Hello, Newly Diagnosed: doing anything wrong?

Hello All,

First off, thank you to everyone who posts on this site. It was a definite help to me as my cat (King Leonidas) was diagnosed with diabetes this past Thursday (4-15-21). Being able to read all the questions and answers, as well as general information, was a great help.

I would like to write out what i am currently doing, and see if anything is glaringly wrong that should be fixed immediately. And maybe have some questions at the end.

General Info:
Cat: Leonidas
Diagnosed: 4-15-21
Weight: 13lb (maybe a touch overweight, but hes a larger cat (lost 2 pounds in past 4 months)).
Insulin: Lantus
First Shot Given: 6PM local time - 4/19/21
Units: 1.5 (Vet recommended 2u to start, but i was scared to start that high).

I have been testing every 2-4 hours with a ReliOn Prime monitor (ordered an Alphatrak).

Food:
Prior to the diagnosis he was getting around 1.5cups of Purina Indoor Advantage a day, as well as some mush or tuna at night.

Since the diagnosis I have been transitioning to a low carb wet food. The vet gave me Purina DM dry food, but after reading up on everything decided to go low carb. I am still trying to get the amount of wet food to feed him right as i have not fed wet food to my cat previously, he seems to really like it though.

Routine:
New Routine (since diagnosis):
5:30am - AMPS and Food - 4.5oz of wet food. (still a mix - transitioning)
6:00am - Morning Insulin Shot (i wait 30 min to ensure he doesn't throw up)

5:30pm - PMPS and Food - 4.5oz of wet food. (still a mix - transitioning)
6:00pm - Nightly Insulin Shot (i wait 30 min to ensure he doesn't throw up)

Testing:
It has only been about 24 hours since his first shot, but i will have had 12 readings to get my first Glucose Curve (image attached, spreadsheet hopefully working).

I have had pretty good luck with the ear pricks, i don't use a Lancet pen, just the Lancet itself. I still feel bad about it because i know it hurts him a little .

Issues:
Getting the amount of wet food right: From what i can tell, my cat (13lbs) needs about 300 calories a day. But that is almost 8-9oz of wet food (4-5oz per meal). That seem right? seems like a lot on a plate.

Between the +5 to +8 hours today, Leonidas had a sharp drop off in BG levels (120 being the lowest i read, averaged low 300s). I panicked a little and gave him a couple treats, and about 30 kernels of the Purina i am transitioning out of. Was this wrong of me?

Questions:
Anything glaring wrong that am doing or NOT doing?

It seems like the majority of users here use a human meter. I am currently using the ReliOn prime (since it was in stock), but have ordered an Alphatrak 2. Is the change worth it?

If i check my cats blood for the AMPS or PMPS and its "Low or Good" (100-200) do i adjust his insulin dosage? or is it important i always give him the same amount. He was reading (at the vet, and with the ReliOn) in the 300-400 range when the vet told me to start at 2u a shot. I didn't want to risk going into Hypo, especially when changing to a low carb diet. So i started at 1.5u instead. After i had the steep drop off today (down to 120) and ask my vet. He said go down to 1u. Does this seem reasonable?

Any good way to tell the difference between "my cat is sleeping, resting" and "My cat may have low blood sugar"? Leonidas was always a frequent and heavy napper.

Is freeze dried (non chinese) chicken a good treat for a diabetic cat?


Sorry for the wall of text, I'm still trying to get all most thoughts in order. And again, thank you everyone who posts here, it has been a great help.

Here is his curve (color represents a new dose of insulin):
https://i.imgur.com/Fam1V2E

 

A good starting point for calories per day is 20 calories per pound of ideal weight and then weigh once a week and adjust as needed. It's also not necessary to only feed twice a day. With the older, harsher insulin's, it was more important but with a gentler insulin like Lantus, most of us feed multiple small meals which is easier on the pancreas. The only time we don't want to feed is the 2 hours immediately before shot times so that when we do the Pre-shot test, it's not food-influenced. Feeding multiple small meals also helps keep the blood glucose more stable as well as making kitty a lot happier!
To go along with this, most of us Test/Feed/Shoot all in about 5-10 minutes. We test to make sure they're high enough for insulin at all, Feed to make sure they're at least willing to eat and Shoot, usually with their head in the bowl. With Lantus, it doesn't usually start to "kick in" for 2-3 hours after the shot is given, so kitty can take their time eating if they don't want to eat it all at once.

All of our dosing methods were developed using human meters so we're very comfortable with them. The AlphaTrak hasn't really been around that long and before it was "invented", the only meter anybody could use was a human one! Also, the strips for the AT run about $1 EACH....when we test at least 4 times a day (more if they're running too low or dropping too quickly), that adds up to some major expense. The Relion strips are 18 cents each.

Yes, most cats should start at .5 to 1U twice a day. It takes 5-7 days before you're going to see the full effect of the starting dose because Lantus is a depot insulin.

While ECID (Every Cat Is Different), most cats actually become very hungry when their BG drops, just like humans do. Of course that doesn't mean a lot of us don't poke our kitties to make sure they're still breathing (and we've all gotten the dirty looks to prove it!). As long as you're home testing, you'll learn when to watch for times when he may be dropping too low and can either plan on getting more tests in or see if he acts like most and comes looking for food.

Lantus craves consistency so you should give the same dose both AM and PM. At first, if you get a BG under 200 you should stall, DON'T feed and test again in 20-30 minutes. If the number goes up, it's usually a good sign that the last shot is wearing off and it's safe to shoot. You should also use that time to post here with a clear subject line like "STALLING! NEED HELP!" to get somebody's attention. We have a tradition here. If somebody encourages you to shoot a lower number than you're used to, they agree to stay online to watch for updates and to help you, even if it means staying up all night (or they will find someone else to take over). We will not tell you to shoot a lower number than you're comfortable shooting and then disappear! As you gain more experience and testing data, that "stall point" drops to 150 and then gradually drops lower and lower. On Tight Regulation, I'd shoot China if she was above 50.

Perfect....any protein source is a good treat. You can get all kinds of flavors of freeze dried proteins or just bake a piece of chicken and cut into treat sized pieces. Put some in the fridge and freeze the rest to use as needed.

Wrong? ...well, yeah. Normal, absolutely!! No harm done though! We usually don't panic until they drop below 50 on a human meter (68 on the AT) and most of us keep several cans of Fancy Feast "Gravy Lovers" to use when we need to. You can pop the top, put it back down and squeeze the gravy into another bowl (the gravy is where most of the carbs are). Usually a couple teaspoons of the gravy is enough to nudge them back up to a safer number. The kibble takes longer to get out of the bloodstream so we don't recommend using it.

I think I got most of your questions! Did I miss any?

 

Thank you so much for taking the time to thoroughly type all that and answers my questions. It really helps put my mind at ease; especially about the eating throughout the day. Leonidas was always a grazer and that is more his style. (i will make sure he doesn't eat 2hr before his shot time).

Thank you again, it is very informative and I am very grateful.

 

Vyktor was a grazer, the only change I made to that after he got diabetes was removing his food two hours prior to his shot. The fact the food was there for him was very handy a few times he got too low - he alerted me to the low numbers by suddenly cleaning out his bowl. Some cats may end up benefitting from more regimented meal times but I never had to do that for Vyktor. I would let Leonidas keep grazing for now.

 

Thank you for your input