11/26 My vet is insisting I switch Lucy back to DM

Hi I finally had a chance to start Lucy's spreadsheet this week.

But I wanted to get some advice from you guys.

I have successfully switched Lucy over to canned food but she is still eating a lot, according to the vet.

She lost a huge amount of weight and was practically emaciated by the time she was diagnosed. So I have pretty much been feeding her whatever she wants to get her weight back up. It's working and I think she is about her normal weight again.

Right now, between the two cats, they get fed 1.5 368 gram cans of various Friskies pates. (One large can is just the equivalent of 2.1 six once cans.) That seems reasonable to since they used to graze on dry food all day long.

They were getting two full cans until about two weeks ago. At that time, Lucy was on 4 units of Lantus and her BG was pretty good but she dipped below 5 a couple of times. I mentioned this to the vet when I sent him her BG curve and he suddenly freaked out and asked what I was feeding her. I told him about the low carb Friskies pate but he said I was feeding her way too much and that she had to be on the DM in order to regulate her BG properly. He said she should not be eating more than one 6 oz can of DM per day. He also said I should cut her back to 3 units.

I cut her down to 3 units, and cut their food down to the 1.5 large cans a day but have not switched back to the DM because I had just bought a case of Friskies which I did not want to waste and to be honest, I cannot afford the DM. More importantly, I have seen on this site that you guys have had a lot of success with Friskies and Fancy Feast.

But anyway, when I explained the cost issue, the vet said that I am just paying for moisture with the commercial cat foods. When I pointed out that the DM has the roughly the same amount of moisture (about 78%) he said that DM is better a stablizing levels because it releases the carbs at a steadier rate.

So I would be interested in any advice on whether or not I should switch to the DM. I personally feel that only one 6 oz can a day is way too little for my cats. Even on 1.5 large cats a day, they seem to get overly hungry.

Sorry this is an incredible ramble, but I would also appreciate it if you guys could take a look a the spreadsheet and tell me what you think.

Lucy's BG is still erratic, depending on how much she eats, I think. I just cut her down to 2.25 units today to see if I could avoid those sudden dips into the 5's. How worried should I be about that? Right now I am working at home so I can keep an eye on her but I will be back to office work the week after next and that number makes me very nervous.

Right now I only have about a week of results on the spreadsheet so I don't know if that is enough to point out any true patterns but I would appreciate any advice you Lantus experts can give me with regards to her insulin dosage, the amount of food she is eating and whether or not I should switch her back to the DM canned food.

Thanks again. I don't know what I would do without this board.

First, the amount you feed should be based on the number of calories per day your cat needs. If you know your cat's "ideal" weight, Lisa Pierson's site on feline nutrition provides a formula for calculating calories per day. Calories are important because each type of cat food has a different number of calories per can. The formula Dr. Lisa provides is:
For example:
Friskies Beef & Chicken Special Diet (4% carbs) is 183 calories per 5.5 oz can - or 33.3 cal/oz
Friskies Special Diet Turkey & Giblets (5% carbs) is 175 calories per 5.5 oz can - or 31.8 cal/oz
Purina DM (7% carb) is 194 calories per 5.5 oz can - or 35.3 cal/oz

So, you have the diet suggested by your vet that is higher in carbs and calories and way more expensive than what you can buy anywhere. The Friskies is lower in carbs and calories and is probably a better quality food than DM. (You should compare the ingredients.) Basically, I think your vet is would like yout to spend your money buying food from him. I had a similar discussion with my vet. The discussion ended when I pointed out that I could spend a lot less money buying human grade food (e.g., Wellness) that was obviously better quality than DM and was lower in carbs. She could not argue.

Thanks for getting your SS up and running. Is there any way you can use the version of the template that will automatically convert your numbers to the US system. I just can't sit and do the conversions for one SS. There should be a format where the world values are on one tab and the US are on another. Alternatively, if you want to post in US numbers, this conversion program will help you to convert the numbers. We use the US numbers on the Board.

Also, what meter are you using? I'm not sure why your are concerned with Lucy's numbers dropping below 90 (i.e., 5 mmol/L). We don't become overly concerned about low numbers until a cat drops below 50, unless you are using an AlphaTrack meter or other meter that is calibrated for animal use only. (In that case you would use a cut off for reducing a dose at 80 or 4.4 mmol/L.)

Lucy's numbers are not that erratic. I don't think the variables that are effecting her numbers are how much she's eating. I think one of the issues is that you are not sticking to keeping shots 12 hours apart. An early shot acts like a dose increase. A late shot acts like a dose reduction. Shooting early then shooting late doesn't cancel things out -- all it does is mess with the shed and give you wonky numbers. Also, Lantus dosing is NOT based on the pre-shot number. It's based on the nadir. Numbers below 50 (i.e. 2.8 mmol/L) qualify for reducing your cat's dose. You have been raising and lowering Lucy's dose. This is also contributing to erratic numbers. When you change a dose, you need to let it "settle" for several days. I'd encourage you to read over the Tight Regulation Protocol sticky so you have a better sense of when to raise or lower Lucy's dose.

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