02/19 Shadow New Member Please Advise AMPS 305 +1 256 +190

Hi everyone, I'm new here but I tried my best to follow the posting instructions. My cat Shadow was diagnosed with diabetes at the end of January. We started him on 1 unit of Lantus insulin and switched him to the Hills m/d wet food upon recommendation from our vet. The vet recommended using the FreeStyle Libre continuous glucose monitor, which Shadow has tolerated extremely well. He was on one unit of insulin for about 6 days. His glucose wasn't dropping below 400 very often, so the vet recommended increasing to 2 units. Nothing happened for a couple of days, then his glucose dropped rapidly to 70, we freaked out, fed him some Meow Mix dry food that we feed to the outdoor cats, and he came back up. We continued with the 2 units, and his glucose stayed high until this morning, when it is dropping rapidly again. I'm working on updating the spreadsheet the way you all prefer it, but in the meantime, I have attached the glucose curves. Does anyone have a suggestion for what to do? Is 2 units too much?

 

Hi Welcome! Let's see if @tiffmaxee can stop by this AM. FWIW, the dosing methods used by most of us here increase/decrease by 0.25u.

I would recommend reading the dosing methods (linked here) - though if you are feeding dry to Shadow, you would follow SLGS. You may also want to go through the low number sticky to help through any drops in glucose.

The sooner you can get the SS up, the better too - with so many kitties, it helps to have a standard way of viewing data, especially when the more seasoned folks are giving dosing advice.

If you are able to edit your title (Thread Tools > Edit Title) you can add "NEW MEMBER, Please Advise" - you can also pick the ? from the drop-down on the left to get more eyes.

Hope that helps a little bit

 

Welcome to you and Shadow. As Susanne mentioned, our methods increase by .25 increments. Even our TR method keeps the cat at the beginning dose fur 7 days and the we increase no faster than every 3 days. That way you don’t miss a good dose. Hills MD wet isn’t a magic food and about 14% carbs. Most feed regular low carb food like fancy feast pates or raw.

A bg of 70 is not too low. Normal bg for a cat is mostly 50-80 or 50-120. We see cats not on insulin even under 50 when n a low carb diet.

Do you plan to continue with the Libre? They don’t always last as long as a week I have seen here. I’d get a human meter as a back up and start to get some tests using ear sticks in case the Libre fails.

Do you need help with the spreadsheet? I’m going to tag someone who can get you set up in minutes. @Bandit's Mom

 

Hi Stephanie, welcome to FDMB. I can help you with setting up the spreadsheet. Won't take me a minute. Let me know if you need help.

 

Thanks everyone! I'm working on the spreadsheet now over my lunch break.

We plan to continue with the Libre. It has been on for 8 days now and seems to be fine. If we start having issues, we will move to the ear sticks. I'm an engineer, so I like to have all the data

I didn't realize that the recommendation was to increase by 0.25u. Our vet recommended the increase from 1u to 2u, so I had assumed that was the correct advice. On the plus side, Shadow is so much more energetic now that he is on insulin.

I am not opposed to switching diets, but we have bunch of the Hills m/d cans now, so I would prefer to finish those before we switch his food.

 

I think I have succeeded in setting up the spreadsheet. Perhaps someone can let me know if I did it properly?

 

Excellent job! Did Shadow receive insulin prior to 02/11? Even if you don't have glucose data, it's useful information to know - so if he was getting shots, you would enter the units cell and leave all the BG readings blank.

Totally get it - I ended up returning some hills w/d food I was encouraged to buy. You can save a few cans of the m/d to keep on hand for what we call "medium carb" (11-15%) and switch to something lower carb - this food chart is used by a lot of us; a lot of people feed Fancy Feast Pate since it's low cost and easily obtained. The idea of the lower carb diet (0-10% is low carb with a lot of folks feeding around 5%) is that there is less demand on the insulin/pancreas to process the extra carbs.

If you're in the US, a lot of us use the ReliOn Prime meter from Walmart. Very affordable. And the dosing methods here are based on human meter numbers (your libre data works great too )

I'm sure others will stop by with words of wisdom. They will probably ask what dosing method you're following so take some time to read that sticky (and ask as many questions as needed!).

 

Yes, he was receiving insulin before we got the Libre and I updated the spreadsheet accordingly. It somehow didn't even occur to me that I could return the cans of food--thanks for the suggestion! I will look into switching food. Our grocery sells a huge variety of canned cat food, so hopefully they stock one of the recommended ones.

I read the sticky about the dosing methods earlier this morning, and I'm not exactly sure what to do. We were following the vet's advice, but it seems that might not be the best course of action. After conferring with my husband, we feel like we would like to try the start low go slow approach, but we have already gone up to 2u from 1u without any intermediate steps. At this point, is it better to hold steady and get more data at 2u, or to back off and start over from 1u or 1.25u?

I appreciate everyone's advice and the general collective wisdom here!

 

I’d let the numbers be the guide. Please add SLGS to your signature. A reduction is earned with this method if any test is under 90. You will hold this dose otherwise for a week before even considering am increase. If you add lower carb food under 10% the insulin needs will for sure decrease.

 

So your new dose for PMPS is 1.75 if following SLGS (like Elise said...I just remember being new and being so confused ). And you can always switch to TR later if you change your mind (and back again...you just can't mix methods for safety reasons).

How are you pulling insulin? Are you using syringes with half unit markings?

If using syringes with half unit markings, you'll line the 1.5 line up with the middle of your plunger. There's a good sticky on insulin handling & fine dosing here (the principle of 0.25u applies to all doses).

Hope that helps