing between shots also, to detect any sudden, significant drops. When we transition off the higher carb food, the insulin dose needs to be reviewed and perhaps lowered accordingly.

Keep your signature updated as you change insulin, food etc. You will want to insert a line in the spreadsheet to indicate that you started Lantus (when that occurs) so that advising members can see that. You can also edit the spreadsheet at the top to change the "Current Insulin" from Novolin to Lantus.

Please read this document New? How you can help us help you. It's very valuable information and tips in case you need some extra help with low numbers, etc.

You can start a new thread in the Lantus forum when you change over, introduce yourself and sweet Jacky so that they know they have a new member of the community and can help you going forward.

I think this is going to help Jacky a lot, and in turn, help you feel better and get a good handle on this new adventure.

 

Hi Lou, just thought I would check in with you and let you know the latest. My vet was willing to change us from Novolin N to Lantus, but she wanted Jacky to come in for a few days to get him started. I did not feel that was necessary and it would have been expensive. She said that was the only way she would agree. So, I made an appointment with another vet whose office said, pending an initial exam, they would write a script for Lantus. We went to the appointment and when the new vet examined Jacky, she said he had some infected teeth that needed to come out. So I left there with Clindamycin and a detailed estimate for having those teeth removed. I absolutely plan to get that done. Wouldn't it be wonderful if that took care of the whole problem. So, now she is reviewing his records from my original vet to make sure he is a candidate for surgery. He has no other medical issues, so I believe we can move forward. I will call tomorrow to see where we are and hopefully get that done. After a bad bout of diarrhea for a few days he is doing clinically good. He plays and eats and seems fine. Will keep you updated. Thanks for your help and concern.