021224 new member VET STUMPED do we need internist?

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Pantera

Pantera

Member Since 2024
Hello. My approximately 12 yr old female Pantera, diagnosed a 3 months ago I think. (had a UTI at that time) Numbers high as 700, hasn't been below 400 in forever. We have done 2 blood tests, About 4 gc curves done so far every 2 weeks. Just tried home glucose monitor Free Libre 2. Always maxed out above 400 and had numerous issues with this thing not allowing readings, etc. We feed Science Diet m/d dry food. Tried to get her to eat Tiki Cat wet, but she's not a fan. She does like the Tiki Cat gravy packets. She was used to Costco super premium dry food with Friskies canned food twice a day. We have 4 other cats. We started with Lantus for a few months, now on Vetsulin for last month. The lowest we have seen if the monitor was correct, is about 396 two times. Vet finally said we need a specialist. I'm thinking an ultrasound is needed to rule out pancreas, liver, kidney or thyroid issues. Nothing showed in the blood work, but for some issues I know it would still appear normal. Should that be my next step? This uncontrolled sugar has gone on for too long. thx
Ginger

Took me awhile to figure out how to post on here, so I will try to figure out the other stuff you want.
Also, is there an updated can food chart. Your links I went to were last updated in 2006 and 2008. Formulas change.
 
Use the 2017 food chart in this sticky: https://www.felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

Lantus / glargine is a great insulin to use. There are published studies on how well glargine works in cats in well know and respected veterinary journals. Switching to Vetsulin is kind of backwards. What was the initial Lantus dose and how often did the vet increase the dose? What is the current Vestulin dose?

The prescription dry food is probably the reason why your cat's blood glucose levels aren't improving. If you can get your cat to eat any brand of low carb canned food that would be helpful. Have you tried Fancy Feast Gourmet? Some of Friskies varieties are suitable for diabetics. I'm not sure if the Tiki Cat gravy foods are low enough in carbs for diabetics. They may be on the food chart. Do you fed the diabetic cat separately from the other cats and keep the Costco dry food out of reach? The Costco dry food isn't any better than prescription dry food.

If your vet is telling you that you need a specialist that means your vet has little experience with managing feline diabetes and has given up. Look for an internal medicine specialist. Some internal medicine specialists have a special interest in diabetes. My regular vet is an internal medicine specialist but he's not an expert on diabetes. There are other internal medicine vets at the same hospital who do have expertise in diabetes so he consults with them for most clients. With me, he lets me do whatever as long as I keep him in the loop since I'm on my second diabetic cat now and he trusts my judgement :p It's definitely important to have a good relationship with the vet.
 
Sounds like your vet just doesn't know how to treat feline diabetes. The sad truth is that vets get very little formal education on diabetes (less than a day) and that covers all types of animals. Vet schools only have 4 years to teach everything from anatomy, physiology, disease prevention/diagnosis/treatment (in thousands of diseases), surgical techniques, etc. etc. etc. Although like human doctors, they are required to take continuing education classes, they get to choose most of them from a list of topics. Since they see more diabetic dogs, if there's a choice, they're usually going to update their education about canine diabetes.

Lantus is the gold standard for feline treatment but you have to know how to use it. You can't treat a diabetic cat like a small diabetic dog. Starting doses should be between 0.5 and 1.0 unit and increases need to be in 0.25 unit increments. Switching to Vetsulin was probably not a great decision, but whatever insulin works for your cat is the best insulin.

Also, just doing curves every few weeks at the vet doesn't give you much in the way of helpful information. Being at the vet is stressful for cats and stress causes the blood glucose to go higher, sometimes up to 200 points! Your vet sees those artificially high numbers and increases the dose by too much or too fast and you could easily bypass what could have been a very good dose for your cat.

Home testing is the best way to know what's truly going on inside your cats body. You don't need an expensive pet meter either. Most of us use a human meter like the Relion Premier Classic from Walmart. It's $9 and 100 strips are $17.88. A box of 100 lancets is $1.62. Those are the main things you must have.

If you need some help getting your signature set up and a spreadsheet started, feel free to send me, or @Bandit's Mom a private message so we can get some details. We are more than happy to help!

I know you're feeling overwhelmed, but you're in the right place! The people here are very generous with their time and are happy to help you learn all you need to know to give your "extra sweet" Pantera the best care possible!
 
Hi. Thanks for the responses. Looking for a meter. Quick question. I see Relion has a platinum version with bluetooth. Would that work as well? We've also heard Accu Chek is good for cats. It comes with 50 strips and 10 lancets. or should I just get the classic like most of you use? thx
 
Either Relion meter is OK.
The Relion Premier Classic needs a little less blood sample than the Platinum Meter.
The premier needs
0.5 microliter blood sample and the Platinum is 0.6
Most use the Premier because the test strips are so affordable
Here is the link for the meter and test strips so you don't have to search for them
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197

When you start testing Pantera
Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up
c2b8079a-b471-4fa6-ac36-9ac1c8d6dcca-jpeg.57072
fec17d29-5ab4-44a8-912b-3a91944c3954-jpeg.57073

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with
Here is a video one of our members made testing her kitty
She's using a pet meter that has to be coded ,with a human meter you don't have to code it.
So ignore that
I have always used a human meter
VIDEO: How to test your cat's blood sugar

As Chris & China said if you need help setting up your spreadsheet just PM her , tap on her name and start a conversation
If you want to give it a try here is the link which will also explain how to use it, it's really easy
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/
 
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Our vet started with Lantus because she said she had had good luck with that one. I think we were on it about 2.5 months and it never made a difference according to the curves. She was very good about only increasing in small amounts. I think we got up to 2 units 2x day on the Lantus. I think we switched to Vetsulin the end of December. We are up to 3 units 2x day on that one at this time. We also recently did the Free Libre 2 device on her to rule out vet stress. We had numerous issues with it not allowing readings, etc. It registered above 400(it's maximum display) except for twice when it showed 396 an hour or two after her morning dose. It was only on for 7 days because of no changes and it not allowing a reading half the time.

Our last interaction with the vet was last week when we did another blood panel to see if there was an infection or something causing the numbers not to come down. (she had uti when diagnosed) This is when she said we need to go to an internal specialist. We've been at this since October I think when she was diagnosed.

I'm thinking we need an ultrasound to rule out anything horrible. I have thought often of changing to wet food and that it may solve the problem. (according to much research I have done) Pantera is a picky eater and loves the d/m dry food. We have bought many kinds of can food to get her to switch. She eats the dry food around it. She loves when we put some tiki cat gravy on it. On your food chart, I see tiki cat canned food is zero carbs. Unfortunately, she doesn't want to eat that. I did get her to eat a little fancy feast with her dry last night. We are really trying to switch her to all can food. I realize if she goes to all can food then the insulin dose would need to go down, correct?

The vet never gave us copies of the readings, blood work, etc. She would tell us, but of course I can't remember all the exact numbers, only that it has never been in the proper range. I think the very first curve during Lantus got down to 2 hundred something, but that was the lowest reading we have ever had and it was only once.

We are going out today to buy a home monitor and will try to get blood. I think I need to go to a specialist and at least get an ultrasound don't you? (she gave me a few places she likes)
Thanks for helping! We are kind of at our wits end to figure out why nothing is working.
Ginger
 
Pantera said:
Our vet started with Lantus because she said she had had good luck with that one. I think we were on it about 2.5 months and it never made a difference according to the curves. She was very good about only increasing in small amounts. I think we got up to 2 units 2x day on the Lantus. I think we switched to Vetsulin the end of December. We are up to 3 units 2x day on that one at this time. We also recently did the Free Libre 2 device on her to rule out vet stress. We had numerous issues with it not allowing readings, etc. It registered above 400(it's maximum display) except for twice when it showed 396 an hour or two after her morning dose. It was only on for 7 days because of no changes and it not allowing a reading half the time.

Our last interaction with the vet was last week when we did another blood panel to see if there was an infection or something causing the numbers not to come down. (she had uti when diagnosed) This is when she said we need to go to an internal specialist. We've been at this since October I think when she was diagnosed.

I'm thinking we need an ultrasound to rule out anything horrible. I have thought often of changing to wet food and that it may solve the problem. (according to much research I have done) Pantera is a picky eater and loves the d/m dry food. We have bought many kinds of can food to get her to switch. She eats the dry food around it. She loves when we put some tiki cat gravy on it. On your food chart, I see tiki cat canned food is zero carbs. Unfortunately, she doesn't want to eat that. I did get her to eat a little fancy feast with her dry last night. We are really trying to switch her to all can food. I realize if she goes to all can food then the insulin dose would need to go down, correct?

The vet never gave us copies of the readings, blood work, etc. She would tell us, but of course I can't remember all the exact numbers, only that it has never been in the proper range. I think the very first curve during Lantus got down to 2 hundred something, but that was the lowest reading we have ever had and it was only once.

We are going out today to buy a home monitor and will try to get blood. I think I need to go to a specialist and at least get an ultrasound don't you? (she gave me a few places she likes)
Thanks for helping! We are kind of at our wits end to figure out why nothing is working.
Ginger
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@squeem3
@Chris & China (GA)
 
What do you all use for lancets and a lancing device? Do I need to get ketone strips too? thx
I see someone said Get 26 or 28 gauge lancets
 
Pantera said:
What do you all use for lancets and a lancing device? Do I need to get ketone strips too? thx
I see someone said Get 26 or 28 gauge lancets
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You use the lancets
They are for pricking your cats ear to get the blood sample and test with the meter. Look at my post I just did above ,post #5
@Pantera
They look like this
sahyog_wellness_finger_picker_sterile_round_twist_comfort_blood_lancets_50s_401966_0_0.jpg
 
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Pantera said:
Is here a certain brand or will any 26 or 28 gauge work? Do I need ketone strips too?
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Any brand lancet 26 or 28 gauge are fine.
About the ketone strips , I never really had to use them but you can pick them up if you want to.
You can just pick up the ones where you put them when your cat is peeing and put the strip under the steam of pee
Or you can buy a specific meter just to check for ketones
Those strips are expensive for the meters
Give me a minute and I'll post some information

You can get urine dipsticks like Ketostix , follow the directions on the box
Most members will either pass the strip through the cat's urine stream while the kitty is peeing or use a spoon, ladle, or something similar to catch some urine and dip the strip in what you collect.

You can get ketone monitors on amazon.
This link will give you the names of 2 ketone meters you can use
Instead of trying to catch the urine with the dip sticks you can get the meter and test strips for them and prick the ear and test that way
The strips are pricey but it makes it LOTS easier than trying to stalk your cat to the litter box.
 
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I just have to say the instructions for creating the spreadsheet were SUPERB! Now I just have to figure out how to fill it in. lol Unfortunately, I threw away the calendar for last year so that info will have to be through memory and invoices.
 
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Pantera said:
I just have to say the instructions for creating the spreadsheet were SUPERB! Now I just have to figure out how to use it. lol Unfortunately, I threw away the calendar for last year so that info will have to be through memory and invoices.
Click to expand...

https://www.felinediabetes.com/FDMB/threads/how-to-use-the-spreadsheet.241653/

Great job setting up the spreadsheet

Also can you go back to your spreadsheet and fill in up top date diagnosed, the insulin you are using, and when you buy the meter fill that in also
@Pantera


One other thing can you set up what we call our signature it's information we need to see about Pantera.
Tap on this blue link
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help. Do you see mine ?
I would also note in your signature that
We started with Lantus for a few months, now on Vetsulin for last month.
Maybe just put Lantus started and the approx date then put Vetsulin now and the date started

If you must feed the dry food you are feeding until you find a low carb wet food she likes and will eat all the time
check this link out for lower carb dry foods. They are expensive, if you do get any I would make sure you keep testing Pantera because it might lower the BG number
Link
https://felinediabetes.com/FDMB/threads/new-member-kanirniq-and-little-man.284435/#post-3131494
Look at post #26
 
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Awesome. I took a picture of it. I had already taken singular pics from Walmart so this is better. Going there shortly. I just dug out Pantera's adoption paperwork. We fostered for the AZ Humane Society for a few years until we had too many 'foster failures' and kept them all. lol We adopted her 4/26/2012 after having her for 2 months treating a cold.

Pantera went to vet on 10/9/23 and we found out she has diabetes. Switched her dry food to Purina Pro Vet m/d immediately and didn't give friskies wet food anymore. We started Lantus at .5 units I think. Then did the 1, 1.5, 2 units increases. Switched to Vetsulin 12/21/23. Think we started at 1 unit, then 2, then 2.5, then 3 units that we are at right now. Like I said earlier, glucose curves a lot, 2 blood panels, just tried the Free Libre 2 sensor on her. Nothing has changed.

Trying really hard to get her on all can food. (per the carb food chart) Some times we have to put Tiki Cat Born Carnivore broths on top of other food if she won't eat. I believe these are really low carb broths according to the formula you are supposed to use to figure it out. Tiki Cat is one item the vet carried. She doesn't like the tiki cat wet food or the fancy feast really. Gonna go back to the Friskies low carb cans and try that.

Yes I will fill out what I can until we try the blood test tonight. thx for your help.
 
To tell you the truth, the reason your cat's blood sugar values are so high is that the insulin dose is too low. 3 units is not a high dose at all. My girl topped out at 8.75 units and it took her up to 3.5 units before she saw numbers under 100. She did have a condition causing insulin resistance and that's why she got to a higher dose. But not all cats over 3 units have that condition. Some just need more insulin for some reason. Our saying here is Every Cat is Different.

I also agree with the others, going from Lantus to Vetsulin is the wrong way, and the opposite of what I did.

If you can home test, or use the Libre values, we can help you get to a better dose much faster.

Getting rid of the m/d from the diet will also help. If kitty is a die hard kibble head, there are low carb dry food options such as Dr. Elsey's. Wet food would of course be better. See if some tips in this post can help. Transitioning your cat from dry to wet food
 
I personally use the AccuChek Aviva, a relic from my first diabetic :cat: Any brand of meter that has affordable test strips that can be bought in a pinch at a local pharmacy will work. There are meters that seem to be sold only online so you're stuck if you run out of test strips and don't have an extra box on hand. Pet meters and their test strips aren't sold in any pharmacy as far as I know.

Ketone strips wouldn't be a bad idea to have on hand just in case. There are meter that claim to test ketones but I think if the bg is too high, the ketone alert will go off and you have to test the urine anyways with strips.

2 units BID isn't a huge dose. Some cats may need more to get their blood glucose levels in a more healthy range (may take some time so have patience) before the dose can be reduced.

Cats who don't respond to Lantus may respond to Levemir better. My previous diabetic cat did although he never went into remission or got blood glucose levels to stay consistently in a normal range.

A low carb diet will definitely help. Go slow with the diet change and monitor blood glucose levels closely. The insulin dose may need to be adjusted to prevent hypoglycemia. There are tips on how to get a cat to eat more canned food such as using toppers. It's here on FDMB somewhere. @Wendy&Neko do you know where the transition tips thread is?

Did the vet do the curves? If so, those are pretty inaccurate because the cat is so super stressed out that the blood glucose levels are super high. It's much better to hometest and do curves at home. Track bgs on a spreadsheet and share the spreadsheet with the vet.

Ask the vet for all copies of your cat's medical records. Review them and ask the vet any questions you may have. If the vet doesn't really give you any answers, a new vet may be in order.
 
Hi Ginger and Pantera. I just want to add one small thing to all this great advice you are getting. My cat started on Lantus. She was and still is a kibble junkie that tries to bury wet food. She is not interested in canned tuna or even fresh chicken or turkey that I prepare for myself. I was able to reduce her BG numbers considerably within 3 months and then ween her completely off insulin by feeding Dr. Elsey's CleanProtein dry food. It is under 7% carb and high in "meat" protein. Sister has remained "in remission" since Sept 2021 on Dr. Elsey's. I accomplished this with the guidance and patience of members on this message board.

I am now trying to gradually switch her from dry to wet food again. IMPORTANT: If you do introduce Dr. Elsey's or another low carb diet, you must be doing BG home testing daily first because you must always know what Pantera's BG is before shooting. Others have already said this.
Hugs and good luck, Ann
 
I read it. thank you. We bought everything you showed above. Now we have to work up the nerve to use it tomorrow. What kind of testing schedule should we do? Like, how many times a day, etc.? I really don't want to do too many times
a day in the beginning.

She was used to Friskies wet food already 2x a day when we were diagnosed. We stupidly stopped giving it to her, because we assumed it wasn't low carb and not good for her. The other 4 still eat it 2 x a day.
We also stopped putting down the dry kibble all day for everybody when we found out. I think we can get her back on Friskies wet without too much trouble. We have gone through half a dozen other brands and she doesn't really eat much of it.

So bottom line is, a lot of you think if we get her on all wet food she may stabilize? I've noticed nobody has commented on me finding a specialist and getting an ultrasound. I wouldn't mind just an ultrasound but keep picturing a 2k-3k 'treatment plan'
if we go to one. (been through that with a cat that had cancer) My vet is waiting for me to tell her the result of a specialist consultation. I'm just feeling a bit overwhelmed with all this new info and not sure what do to next.
 
It's possible that she'll stabilize, or at least need less insulin on an all wet food low carb diet. I believe the Friskies pates are low carb.

I have no idea why they'd want to do an ultrasound or what they'd be looking for. I'd go for the low hanging fruit first and get her on low carb food. There are reasons cats need higher doses, but ultrasound would not be the first step in diagnosing them. In addition to low carb wet food, another reason kitties something are hard to regulate are if they have mouth infection/inflammation and need a dental. Pancreas, kidney, thyroid, liver issues can be indicated with blood work and don't need an ultrasound as the first step, or maybe at all.

Perhaps the vets recommendation to go to an IM vet is because she's out of her depth on diabetes. I would not go to this vet for an ultrasound if you do decide to go that way. An internal medicine vet may or may not be a better solution. Or perhaps try a feline only vet practice if there is one near you for a new vet.
 
ok so we just tried our first test. Thought my gf new how to use the meter, but apparently n ot. When we put the strip in with big blood on the end of it, nothing happened. didn't read anything. She went back for more blood and a new strip and it worked this time. dinner shot at 525pm. This test was 3 hrs later and it reads 445. Finally, an accurate reading. It is hard to see blood on a black cat. I don't know what kind of schedule you guys test on. I think you do before and after insulin shots don't you?

Nobody mentioned an ultrasound except for me. My vet just said we need an internist. Before we get a 5k estimate for a 'treatment plan' I wanted an ultrasound to rule out some of the insulin resistant reasons I have read about. I pretty sure that's the first thing they would want to do if we went to one. I have also read that some of these issue would present as normal on blood work. (and ours have nothing outstanding on them) Our vet said only mild tartar so we didn't think that was the issue.
 
Tip for black ears (the blood IS hard to see on black fur) - I put a very fine smear of vaseline on the poke spot first. That way the blood pools on the vaseline.

My cat was a complicated kitty with two extra secondary endocrine conditions. With a treatment plan that involved driving to Fort Collins, Colorado for 3 days each way, for specialty radiation treatment. Not sure I paid $5K, but that was a while ago. And I did it without going to an internal medicine vet first.

What insulin resistant conditions were you thinking about?
 
Pantera said:
I wanted an ultrasound to rule out some of the insulin resistant reasons I have read about.
Click to expand...

The high dose conditions we talk about most, acromegaly and IAA are diagnosed through specialized blood tests done at one lab in the country, MSU.

Pantera said:
When we put the strip in with big blood on the end of it, nothing happened. didn't read anything
Click to expand...

Let the strip do the work. Don't put the blood on it or flood it. You just barely touch the end of the strip to the edge of the blood drop and it will "suck" it in. Don't know if you'll be able to see this video or not but it shows exactly what I am describing.

Pantera said:
I don't know what kind of schedule you guys test on. I think you do before and after insulin shots don't you?
Click to expand...

Always test before shooting to make sure they're high enough to get insulin. Then if possible, get at least 1 mid-cycle on the AM cycle (usually 5-7 hours after the shot) and at least 1 "before bed" test on the PM cycle (usually 2-4 hours after the shot)

If you can get tests at other times, the more data you have, the better. Sprinkle tests around at different points in the cycle. Think of your spreadsheet like it's a puzzle....the more pieces you have filled in, the easier it is to see the whole picture.
 
I see you have the time 7:00 AM in the AMPS cell ( or square) filled in on your spreadsheet. What would go there is the BG number you get when you test first thing in the morning. You have 5:25 PM in the PMPS cell, What would go there is when you test the BG number 12 hours later after giving the insulin in the AM
With Vetsulin you test , feed then wait 30 minutes ,then give Vetsulin.
Don't feed 2 hours before testing the AMPS (AM Pre Shot) and the PMPS (PM Pre Shot) because you don't want the number to be influenced by food. If you did test first thing this morning AMPS and the PMPS
please put that in. If not get rid of the 7:00 AM and the 5:45 times and just put No Test instead
Have you read how to use the spreadsheet?
https://www.felinediabetes.com/FDMB/threads/how-to-use-the-spreadsheet.241653/

I would read these links about Vetsulin
https://www.felinediabetes.com/FDMB/threads/introduction-to-cannisulin-vetsulin-n-nph.231602/

https://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/
Do you have your hypo kit ,since Pantera likes Friskies look for med and high carb Friskies and mark the cans
https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb
One last thing do you have the U-40 syringes with the half unit markings?
We increase or decrease by 0.25 units at a time.
These will make it easier to do that
 
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Pantera said:
ok so we just tried our first test. It is hard to see blood on a black cat..
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There is the Vaseline trick that I have read about on this board. Works good with black cats. You smear Vaseline on the "fur side" of the ear in the area you plan to poke. The Vaseline causes the blood to bead up on the surface so you can see and capture it. They also make lighted magnifying glasses if the room you are in has insufficient light.
 
Pantera said:
ok so we just tried our first test. Thought my gf new how to use the meter, but apparently n ot. When we put the strip in with big blood on the end of it, nothing happened. didn't read anything.
Click to expand...

Read the instruction manual that comes with the meter. With most meters, you fully insert the test strip into the meter to turn it on. When the screen flashes the blood drop or other symbol (may vary depending on meter), touch the edge of the test strip to the blood drop. Let the meter think and give you a reading.

Always test before giving insulin. That's the only way you know if the blood glucose level is at a safe enough level for insulin or not. It's usually recommended for newbies to NOT give any insulin if the level is at 150 mg/dl or less. The cat will be fine with a skipped insulin shot. You can do as many mid cycle checks as you want.

Wearing a head lamp may help see where on the ear you are poking and where the blood drop is.

Getting a second opinion from another vet, whether a regular vet or a specialist, is a good idea. I'd wait to discuss possible ultrasounds with the second vet. It may or may not be needed. There are lots of things you can try now to get blood glucose levels in a more range without spending too much money, such as feeding low carb canned food.
 
If your cat is a dry food addict, two low carb / high protein foods we recommend are Dr. Elsey's Clean Protein and Young Again Zero Carb. Though a low carb / high protein canned or raw food diet are recommended, these are two additional option. For canned food, pate flavors are lower carb than anything with gravy. Here is a link to our food lists that can help you find foods that are low carb. https://felinediabetes.com/FDMB/threads/links-to-food-charts.174182/
 
Diane Tyler's Mom said:
With Vetsulin you test , feed then wait 30 minutes ,then give Vetsulin
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Did not know that about Vetsulin. I have always read that you MUST give insulin no later than 30 minutes after and we actually give it to her about 10 minutes after she starts eating. (while she is still eating)

It was our first attempt EVER last night and we had way too much blood. I don't know how she got so lucky. Yes we watched the video that someone gave a link to first.

Ok i removed the times that we were feeding on the chart. We feed approximately 7am and then 5pm or a little after. I know its not 12 hours, but that is too long. I don't want her eating at 7pm at night. That's just too long and she is starving.
Plus the other 4 cats want to eat and it's just mean/heartbreaking to not give her any. We wait at least 10 hrs between feeding. Yes, our cats were used to grazing all day with dry food. We have taken that up off the floor for everybody so Pantera doesn't get it. She was also the queen of treats and wanted them all day long. We don't do that anymore either.

So we did a test this morning one hour (i didn't know the schedule you all use then) after eating and it was 391.

I don't want to piss our vet off by refusing to go to a specialist, but I don't want to go to one right now. I want to try our testing and can food first. I need to handle this in a delicate manner, as I still need her for prescriptions, etc. If she found out I was following a website for vet advice I'm sure she would be insulted.

Thanks everyone for being so helpful. This is A LOT of information to take in.
 
Pantera said:
We wait at least 10 hrs between feeding
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Hi Ginger, we feed our cats small snacks during each 12 hour cycle.
About 2 teaspoons or so of wet low carb food.
Maybe at +2 then at +4 or at +3 and +5
What are exactly or shooting times for giving insulin
You said she likes treats
Click on this link and look at post #6. Numbers are to the right
You can get any freeze dried treats ,information is there
https://www.felinediabetes.com/FDMB/threads/brand-new-many-questions-3.255627/#post-2878703
 
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omg we just did a test and got 284. Just about the lowest ever. Awesome. it went from 445 last night to 391 this morning to 284 just now. Things are going well with the wet food. She used to eat Friskies pate anyway. It is low carb according to Lisa's food chart, below 10. The tiki cat is ZERO carbs, but she's not crazy about that one. The Tiki broth topper is also very low carbs and acceptable.

Yes the U-40 have half line markings.
 
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Switching to low carb wet can be a game changer. Over the next few days you may see the numbers come down even more as the carby food gets out of her system.

Some cats do better with slightly higher low carb foods than going to zero carb foods. Maybe that's what she's telling you too. :)
 
Friskies Liver & Chicken can food is 35 protein, 60 fat, 5 carbs. A bit high in fat, but she does eat it. Lisa also said she likes to see liver in the food, so it's got that too.
Friskies Flaked With Tuna 51 protein, 45 fat, and 4 carbs. Will see if she likes that one, but someone in our group didn't last I remember.

We used to buy freeze dried treats, but only 2 cats liked them.
 
Pantera said:
We used to buy freeze dried treats, but only 2 cats liked them
Click to expand...

Were they like the PureBites freeze dried treats? They are very hard. I had bought every flavor they had (and there's a lot) and my China wouldn't touch them.

Then I tried Orijen Wild Boar (they don't make specific protein treats anymore) and she was in love. They are a softer texture....more "crumbly" for lack of a better term. If you haven't tried them, I encourage you to check them out. The dog ones are cheaper per ounce than the cat one and they're easy to crumble into smaller pieces if you need to. All their freeze dried treats are low carb with just protein sources in the ingredients. The type I'm using with my new cat, Garfield, are the "Regional" ones and he loves them!

In all the years I've been on the board, I've seen lots of members whose cats didn't like the other treats, but the Orijen's were a game changer.
 
We have a bag of Nutri Bites freeze dried wild caught salmon that's in the cabinet because nobody wanted it. It's a huge bag for dogs or cats. It's from Canada and has Salmon and mixed tocopherols as the only ingredients. What is that?
crude protein 60% min
crude fat 13% min
crude fiber 1% max
moisture 4% max
I just gave Pantera a piece and she scarfed it.
I just looked this up. Apparently it is in a lot of human food too.

Tocopherols are organic compounds derived from Vitamin E. There are four types ot tocopherols: alpha, beta, gamma, and delta - tocopherols, slightly differing in molecular structure.

Tocopherols are antioxidants. They prevent cells from oxidizing, or in other words they protect cells from damage. that's why manufacturers love tocopherols; they minimize oxidation, are resistant to high temperature food processing steps, are soluble in a variety of fats, and are relatively stable over time.
By protecting cell membranes and other cell structures from damage, Vitamin E has been shown to lower the risk of many degenerative diseases.

"Mixed tocopherols" are combinations of the four different types of tocopherols mentioned earlier. Each has a slightly different health advantage, so when mixed together, the body enjoys them all: protection from cardiovascular diseases, anti-inflammatory effects, diabetes prevention, and lowering hypertension.
 
opened a new thread as this one is 38 now. Who closes this one?
new title is
Continuing-Pantera-Uncontrolled BG
 
Pantera said:
We have a bag of Nutri Bites freeze dried wild caught salmon that's in the cabinet because nobody wanted it. It's a huge bag for dogs or cats. It's from Canada and has Salmon and mixed tocopherols as the only ingredients. What is that?
crude protein 60% min
crude fat 13% min
crude fiber 1% max
moisture 4% max.
Click to expand...
I would want to know the carb content.
 
Ann & Sister said:
I would want to know the carb content.
Click to expand...

If the only ingredients are a protein source (salmon) and vitamins (tocopherols), they are very low carb. We tell people all the time when looking for treats, check the ingredients. As long as they only contain a protein source and maybe some vitamins/minerals, they're fine. It's the ones that add tapioca starch, rice flour, and other sources of carbs that should be put back on the shelf.
 
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